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Swine Flu

Ministerial Statement – in the Northern Ireland Assembly at 10:45 am on 5th May 2009.

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Photo of William Hay William Hay Speaker 10:45 am, 5th May 2009

I have received notice from the Minister of Health, Social Services and Public Safety that he wishes to make a statement on the position of the swine flu outbreak.

Photo of Michael McGimpsey Michael McGimpsey UUP

I will provide a further update on the influenza AH1N1 virus, or swine flu as it is more commonly known. Since my statement to the Assembly last week, there has been a number of new developments of which I would like to make Members aware. Many countries have confirmed cases of the swine flu virus, but outside Mexico and the United States the numbers of affected individuals remain low. As a consequence, the World Health Organization pandemic alert level remains at level 5. That indicates the increasing likelihood of a pandemic, but does not indicate, I must stress, that one is inevitable.

In the UK, 27 cases have now been confirmed, and in the Republic of Ireland one case has been confirmed. In Northern Ireland, there are no confirmed cases, and test results are pending for four individuals.

The lack of information and the uncertainty about the situation in Mexico makes it difficult to establish exactly what the impact of the virus will be. During previous pandemics, such as the Spanish flu in 1918, it appears that the rate of infection abated over the summer, with an increase in cases over the winter. The lower summer rate of infection was also true of the Asian flu and Hong Kong flu in the 1950s and 1960s. We must, therefore, be on our guard and prepare for a potential further wave of the swine flu virus in the autumn, which may be more widespread.

It is also important that we use our stock of antiviral drugs carefully so that the public will be protected during the winter months. Preparations are under way, for example, to increase our stockpiles of antiviral drugs, and I will return to that issue in a moment.

We must take some reassurance from the fact that, to date, anyone who has contracted the virus outside Mexico has had a relatively mild flu, similar to the seasonal flu. In addition, it appears that swine flu responds well to treatment with antiviral drugs, and, in fact, some patients have recovered without antiviral treatment.

That does not mean that we will be complacent. No one can say for certain how the virus may change or if the situation will worsen. We have been planning for a potential pandemic for a number of years, and this country remains among one of the best prepared in the world.

My officials and staff in the Public Health Agency and the health and social care sector have been working tirelessly over the past week to ensure that there is robust surveillance and appropriate testing of individuals at risk. They have also put measures in place to ensure the immediate availability of antiviral medications to those who may need them. However, I reassure Members that we have no confirmed cases and are well prepared for any cases that may emerge.

I will now set out some of the measures that I have put in place. With regard to the production of a vaccine, the four UK Health Departments have sleeping contracts in place with manufacturers. That arrangement reserves our place in the global queue should production of a pandemic-specific vaccine become necessary. The contracts ensure that manufacturers reserve production capacity for the UK should a vaccine be needed. Given that it will take several months before a vaccine becomes available, we will, in the interim, need to ensure that we have adequate supplies of the antiviral medication that is proving effective in treating the virus.

We have a stock of antiviral drugs that will cover half the population, and steps are in place to increase that stock so that there will be sufficient antivirals to treat up to 80% of the population. No previous pandemic has been known to affect more than one third of the population. We have placed supplies of the antiviral medications in hospitals and in GP out-of-hours centres. In addition, measures are in place to ensure that an adequate supply of antiviral medication will be available in community pharmacies.

We know that the complications of influenza, particularly pneumonia, may require treatment with antibiotics. Although it is expected that antibiotics will be needed for only a small proportion of individuals who may develop swine flu, it is important that there are adequate supplies, and work is, therefore, under way to increase supplies of antibiotics.

The helpline that we set up in Northern Ireland has played a most important role in providing advice to anyone who has concerns. Since it was established last Thursday, around 800 people have called the helpline on 0800 0514 142. Information on swine flu is also available from the UK swine flu information line on 0800 1 513 513.

In addition to the range of measures that I have outlined, I emphasise once again the most important message, which is that members of the Northern Ireland public should follow good hygiene practices. Those include regular hand washing, using a clean tissue to cover mouth and nose when coughing or sneezing, and remaining at home if people develop flu-like symptoms. Those are simple, highly effective steps that every individual can take and that will make a difference. That is why those messages have been reinforced in advertisements running on television and radio. A leaflet providing further advice and information for the public will be delivered to homes across Northern Ireland from the end of this week.

I continue to receive full and detailed briefings on the situation as it develops. I also have regular discussions with ministerial colleagues in other UK Administrations and in the Republic of Ireland. That has included daily meetings of COBRA, which is activated only in cases of national emergency or crisis, or during events abroad that have major implications for the UK. Those meetings, which I attend, are chaired by Alan Johnston, Secretary of State for Health in England, and the Health Ministers for Wales and Scotland participate also.

