End of the second wave?

Judging by the drop in swine flu figures over the last few weeks, it would seem we are coming to the end of the second wave. Could it be the end of swine flu or will there be yet another wave in the new year? We will have to wait and see. In the meantime I'm off on a week's holiday ahead of Christmas so it seems a suitable time for a break. I may add any breaking news on here. And keep an eye on my other blog, Copeland Crack. For those not from Cumbria, I should explain that 'crack' is a dialect term for gossip or chat - not some suspect drugs!

Caption competition

It's the must-have toy for all swine flu followers: A swine flu cuddly toy from GiantMicrobes! And I'm prepared to go to all the expense of givine one away free to the person who comes up with the best caption for the picture of me holding the GiantMicrobe (above). Just email your caption to alan.cleaver@whitehaven-news.co.uk by midnight on December 31st 2009 and the best one will win.

Swine flu spin

Doing my usual trawl of swine flu news, I came across the startling news that "The UK’s Chief Medical Officer Sir Liam Donaldson resigns". And this world exclusive was in the Pharma Times - had this unusual news service really scooped the BBC et al? Er, no. Having been tricked into clicking on the link I was duly told that he is due to resign in May - as has always been planned, after 12 years dutiful service. If I need to increase hits to my website I usually resort to reviving the Parton sea monster story or I light a Chinese lantern and wait for UFO reports to flood in. But hats off to The Pharman Times for some delightful swine flu spin.

You can quote me on that

In addition to swine flu headlines, I keep an eye out for swine flu quotes. And the 'distance' of a few months is already showing one or two of them to be dangerously naive. Take my favourite from Ryanair boss Michael O'Leary (The Times April 28, 2009): “It is a tragedy only for people living ... in slums in Asia or Mexico. But will the honeymoon couple from Edinburgh die? No. A couple of Strepsils will do the job." It would be  funny if the people of Scotland hadn't been so badly hit by swine flu.

And I'm not sure how genuine this one is (it's doing the rounds on the net) but it seems to illustrate how in the early days even someone getting swine flu was considered news: "People in the town of Chipping Sodbury were shocked to learn today that a member of their community had swine flu."

Leave emotion out of it

The post at the end of my Whitehaven News blog from Mary Grady is typical of the frustration felt by many people hearing conflicting views about the swine flu jab. She asks for my opionion and I always have to start by saying I'm a journalist, not a doctor. But I'm not going to chicken out of stating my view: Yes, I would get the swine flu jab (I have asthma so will no doubt get called up at some point). Mary says it is "very emotional" trying to decide. Well it is but emotion is probably the last thing you need to make the decision. I'd rely instead on cold logic. Which is more likely - getting swine flu or getting complications from the swine flu jab? In short, getting swine flu. Both are rare occurrences at the moment but it's no good starting to get a bad reaction to swine flu and then wishing you'd had the jab. If you're deciding to have or not have the jab it has to be based on 'something' and "just a feeling" ain't no good. So you have to base your decision on cold scientific logic - in which case there's no argument: have the jab and stay well. These articles on the New Scientist website may also help you: Swine flu - eight myths that could endanger your life.

Christmas Cheer

I'm worried that this blog is a bit too depressing at times so for Sunday here's a piece of good news and Christmas cheer to show it's not all doom and gloom in flublogia. It concerns a Wiltshire man who came close to death with swine flu complications but is now on the mend and could be home for Christmas. Credit where credit is due to the health professionals on the front line in the swine flu war. See Wiltshire Times.

Cold snap to freeze out swine flu?

The temperature in Britain has dropped faster than Tiger Woods' trousers. It's been about 2C today and could drop even lower tomorrow. I'm willing to be corrected but this seems to be good news for the fight against swine flu - the virus preferring warmer weather. The old myth that cold weather gives you colds is true but only to a certain temperature. This cold snap is hopefully cold enough to even freeze out swine flu. Certainly everyone is wearing scarfs now which are probably as effective as face masks ever were!

Meet Auntie Doris

Week 50 and the latest figures show another 17 deaths in the UK (actually only in England - Scotland, NI and Wales not having any deaths in the last seven days). The general trend seems to be downward which bodes well for swine flu fizzling out. May I at this stage introduce my Auntie Doris (see picture) who is 100 years old and thankfully still as bright as a button. She has survived two world wars and the great flu pandemic of 1918 and much more besides. I popped down to the Midlands this week to see her so I asked if she had had her swine flu jab. She told me she had decided not to have the jab as she had heard "so many things about it". She did however say that the free computer classes mentioned by the social workers sounded of interest to her - and she was also considering learning sign language. Although her hearing is excellent at the moment, she's considering learning it in case her hearing goes "later in my life". A lesson for us all on keeping things in perspective!

The doctor is back in

Good grief, I was only absent for a couple of days and the whole swine flu world goes into turmoil: researchers moaning they can't get any study data from the manufacturers of Tamiflu (now why do I have little sympathy with that!) and GPs and the government falling out over the swine flu vaccine for under fives. Fear not. I'm back and from tomorrow will start restoring world order :-)

Don't count your chickens just yet

I'm a little bit nervous at the number of people I meet (and press reports) that keep saying "the swine flu thing is over". I'm really not sure we can let our guard down just yet. I also heard today about a GP telling a friend of mine that "I ought to tell you to have the swine flu jab but actually I'd advise you against it". Now there may be very specific reasons why this elderly friend should not have the swine flu vaccination but the GP did say "many people are reporting side effects". This doesn't sound a good message for GPs to be putting out. Yes, people are reporting side effects. The chart above shows they are - just as those taking the placebo are reporting side effects. Let's keep our guard up chaps. Winter's only just started.

Swine flu riddle

The latest figures show the usual riddle of swine flu: A general decrease week-on-week in the severity of swine flu but still a leap of 25 deaths in the last week. There have now been 265 deaths (240 last week) in the UK. I've pulled out a graph of Influenza activity around England by strategic health authority (see above). It shows London, Manchester and Birmingham of course as having the most activity, presumably because of the high density population in the major cities.

Swine Flu Top Ten

I'm grateful again to Celvin for bringing together the Top Ten (that's probably not the right phrase) of swine flu death tolls in European countries. It's posted below but to save you scrolling down... 

Europe: death rate by country
So far, around 1125 people have died from H1N1 in Europe*. If we measure number of deaths per million inhabitants, Europe has seen 1.54 deaths per million people as an average
The countries with the highest death rate are
1. SCOTLAND (47) : 9.09
2. WALES (23) : 7.68
3. NORTHERN IRELAND (13) : 7.32
4. MALTA (3) : 7.25
5. ICELAND (2) : 6.26
6. NORWAY (25) : 5.21
7. LUXEMBOURG (2) : 4.05
8. IRELAND (17) : 3.82
9. KOSOVO (7) : 3.25
10. ENGLAND (163) : 3.17
11. MOLDOVA (11) : 3.08
12. FINLAND (16) : 3.00
13. SPAIN (135) : 2.95
UK as a whole : 4.01
*As reported by 29 November
Ukraine's numbers are based on ECDC's data; currently reporting 18 H1N1 deaths

The Scottish official figure released today is 49 but that takes us up to November 30 and Scotland announced a total of 51 deaths yesterday. Scotland as I suspected comes top. Even Wales comes up in second place but Spain seems to have lost its early tag of being a swine flu hot spot and is only at number 13. The latest UK figures are being released at 5pm today.

