Statement to the Assembly by Health Minister Michael McGimpsey on swine flu
Tuesday, 15 September 2009"Mr Speaker, I would like to take this opportunity to provide an update for Members on the Northern Ireland response to the swine flu virus. There have been a number of developments during the summer recess. During the summer months I have continued to participate in regular Cabinet Office meetings with Ministerial colleagues from across the UK. My Department remains in regular contact with officials in the Republic of Ireland.
"Worldwide there have been over 275,000 cases and over 3000 deaths. Within the UK there have been more than 70 deaths. In the main, the illness continues to be mild and self-limiting, although for some people it can be severe.
"To date, in Northern Ireland we have had 217 laboratory confirmed cases. However, the actual number of cases is much higher with almost 9,000 courses of antivirals prescribed to people clinically diagnosed with swine flu. In addition, the number of people consulting their GP with flu-like symptoms is significantly higher than in previous years at this time.
"Up to now, 94 people have been hospitalised with swine flu in Northern Ireland. I have also been informed of a second death possibly associated with swine flu. Obviously every death is tragic and my thoughts and sympathies are with the family. Members will understand and respect that it would not be appropriate for me to make any further comment at this time.
"While the levels of flu have been decreasing since its peak at the end of July, we should not be complacent. The scientific experts have advised that it is unlikely this downward trend will continue. We are preparing for a future surge in cases later this year and potentially for a more severe pandemic strain.
"We now know more about the virus and its effects and have been able to revise our planning assumptions. We have gathered more information from experiences of the pandemic in the UK and internationally. This has allowed us to refine our reasonable worst case scenario. Timing of a possible pandemic wave has also been reassessed.
In the worst case scenario, we still expect around 30% of the Northern Ireland population to be affected by the virus in a future wave.
"That means around over 500,000 people, or one-third of the population, may become ill with swine flu over the course of the next wave. In addition, potentially 5,000 people may be hospitalised due to the virus and up to 525 could die.
"During the peak week, as many as 113,000 people could be affected. These are not predictions but assumptions which enable us to plan for the very worst that could happen. Scientists have now advised that a substantial peak in the virus may occur in mid or late October.
"Mr Speaker, I announced during the summer that advice had been received from the Joint Committee on Vaccination and Immunisation on which groups should be prioritised for vaccine. When the vaccine is licensed, it will be initially offered to:
- Individuals aged between 6 months and 65 years in the current seasonal flu clinical at-risk groups;
- All pregnant women, subject to licensing considerations;
- Household contacts of immuno-compromised individuals; and
- People aged 65 and over in the current seasonal flu clinical at risk groups.
"These priority groups have been selected because they are at higher risk of severe illness from swine flu. Prioritising these groups ensures we make best use of our initial quantities of the vaccine.
"Frontline Health and Social Care Workers will also be among the first to be vaccinated. The close contact they have with patients means they are at additional risk of contracting and transmitting the virus.
"I expect to have sufficient vaccine for all those in the initial priority groups by the end of November. I anticipate a license being granted in October, however, this is the responsibility of the European Medicines Agency and I await their decision.
"I will continue to monitor the emerging evidence and expert scientific and medical advice before taking decisions on extending the programme beyond these initial priority groups. The planning assumptions will also need to be revised to take into account the impact of the vaccination programme.
"Mr Speaker, I am pleased to announce that a UK wide deal has been agreed with the General Practitioner's Committee regarding administration of the vaccine this autumn. We have agreed that GPs will receive £5.25 per dose of vaccine given and that district nurses will assist by vaccinating the housebound in line with existing seasonal flu arrangements.
"I am grateful to GPs for their willingness to take on this major vaccination programme. I am satisfied that their co-operation represents value for money in delivering the programme. Preparations will now begin for GPs to immunise the priority groups once the vaccine is licensed.
"Whilst vaccination is our best defence in the battle against swine flu, we also need to be prepared for a significant increase in hospitalised cases. Experience elsewhere has shown that up to a quarter of the hospitalised cases may require intensive care.
