Lisa Markwell: There could be a bright side to the flu crisis...

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Should schools stay closed in September in a bid to slow the spread of swine flu? Your guess is as good as mine, or indeed a minister's. The maddeningly oblique messages coming out of the health ministry, the doctors' surgeries and over the garden wall do nothing to calm us. Working in central London at the height of holiday season means coming eye-to-eye with folk in surgical masks (there's no such thing as face-to-face when the face is obscured). Do they know something we don't? A friend travelling through Gatwick airport on Monday witnessed a whole planeload of tourists donning masks and gloves as the doors switched to manual.

Meanwhile, a colleague whose wife is in the mid-stages of pregnancy reckons that his unborn child, when it reaches school in five years, may find the class half-empty, as prospective parents are probably thinking twice about trying for a baby just now. It's an intriguing thought – which not so long ago could have been the plot line from a low-budget sci-fi film.

The hackneyed "keep calm and carry on" mantra is becoming ever more difficult to spin when we all, by now, know someone first- or second-hand affected by swine flu. Sure, most of the cases bring nothing more than a high temperature and the sniffles, but that's scant consolation if you've got "underlying health issues" that you don't know about. Yet.

It's thrown all my usual rules about germs topsy-turvy. I've raised my children to wash their hands and cover coughs, but until now we've lived by the three-seconds-and-its-fine rule when it comes to toast dropped on the floor. No longer.

Every day we're bombarded by new ways to spend money on products that may – or may not – make a difference in the battle against the H1N1 virus. Anti-viral tissues, bug-nuking surface cleaners, special holiday insurance, hand-sanitising gels (I'm actually rethinking my aversion to that last one). The commercial sector has, as is often the way, got its act together before the public service sector and is selling us, the "worried well", its version of peace of mind.

We all want someone to take charge of the situation, to give concrete advice that we can adhere to. But having been on the receiving end of the dismal advice offered by NHS Direct phoneline in the past ("grade your pain from one to 10... if in doubt, call an ambulance"... gee, thanks), I don't hold out much hope for the government-endorsed flu advice phoneline and website, to be launched later this week.

Being sent out Tamiflu by a temp call-centre worker is only one notch above clicking "yes please" to those libido-enhancing adverts on the internet, in terms of targeted and authoritative prescribing. Won't the phones be flooded with calls from those in good health who want to stockpile the drugs?

So until Andy Burnham is briefed to the point of cast-iron authority, it feels as if we're pretty much on our own.

All I really want right now is a definitive decision on those school closures. For if they are to remain locked in September, I'd rather cancel next week's holiday in rainy Cornwall and book something last minute outside the usual school-holiday dates (ie those made prohibitively expensive by the in-cahoots travel industry), somewhere with guaranteed sunshine. It's one way to make something positive out of the pandemic panic.

Aren't matters of life and death best left to the experts?

"Everyone's entitled to change their mind." These words from Hannah Jones, the 14-year-old who went to court to prevent doctors from compelling her to have a necessary heart transplant, raise concerns. Was a child able to make an informed right-to-die decision before she'd really lived? Were her parents acting in her best interests by allowing her to make that decision? And can those co-ordinating her care be sure that, this time, Hannah's decision is final?

It is, of course, positive news that a young girl is able to reverse her decision in time for it to make a difference, for her health has deteriorated since her doctors battled to persuade her to join the transplant list eight months ago. But who should be in charge of our healthcare decisions? We often hear of a health service committed to allowing patients their own say in what happens to them. In Hannah's case, the fact that she is a child very likely informed the doctors' insistence that they knew the best course of action. But what if she was an adult?

Cancer patients report oncologists giving them statistics with infinitesimally differing outcomes relating to chemotherapy and ask them to choose whether or not to proceed. A 2 per cent improvement in the chance of being cancer-free in 10 years against months of painful treatment that brings with it significant other risks to health? It's not an easy decision. In fact, it is a decision the vast majority of us would prefer left to professionals. When it comes to life or death, a little knowledge is a dangerous thing.

Maybe pale and interesting got boring

Much was made recently of Victoria Beckham's decision to abandon fake tan. The mahogany skin tone she'd made her own was, fashion pundits agreed, rather downmarket, and if she wanted to be taken seriously as a style icon, she'd need to tone it down to pine, or beech at the very least. Photographs of her were circulated to prove she'd listened, along with interviews with the "tan artiste" she'd employed to get rid of the "Oompa-Loompa orange".

But what's this? Two days ago Mrs Beckham was pictured watching Mr Beckham playing football, and she looked positively radioactive. Either the man with the spray-tan gun locked her in and applied product in industrial quantities, or Victoria tired of looking pale and interesting.

Perhaps her love affair with haute fashion is over – it's certainly tricky to pull off the discreet look without teetering over into dull. It's generally known that a smooth tan, whether fake or real, has the effect of making us look slightly slimmer, but the wraith-like Beckham can't believe she's in need of such visual trickery, surely?

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