Scotland's heavy toll

There have been an increasing number of headlines in the UK talking about the demise of swine flu. That might be premature. Scotland has just announced that it's death toll has risen above the landmark of 50 to 51. Last Thursday it was 41. Scotland has suffered more than its fair share of tragedy from swine flu including the first UK victim back in June 2009. Lately, Scotland has had something of a half-term breather but swine flu has been quick to catch-up. Schools will soon break-up for Christmas giving a new fire-break but that may suggest January to March 2010 could be our worst weeks.

Fisherman's Friends - the latest miracle cures

I am losing track of the 'miracle cures' for swine flu but so far they have included black elderberry, onions, green tea and Welsh Whisky. But the latest one is likely to take your breath away: Fisherman's Friends. Rumours have started that the throat lozenge beloved by grandparents worldwide is a cure for swine flu and in Scotland at least packets are now flying off the shelves. The manufacturers suspect it is because they contain aniseed which is also apparently a key ingredient of Tamiflu. Personally, it would take more than the threat of a potentially fatal disease to get me eating Fisherman's Friends. Besides if you're having onions, Welsh whisky and Fisherman's Friends what on earth is your breath going to smell like?

Is jab a cure for headaches?

My colleague at work was off to have her swine flu jab today so was questioning me about the side effects. Fortunately the wonderful David McCandless and his Information is Beautiful website came to the rescue. I was able to point out that the side effects included a sore arm, muscle aches, headache, a general feeling of being under the weather... and then pointed out that they were also the side effects you got from the placebo! In fact as David's chart above shows, you actually have less chance getting a headache from the jab than you do from the placebo. Since my colleague is prone to headaches, the idea that the jab might actually prevent her getting headaches quite appealed! Just call me Dr Cleaver!

UK swine flu statistics

As Sunday is my 'day off', I'm very grateful to Celvin who has posted (below) figures for UK nationally, sorted by region. It makes for a useful and interesting read. Just the sort of information the UK government should be making easily accessible! Talking of which, Jonathan also comments at the end of this column on reliable data on deaths among pregnant women with swine flu. I quickly stumbled across these figures on Bradford NHS website but if anyone has more relevant stats please post them below.

The figures for deaths in pregnant women (as at Thursday 12 November) with which swine flu was associated (including deaths shortly after birth as well as before or during) are:

England: 6
Scotland: 2
Wales: 1
NI: 1
Total: 10
Total swine flu related deaths in the UK – 124

England: death rate by region

As of 18 November 2009, there were 142 confirmed H1N1 deaths in England.
The deaths were distributed by regions as follows :
source: www.bradford.nhs.uk
North West : 21
North East : 7
Yorkshire and The Humber : 13
West Midlands : 23
East Midlands : 6
South West : 8
South East : 11
London : 45
East of England : 8
ENGLAND : 142
Population, as of mid-year 2008 (official ONS data)
North West : 6,875,700
North East : 2,575,500
Yorkshire and The Humber : 5,213,200
West Midlands : 5,411,100
East Midlands : 4,433,000
South West : 5,209,200
South East : 8,380,100
London : 7,619,800
East of England : 5,728,700
ENGLAND : 51,446,200
Death rate (number of deaths per million inhabitants) as of 18 November 2009
North West : 3.05
North East : 2.72
Yorkshire and The Humber : 2.49
West Midlands : 4.25
East Midlands : 1.35
South West : 1.54
South East : 1.31
London : 5.91
East of England : 1.40
England average : 2.76

The curry house theory

While sitting in my local curry house last night my dinner guest came up with a theory that might explain the apparently mild swine flu but a growing death rate: Swine flu isn't that mild. The official figures always warn of the problem in trying to find out exact figures of swine flu and if they are badly wrong that would level out the death rate. If we're seriously underestimating the swine flu cases then the high death rate is not so unexpected. It's only a theory but seems sound to me.

And the not-so bad news...

I thought I'd better look at the reports on the Canadian situation where they have withdrawn a batch of the swine flu vaccine. The BBC generally prove reliable so here's the link to their report. The bad reactions reported include breathing problems, increased heart rate and skin rashes. The vaccine has not been withdrawn in its entirely but just one bath of 170,000 doses. And the bad reactions have been experienced by one in 20,000 people. So we're not talking big numbers and we're not talking major side effects. Even so, it's going to feed the paranoia of those already convinced the vaccine is the devil incarnate.

First the good news...

There is some good news with the release of the latest swine flu data from the Health Protection Agency (Week 48). But, sadly, also some bad. There has only been a slight increase in influenza consultation activity in England and stable or a decrease in Scotland, Northern Ireland and Wales. The 'rumour' of an increase in swine flu activity in the south is borne out by the latest HPA figures. Although there is an increase in the hospitalisation rate of under fives, there is a decrease across the board. But the bad news is leap of 36 deaths across the UK to 240 - I'll need to double-check but I think that's the biggest weekly rise in deaths since swine flu began. It shows that while the illness is mild for most people, for a minority it is fatal. And there's also the throwaway remark that a batch of swine flu vaccine in Canada has been withdrawn because of higher than expected reports of adverse reactions. Cue The Daily Mail.

Plagues and rumours of plagues

There's always going to be a problem with a pandemic like swine flu - rumours and increased background noise are going to create their own problems. That's what seems to be going on in the south at the moment with The Portsmouth News reporting that increased 999 calls from people who think they have swine flu are putting untolerable pressure on the ambulance service. It little matters that most of the calls turn out to be "only ordinary flu". The problem of increased pressure on the ambulance service continues. If flu-like illnesses rise as the winter progresses so will the problems. To be clear: If you are struggling to breathe or have tightness in your chest, call an ambulance. If you also have flu symptoms go to the National Pandemic Flu Service at direct.gov.uk or call 0800 1 513 100.

Swine flu jab for flood workers

Whitehaven in West Cumbria, UK from where I write this blog, has thankfully escaped the floods sweeping the rest of the county. But it's still raining and the Met Office has issued another flash severe weather warning for this part of the world. In fact, there are only two major stories as far as this website is concerned: floods and swine flu. So it was probably inevitable that the two should combine at some point. Today it's been announced that flood workers (which includes the media covering the floods) are to be offered jabs for swine flu, winter flu and the other horribles that swirl around after floods. To quote Dr John Howarth,NHS Cumbria’s lead GP for Cockermouth: “We know from experience that the risk of respiratory infections can increase following floods. This is why it’s important that we provide protection for those vital people who are working tirelessly to help the residents of Cockermouth to recover from this disastrous situation." You can donate money to the flood victims at Cumbria Community Foundation.

