Update to NHS Bolton
Jan Hutchinson, DPH
A pandemic has been forecast for some time – last world
wide pandemic was in 1968
Concern had centred on Avian Flu (H5N1) but we are
now dealing with swine flu – H1N1(described as 2 parts
pig, one part bird and one part human)
Cases can be traced back over recent years to outbreaks
in N Carolina associated with pig farms, and more
recently to Mexico
WHO announced alert level 6, 2 weeks ago – sustained
outbreaks in 2 or more countries
UK alert levels are not being used as the spread across
the UK is so variable
52160 laboratory confirmed cases worldwide,
since the outbreak began
231 deaths (113 in Mexico)
21449 cases in USA, 7624 in Mexico, 5710 in
Canada, 4315 in Chile, 2436 in Australia
2905 cases in UK, with 1 death
Most cases in Scotland, W Midlands and London
43 cases in NW, of which 11 are in GM and 1 in
What do we know about the virus?
Appears to affect children and young adults under 30 far
more than other age groups (few cases in over 50s and
very few in over 65s)
Seems to be a highly transmissible infection, but in most
people, causes only a mild illness, very similar to
seasonal flu – high temperature, cough and cold
Viruses behave very unpredictably – this one could
mutate and become more serious
Particular concern about H1N1 mixing with seasonal flu in
the autumn (so great interest in monitoring what happens
in the southern hemisphere during their winter flu season)
What are we doing to prepare?
We have been preparing for a flu pandemic for the past 5 years, via a
multi-agency borough planning group.
This has now become the borough’s Pandemic Influenza
Coordination group, which has met three times in the past 6 weeks
Tactical plan in place, constantly under review
Sub groups include health and social care group, communications,
anti-viral distribution / flu line, vulnerable people, and bereavement
Links in place with the resilience forum and SCG (Strategic
Command Group) at Greater Manchester level
Reporting arrangements in place to SCG and on to COBR (cabinet
office) and NHS NW through to Department of Health.
NHS and Council have their own pandemic flu planning and response
groups in place, and meeting regularly.
NHS Bolton has an outbreak team, which has met at least weekly
since the outbreak began.
Action taken so far………….
In containment phase – emphasis on slowing the spread. Swabbing
potential cases, prescribing anti-virals to confirmed cases and
May very soon move to next phase – mitigation – in which anti-virals
will be given to people with symptoms of flu, and testing for H1N1 will
cease (NB anti virals may be given to high risk groups only – this is
the strategy in Scotland, USA)
Plans for 4 x ‘Assessment and Collection points’ across Bolton, one
of which could be opened at 24 hours notice, and could operate 24/7
Good stock of anti-virals and PPE (masks etc) are available in Bolton
and more being delivered
Local Flu line plans in place (may be required if national flu line is not
Action so far…………..
Testing plans eg Anti-viral collection point, local flu line
Multi-agency exercise on June 12 used a worst case
scenario – very useful learning
Business continuity plans reviewed and revised
Ensuring synergy between plans – especially NHS
Bolton, hospital, and social care
Plans for support to vulnerable individuals (eg flu friends,
home delivery of anti-virals) via CVS
Preparation for mass vaccination
Communications – very important messages about
infection control (‘Catch it, Bin it, Kill it’) and self care
What will happen next?
The big question – we don’t know.
We need to take this very seriously – even
if it’s only a mild illness, the impact on the
NHS would be a concern (particularly
We need to continue to plan carefully so
that we are ready to deal with whatever
challenges come along