"There have been a number of significant developments since my last statement on 15 June. At that point we only had eight cases across Northern Ireland. That number has more than quadrupled in just a fortnight to 33 confirmed cases. One person also remains in hospital after contracting swine flu.
"For the first time we have seen cases of swine flu in children which have resulted in the early closure of a primary school. A further case has now been confirmed in a classmate of this pupil and was picked up through our standard procedure for following up cases. This child has mild symptoms and is at home. This is our third case in a child and is the fourth case of person to person spread.
"Worldwide there are now over 70,000 confirmed cases in 112 countries and 311 deaths. Across the UK, there are around 6,538 cases and three deaths. In the Republic of Ireland there are now 40 cases.
"As these figures illustrate, the number of new cases continues to grow, doubling in the UK every seven days. Although the disease appears to be spreading quickly, I would again reassure Members and the public that, to date, the swine flu symptoms are generally mild in most cases but can be severe in a small minority.
"The situation currently elsewhere in the UK is that most cases now result from spread within local communities rather than as a result of travel to other countries. Clusters of cases and widespread community transmission is already prevalent in parts of Scotland, the West Midlands and London.
"At present in Northern Ireland, the situation is different and the vast majority of cases to date continue to be travel related. However as in the rest of the UK, we can expect to see similar clusters here, with a growing proportion of cases arising from community transmission rather than travel. This is entirely in line with what we would expect in the course of an outbreak. These ‘local hotspots’ will also continue to grow across the UK in the weeks and months ahead. Of course, as many families will now be heading off on holiday, we can still also expect a continued number of travel related cases.
"As we learn more about how this virus behaves, we have been adapting our response accordingly. Early actions taken to contain and reduce the spread of the virus throughout Northern Ireland have been very successful.
"I must pay particular thanks to staff in the Public Health Agency and frontline health professionals for their tireless work in managing the swine flu outbreak. They continue to provide important clinical advice and support to my Department, the health and social care service and to the public.
"Our strategy to limit the spread of swine flu has involved offering antivirals to those who develop the disease and, as a preventive measure, to their close contacts. This approach is part of our pandemic flu preparations and is in line with advice from the World Health Organisation, the Scientific Advisory Group for Emergencies (SAGE) and the Joint Committee on Vaccination and Immunisation (JCVI).
"While this policy has worked to date, we have always made it clear that we would not be able to prevent the spread of swine flu indefinitely. Emerging evidence and the experience in the so-called hot spots in England and Scotland supports this view. As the number of cases continue to rise, across the UK we have adopted an appropriate response and one which allows flexibility in areas where there have been significant increases.
"Ensuring this flexibility is crucial. As our experience of this virus develops, it is essential that our GPs and other health professionals are able to use their clinical judgement in deciding how to best treat patients.
"Our knowledge of this virus is only 10 weeks old. The initial position emerging from Mexico suggested a severe illness. In light of this and the fact that so little was known about the virus, it was entirely appropriate to take all available steps to slow its spread whilst we learned more about it and to buy time until a vaccine was available.
"Experience gained since that time across the world suggests that to date this virus causes less severe illness than was initially feared. At present, it has many of the characteristics of seasonal flu with most people having a mild illness and making a full recovery.
"As with seasonal flu, most otherwise healthy people generally do not require antivirals. What is more, antivirals can produce side effects such as vomiting, diarrhoea and nausea. The continuation of widespread use of antivirals also runs the risk of the virus developing resistance and so reducing the level of protection this treatment gives.
"Emerging clinical experience of this virus suggests that for many people, the symptoms of swine flu can be treated in the same way as a normal cold or seasonal flu, by staying at home; taking paracetamol and cold remedies to reduce symptoms; drinking fluids and resting and only contacting your GP if your symptoms are not improving.
"If we were to adopt this approach, as with seasonal flu, it would mean that we would rely more on symptoms rather than swabs to diagnose the illness. It would mean that the use of antivirals as a preventative measure and the tracing of close contacts of a symptomatic patient, would be largely discontinued, although that would be based on the clinical judgement of local clinicians.
"This is in line with what is currently happening in the US, Canada and Australia where there are large numbers of cases.
"This would represent a change to our current strategy and one that requires careful consideration. Any such decision would be based on scientific and clinical advice and would be kept under review. As I have said, local clinicians and healthcare professionals would however have the flexibility to use their clinical expertise and judgement in how best to treat patients.
"On Wednesday, I will be taking part in the Cabinet Office meeting, COBR which is chaired by Andy Burnham, Secretary of State for Health in England. Health Ministers from Wales and Scotland also participate in this meeting, along with scientists and other senior health professionals including the four Chief Medical Officers.
"Mr Speaker, there may be actions arising out of this meeting which could result in changes to the way we deal with the swine flu pandemic along the lines I have set out. I will of course update members of any decisions leading to a change in approach by way of a written statement.
"It is important that our response to swine flu is proportionate.
"The investment we make of money and of people’s time and energy should be targeted on what needs to be done to manage the needs of patients and of society as a whole.
"That does not mean that we should be complacent.
"The Scientific Advisory Group for Emergencies (SAGE) advises COBR on modelling for the spread of swine flu. They have advised that if the virus continues to spread at current rates in the UK, we could potentially expect to see up to 500,000 cases in the UK by the end of August.
"Northern Ireland has a stock of antiviral drugs that will cover half the population. I have ensured that steps are in place to increase this so that there will be antiviral drugs to treat up to 80% of the population.
"Whilst this represents a significant stockpile we must be prudent in its use.
"As I said earlier, it is important that we use antivirals in a way that minimises the potential for resistance to develop so that they remain an effective treatment for those most at risk and with those with a less mild illness. We also need to ensure that they remain effective in case the virus becomes more severe in the Autumn.
"As in the rest of the UK, we have been planning for a potential pandemic for some time and since the emergence of swine flu, we have been operating at a heightened state of readiness. Our plans are robust and well- rehearsed. However, as I have tried to make clear, they need also to be sufficiently flexible to respond to changing circumstances. The UK including Northern Ireland is one of the best prepared countries in the world.
"The Department of Health in London has concluded negotiations with the two main vaccine manufacturers on behalf of the four UK Health Departments. The UK will be procuring pandemic vaccine for the entire population. This will arrive in stages commencing August 2009 with full delivery anticipated in November 2010.
"I would remind members and the public that we cannot do this alone. Everyone must play their part in helping to reduce the impact of this pandemic. Now that schools are closing for the summer and people are going on their holidays, I would reiterate my public health messages and for people to contact their GP when they return home, if they feel unwell.
"In addition, the public can reduce their chances of catching the virus by following these simple but effective steps. Wash your hands regularly, and cover your mouth and nose with a tissue when you sneeze, then put the tissue in a bin – catch it, bin it, kill it.
"We need to be prepared for every eventuality in relation to swine flu to ensure that the public has access to the right treatment, this requires the necessary funding from the Executive.
"I will be discussing the financial commitment required to manage our response to this emergency situation with executive colleagues on Thursday.
"Members will be aware that, as part of the final budget settlement, my Department could bring bids to the Executive table in situations of a national emergency such as pandemic flu. Given the context of this emergency and the national response required I regard swine flu as falling within this 'defined category.’
"Mr Speaker, this Assembly and the people of Northern Ireland can be assured that I will do all in my power to respond to any emerging situation over the summer months and into the autumn and winter.
Notes to Editors:
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