First report of a death after taking vaccine

It's a story just made for The Daily Mail: Patient dies after being given swine flu vaccine. Suitably scary and "I told you so" all at the same time. My first reaction is "Well, they would wouldn't they." I mean, unless the vaccine is also a cure for death then people are going to continue dying - it's a given. The Daily Mail article is suspiciously short but The Daily Telegraph reporter kindly goes on to explain that there may not be a link between the person dying and the vaccine. One is reminded of the Coventry girl who died having received the cervical cancer jab. Despite the initial scare stories it turned out the poor girl had a dreadful tumour and could have died at any moment. We're back in the numbers game. The Daily Telegraph reports that if "ten million people were vaccinated there would be six sudden deaths". Let's wait a bit before we hit the panic button.

Information is beautiful

As Sunday is my day off, I usually 'delegate' the blog in the form of recommending a fellow blogger. I've often talked about the presentation of facts and figures in meaningful ways, particularly in regard to swine flu. So I have no hesitation in pointing you in the direction of informationisbeautiful.net and in particular it's graphics on swine flu. If only all statisticians worked in this way!

Actually, I do want to scare you

Actually, I say I don't wish to scare people but sometimes I think making swine flu a bit more scarier might encourage people to think more carefully about having the vaccination. Few people I speak to are basing their decision as to whether they have it or not on any carefully-reasoned basis; it's a purely emotional decision. Pregnant women instinctively feel they shouldn't have the jab even though all the science says they should. And having decided not to have the jab, they then allow the neighbours' kids into their home - a frighteningly stupid thing to do given how children are the ones spreading swine flu. And today there is news of Tamiflu-resistant swine flu being identified in Wales (remember when we thought Wales was proving immune to swine flu?!). Just to frighten you all a bit more, I've posted a graph above illustrating the leaps in death rates each week from swine flu in the UK. Still don't want the jab?

H1N1 cuddly toys

It's okay - I've found the ideal Christmas present: Giant cuddly toys of the H1N1 virus, bird flu virus, black death and even The Clap! It comes courtesy of Giantmicrobes website and is a stroke of pure genius!

Tough-decision time for parents

Swine flu stays top of the news agenda again today with the UK government announcing that healthy under-five year-olds to be offered the swine flu vaccination. The plan is unveiled as it's revealed that 21 per cent of swine flu deaths in England are of children under the age of 14. The government also point to the number of children who catch and spread the swine flu virus. Given the problems of getting adults to vaccinate themselves, don't be too surprised when figures are revealed showing how few parents want their child vaccinated.

Pay-back time

Making headline news today is a survey by Pulse magazine which says more than half (54 per cent) of patients are rejecting the swine flu jab.  First, it should be said that this is a survey of only 107 GPs but it's still a worrying statistic. The vaccine is not compulsory in the UK and it's up to individuals to make their choice. But a Nottingham GP is reporting only one in 20 pregnant women having the jab which - given the number of high-profile deaths of pregnant women is particularly worrying for a government keen to see as many people as possible get vaccinated. The reasons for refusal given fall into two main categories: worries about side effects and "it's only mild". My gut feeling is this is payback time for a government that has carried out a hush-hush policy on swine flu deaths. The problem is perhaps that people are concerned about side effects from the vaccine. But it's probably also a case that they're not scared enough of the swine flu. As long as anonymous statistics die from swine flu instead of real people, and as long as those deaths only happen to "people with underlying health problems" then the public are going to reason that it's never going to happen to them or anyone in their 'real' world. Health officials have jealously guarded details of swine flu deaths - sometimes refusing to say even if the person who died was a man or woman. So they can't complain too much if the public decide against vaccinations - and the death toll (already at 180) keeps on rising.

A jab - and make it snappy!

Typical. If it's free, our photographers want it! Our neighbouring doctors' surgery has begun giving the swine flu jab to those in at-risk groups and were kind enough to off themselves up for a photo-call. And since our photographers were due to be jabbed anyway they were happy to oblige. Pictured is Dr Graham Ironside receiving his swine flu jab - and it's worth mentioning the only side effect is a slightly sore arm; the urban myth that you then catch the flu is nonsense as the vaccine is 'dead' and cannot give you flu.

North-west winning the fight

Although the national picture on swine flu is mixed, the north-west seems to be winning this round at least in the fight against the spread of swine flu.The number of people in North West hospitals in connection with swine flu has fallen again over the past week; there were 117 people in hospital with symptoms last Thursday (down from 124 last week), and of the current inpatients 49 have underlying health conditions (down from 64 last week); there are currently 27 people with swine flu symptoms in critical care (down from 29 last week).
Dr Ruth Hussey, North West Director for Public Health said, “This is welcome news. However I would still encourage people to stay on top of the virus and be aware of what to do should they become ill with swine flu this winter. Practising good respiratory and hand hygiene is vital to stop the spread of the virus. And if you are normally healthy and you think you could have swine flu, stay at home to avoid spreading the virus, call the NPFS for a diagnosis and get a flu friend to pick up your anti-viral medication.”

Hats off the staff of NHS Cumbria for their good work. Long may it continue.

Even the pope is doing it

Black elderberry as a cure for or prevention of swine flu seems to be popular in high places. According to a number of sources even the Pope has been stockpiling the stuff to fight swine flu. There are plenty of claims going around for the stuff but, as far as I can see, very little scientific evidence. Perhaps it's as much a belief as Catholicism.

The latest miracle cure: black elderberry

During my time writing this blog I have collected a variety of the 'miracle' cures for swine flu ranging from green tea, oinions and Welsh whisky. Now there's another one to tell you about: black elderberry. Unlike most other miracle cures, however, this one has an actual scientific study to back it up - and it's online so you can read it for yourself to make up your own mind. You'll find it online at blackelderberry.info. Strangely it's got "confidential" stamped across the front page. The summary on the home page of the website says: "During an in-vitro study carried out in London by Retroscreen Virology in October 2009, black elderberry extract was found to be at least 68.37% effective against the H1N1 strain otherwise known as Swine Flu Pandemic strain." It doesn't say whether it's suppossedly effective at preventing you catching swine flu, getting rid of it once you have it or both. Us mere mortals need to know whether pouring black elderberry juice on swine flu cells in a test-tube equatest to a 'cure'. I'd like to think so but I've read Bad Science by Ben Goldacre so my cynical levels are off the scale at the moment. Maybe I'll stikc to Tamiflu. (Picture by OliBac - Creative Commons License)

The UK holds its breath

The HPA points out that most of the UK  were on half-term last week (but not Scotland) so they might have been hoping for a bigger break in the swine flu figures than they got. Week 46 does show a small drop in new cases and hospitalisations but deaths have taken a leap going up from 151 to 180. Scotland is usually the spike in the graph but in fact they only had one death and Wales had the spike with deaths jumping from 8 to 14. Here are the last few weeks death figures with the increase given in the last column:

Week 46 - 180 - 29
Week 45 - 151 - 16
Week 44 - 135 - 16
Week 43 - 119 - 14
Week 42 - 105 - 15
Week 41 - 90 - 6
Week 40 - 84 - 2
Week 39 - 82 - 4

The figures are open to interpretation of course but at first glance it would suggest that half-term has not been the fire-break most would have hoped. And schools are now back.