"Plans are in place locally and nationally to increase critical care capacity to cope with the potential demands of swine flu. I intend to more than double capacity in adult critical care. Forty seven adult ventilators are being procured to provide this additional capacity in Northern Ireland.
"We also have plans to substantially increase the number of paediatric critical care beds. It is also recognised that some older children may need to be cared for in adult critical care facilities, with the necessary support from paediatric staff.
"The number of appropriately trained staff must be increased to support additional capacity and plans have been developed to achieve this.
"Doubling critical care capacity will allow many more people to benefit from critical care than would otherwise be the case. In order to achieve this very significant increase hospitals will need to deploy their trained workforce differently.
"They may also need to postpone non urgent, planned operations, so that they can concentrate their staff and resources on the most seriously ill patients.
"Keeping the public informed is a key element of our preparations. To this end, I have a major communications programme planned for the autumn and winter to maintain public confidence and awareness. This will build on the work to date, including the very effective bus panel advertisements of the ‘sneezy man’ image which stress the need for good hand hygiene.
"To reinforce the message for people to ‘stay at home’ if they are experiencing symptoms, I ran a local advertising campaign. We are developing leaflets and other public information for the public to accompany the swine flu vaccination programme.
"England launched the National Pandemic Flu Service over the summer in response to the significant pressure being experienced by GPs there. However, the number of cases to date in Northern Ireland and the fact that our primary care services have been coping well, has not merited its introduction here. This situation is constantly under review and should the need arise, this facility can be introduced quickly.
"Mr Speaker, to date, most of the focus in the pandemic response has centered on the health service. However, if a more severe pandemic wave is experienced later this year, we can expect to see significant pressure on our schools and local services.
"I recently met with my ministerial colleagues in Education and Employment and Learning, to stress the need for ‘business as usual’ as far as possible in this pandemic. I am pleased to note that schools have returned as normal following the summer break.
"The Public Health Agency continues to work closely with schools to ensure local risk assessments are provided if significant absenteeism rates are reported.
"I do not expect the recent decline in the number of cases to be sustained now that schools have reopened and with the onset of the autumn/winter flu season.
"I met yesterday with the Minister for Enterprise, Trade and Investment. A future pandemic wave could have a very disruptive effect on businesses due to absence and difficulty in delivering normal services.
"I have also met with the Finance Minister, Sammy Wilson to discuss funding for the swine flu pandemic. I will be meeting him later this week to continue this discussions.
"The bill for dealing with this pandemic could be as much as £80million or higher. To date, we have spent almost £30million, most of this solely relating to national initiatives such as antivirals, vaccines, personal protection equipment and antibiotics.
"This does not include costs such as the delivery of vaccinations, antiviral distribution, staff backfill costs for sickness absences and extra capacity in intensive care. Therefore there can be absolutely no doubt that costs will rise.
"My officials have developed and costed three possible scenarios
- A relatively benign estimate assuming a moderate peak in demand;
- A reasonably prudent estimate factoring in our best assessment of the extent and pace of the pandemic; and
- A reasonable worst case scenario.
"I have bid for scenario two, £77million, on the basis that it represents the most realistic estimate of the costs likely to be incurred. Against that I can find a total of £27million, over one third of the costs.
"I must remind the House that without funding there will be serious consequences for the health and social care service, patients and the public.
"Mr Speaker, regular hand washing and respiratory hygiene remains the single most important thing that people can do to protect themselves and prevent the spread of the disease. If people have flu-like symptoms, they should stay at home and call their GP who will provide advice. People should not go to their GP surgery, or to a hospital, as they may spread the disease to others.
"We cannot predict with certainty when the pandemic will peak in Northern Ireland or the numbers of people who will need hospital treatment. However, our robust preparations enable us to ensure we can respond to any scenario, even that worst case outlined at the beginning of my statement.
"Mr Speaker, we must not be complacent. This is not a killer virus but is still one that can kill. So we must continue to put plans in place which are proportionate to the threat we face. I am confident that our Health Service will cope with any increase in cases which occur in the coming months.
"I will continue to keep Members updated on a regular basis and commend the statement to the House."
Notes to Editors:
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