Coping with swine flu

WITH RECORD-breaking numbers of patients on trolleys and chairs in our public hospital emergency departments, the perennial “…

WITH RECORD-breaking numbers of patients on trolleys and chairs in our public hospital emergency departments, the perennial “beds crisis” seems worse this winter. There are two principal reasons: ongoing cuts to health budgets and a resurgence of the influenza A (H1N1) virus.

Although not at pandemic levels, swine flu is this year’s main seasonal influenza strain, with the number of cases rising significantly in recent weeks. The increase is likely to continue as the surge in flu cases in the UK impacts here. Holiday travel and inclement weather mean the flu virus has ideal conditions for cross infection and further spread.

Swine flu remains a mild illness for the majority of people who contract it but it does pose a particular risk for pregnant women and those with underlying chronic illness. It also has a predilection for some otherwise healthy adolescents and young adults, who are not in official “at risk” categories. Meanwhile the over 65s, for whom seasonal influenza usually poses a particular risk, are relatively unscathed by the H1N1 strain; experts now agree that older people were exposed to a previous strain of H1N1 which means their body’s defence systems are primed to ward off swine flu.

It is not too late to avail of the flu vaccine, the efficacy and safety of which are well proven. Pregnant women, who we know are more at risk of swine flu complications, have been especially slow to accept the jab. Any woman who is currently pregnant or who gave birth within the last six weeks must seriously consider being vaccinated. Similarly, those with long-term health conditions including heart disease, diabetes and chronic liver and kidney disease, risk life-threatening complications by not being vaccinated. All at-risk groups are entitled to free vaccine, while those without a medical card pay a fee for administration. And for those not at risk but who wish to be immunised, some pharmacy chains, as well as family doctors, provide private vaccination for a fee.

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More fundamentally, however, the health service itself should be better prepared. The surge in winter illness, whether caused by influenza or other viruses, is an annual event and, as such, is entirely predictable. A modicum of basic forward planning, using the principle of surge capacity established in other health systems, seems lacking. Yet there is no disguising the reality that patients queuing for care, being treated on trolleys or chairs, or having elective procedures cancelled, are among the first to pay a price for cutbacks in exchequer spending.