Swine flu and spam

I get very little spam on my AOL or work accounts but it's not been too surprising to see emails in my inbox with a subject line about swine flu which is just an advert for Viagra or some miracle cure. McAFee monitor this kind of stuff and I thought you'd be amused by some of the popular subject lines:

First US swine flu victims!
US swine flu statistics
Salma Hayek caught swine flu!
Swine flu worldwide!
Swine flu in Hollywood!
Swine flu in USA
Madonna caught swine flu!

I've even got a graph about it. Anyone got a vaccine for spam??!

Make or break time

These two headlines show the discrepancy in swine flu predictions at the moment:
Pandemic? What flu pandemic?
Swine Flu Deaths in Europe Doubling Weekly, Health Agency Says
On the one hand people are talking about the 'half-term effect' resulting in swine flu levelling off. But then they are also starting to warn of a third wave in January. Perhaps it's just that the vaccinations are proving effective?

A swine-flu free Christmas

My family keep asking me what I want for Christmas so I thought I'd challenge them by asking them for something swine-flu related. Of course I already have my mug (see picture above) but I wonder what else I might receive. A thermometer would be useful. Vital for diagnosing swine flu of course. A large box of tissues might be useful or how about some healthy vitamins to help stave off the flu in the first place. Any one else any ideas?!

I'm happy to promote a fellow blogger in eastern Europe who shares my passion for sharing information on swine flu. He's posted below but his website/blog is at http://fluhealer.blogspot.com

Insuring against swine flu

People preparing for a winter break and heading to the sun will want to know whether their travel insurance covers them for swine flu. The short answer, I'm glad to report, is yes. But check the Association of British Insurers site before you travel or try to claim.

A charm against swine flu

I've always enjoyed the number of goldfinches that visit my garden each day - sometimes as many as 15 in one go. But I've now discovered that the collective noun for goldfinches is a 'charm' which came about because it was believed that they could ward off the Black Death. Perhaps I don't need vaccination against swine flu after all!

How bonkers is this

The latest swine flu death in Scotland is of an adult from the Ayrshire and Arran area. Authorities are not releasing the gender "for reasons of confidentiality". Has this country gone completely bonkers. One can understand the family not wanting the name of the person released but is saying the person is male or female really going to cause them any grief. Are reporters, on hearing it's a man, going to knock on the door every every family who have recently had a man die in the hopes of an exclusive interview?! We can laugh at the Ukraine or other countries for not telling their public what's happening with swine flu but it pales into comparison with the culture of swine flu secrecy in the UK. I post up again (above) the comparison with what data we get now with what people were told during the Black Death! I suspect Scottish authorities are not releasing details because if it's found out that the person who died worked at a children's nursery there might be a certain amount of panic among parents. But judging by the death rate in Scotland from swine flu a little bit of panic might actually do some good in encouraging people to get vaccinated. Thirty years in journalism, and I've never come across anything as bonkers as this.

Strange Days

It's been a strange week. Topped perhaps by the phone call I've just from a gentleman reporting a strange light in the sky over Whitehaven last night. It might have been a UFO of course but considering last night was November 5th (Guy Fawkes Night) when the whole of Britain set off fireworks, I don't think we're going to need Mulder and Scully to solve this particular case.

It's also been a strange week for swine flu with only a small increase in the number of cases but a 'snowballing' (to quote chief medical officer Sir Liam Donaldson) of cases in intensive care. Deaths have also risen by 16 to 151. That's 105 in England, 31 in Scotland, 10 in Northern Ireland and eight in Wales. The mathematically acute among you will note that adds up to 154, not 151. I'm guessing the discrepancy arises in when each country in the UK announces its figures and the 'extra' ones are people who have died since the official figures came out in that specific country. Or it could just be a cock-up.

There's likely to have been the half-term effect. Schools in England have been on half-term reducing the likely spread of the virus. The holiday was only one week long though.

And finally there's the strange happenings in the Ukraine and the announcement that a cat has, for the first time, caught swine flu.

Guy Fawkes - the swine flu connection

Did swine flu 'do it' for Guy Fawkes and his fellow conspirators? New photographic evidence (above) seems to suggest it might have done! For those living out side the UK, today is bonfire night in Britain when  we light bonfires and set off fireworks to commemorate Guy Fawkes' failed attempt to blow up parliament.

The politics of swine flu

It's becoming clear that much of what is happening in the Ukraine is down to the politics of swine flu. Politics is also rearing its head in Northern Ireland with discussion of when details of swine flu deaths should be released. The Belfast News Letter is sharing my frustration at getting details confirmed (and so alerting the public) Health Minister Michael McGimpsey says he is just following the UK practice of weekly briefings but I'm not sure that's right. Scotland appears to confirm details as soon as they are known. I say "details" but of course it's usually along the lines of "someone, somewhere in Scotland has died from swine flu. We can't tell you whether it's a man, woman, how old they were or anything useful but 'they did have significant health problems'. And we're not telling you what those significant problems were". You get the picture. Glasnost it ain't. It's no good health authorities not telling the public when full-of-health Mr Smith who lives two doors away and was a teacher in your local school has died of swine flu and then expecting the public to have credibility in those same authorities when they urge people to get vaccinated.


My death list remains up-to-date as possible but I fear that the rate of deaths is now too high to keep the list going for much longer.

Strange goings-on in the Ukraine

First, I've updated my swine flu deaths list with the Wigan mother who died shortly after giving birth (the baby's okay). It's another sad case and surely no pregnant woman is going to risk not having the vaccine after this and other high-profile deaths of pregnant women? But now to strange events in the Ukraine. Type 'swine flu Ukraine' into Google news and you'll see unfolding some extraordinary events. Nearly 70 people have died from swine flu according to the authorities (in the UK the total is 135 so I'm not sure why that's worried them so much) but they're closing schools, universities, banning public meetings and you can't buy a face mask for love nor money. People are apparently turning to old folklore remedies (it's the onions again!). Some Western commentators are bemoaning that the Ukraine is asking the world for help but not giving any deatils about why these 70 people died or any background information (Good grief! They should try getting information about UK deaths - it makes the Ukraine look like a role model in openness!). Here's a link to one article giving an overview but Google news will provide much more.

Postal strike?

There appears to be discussion in the UK about how the postal strike in this country might affect swine flu vaccination, specifically the letters going out from GP surgeries to those on the at-risk register. This might be simplistic but can't the surgery just ring them up?!