I assure Members that this issue is being taken seriously by Governments, not just in Northern Ireland but across the world. Internationally, the World Health Organization is taking the lead in providing advice and information on the ever-changing situation. At national level, the situation is being managed through COBRA and the four home countries. Locally, the Department of Health, Social Services and Public Safety, the Public Health Agency and the health and social care service are in the lead. Daily updates on the situation are issued to the media and to all Assembly Members. I will, of course, report again to the Assembly if there are significant changes in the current situation. In the meantime, Members can remain assured that we have the necessary capability to respond to the swine flu virus. The Health Service is well prepared, and I thank staff in the service for the commitment, support and dedication that they have demonstrated in the face of a potential pandemic.

Photo of Michelle O'Neill Michelle O'Neill Sinn Féin 11:00 am, 5th May 2009

Go raibh maith agat, a LeasCheann Comhairle. I thank the Minister for his statement to the House and for coming to the Committee last Thursday to brief members. The Minister referred to four cases here and said that the results of those are pending. When are those test results due?

I would also like to ask the Minister about the use of the antiviral drug Tamiflu. In a previous statement, and at the Committee, the Minister told us that the flu is susceptible to treatment by that drug. He said that we have a sufficient stock of the drug and referred to the need to use that stock very carefully.

I had understood that the drug was given only to people who have flu-like symptoms and who may have been in contact with an infected person. However, over the weekend, there were media reports about a confirmed case of the flu at a school in London. The school was closed as a result, and reports suggested that the 1,200 children at the school had all been treated with the Tamiflu antiviral drug as a precaution. Will the Minister clarify whether that drug has preventative qualities or whether it can be used only to treat symptoms?

Photo of Michael McGimpsey Michael McGimpsey UUP

The preventative measure comes from a vaccine that is yet to be developed. Isolation of the virus seed will allow the manufacturers to proceed with the development of that vaccine. Discussions in that regard are ongoing between COBRA and the manufacturers.

It is true that we need to be careful with our stocks of Tamiflu and other antiviral drugs. The stock is enough to cover 50% of the population, and that will rise to 80% cover. However, we are still using the regular supply of antiviral drugs and are not yet dipping into the stock. If an individual tests positive for the flu, all the contacts that that individual might have made are treated with the antiviral drugs. That is done in an effort to contain the spread of the virus, because the UK is in a containment phase.

Four tests are being run in Northern Ireland, and such tests have been negative to date. The first response has been to issue Tamiflu to those people suspected of carrying the flu and to take specimens for testing. I cannot give an exact time frame for when the results of the four tests will come through, but it will be as soon as possible.

Photo of Ken Robinson Ken Robinson UUP

I thank the Minister for his statement to the House. I note that he is giving daily updates to the media. The public will also be kept informed by the leaflets that will be delivered to every household, by adverts in newspapers, and so forth. Can the Minister assure the House that there is a co-ordinated and clearly recognised link between his Department and local media outlets so that accurate, up-to-date and factual information will be readily available to the general public in Northern Ireland? That will ensure that needless anxiety is avoided and that the focused response to the threat is clearly understood by everyone.

Photo of Michael McGimpsey Michael McGimpsey UUP

Yes; I can give that assurance. We have made every effort to keep everyone as well informed as possible. Public awareness and knowledge is a key defence in this situation. There are messages about hand hygiene and respiratory hygiene: people are being told to keep washing their hands, to use a tissue if they cough or sneeze, and to cough it, bin it and destroy it. Those messages are a very effective part of the containment phase. We will continue to brief the media on a daily basis and to share those briefings with Assembly Members. I continually seek to provide updates when we have specific information to provide.

The battle is ongoing. The Spanish flu outbreak arrived during the spring in the form of mild flu symptoms. It abated during the summer and returned at its most destructive in the winter; that was its pattern. I am not saying that it will be the same with swine flu. Spanish flu was an avian virus, and swine flu is a mixture of avian, human and swine elements. However, it could follow the same pattern, and we are planning for that eventuality. We plan for the worst and hope for the best. We must do that, because come the autumn, we may be facing the second wave of the virus.

Photo of Carmel Hanna Carmel Hanna Social Democratic and Labour Party

I also thank the Minister for his update on the situation — it is much appreciated. I also thank him for all his hard work and that of colleagues in anticipation of the arrival of swine flu. The work on the vaccine is also very welcome. As the Minister said, who knows what will happen? The vaccine may be needed later.

