Influenza A (H1N1)
Health Secretary Nicola Sturgeon
Statement to the Scottish Parliament
May 6, 2009
I am grateful for this further opportunity to update Parliament on the current situation in relation to the (A) H1N1 flu virus.
Members will be aware that on 29th April the World Health Organisation raised its pandemic flu alert to Phase Five, following confirmation of person to person transmission in the United States as well as in Mexico.
I would like to remind members that this does not mean that we are in a pandemic situation; nor does it mean that a pandemic is inevitable. But the risk remains high and we must be ready for instant activation of pandemic responses when required.
As of this morning, the World Health Organisation reports that 1516 cases of (A)H1N1 have been officially reported across 22 countries. As members will know Mexico and the United States have seen the greatest number of cases, but cases have also been confirmed across Europe, as well as in Canada, South America and the Far East. In the UK as a whole 32 cases have been confirmed.
In Scotland, we have 4 confirmed cases, including 1 case of person to person transmission. As a I indicated yesterday, a further case in the Grampian area is being considered probable - this means they have tested positive for influenza A but that we are awaiting further test results to confirm the strain.
In addition, there are 27 possible cases currently undergoing testing in 9 NHS Board areas. I would like to stress that these are all cases being treated and investigated on a precautionary basis. They are not confirmed as positive for Influenza A, let alone the specific H1N1 strain.
It is likely that further cases will continue to emerge and we, are continuing to monitor the situation very closely.
However, while numbers remain low, our focus continues to be on containing the virus and minimising further spread.
A total of 77 close contacts of the four confirmed cases have been identified and given the appropriate advice and treatment.
The fact that only one of these contacts has gone onto develop the virus is evidence of the success, so far, of the containment strategy.
I want at this stage to pay tribute to the efforts of staff across the NHS who have worked so hard and, to date, so successfully, to stop this virus spreading.
We shouldn't underestimate the scale of the challenges the NHS in Scotland has faced in the last ten days. They have coped with:
· the first confirmed UK cases;
· the first documented person to person transmission in the UK; and
· the first exercise involving notification of all passengers and crew on an internal flight.
The NHS has responded swiftly and effectively to all these challenges.
The response has involved many people working long hours and considerable redeployment of staff. Our health protection response, which is usually invisible to the public, has been excellent. I am sure all members would join with me in commending and thanking Health Protection Scotland, the Public Health teams across Scotland and the virus labs for working so hard and so effectively.
Presiding Officer,
Our containment strategy is so far proving successful. The continuation of this strategy is, at this stage, justified by the available evidence. Of course, this may change in the future - and I will touch on that eventuality again in a moment - but currently a precautionary approach is entirely appropriate.
However, while we continue with our efforts to contain the virus, we must also continue to prepare for the worst
Whilst emerging science suggests that the virus, outside of Mexico, may be less serious than initially feared, it is still too early to make, and we have too few cases on which to base, any confident predictions.
What we have just now is nothing more reliable than the scientists' best guess and therefore a number of strong caveats require to be inserted. The virus might yet mutate and develop greater virulence; and it may return in the autumn and winter months as a more serious strain.
These are very real dangers and so we must continue to plan ahead. I therefore now want to outline the wider action we are taking to ensure we are well prepared.
First we have been working very closely with the other UK countries to ensure that we are in a position to secure supplies of a vaccine under our sleeping contracts at the appropriate time. I will keep Parliament updated with any developments in that regard.
Secondly, although we already have sufficient levels of antiviral drugs to treat half of the population, we have taken steps to increase stocks significantly beyond that. Our stocks are already being used to treat the small number of confirmed cases, as well as on a prophylaxis basis for the close contacts of probable and confirmed cases as part of our containment strategy.
It is important to point out to parliament, however, that we may at some stage over the coming weeks require to move from a containment to a mitigation strategy. That is most likely to happen when there is sustained community transmission - that is when the virus is circulating freely within the community and amongst people with no direct or indirect connection to Mexico or other affected areas or to other known confirmed cases. At that stage, while it is likely that antivirals will still be used for treatment, the use of antivirals for prophylaxis may require review.
In the event that the current outbreak does become more widespread, it will be important that we have arrangements in place for the distribution of antivirals to large numbers of patients. Considerable progress has been made on this in recent days. This has involved significant preparation by NHS Boards to identify suitable collection points from where antivirals could be collected on behalf of patients with flu; and by NHS 24 in supporting the development of a telephone and web-based UK service that symptomatic patients would use to be assessed and issued with authorisation for antivirals to be collected on their behalf. I will keep members updated as the detail of these arrangements develop.
Of course, such arrangements would not be activated unless and until a pandemic was declared. But doing the work now means that we will be ready should that happen.
Finally, on wider preparations, on Monday I confirmed that Scotland would make available 1.45 million surgical facemasks from our stockpile of over nine million, to address a temporary shortfall of masks in England and Wales. This reflects the close working across the UK which is ongoing in response to the current situation. Deliveries of masks from Scotland are already being arranged. Additional facemasks are currently being procured for the whole of the UK , and these will replenish our stocks.
Presiding officer,
A virus knows no boundaries and we are clear that this is an issue which demands that we work closely with stakeholders in Scotland, across the UK and internationally.
As members will know, I recently met with a range of Scottish stakeholders to discuss our response to the current situation. The meeting was productive and we have agreed to meet on a weekly basis at this stage.
We are also continuing to work closely with our colleagues across the UK, using the daily COBRA arrangements to coordinate with other UK administrations and ensure our response to this virus is consistent and well managed.
In addition we are maintaining contact with the World Health Organisation and the European Centre for Disease Prevention and Control (ECDC) to ensure the unique Scottish experience can be fed in to international developments.
We have sought to maintain clear and effective channels of communication with parliament, the media and the public.
A communications campaign started across the UK on 30 April. The campaign, which focuses on respiratory and hand hygiene messages, aims to reach 98% of the population within a two week period.
As members will know, as part of this campaign an information leaflet is being delivered to every household in the UK. The leaflet is also available on the Scottish Government website or via NHS24 website in a range of alternative formats including large print and 15 different languages.
In conclusion, the considerable planning which has been undertaken over a number of years has so far paid off. At this point I am encouraged that we have been able to effectively contain the virus, but of course we cannot predict with any certainty how things will develop, and we remain vigilant. The NHS is working hard to disrupt the spread of the virus and we in the Government are working hard to support the NHS and to prepare for future scenarios.
I will continue to keep Parliament fully updated as the situation develops.