Wouldn't It Make Sense to Buy Some Supplies Now?

[indigo girl]

http://www.cnn.com/2009/HEALTH/07/25/uk.swine.flu.pharmacies/index.html

While I don't much care for the title of this article that describes a population in panic, I do think that an informed and well prepared public will get thru the flu season much better than having folks just waiting around for the flu vax which most of them won't get in time anyway.

No need for panic, but there is need for commonsense. There is only so much of any given product on the shelves of any store. If many are trying to buy at once, you are going to go home empty handed. Mexico, Argentina and now the UK are excellent examples of what to expect.

Please don't wait until you are sick, and then go out to infect others at stores and pharmacies as someone in this article did. It is not flu season yet in the UK, but they are going through a spike of cases this summer, nonetheless.

Pharmacies in England are reporting a run on supplies like surgical masks, thermometers and anti-bacterial gels by customers concerned about swine flu amid a surge in the number of people infected by the virus.

In some cases, drug stores in England say they are out of the items and may not get more in for weeks or months.

But at Hodgetts Chemist in north London, a supply of surgical masks that normally lasts for half a year has gone in three days, said pharmacy assistant Sylwia Sznyk.

Sznyk displayed a receipt from the chemist's suppliers that showed three types of digital thermometers that were out of stock. The pharmacy is now out of thermometers.

"One of the manufacturers, he said the next thermometers they will have is in October, so now there is no chance to get them from this particular supplier," she told CNN.

"There's no thermometers at all, which is worrying because it's just a sign that it's going to impact on other supplies as well linked to people generally not feeling well -- in particular paracetamol (acetaminophen), ibuprofen, and other medications," Shah said.

The pharmacy was out of stock of anti-bacterial gels last month, but manufacturers are making more so it's back on the shelf, he said. However, it's being sold for nearly double the price, he said.

"They're pennies otherwise to buy, but very quickly some manufacturers have got into the market of producing gels and their prices are quite high," Shah said.

At their sister pharmacy in nearby Morpeth, any anti-bacterial products at the checkout counter are "gone in a day, rather than in a month," he said.

While it is not running out yet, one pharmacy in the eastern English city of Norwich said it is noticing an increase in demand for masks, thermometers, and anti-bacterial items.

"It's not completely a foregone situation where I can't get hold of it, but it's becoming difficult," said the pharmacist, who asked not to be identified because his pharmacy is one of the government's distribution points for the antiviral medication Tamiflu, and he didn't want to spark concern.

The pharmacist said he was doling out Tamiflu to 70 to 80 people a day and described the lack of supplies as worrying.

"From a business point of view, yes, and from a clinical point of view, yes, because I can't offer the services I need to," he said. "And if people want reassurance from (the supplies), I'm not able to reassure them."

Shah, of Central Pharmacy, said the run on supplies makes him worry that they won't be available later in the year, when flu season kicks in.

"Manufacturers would have made their plans for winter a while ago, but if we're consuming these products early, in August and July, I don't know if those manufacturing plans are in place yet," he said.

The government advises anyone suspected of having swine flu to send a friend or relative -- a "flu friend" -- to their pharmacy to pick up the medicine for them. But that advice isn't being followed by everyone.

"Some patients come in directly rather than ask their friend to come," said Le, of Boots pharmacy in Fulham. He said one dispenser has come down with swine flu after being infected by a sick customer.

[nightmare, RN]

Perhaps I'm out of step here but swine flu has been relatively mild in the UK ,I certainly am not worried about getting it as I have had flu before and ,although it knocks my off my feet I am still here to tell the tale.(this includes surviving Asian flu in the 50's) There seems to be a lot of panicky negative press with this flu which,although it has killed some here (as does 'normal' flu every year) seems to be no worse than other strains of flu.

[lamazeteacher]

I haven't seen the surge of cases in the UK reported in the article, coming out of WHO.....

When Americans started to buy out pharmacy supplies of PPE, our government stepped in and prohibited refilling their orders, preferring to conserve its use. Hospitals have priority for obtaining such supplies, and the public needed to see srticles in newspapers about that policy, so they wouldn't put a rush on pharmacies for all their products.

When people in the homes of nurses have/are suspected of having A/H1N1, they should be able to protect themselves, in order to be available where they're employed.

Whenever products such as N95 masks are purchased by "lay" people, it should be emphasized with large signs and personnel selling them, that they don't work unless they occlude air, and the methods to fit them securely.

