100,000 new cases heighten concerns over intensive care beds for youngsters

Fears about the capacity of NHS intensive care units to cope with a surge in cases of children struck down with swine flu were raised yesterday as figures showed that the pandemic was gathering pace.

An estimated 100,000 new cases of swine flu were recorded last week, almost double the 55,000 in the previous week, and the under-15s were predominantly affected. All regions of the country are now seeing "exceptional levels of influenza activity", which was "highly unusual" in summer, the Chief Medical Officer, Sir Liam Donaldson, said.

The National Flu Pandemic Service, launched to coincide with the release of the new figures, crashed within minutes of going live yesterday afternoon. The website and telephone helpline, designed to enable the public to diagnose swine flu and collect antiviral drugs, appeared to be running normally later and was experiencing "unprecedented" levels of demand, the Government said.

The website service is backed by a telephone helpline staffed by more than 1,500 call centre staff, capable of answering more than 200,000 calls a day – or more than a million calls a week, officials said. It is intended to take the pressure off GPs and other NHS services which have seen huge peaks in demand in some places.

Doctors warned that at these levels, the impact of flu on the health service in the winter could be much greater.

Douglas Fleming, of the Royal College of GPs monitoring centre in Birmingham which tracks trends in GP consultation rates, said: "There has been an approximate doubling in cases in all areas, except Wales. If this were happening in winter, on top of all the other respiratory infections, the impact would be very much more substantial. The impact would be very high indeed."

Intensive care specialists view the way the virus is infecting and causing serious illness in children with alarm. The number of people admitted to hospital last week increased to 840, up by one-third from the previous week. The proportion of under five-year-olds in hospital rose to five times the rate for other age groups and 12 under-fives were in critical care.

Roddy O'Donnell, secretary of the Paediatric Intensive Care Society, which represents 25 intensive care units for children with 603 beds across the UK, said: "In the last two winters, the units have come under huge pressure from normal seasonal viruses. We have got to the point where very few beds are available. There have been several occasions when our transport service [which arranges transfers] has said there are no beds. It is inevitable that we will come under pressure again this winter.

"I am worried whether we will be able to cope. We don't know how big this pandemic will be for paediatric intensive care. It will be no surprise to me if we can't place children or move them in a timely manner."

Dr O'Donnell, a paediatric intensive care consultant at Addenbrooke's hospital, Cambridge, said he had asked for an extra six beds which would nearly double the capacity of the existing eight-bedded unit at the hospital, as well as contingency plans to take over adult beds if the paediatric unit was overwhelmed. "But we have not had the green light yet," he said.

Among the 25 paediatric intensive care units, a number had put in plans to expand capacity but a minority had been successful. "Some have done it but in many it doesn't look like it will happen," he said.

"We have 20 hospitals in our region who call us [when they need to place a child in intensive care]. We have all been worried about flu. I expect this to be a bad winter."

The number of deaths from swine flu remained the same as last week at 26 in England. This followed detailed investigations which led to some deaths originally attributed to swine flu being removed from the total while others were added. There were four deaths in Scotland.

One-third of the deaths were in children under 16 and three-quarters were aged under 45 – the reverse of the pattern with seasonal flu which is most serious in the elderly. Sir Liam said the total of deaths was provisional, because investigations were incomplete. Of those investigated, 16 per cent of the victims were healthy before they got swine flu. The remainder had underlying conditions ranging from mild (high blood pressure) to severe (leukaemia).

Sir Liam said it was "a little bit of possibly good news". In addition, the most recent figures for this week showed signs of a dip in the number of cases of swine flu.

"There will be a 'worried well' effect when the media write about this. The US appears to have peaked and we may be seeing a lull effect but I don't think we have got there yet."

Justin McCracken, chief executive of the Health Protection Agency, said: "There are some early signs for cautious optimism. What we might be seeing is an early slowing in the rate of the increase. We have said all along this is a mild disease in most people. This week's figures are entirely consistent with that. There is absolutely no sign of the disease becoming more virulent or more serious."

The number for the National Pandemic Flu Service for England is 0800 1513 100 and the website address is www.direct.gov.uk/pandemicflu.

Pandemic notebook: Not even swine flu can get into Gaza

Gaza has enough problems without adding that of swine flu. Which is why the Hamas authorities have begun to screen foreign – or at least British – visitors to ensure that the Strip stays free of the global epidemic, as I discovered on my most recent trip to the besieged territory last week.

At the Hamas-controlled checkpoint 2km in from the Israeli border, my passport was examined and my bags searched as normal. I was then asked by a police officer to step inside an adjacent hut to see a doctor.

The medic, a general practitioner from the northern border town of Beit Hanoun, then politely – in English – asked me about my recent trips to Gaza, when I had last been in the United Kingdom and whether I had suffered from fever or any other symptoms in recent weeks.

Once reassured, and after flipping through my passport, he shook my hand and bade me goodbye. Unlike Israel itself, where the media have reported about 300 cases (and where I was not similarly checked when I last came through Ben Gurion airport in June), and the West Bank, where at least 11 cases have also been reported, Gaza has not so far had a single case. It is perhaps the only benefit of the stringent closure imposed by Israel. And the Hamas de-facto government plans to keep it that way.

Donald Macintyre

42-mile trek through Dales to get Tamiflu

Relatives of a woman from the Wensleydale area of the Yorkshire Dales diagnosed with swine flu had to make a 42-mile round-trip to lay hands on the antiviral drug Tamiflu, despite the existence of a chemist four miles from her home. Doctors told the retired 64-year-old from West Witton, who did not want to be named, that she would only need Tamiflu if her 82-year-old husband, who suffers from Guillain-Barré syndrome, also showed symptoms.

"The doctors said I couldn't go out so I asked my brother to pick up the prescription for me. He travelled the few miles to the surgery and then to the chemist. But he was told that they were not stocking the drug. He then had to travel to another village, 13 miles away, to get my prescription before coming all the way back. I just don't understand how a chemist can not stock a drug which is in such high demand. The Government keeps saying Tamiflu is readily available. But that's no use if nobody is stocking the drug."

Kevin Rawlinson

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