What would a flu pandemic look like in 2018?

[AbsentmindedWoman]

Planning on taking my flu jab soon after my gp practice has it available. Obviously, it's not foolproof and we keep hearing the world is due a flu pandemic.

What would this look like in 2018? Say, if we had a strain on a par with the 1918 Spanish flu?

I guess it would spread more rapidly because of international travel. But we do have much more sophisticated healthcare available to us compared to 100 years ago - how would a system like the NHS, in a rich country, cope?

I feel I don't know quite enough about the actual mechanics of flu, once it goes into territory where it becomes very serious and possibly fatal in people who are not vulnerable due to age or compromised immune systems.

Well I'm going to panic about that now!

Presumably we're all a bit healthier than post-war Europe was, and have better healthcare?

This was my job...
There are detailed contingency plans. Mainly for the NHS - how do they cope if 1/4 of staff are off at a time for a couple months? But then also for education, delivery - food delivery to London suffers if loads of drivers are off sick. Public events get cancelled to reduce spread.
The 1918-9 flu disproportionately affected young healthy adults, which is why the recent similar H1N1 flu have been such a concern - the impact on the elderly, small children and the ill is at least tested most years.

We do at least have annual vaccines now which may be why we haven't had a bad epidemic in years and are overdue - even when not hugely effective against that year's strains, if they reduce average infection rates overall, that may be enough.

Yes - when lots of adults of working age with healthy immune systems get seriously/ fatally sick - that seems to mark the difference in 'normal' flu and something like the Spanish flu. It caused cytokine dysregulation. But I don't know enough about it to know why some flu strains pose this threat, and others don't.

Don't think panicking is the answer though!

We have better drugs and healthcare to deal with it. I thinks lot of people due from complications caused by flu such as pneumonia etc and we are better able to treat that kind of condition.

Also education that a bad cold/virus is not actual flu would help. My friend and her husband had ‘flu’ for 3 days last year

Eek now I’m worried. My lungs were damaged by the H1N1 about 10 years ago when I had been previously fit and healthy and now I’m asthmatic and very prone to bad chest infections. Last year I had the flu jab and I still ended up with pneumonia. So the answer is - it could be just as bad for young people. Thinking about it scares the bejesus out of me!

sohard make sure you get the flu jab, it’s so important. I have watched someone die from pneumonia (they were weak anyway) and it was awful. If you have to fight it and flu your body will struggle.

I do always get the flu jab - but last winter I still caught the flu and got pneumonia. They said the flu jab only covers you for one kind of flu and apparently last year there were a couple of strains.

(Sorry I didn’t mean to sound snappy there - thank you for your concern )

The NHS can't cope with the demands of a normal winter let alone flu on pandemic levels.

Don't worry though, the Tories are going to pump lots of money into it to make everything better. At some point in the distant future. Never.

One factor in our favour is the ability to get information so quickly now; plus antibiotics for opportunistic secondary infections; and better living conditions (central heating saves lives!) When I think how harsh my grandmother's early life was I am astonished any of her family survived 1918.

Sohard, the WHO holds a meeting early every year during which it decides which strain(s) of flu are most likely to be prevalent during the following Autumn/Winter. It's a long time between the meeting and when vaccines become available because it takes time to produce so many doses. Sometimes the vaccine's a good match and sometimes there's a surprise! new entrant and the vaccine doesn't offer particularly good cover.

Anyone who wants to help studies into the spread of flu can sign up to flusurvey.net and take a quick weekly survey during flu season.

Bombardier25966 , all that money the Brexiteers promised would be pumped into the NHS will help, won't it?

Or not. Maybe not.

ThatLibraryMiss that makes sense. Let’s hope they get it right this year! Thanks for the link, I’ll check it out.

Everyone - flu turned me in my early 30s into an old crone who is now in her 40s. I’m working hard to stay fit etc but I cough like an old man on 60 fags a day every day and night thanks to the flu. My message is - get the flu jab!

And also if you are really ill with suspected flu or even a very nasty cold over the winter please stay at home.

Information is really useful. We can look out for sick people in various countries and cancel flights and travel if needed - the huge movements of people at the end of WWI couldn't be controlled.

Also while each vaccine only aims to protect against 3 prevalent strains, after some years of vaccines you'll have a bit of protection against many possjble H and N bits of the flu virus (the parts that mutate so rapidly).

I would expect the next epidemic to be worst in Africa and rural Asia - they start in Asia in pigs and then birds each year, then pass to humans. We have pretty effective animal and human disease controls here; other countries don't.