People tend to want to be in the company of others when they're very fearful, and yet being in crowds is a prime way to get any bug. TV programs for use in homes, educating the public in personal hygienic care, modes of transmission of infectious diseases, s/s of flu, and how to deal with them, and up to date treatment methods, where that's available would be helpful to allow less harmful effects in this pandemic.

Prevention of flu through immunization and locations of clinics where that can be obtained, with information regarding safety of vaccines needs to be published in newspapers, on news programs and TV programs.

[indigo girl]

Perhaps I'm out of step here but swine flu has been relatively mild in the UK ,I certainly am not worried about getting it as I have had flu before and ,although it knocks my off my feet I am still here to tell the tale.(this includes surviving Asian flu in the 50's) There seems to be a lot of panicky negative press with this flu which,although it has killed some here (as does 'normal' flu every year) seems to be no worse than other strains of flu.

Thanks for your comments especially since you are over there. They don't seem to be saying that the swine flu is worse than seasonal flu. At least, I do not interpret it that way. What they seem to be saying is that the number of people becoming sick is unusual for this time of year. This seems to be triggering a wave of of buying as people hear about others becoming ill. The stores seem to be concerned about how the supply situation for meds such as acetaminophen or ibuprofen, and items such as thermometers, will be met if there is an increase in cases this fall.

You sound very healthy, and without any exisitng health conditions that would put you more at risk. Where are you exactly if you don't mind telling us? And, what type of nursing are you doing as well as the type of facility?

Is it possible that different areas of the country are having more cases than others? I am wondering how all of the pharmacies in that article are experiencing some degree of shortages if your area is not. Is it possible that the media is just making these reports up or would some areas be more affected than your area?

Thanks very much for any reply.

[indigo girl]

Flu drugs for 5,500 hotline users

http://news.bbc.co.uk/2/hi/health/8168969.stm

This is quite a bit of Tamiflu being handed out on a summer's day. Surely not all of them are just worried well or people pretending to be sick. 5500 is an astonishing number in July.

I have to disagree about this being just like seasonal flu. As a good friend of mine has pointed out, seasonal flu doesn't kill kids and young adults in the summertime. It isn't the total number of deaths that are concerning, it's the age shift as well as the time of year.

More than 5,500 people received anti-viral drugs for swine flu on the first day of England's National Pandemic Flu Service, the government has said.

The telephone hotline and website were launched so patients could obtain treatment without a GP's prescription.

The system was "working well", Health Secretary Andy Burnham said.

Sufferers are advised to select a "flu friend" to pick up medicine for them. Critics say the system is open to abuse and should be staffed by experts.

And the Conservatives have argued the service should have begun earlier, when a global pandemic was declared, as it was now "too little, too late".

There are now 1,031 locations across England where the drugs can be collected, up from 330 on Thursday, when the service began.

People who think they have swine flu can complete a questionnaire online or over the telephone.

Among the symptoms listed are fever or temperature over 38C or 100.4F, coupled with two of the following: unusual tiredness, headache, runny nose, sore throat, shortness of breath or cough, loss of appetite, aching muscles, diarrhoea or vomiting.

We're greatly encouraged that the flu service is doing the job intended, but we're also aware that the system is in its early days and we are keeping its operation under close review

If patients are diagnosed with the virus, they are issued with a unique reference number which must be given when the drugs are collected.

However, patients are still being advised to contact GPs if they have serious underlying illnesses, are pregnant, have sick children aged under one, their condition suddenly worsens or continues to worsen after seven days - five for a child.

More than 100,000 people in the UK are estimated to have caught swine flu in the past week along, while 30 people have died after contracting the illness.

There was a huge rush to access the government website when it went online on Thursday, with reports of it receiving initially 2,600 hits a second, or 9.3m an hour. More than 58,000 assessments were completed that day, 89% of them online.

"These figures show that, despite an unprecedented demand for the National Pandemic Flu Service, the phone line and website are running well," said Health Secretary Andy Burnham.

"People in need of anti-virals are able to get them quickly and conveniently using the new service and it is freeing up GPs to look after patients in risk groups as well as those with other illnesses.

"We're greatly encouraged that the flu service is doing the job intended, but we're also aware that the system is in its early days and we are keeping its operation under close review."

A £2.4m advertising campaign was launched on Saturday, directing people in England to the hotline number, which is 0800 1 513 100, and the website - http://www.direct.gov.uk/pandemicflu

The flu service is not covering the rest of the UK as Wales, Northern Ireland and Scotland have all experienced much less demand.

(hat tip FlaMedic)

[indigo girl]

I haven't seen the surge of cases in the UK reported in the article, coming out of WHO.....