The anti-vaccination militia

The vaccine against swine flu has always had its opponents but since it's not compulsory it's never really had any raison d'etre. However, a group calling itself The People's United Community have gone into Birmingham hospitals putting up posters and handing out leaflets attacking the vaccine. "Swine flu is not the biggest danger. It’s the vaccine.” say the posters. Not surprisingly their campaign has incurred the wrath of health officials who point out that a) They're wrong and b) 89 of the 137 deaths from swine flu so far might have been avoided if the vaccine had been available earlier in the UK. How many more deaths might therefore be caused by inaccurate information persuading people not to take the vaccine? Healthy debate is one thing. Irresponsible scare-mongering is another.

• See Birmingham Mail article. 
  

Onions - the (latest) miracle cure

Emails from my friend Ruth don't usually make it as far as my Inbox. Despite telling her many times not to, she insists on forwarding those hystically funny emails (you know the ones dripping in viruses) to everyone in her contacts book. She's probably only second to the Nigerian widow looking for someone to handler her millions of dollars on the all-time top spam list. But I'm glad this one made it as it's about swine flu. Judging by the number of "FW:"s it's been round the world three times so sorry if you've seen it before:

"In 1919 when the flu killed 40 million people there was this Doctor that visited the many farmers to see if he could help them combat the flu. Many of the farmers and their family had contracted it and many died.

The doctor came upon this one farmer and to his surprise, everyone was very healthy. When the doctor asked what the farmer was doing that was different the wife replied that she had placed an unpeeled onion in a dish in the rooms of the home, (probably only two rooms back then). The doctor couldn't believe it and asked if he could have one of the onions and place it under the microscope. She gave him one and when he did this, he did find the flu virus in the onion. It obviously absorbed the bacteria, therefore, keeping the family healthy.

Now, I heard this story from my hairdresser in AZ. She said that several years ago many of her employees were coming down with the flu and so were many of her customers. The next year she placed several bowls with onions around in her shop. To her surprise, none of her staff got sick. It must work. (And no, she is not in the onion business.)

The moral of the story is, buy some onions and place them in bowls around your home. If you work at a desk, place one or two in your office or under your desk or even on top somewhere. Try it and see what happens. We did it last year and we never got the flu.

If this helps you and your loved ones from getting sick, all the better. If you do get the flu, it just might be a mild case. Whatever, what have you to lose? Just a few bucks on onions!!!

Now there is a P. S. to this for I sent it to a friend in Oregon who regularly contributes material to me on health issues. She replied with this most interesting experience about onions:

Weldon, thanks for the reminder. I don't know about the farmers story...but, I do know that I contracted pneumonia and needless to say I was very ill....I came across an article that said to cut both ends off an onion put one end on a fork and then place the forked end into an empty jar...placing the jar next to the sick patient at night. It said the onion would be black in the morning from the germs...sure enough it happened just like that...the onion was a mess and I began to feel better.

Another thing I read in the article was that onions and garlic placed around the room saved many from the black plague years ago. They have powerful antibacterial, antiseptic properties."

So that's a bowl of onions, hot milk with red wine and Welsh Whisky so far in the 'miracle cures' folder. Anyone got any more?

Sneeze the day

Some key points from yesterday's HPA report on the swine flu pandemic:

• The majority of pandemic influenza cases continue to be mild. The cumulative number of deaths reported due to pandemic (H1N1) 2009 in the UK is 135 (97 in England, 23 in Scotland, eight in Northern Ireland and seven in Wales).
• The weekly influenza/ILI consultation rates increased, and was above the winter baseline thresholds, in England, Scotland and Northern Ireland.
• There was a total of 1200 new patients hospitalised in England with suspected pandemic influenza in the week from 22-28 October, an increase from 884 in the previous week.
  

Deaths have lept up from 119 last week and the number of those in hospital has also risen sharply and yet the pandemic in general remains mild. Swine Flu has turned into a strangely malevolent creature unfairly picking to exercise its wrath on a minority.

Smarties and Liquorice Allsorts

I'm sure there are many urban myths, friend-of-a-friend stories and complete fabrications surrounding swine flu so I'm happy to officially dismiss one now: when you get a flu jab (swine or winter flu) it doesn't cause you to get a mild dose of the very flu it's trying to protect you from. The vaccine is 'dead'. There is, says Dr Nigel Calvert, associate director of public health for Cumbria, no way it can give you flu. But he acknowledged that it is a widespread myth doing the rounds. He was speaking at a press conference in Cumbria to launch the vaccination programme. My favourite quote came when he was trying to explain that as a flu vaccine is "not such a new vaccine". In effect, it's just another winter flu vaccine. Dr Calvert went on: "It's a red Smartie, not a blue one" and added "it's certainly not a Liquorice Allsorts"! Hans Rosling would be proud of him!

No spitting, shaking-hands, kissing...

Kissing, shaking-hands, spitting - is there no end to the list of things-not-to-do to avoid swine flu! The spitting rule has been issued because Premiership footballers are, surprisingly, not immune to swine flu. Spitting is a rather disgusting habit - as is the footballers' habit of blowing out the contents of their noses - and is made even worse now we have high definition TV. But spitting is rather low risk for spreading swine flu. Shaking hands is rather more dangerous and last month Sweden disuaded football players from indulging in this practice. Pity the poor referee who has to shake hands with everyone at the end of the game. And then there's the goal celebrations where players jump on each other, hugging and kissing. Fortunately, this is such a rare occurrence at the moment at Carlisle United that the chances of swine flu spreading at Brunton Park are as remote as anything going wrong with the swine flu vaccine. And what of large crowds of fans all packed in together in a stadium? Surely, that's not good either. But at least Chelsea manager Carlo Ancelotti, has shared his family's traditional remedy for flu. ''It is my grandmother's prescription,'' he said. ''It's hot milk with red wine. Fantastic.''

Swine flu vaccine - an odds-on winner?

SINCE no one can guarantee 100 per cent that the swine flu vaccine is safe, I disucssed yesterday about the pure statistics of it as a risk management exercise - which is the greater risk: getting complications from swine flu or getting complications from the vaccine. So very timely, this week's New Scientist will discuss that very issue. And here's a sneak glimpse at their reasoning:

"The risk of getting Guillain-Barré from a flu vaccine is almost certainly less than 1 in a million; the risk of getting it from flu itself is more than 40 in a million. Swine flu is estimated to have killed 800 people in the US already, or more than 2 in every million so far. And during the first wave of swine flu this summer, 1 out of every 20,000 children aged 4 or under in the US ended up in hospital."

It adds: "Still think it's safe not to get vaccinate?". Find out more at The New Scientist.

States of Emergency

IT was just as I was hearing that my diabetic friend had decided not to have the swine flu vaccination that America declared a State of Emergency over the deteriorating swine flu situation. It struck me that her drive into town was probably statistically more dangerous than any risk from the vaccine. In fact, as there's been no problems with the trials, it certainly is more dangerous to drive on Britain's roads. The vaccine is rolled out this week and, while pointing out I'm not a specialist medical reporter (my only speciality is that I ask questions), I do tell friends that I'll be first in the queue for my swine flu jab. Why was my friend not having the vaccine even though as a diabetic she's in the 'at risk' group? She was worried about any potential side effects. I asked her which articles she'd read to come to this conclusion - "none". I asked her if she'd spoken to her GP about the decision or any other learned person - no. Did she know what risks and how much at risk she was from contracting swine flu? No. The UK government begins another advertising campaign this week but faced with this sort of 'gut feeling' decision-making, they've got a tough battle on their hands.

