Swine flu: The epidemic that never was

Six months ago we were facing what could have been one of the biggest pandemics of the modern world. Swine flu had hit the country and health experts predicted hundreds of thousands of deaths.

At its peak 700 people a day in Norfolk needed anti-viral drugs, but now numbers rarely rise above 35.

Sarah Hall talks to two experts about how - and why - we had a lucky escape.

The winter this year has so far proved pretty similar to previous years in terms of health - some people have struck down with seasonal illness or virus, many more have had colds and the NHS is struggling to cope with the high demand.

But the scenario could have been devastating if the H1N1 virus had really taken hold. Thousands of our hospital staff could have been hit with the virus, leaving the NHS in chaos and staff being pulled out of retirement to help them cope; parts of hospitals having to be closed down or cordoned off while people with the virus are isolated; businesses could have collapsed due to absent staff; half of schools may have been closed down to contain the virus and thousands could have died with many more critically ill for weeks.

Dave Kerrie lead emergency planner for NHS Norfolk, said by this time of the year they thought there would have been at least 1000 deaths in Norfolk. In fact, there has been one confirmed death.

He said: 'We certainly thought it would be a different picture right now. This was a very challenging and difficult time and I am relieved and pleased swine flu did not turn out to be as severe as we initially expected. Many people were expecting Armageddon.

'The main concerns have gone and numbers are continuing to drop. It is too early to say if the pandemic has passed because we are about to hit a holiday period where people are travelling around. In France, for example, they are experiencing a peak of swine flu so there is a chance people could become infected again.

'Largely the fears are gone and the operation has been scaled down, but that doesn't mean we should become complacent.'

As head of emergency planning Mr Kerrie is responsible for the co-ordination of emergency planning for swine flu, a team which also comprises the council, police and education authorities.

In the first month of operation there were 20 people from NHS Norfolk working on the swine flu plans, many of whom had expected avian flu, rather than swine flu, to be the next big virus that hit us.

The carefully-laid plans were thrown off course on several occasions as the government changed their guidance on dealing with the pandemic.

For example, the move from containment to treatment was introduced in July due to the sheer scale of suspected swine flu cases - which meant health services could spend more time treating people.

Mr Kerrie said: 'Our first thought was to get people anti-viral drugs, especially vulnerable people. The Pandemic Flu Service being set up really helped us and we were able to focus and get a clear message out to patients.

'Because it was confusing for a while, people didn't know where to go or who to see if they had concerns. The flu service meant GPs could focus on the really poorly people and we concentrated on getting as many anti-viral collections points as possible.

'We have 43 still - the most in the region. We had great co-operation from community pharmacists - it is particularly important that because of Norfolk's rurality we created as much access to medication as possible across the whole county.'

Mr Kerrie is unable to pinpoint an exact reason why the pandemic was not as bad as expected but said planning and the number of people taking anti-virals was probably one of them.

He said: 'Anti-viral medication would have helped in some way. Evidence has also emerged that in the early 50's there was a similar strain of the virus which had led to a large number of people having some natural immunity.

'Also the public has been very responsive. People were scared and they reacted to that by following hand hygiene guidelines. We could have been looking at a crippled health service in Norfolk this Christmas due to swine flu, as well as a dire economy, but we are fortunate that the worst of it did not materialise.

'However we have built up a lot of planning skills for swine flu and we will definitely benefit from this experience in the future.'

Local and national health services acted swiftly to establish a public campaign immediately after swine flu broke in the UK. The images of a man sneezing germs into the air with a the logo: 'Catch it, bin it, kill it' appears to have been a very effective marketing strategy.

Judi Ames is the lead infection control nurse at NHS Norfolk and responsible for ensuring people maintain good hygiene.

She said: 'People have generally been very good at following the simple guidelines we have dished out. A lot more people use hand gels and people seem to be more aware of how not to spread germs by throwing tissues away, cleaning work surfaces and ensuring general good hygiene.

'I think this has contributed to swine flu not spreading as much as we thought and I hope now this is etched on people's minds. We need to keep up this level of cleanliness because it applies to a wide range of infections. Good hand hygiene is so unbelievably important.'