They stopped testing, and are only tracking hospitalized cases and deaths now. So, WHOse to know? I think we have to look at the Tamiflu scripts for now. It's the only number left to look at, and 5,500 scripts dispensed in one day is hard to ignore.

http://www.who.int/csr/disease/swineflu/notes/h1n1_surveillance_20090710/en/index.html

(hat tip FlaMedic)

[HonestRN]

They stopped testing, and are only tracking hospitalized cases and deaths now. So, WHOse to know? I think we have to look at the Tamiflu scripts for now. It's the only number left to look at, and 5,500 scripts dispensed in one day is hard to ignore.

http://www.who.int/csr/disease/swineflu/notes/h1n1_surveillance_20090710/en/index.html

(hat tip FlaMedic)

While I agree that 5,500 scripts in one day is significant I do think that there is a degree of panic going on and not all those scripts are necessarily for sick people. Especially since people can get the script by telephone or online without ever having to see the Dr. and pharmacies are already reporting panic buying of supplies and shortages. Interesting way to handle the flu crisis though.

Thanks Indigo girl for keeping us all updated on international cases.

[indigo girl]

While I agree that 5,500 scripts in one day is significant I do think that there is a degree of panic going on and not all those scripts are necessarily for sick people. Especially since people can get the script by telephone or online without ever having to see the Dr. and pharmacies are already reporting panic buying of supplies and shortages. Interesting way to handle the flu crisis though.

Thanks Indigo girl for keeping us all updated on international cases.

Yes, it is a completely different approach. I am not sure that I would agree with it for this reason alone, not everyone that has the flu needs to be on Tamiflu. Most will recover without it. Giving everyone Tamiflu will just hasten the demise of the drug. Tamiflu resistant cases will continue to appear especially in countries like Japan where lots of the drug is used.

But, with that said, here in the US, docs need to make a clinical judgement about how sick someone is and what their risk factors for a fatal outcome are. And, you will still not know if the person you sent home without a script for Tamiflu is going to be one of the ones that will die even with no other health problems. The UK is avoiding that dilemna by giving everyone that meets the criteria the drug. Well, almost everyone because there will still be a few that have no fever or have some other symptom that is not on the list but they are still infected. They are are still physically seeing some patients apparently.

http://www.thecourier.co.uk/output/2009/07/29/newsstory13528460t0.asp

(hat tip flutrackers/hogweed)

I don't know exactly how they are doing things in the UK since I am just reading online like everyone else. I wish that we had some allnurses members that were genuinely interested in influenza that would be willing to seek out info.

Sure, there is lots of crazy press about what is going on in the UK. We are only seeing part of the picture, no doubt. But, if you can look past the emotional content of how they are reporting things, you are getting pieces of information. Maybe I have a built in filter or something but, I don't usually react much to the hysteria because I am just looking for why they are concerned. But, I also well know that it is easy to dismiss something when you can feel the panic in the reporting.

I'll give you an example of how I almost missed something of major importance. A poster over at flutrackers started reading translations from Mexico back in early April about many people being hospitalized with influenza. It was all very mysterious, but it was April. Mexico is a warm country so this was rather odd. There were so many panicky posts from this person that I was beginning to think that this was a nutter. But, guess what? This person actually had picked up the first information about the pandemic before the CDC did. I kept following the story, but I almost didn't. The rest is history, and here we are today.

[RuRnurse?]

"I have to disagree about this being just like seasonal flu. As a good friend of mine has pointed out, seasonal flu doesn't kill kids and young adults in the summertime. It isn't the total number of deaths that are concerning, it's the age shift as well as the time of year."

You are right, indigo girl. This flu IS different. Like the 1918 strain, this one is killing the younger and healthier ones. Something different is going on here. But we are so used to seasonal flu, I think we are missing something...Flu is a very unique virus, it "shifts"...a small antigen difference, and it becomes a killer. And flu does this "shift" all the time. It's just that we haven't seen a true killer in our lifetimes, and we are accustomed to having new "cures", we don't take it as seriously as we should.

Actually, even in 1918 we didn't see the real significance...we had a World War going on to distract us. Historically, the closest thing we have had to a real killer was the Black Death, and that was way back in the Middle Ages. In some places, HALF the population was gone within a few years. A book I recently read about that spoke of a kind of amnesia that took place, because of the high death rate. As though the minds of the survivors developed a kind of callous for protection. That same author claimed the same happened with the 1918 pandemic. Funny how we learn all about the war deaths, but not too much about how many actually died from the flu!

It makes sense...when something so horrendous happens, one wants to "forget it" once it's over. It's a protective mechanism.