Chris Lancelot: Swine flu: lessons for future pandemics

Now that the dust has settled, how well did we do in combating swine flu?

The bottom line is that it got out and will probably become a pandemic: but that is not the whole story, because it has been a good dry run for dealing with future, more dangerous infections.

Paradoxically, had swine flu proved as lethal as SARS we might have got it fully under control: the public would have been more wary and the government could have curtailed public gatherings and insisted on much stricter isolation.

In general, the Health Protection Agency (HPA) performed well. Undoubtedly, there were failings: locally we didn't have immediate access to swabs and viral transport medium; and the thought of going into a highly-infected house protected only by gloves, surgical mask and mini-apron fills me with horror because of my potential infectivity to subsequent patients - or indeed, to my family. Assessing potentially lethal pandemic cases is not something GPs should be doing: it should be left to dedicated, specialist teams with separate transport, full protective gear, all ancillary equipment immediately to hand; and no contact with non-flu patients. These are, I hope, lessons learned for the next time.

Because there will be a next time. We have been very fortunate in the past few years. SARS so nearly got out: how it didn't become pandemic, I don't know. Then swine flu struck, but turned out to be relatively benign.

This has led the media to complain that the whole response was an over-reaction (though it would have been a different story had it proved more lethal). Doubtless stockpiling Tamiflu for half the nation was expensive; it took time and money for all that pandemic training; but in the end it more or less worked - airport scanning, contact tracing, regularly updated swine flu protocols, HPA coordination and the like.

Had the virus been more lethal we could have clamped down even harder.

But now that we know this virus is relatively benign then paradoxically it might be better to let everyone in the UK catch it. That way we would protect large numbers against a potentially more lethal mutation during the second wave next winter. Swine flu parties, anyone?

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