Passing the buck

Sunday is my day off so I usually use this day to flag up someone else's swine flu blog. Take a look at this one by Tom, a north London freelance writer. Nicely written and nicely illustrated.

Elmo v Dirty Bertie

This blog is 100 days old and it began with a disucssion about what advice to give children. So after the 100 days I thought I would return to the varying advice for kids. In the blue corner is Elmo who is teaching American kids to wipe their nose on their sleeve - something that will have every UK parent going "eeeuuugh!!" at this moment. In the red corner is Dirty Bertie who advises children through a comic strip to use a tissue. Don't American kids have hankies or tissues? Is the UK the only civilised country in the world when it comes to personal hygiene for children? Or could the Americans actually be offering better advice? In England we have a popular Saturday evening show  and the first part always ends with a comical fight between two burning issues of the day (usually portrayed by dressed-up characters shown fighting it out). I think Elmo and Dirty Bertie should be lined up for such a fight to find out who is right! In the meantime, here's the link to Dirty Bertie's comic strip and below is Elmo's more hi-tech video: (post your comments below as to who should be the winner).

The nature of the beast

I think Dr Ruth Hussey has put her finger on the nature of the swine flu beast in her latest bulletin. The North West Director for Public Health said: “It seems that although the total number of people catching the virus is going up slowly overall, the complications people are experiencing are severe." In the early days of swine flu, we were expecting many people to be ill and many to be seriously affected or killed. But it seems rather than this strain of pandemic is affecting many - most not seriously at all - but others it is singling out for a particularly severe attack. Why? What is it about those who are being worst affected? There seems no common denominator - you can be very healthy or have severe health problems; you can be young or you can be old; you  can be male or female. But Dr Hussey's observation perhaps gives a clue to how best the NHS can form a strategy to tackle swine flu in the next few weeks - a concentration on the large minority who are going to need very specialist treatment to get them through it.

The latest UK figures from the HPA show 119 deaths so far from swine flu (up from 109 last week) And 884 were hospitalised in the week from Ocotber 15 to 21 compared with 667 in the previous week.

In case you haven't seen it already, my interview with Professor Ashton, Cumbria's director of public health, is now online.

Healthy 'at risk' from swine flu

The general view of the public is probably that everyone can get swine flu but only the unhealthy suffer serious complications. It's reinforced by the health authorities declaring Mr or Mrs X had "underlying health problems" (UHPs). But as we have seen, even soldiers who have just passed a full medical can succumb to this virus.

The Health Protection Agency has said that about one-fifth of deaths from swine flu are among the fully fit. Now the latest report by the World Health Organisation highlights the number in intensive care who had "no predisposing conditions". There's still a lack of clarity over what are UHPs (pneumonia sure - but what about pregnancy or that the person is a smoker?) but I can do no better than quote the relevant part of the WHO report:

"Three articles of interest published this week in the peer reviewed literature reported three different series of seriously ill pandemic influenza patients in Canada, Mexico, Australia, and New Zealand. Several important observations were made including:

• A significant portion of patients with severe disease requiring intensive care had no predisposing conditions. The numbers are not directly comparable as the studies categorized conditions differently but nearly 1/3 of ICU patients in Australia and New Zealand had no predisposing conditions. 98% of ICU cases in Canada had a comorbid condition, which in this report included hypertension, smoking, and substance abuse, but only 30% had comorbid conditions that were considered "major". In Mexico, 84% of critical patients had an underlying condition, which in the report included hypertension, ever having smoked, and hyperlipidemia, conditions that are not considered risk factors for severe influenza outcomes. All three groups were impressed by the number of severe cases occurring in previously healthy individuals."

and here's the link to the rest of the article. Methinks the simplest answer to which members of the swine flu family (pictured above) should get vaccinated, is "all of them".

Ho-hum news

"Ho-hum news" is how one fellow blogger describes it. That's the news today of vaccinations starting against swine flu. I have heard some discussion among colleagues and friends about 'should-we or shouldn't-we have the vaccine' but it's probably more concerning that the majority aren't discussing it. It's all part of this culture of swine flu happening to someone else - perhaps an elderly asthmatic grandmother. But you only have to look at the official figures for age groups affected by swine flu - or my unofficial death list - to realise swine flu can strike anyone and everyone. The young and healthy are, in fact, more likely to suffer from swine flu than the older person. Today is the anniversary of the Battle of Trafalgar and today begins a new battle - the Battle against Swine Flu.

Fighting swine flu on the front line

Hats off to our own health and safety officer who has put a box of tissues and swine flu notice in our reception area (see picture above). A simple but hopefully effective way of combating the spread of swine flu. The government advise people throw the tissue in a bin afterwards so make sure there's a bin handy. And offering somewhere for people to wash their hands may not always be practical but a bottle of handgel will do the trick. Pass it on - the good tip, not the swine flu!

I told you so

Some people question the purpose of the list of UK swine flu victims that I run but it is about the only public source of UK data on deaths available at the moment. And as long ago as October 3 I flagged up that women seemed more vulnerable than men. Now there's a bit more scientific credibility lent to this. The World Health Organisation have flagged it up and a Canadian doctor has also raised it in a survey reported in The Vancouver Sun. It's probably too early to prove scientifically that women are more at risk but it will probably encourage more women to take the vaccine being made available in the UK on Wednesay. More worryingly, the Canadian study suggests 70 per cent of those who suffer the most severely (or die) were perfectly healthy beforehand. In this country the HPA have said that one-fifth were previously healthy. Whatever the precise final figure, it shows that young fit and healthy people need to be on their guard as much as asthmatic, pregnant or other at risk folk.

Intrusion into grief

Is wanting to know about the lives of those who died from swine flu an intrusion into grief? The short answer is yes if the family and friends would prefer not to talk about it. But many do and I for one am glad that they do tell us about their loved one's lives. It stops these deaths just being cold statistics and makes us aware that some lovely people have been brought down by this vicious bug. And it shakes off any complacency that swine flu is just something that happens to "other people". Those 'other people' are perhaps envisaged by most of the public as still weak, sickly old people. Far from it. Health officials seem quick to say they're not realeasing any more details out of respect for the family but I don't suppose I'm the only journalist to have received a call from the bereaved family the day after publication wanting to know why we didn't get in touch to find out more about their loved one's life. The decision to talk or not to talk must be the family's and not the well intended but misguided view of the health authority press office. And if anyone needs reassurance that talking about the loss of a loved one need be a morose affair rather than a celebration of that person's life just look at the many wonderful tributes to David Hayes.

