Wednesday, 29 April 2009

Global 'Flu Pandemic

As a doctor who spends a lot of time looking after patients on life-support in the Critical Care Unit, I have a vested interest in paying close attention to the reports of the spread of the “Swine ‘Flu” epidemic.

 From the moment the story broke on Saturday morning, we’ve had people from the Department of Health and the Health Protection Agency on the telly and radio telling us that “the UK is the best prepared country in the world to deal with a pandemic.”

 I really hope that this is true and our preparation is sound, but the thing that’s worrying me is that no one seems to be telling me or my colleagues what the plan is. There doesn’t seem to be any advice about how we actually treat someone who becomes critically ill with swine flu. We haven’t been told what type of protective measures we should take to prevent the in-hospital spread of this flu or how to protect ourselves from it. Should we use special masks? If so, where do we get them from? What should the isolation policy be? What do we do with the rest of the inpatients? Should we come in to work if we start to feel a bit rough? The hospital is pretty much constantly full anyway, so what happens when we get a big influx of admissions with ‘flu? What happens when we run out of beds? What happens when the staff start getting ill?

 These are all questions that we’ve been given no official guidance on. Obviously, we’ll do the best we can and try to deal with situations to the best of our ability, but it would be nice to know what sort of special measures or help is available to us.

 The thing that’s really worrying me is that nobody in the hospital seems to know the answers to these questions either. The consultants don’t know, the critical care sisters don’t know, and word is that the chief executive only has a sketchy idea about how manage an outbreak in this town.

 Reading between the lines, what I gather from the radio is that there seems to be some sort of secret masterplan and I really hope that this is the case. I really hope that a whole chain of events swing into action once we have a suspected case come through the hospital doors.

 I’m covering intensive care next week and I want to know if there’s anything different I should do from normal if the medical reg bleeps me and says, “I’d like to refer you a 31 year old man for consideration of ventilatory support. He presented with severe ‘flu-like symptoms after returning from a holiday in the USA on Tuesday…”


Harry said...

what seems to be most worrying is you're not alone in saying this. another doctor's blog also says he has no official guidance on what to do, despite media reports (or whatever the govt feeds them) saying otherwise.

still, i'd rather be in the UK than here in China if this thing takes off bigtime. don't trust the "medicine" here for toffee.

Jo said...

Don't worry - the government is going to put leaflets through all of our doors telling us what to do when we all start dying...

(news report this morning said that the advice included using paper handkerchiefs and washing your hands when you sneeze...)

Harry said...

if i was feeling more facetious i would say here that we're all dying (life being a sexually transmitted condition with a 100% mortality rate and all that ;))

so basically the govt is telling people to exercise common sense? god i wish people here believed "washing hands" and "using a tissue" was common sense, China is by and large a filthy hole when it comes to hygiene. wonder how fast the disease can spread here when it arrives?

regarding what to do when we all start to die, i suppose they'll want us to mark our house with an X, board up the windows and lie down conveniently outside, so the death-carts can pick us up with minimal fuss a la plague circa 1600.

oh the fun times we live (and die) in, eh? ;)

Anonymous said...

I wouldn't want to be in China, but I would rather be in Hong Kong than in the UK. They know what they got wrong 6 years ago. Oh, and doctors and nurses who die in HK will get a state funeral.. wonder if that would happen here?

rosiero said...

"I really hope that a whole chain of events with (sic) swing into action once we have a suspected case come through the hospital doors." I wouldn't bank on it - I know how the civil service and officialdom in general works! I think the best policy is to be prepared and think what YOU would do.

Anonymous said...

Hi there. I'd just like to say that as a med student, I find your blog pretty entertaining.

I'm currently on a placement on ITU in a hospital in the East, and over here, all of the ITU and respiratory staff are being fit-tested with masks to use in cases of ?H1N1, as they'll be the staff making the most 'close' contact with such patients.

As far as I can tell, that seems to be the only sort of preparation I can see, but goodness knows what happens behind the scenes...!