Medical Life

Keep things in perspective," Andy Burnham, the health secretary, urged reporters yesterday while saying that his own family of three was "going about our normal business" during the swine flu epidemic.

Ah yes – but it isn't easy, is it? How to keep your head when all around are losing theirs. Now we have a panic over pregnancy. Just because it is more likely that the pregnant will suffer with the infection, compared with the rest of us, doesn't make it likely. On present experience, a pregnant woman is more likely to be killed in a road accident than by swine flu – but no one is suggesting they should avoid travel by car.

It is the fact that pregnancy raises the risks that catches the eye, not the risk itself. Natural immunity falls in pregnancy (to prevent the foetus being rejected) and the virus may have more severe effects because the growing foetus can compress the woman's diaphragm and restrict her breathing. So pregnant women are at extra risk from flu every year.

In describing these risks, it is very difficult to get the balance right. Highlight them and you risk being accused of hype, but play them down and you stand charged with complacency. Part of the problem is that people tend to concentrate on the headlines and ignore the small print.

Doctors think we – politicians and the media - are over-reacting, and fomenting panic. Laurence Buckman, chairman of the British Medical Association's GPs committee, said in The Independent last week: "More of my time nowadays is spent reassuring patients about swine flu than diagnosing them with it."

Experience elsewhere bears him out. NHS trusts across the country are in meltdown, we are told, GPs cannot cope and services are overwhelmed. The pressure of demand is now at such a pitch that the Government has announced a new organisation to deal with it – the National Flu Pandemic Service, to be launched on Thursday.

Yet overall, the number of consultations for flu-like illness (at 73.4 per 100,000 population) is roughly where it was last December , when seasonal flu peaked shortly before Christmas. No one was bleating about problems coping then. It is a third of the level in the last flu epidemic in 1999-2000 when consultations rose to more than 200 per 100,000 population – and the NHS has since had billions of pounds of investment and thousands of extra doctors and nurses.

If the NHS is struggling now, how will it manage later in the autumn and winter when – if – the number of cases rises to true epidemic levels? We all calm down.


The charitable trust that supports Addenbrooke's hospital in Cambridge donated £3,850 towards research that found workers smoking in the grounds, despite a smoke-free policy, did so because of "nicotine dependence." Local councillor Geoff Heathcock said spend money this way was barmy. I call it breathtaking.