I think poster Pauly below is quite right - I have misunderstood the maths in the wire stories that talked about a doubling of swine flu (journalists and maths eh?!). My only defence is that the story I was looking at (here) doesn't readily justify the headline "rate doubled". I'm an old-fashioned sub who likes the justification of the headline in nothing lower than the second paragraph! But has the rate 'doubled'? (and is that the rate for England or the UK, and has it doubled in a week, fortnight or month). If it went from 14,000 to 18,000 to 27,000 over the last three weeks that's surely 'more than doubled' over the last week. I feel a graph coming on! There was a headline during the week which talked about swine flu deaths  in Scotland rising by 40 per cent - they had gone up from 10 to 14. It's quite accurate but "four more deaths from swine flu" might have been a better way of putting it in context.

So what is two times 18,000?

When I started this blog I said I would look occasionally at the use of maths and statistics. Journalists are not known for their numeric skills and this is ably demonstrated by a story that went round the wires a couple of days ago. To quote just one such headline from the web coverage: " Swine flu rate doubled last week, according to new figures" and it goes on to say: "There were 27,000 confirmed new cases of H1N1 swine flu last week, an increase on the 18,000 cases the previous week..." So twice times 18,000 is 27,000? Er, shurely shome mishtake! I also said I'd criticise any irresponsible journalism but the Daily Mail just makes that too easy. I'll wait until a paper with some credibility starts doing daft things.

Swine flu's wake-up call

I was talking to a lady earlier this week about swine flu and she said: "Swine flu? I thought that was all finished with?". And on Tuesday it was very much 'yesterday's news'. But today it's back with a vengeance. Deaths have jumped from 89 to 105. The number of new cases (although difficult to estimate) has increased from 18,000 last week to 27,000 this week. And the human side of the tragedy is highlighted by the deaths of two pregnant women (one in Wales and one in Scotland). Neither had any underlying health problems. At least no pregnant women will be in any doubt this morning that they are in the 'at risk' category. Vaccination starts in the UK on October 21st - postal strikes permitting.

In our region (the north west) the number of anti-virals collected in the North West on October 7th was 1,501, up from 1,306 on September 29th. And the number of people being treated in hospital has gone up to 62 from 54 a week ago.

The readers of this blog fired a number of questions at Cumbria's director of public health, Prof John Ashton. The answers are now online and my interview with him will be published shortly.

UK swine flu death toll nears 100

The official swine flu figures for the last week will be announced today at about 5pm and are likely to show death figures nudging up to 100 - a sad landmark. While we may think the numbers are small, each death is a tragedy - and it's sobering to remember it's early days yet. This could be a long winter. So no complacency, keep up that catch it, bin it, kill it regime and plenty of handwashing. Looking back on the 100 deaths, perhaps the most surprising factor is the number of perfectly healthy people killed by the virus. That's something the public probably didn't expect it. But even that is a reminder that we all need to take this pandemic seriously.

A family contingency plan

One interesting point out of my meeting with Cumbria's director of medicine, Prof Ashton, yesterday was the advice for families to have a contingency plan ready for if swine flu does worsen over the winter. He pointed out that during the Carlisle floods, smaller firms struggled to cope. Bigger firms had a contingency plan but smaller ones had never bothered - and on occasion paid a heavy price. And if small firms aren't prepared for the swine flu epidemic, then you can bet few families have prepared a plan. But if 30 per cent of your family is incapacitated that could mean both mum and dad in bed with flu - so who is going to take the kids to school? Who is going to get the food shopping? Time to draw up a plan - just bear in mind that, on current figures, 30 per cent of your extended family and friends will also be ill with flu!

The vaccine: A briefing

There are  two pandemic flu vaccines to be given to UK patients. Both  have been approved by the European Medicines Agency and licensed by the European Commission: Pandemrix, manufactured by GlaxoSmithKline and approved in September, and Celvapan, manufactured by Baxter and approved last week.

From the www.nhs.uk website:

Is the vaccine safe?

The government will use the vaccines only after they have been licensed by the European authorities. The licence will be issued by the European Commission following advice from the European Medicines Agency. Vaccines would not be licensed if they were considered unsafe.

And more from European Medicines Agency (EMEA):
 
The EMEA’s decision to approve the two vaccines came after detailed study of the vaccines’ quality and safety, including information on trials in more than 6,000 people. Further trials in adults and children are continuing and more results will become available from October/November 2009. As with all medicines, rare bad reactions may only come to light once the vaccines are used in large numbers of people.

The EMEA has requested that vaccine manufacturers introduce plans to investigate and monitor the safety of vaccines as soon as they are used across the EU, so that action can be taken as early as possible if a safety issue emerges.

Priority for swine flu vaccine

People at the most risk from swine flu will be given priority for the swine flu vaccine. The following groups will be prioritised in this order:

   1. people aged over six months and under 65 years in seasonal flu vaccine at-risk groups
   2. all pregnant women, subject to licensing conditions on trimesters
   3. household contacts of people with reduced immune systems - eg people in regular close contact with patients on treatment for cancer
   4. people aged 65 and over in the seasonal flu vaccine at-risk groups - this does not include otherwise healthy over 65s as they appear to have some natural immunity to the virus

Vaccination of frontline health and social care workers will begin at the same time as the first at-risk group.

The Guardian reoprted this about side effects:

The common side effects were those you'd expect from seasonal flu vaccine: pain where the vaccine was injected (reported by 36 percent of Australian volunteers and 70 percent of UK volunteers) and muscle aches or headaches (reported by 45 percent of Australian volunteers and 42 percent of UK volunteers).

Why all the interest?

I'd intended to start today on the coverage of the vaccine - but I need to get one thing off my chest first (if you'll pardon the flu analogy). Log on to any swine flu discussion on the net and there's always someone ranthing about how much coverage the subject is getting when "only 89 people have died" (and yes, we all acknowledge that a death toll of one is too many). The posters point out that 5,000 die each year from ordinary winter flu. So can I just remind everyone why the media is/are so interested in swine flu:

1. It's a pandemic. A global one. Rather than the more geographically-limited epidemics of winter flu

2. It's predicted that (worst-case scenario) 19,000 people could die.

The media can't start covering swine flu only when it gets to 5,001. The media needs to start educating and informing people now. That's why we should be interested in swine flu.

Two more Scottish deaths

Scotland continues to suffer a heavy toll from swine flu. The deaths of two more men have been reported today. Press Association say: "Both patients, a 42-year-old man from Glasgow and a 75-year-old man from Grampian, had underlying health conditions." This brings the Scottish death toll to 12. And just as we were thinking swine flu might go away.

Getting really serious

I was cynical from the start when health spokesman kept saying that the people dying from swine flu had, by and large 'underlying health problems'. Particularly as they wouldn't say what the UHPs were. And when that phrase became a little tired they suddenly started throwing in "serious" underlying health problems. But they still wouldn't explain what an underlying health problem was, yet alone what a "serious UHP" was. So I had to give a whince when the BBC reported that a boy who died from swine flu not only had UHPs and that they were serious but even added "the boy was confirmed having serious underlying health problems". Still no details as to what they were but no doubt the next case will be "confirmed as really, really definite serious UHPs. Honest.".