The reality is that people would get very sick, we would try to keep everything running, but there could well come a tipping point where it all goes to hell. This is for a Spanish flu style event.

Large towns would suffer food shortages simply because there would be too few deliveries. People would then leave them in search of food elsewhere, so moving the problem on to smaller and smaller places. People in those places would defend their food stores and properties. Real risk of civil disorder, not least because people are more mobile now (cars). The government would restrict movement and possibly shift to rationing to keep things in check.

Hospitals wouldn’t have enough staff and so would turn away all but the most sick. People would be told to stay home and avoid others. People actually aren’t all that healthy these days - we have pretty poor nutrition amongst many groups just like in the Spanish flu - so it would still kill a lot.

Interesting range of thoughts, thank you. Agree information is a great weapon against any health crisis. Although, the thing is with so much air travel people have been and gone through airports and onward to their destination before incubation periods are up. So we're always going to be a couple of steps behind, even though our information technology is lightening quick.

It's really not that easy. I went for my flu jab two weeks ago. After queing in the rain outside my surgery for 20 minutes I was told that there was a new jab for the over 65s. But my surgery hadn't got it. They may get it in November, but they may not. I was asked to decide, with no clinical input, if I wanted the "old" injection, or wanted to wait to see if the new one emerged. oh, and there were two cases of flu already confirmed in our area.

As it it happened, I had a letter from Boots the chemist to say they could give me a flu jab (the new one) for free any time after 30th September.

Privatization of the NHS?

It sounds like privatisation of the Nhs but chemists have always had contracts with the Nhs and it makes sense to use them for things which free up practice nurses and GPs time. Having said that, where do you draw the line? Also if it’s fobbed off to Boots the patient misses out on the chance to have a chat with their healthcare practitioner when that professional might spot there was something wrong.

I was in our local Boots on Saturday afternoon and overheard someone in the pharmacy talking to the person in front of me in the queue about the new one for the over 65s otherwise i wouldnt know anything about it. i googled and found this.......

www.pharmacymagazine.co.uk/-trivalent-flu-vaccine-approved-for-2018-19-season

I showed it to DH who is 68 He has COPD and ischemic heart disease and is now saying hes going to swerve having the flu jab.

Could he request the one for the under 65s as that would be similar to what hes always had. Im 45 so i would have the usual one.

Sohard DH and i have it done at Boots as its less stressful than dealing with our Virgin Care surgery.

Plenty of seats on trains.

I work in the NHS and before I went on mat leave I went to a meeting about mass scale events like this and I think it will be very, very difficult.
I work in ED and we barely cope when we hit peak flu week but we push on through.
If we were under staffed I expect the armed forces would be called in as civil disobedience would be high due to shops and services being closed.

To public I would say

1. Get your jab
2. Stock your home with common medicines, tinned soups, loo roll and disinfectant.
3. Get yourself first aid trained
4. Keep your home clean and tidy so you have as little to deal with as possible should you become ill.
5. If you have repeat prescriptions keep updated with collecting them.
6. If you attend the GP or clinics regularly ask them for details re the flu impacting your condition.

It hopefully won't get that far. There was a harsh flu season in Australia last year apparently, and some people died. This year, jabs were available in local hospitals which was a good initiative

We have better drugs and healthcare to deal with it. I thinks lot of people due from complications caused by flu such as pneumonia etc and we are better able to treat that kind of condition.

Actually we don't have much in the way of drugs to treat flu, it is now, as it was 100 years ago, mainly treating the symptoms.

Healthcare is better for more serious complications and people can be intubated these days, but it's not a case of going to hospital and being cured.

I guess it would spread more rapidly because of international travel.

Not necessarily, it could get further faster but one of the reasons the 1918 epidemic spread so far so quickly was soldiers being in close confinement and then being shipped home in close confinement.

There were men who had survived years of war who then died of flu before getting home.

Also people wanted to party, they had just come through years of war, if your relative(s) did come home you would invite the entire family round or if you were richer you might hold a party.

This is one thing that could make a huge difference, housing is so much better. If yo have flu you can go to bed. As long as you can drag yourself to the toilet and get a drink you are not going to be sneezing on other people.

If you were a family sharing the same room and the same bed you couldn't get away and even if you did have room to be on your own someone needed to bring you water and empty the chamber pot.

I agree with most of milk monitor's post, except I'd add that you can have your prescriptions delivered to you.

There's a really interesting drama doc, actually more of a documentary with bits of drama on you tube.

They took records of an outbreak of fly in a Canadian city and then applied it to real life eg instead of a train driver bringing the flu it was a flight attendant who was patient zero.