Swine flu: NHS ‘muddle’ as London on brink of epidemic

A leaked memo has revealed that senior NHS officials consider emergency plans to combat the swine flu pandemic in Britain are muddled and pointless.

The news comes as the death toll in the UK from pandemic flu, also known as H1N1, has reached 14 - all of whom had "underlying health problems". The total is the third highest in the world after Mexico and the United States.

The memo, which was sent by an NHS trust executive and leaked to the Times, criticises the government's "muddled thinking" on emergency planning, including the setting up of a national diagnosis phone line, which is yet to materialise - forcing NHS trusts to set up their own.

The memo also raises concern at the proposed system whereby a swine flu patient's friend would pick up a voucher for Tamiflu - the main flu antiviral drug - from a GP. The executive calls the vouchers a "complete waste of time" and says it would be more efficient to use the current prescription system.

With at least 9,718 confirmed cases of swine flu in the UK, Chief Medical Officer Liam Donaldson has said London and the West Midlands are on the cusp of H1N1 epidemics. He says there are currently 43 people who are critical with the virus in England and another 292 people being treated in hospital.

However, he admits that the true extent of swine flu is likely to be much larger, partly because of the disease's relatively mild symptoms.

"We do know something about the people seeking help from the NHS but there will be many other people who look after themselves, don't realise they have it and don't show up," he says.

"We have to acknowledge the problem is bigger than surveillance is showing us."

Meanwhile, the New Scientist reports three ominous developments:

• Southern hemisphere countries have reported that H1N1 is replacing regular seasonal flu, rendering seasonal vaccines built up over the past year useless. In Victoria, Australia's hardest-hit state, 99 per cent of all flu cases are H1N1. It is a similar story in Chile and Argentina.

This is exactly what happened during the notorious Spanish flu pandemic of 1918 and is bad news because the northern hemisphere will move into the autumn and the flu season proper with potentially useless seasonal flu vaccines.

• Last week three cases of Tamiflu-resistant H1N1 were discovered. While two of these cases were in people using the drug, the other was found in a girl who had never used Tamiflu, suggesting a Tamiflu-resistant strain of swine flu could be circulating already.

• A mutation in the virus discovered in a sample from Shanghai, China, helps H1N1 replicate more efficiently, potentially making it more contagious and nastier.