Not with a bang but with a sneeze?

THE phrase of the day among the national press is 'lucky break' - pointing to the latest swine flu figures from the Health Protection Agency. As the BBC says, new cases in England have risen from 14,00o to 18,000 but they were 9,000 the week before which suggests a slowing down. Or does it. The HPA report precedes this 9,000 figure by saying: "Interpretation of data to produce estimates on the number of new cases continues to be subject to a considerable amount of uncertainty".

The BBC goes further and say "in Scotland the number of new infections has halved to 6,800". I finally found this figure in the Health Protection Scotland figures - they're at the bottom of page 13. The next line at the top of page 14 starts "At present these are unreliable estimates..." Hmmm. The top bullet point in the HPS report is: "16% decrease on the consultation rate" - still encouraging news. The problem with us journalists is we like to pull out one headline-grabbing figure from a mass of facts and figures that are better kept alongside each other. Of course, in this age of the web it would be easy for the BBC and other news services to give a fair summary and then give links to the actual reports so readers can investigate further. A bit like this:

* This week's HPA report for the UK
* This week's HPS report for Scotland
* This week's NPHS report for Wales

There. How difficult was that.

You can probably guess that I'm trying to make the point that "lucky break" could instill an unwarranted sense of complacency.

So has swine flu gone away - not with a bang but with a sneeze? Sadly, I doubt it and Sir Liam Donaldson says it's a lucky break as it will give England the chance to get the virus out before the predicted second wave really begins to bite. Deaths have also risen from 84 to 89 in the last week (I've updated my unofficial list with details that have been made public). The number taken into hospital in the last week was 520, compared with 498 the previous week (the biggest age group being nought to five). A more considered view of the national situation probably comes from the HPA report:

"In week 40 (week ending 04 October), the weekly influenza/ILI consultation rates increased in England (though remained below the baseline) and Wales (over the baseline) and decreased slightly in Scotland (below baseline) and Northern Ireland (remaining above the newly defined provisional threshold levels). In England the highest rates continue to be in the northern regions."

Good news is always welcome but let's avoid unfounded complacency.

The Emperor's new clothes

I've a feeling that today's going to be a rather grim day when the Health Protection Agency announces the latest swine flu figures at five o'clock. So here's some light relief: It's a suit that will protect you from swine flu - at least according to the Japanese manufacturer. The suit (pictured above) is coated with titanium dioxide, which reacts to light to break down and kill the virus when it comes into contact with it - allegedly.

And a final call for questions for Prof Ashton, Cumbria's medical director. I'll be meeting up with him on Tuesday to discuss all things swine fluy, so if you have any questions email me.

Ten deaths in the north west

FOR some reason Dr Ruth Hussey, the north west director of public health, has finally relented to tell the press how many people have died from swine flu in the north west: It's 10. Well done to the Manchester Evening News for obtaining this data. But given the small number, one wonders why she was so scared of telling the press? It seems to be a reaction to the very sad death of a fit and healthy 24-year-old woman, Louise Jones, whose death in Greater Manchester has just been made public by the family. Dr Hussey rightly reaffirms that despite the tragedy of this event the virus is usually mild and deaths rare. Did she fear a 'We're all going to die" type headline? I've not seen any reckless reporting by the media - rather the opposite. It might be too much to ask how many of those 10 deaths occurred in Cumbria but it is top of my list of questions for Prof Ashton, Cumbria's medical director.
So why all the fuss if there are so few deaths? Because the government has warned of 19,000 deaths over the winter and it would be useful to know if only women were dying or only people in their 20s were dying or if only cyclists living in Whitehaven are dying. They're not. But without any information, how do we know?! And why are medical authorities so scared of releasing even basic data?

• Cumbria swine flu information.
  

The young and healthy

There was some interesting data in The Guardian last Thursday (October 1) on swine flu patients.
Unfortunately, I've been unable to find out where The Guardian got this information from. The paper describes it was a Department of Health patient survey but despite an extensive search by the DofH press office, they could find no record of it. But I trust The Guardian so I'll happily repeat the few findings they reported:
* More than 80 per cent of children under the age of five who have been hospitalised with swine flu had no underlying health problems.
* And almost half of those aged 16 to 14 who needed inpatient treatment for the infection had also been previously healthy.
* More than one in four patients admitted to hospital had asthma, more than 15 per cent had heart disease and more than 10 per cent had diabetes
However, the sample was only of 192 patients. It reaffirms that the fit and healthy among us - that's Dad in my swine flu family above - shouldn't be complacent. And while The Whitehaven News reported this week on an outbreak of suspected swine flu in an old folk's home, the elderly actually seem to be more resistant to it than most.

The more bizarre headlines

Swine flu is not a laughing mater but here are some of the more bizarre swine flu headlines that have caught my eye...

• No Swine Flu deaths in Botswana
  
• Canadian Aboriginals get body bags after asking government for swine flu help
  
• Is St Thérèse of Lisieux spreading swine flu?
  
• Prisoners Got Drunk On Swine Flu Gel
  
• Now they want to ban handshakes
  
• Media spreading virus of fear
  

MP's questions

Helping flublogia (the internet community interested in swine flu) in their quest for data on swine flu in Andrew Pelling, MP for Central Croydon. He has tabled questions in parliament seeking information with limited success. The answers provided by the HPA have proved to be 'lacking'. I can't find the figures on Andrew's site at the moment but they are included in the rebuttal by Sheila Bird on Straight Statistics. Sheila says: "Either the Health Protection Agency doubted that a Member of Parliament was capable of posing an epidemiologically-adept Parliamentary Question and hence misread it, or HPA chose helpfully to answer a different question which they could answer." Crucially she appeals for data by age group to help form a strategy for dealing with the second wave.

Are women more at risk?

It would be interesting to see male/female figures on swine flu. The impression I'm getting from the limited data available seems to suggest women are more at risk from swine flu than men. Anyone got any official data?

Latest figures

"Swine flu almost doubles" is the headline figure from the latest HPA reports on swine flu in the UK. But despite that I think there are reasons to be optimistic. It's easy to concentrate on 'doom and gloom' but with just two more deaths (total now 84) and a slowing down in fatalities, I'd suggest that the health service is doing a good job of containing the worst effects of this virus. Sure, more are getting it but it's generally a mild condition. Other headlines from the HPA report on Week 40:

* Rates remain below the normal winter seasonal baseline thresholds in England and Wales. The threshold has been breached in Scotland, and rates are well above newly defined provisional threshold levels in N. Ireland. In England the highest rates are in the northern regions.

* In England, on 30 September there were 286 hospitalised patients with suspected pandemic influenza, an increase from 218 seven days previously.

* The consultation rates in the RCGP scheme have increased in most age groups (figure 3), with the greatest increases in the 1-4 year-olds (15.7 to 37.8 per 100,000) and 5-14 year-olds (22.6 to 22.4 per 100,000. (5 to 14 age group is down in Scotland but remains high in 0 to 4 age group)