What is the reaction of the Minister and his colleagues to the World Health Organization’s statement that it is not, at present, considering a move to level 6, which is pandemic status?

Photo of Michael McGimpsey Michael McGimpsey UUP

The response is international, national and local. The World Health Organization is responsible for the international response. It took us from level 3 to level 5 rapidly, and we have set responses as each of those levels is reached.

The important message that the World Health Organization gave is that, as yet, there will be no move to the pandemic level, which is level 6. However, that should not be interpreted to mean that we should be complacent. We must continue our preparations and be on our guard. Level 5 means that a pandemic is likely, but not inevitable. That is the current situation. The world’s best expert scientists and virologists cannot be certain in their predictions. We deal only with probabilities and likelihoods.

Photo of Kieran McCarthy Kieran McCarthy Alliance

I also thank the Minister for his update to the Assembly on the situation with swine flu.

I have heard that we may be able to improve upon measures that were taken at our seaports and airports with the distribution of information leaflets and precautions. Will the Minister respond to that, so that visitors, on arrival in Northern Ireland, may be reminded of the dangers?

Photo of Michael McGimpsey Michael McGimpsey UUP

I take Kieran McCarthy’s point, and we have been responding to those concerns since early last week. For example, I was with Public Health Agency staff at Belfast International Airport who leafleted the passengers who were coming off planes. That is a standard practice that also happens at George Best Belfast City Airport. I thank the management of both airports for their help and co-operation.

The same precaution is taken at seaports, where leaflets are distributed. It is an important precaution to take, just in case folk who arrive here do not understand the situation.

Photo of Willie Clarke Willie Clarke Sinn Féin

Go raibh maith agat, a LeasCheann Comhairle. The precautions against swine flu carry serious financial implications. Has the Minister discussed them with the Executive to secure the necessary resources? What is the shelf life of the vaccine?

Photo of Michael McGimpsey Michael McGimpsey UUP

The shelf life of the vaccine is limited to one year because the virus mutates annually. That is certainly the case with the annual flu vaccine. Every year, we distribute hundreds of thousands of units of the flu vaccine. Any that are not used are destroyed, because the virus mutates. Viruses are very intelligent organisms and they mutate constantly and, therefore, vaccines must change.

As to the financial implications, the cost of purchasing the vaccine — when it is available — will be considerable for Northern Ireland. I do not want to put a figure on that today. Stockpiling antiviral drugs and antibiotics will also cost a great deal. Furthermore, the effort that we put into leafleting and expanding public awareness through advertising and the provision of information will result in extraordinary expenditure that has not been anticipated.

However, none of that matters as long as we are prepared properly and are ready for a pandemic, should it hit us. It is important that we do everything possible to ensure that the population does not come to harm.

Photo of Samuel Gardiner Samuel Gardiner UUP 11:15 am, 5th May 2009

Like other Members, I thank the Minister for his swift action in bringing the issue to the House and to the Health Committee. In fact, he has moved so fast that he might quickly earn a reputation as the ‘Action Man’ for the health, welfare and good of the community in Northern Ireland.

Given that we are facing an epidemic, because people in other parts of the world are already suffering from swine flu, how will the Budget be affected if extra expenditure is being used to protect people?

Photo of Michael McGimpsey Michael McGimpsey UUP

Preparations are well under way. I do not want to put a figure on it; however, our share of the national budget for vaccines will have to be met. I have seen the figures, and considerable sums of money are involved in preparing a vaccine for UK-wide distribution. Our Barnett formula share will be considerable. The costs for the other measures are only estimates at the moment. There will be budget implications, but I do not want to get into that. My officials are having ongoing discussions with the Department of Finance and Personnel (DFP) officials.

Photo of John Dallat John Dallat Social Democratic and Labour Party

I also congratulate the Minister. I am sure that his performance in respect of the swine flu outbreak must have accounted for his high rating in the ‘Rate Your Minister’ feature in today’s ‘The Irish News’.

I am sure that the Minister will agree that complacency is a problem. Even this morning, I note that the DUP has not asked one question in the Assembly. What does the Minister propose to do over the next few months to ensure that complacency does not creep in and that, in fact, we reap the rewards in the autumn, as some people have predicted?

Photo of Michael McGimpsey Michael McGimpsey UUP

Complacency is one of our enemies in this process. There is a sudden scare, then nothing appears to be of serious consequence and people get complacent. However, we are always warning people not to be complacent about this issue. I have outlined the simple measures that the general public can take, such as hand hygiene, respiratory hygiene and self isolation at home if one has flu-like symptoms. Those are the key messages, and it is important to repeat those messages. I have to make sure that the health and social care system in Northern Ireland, for which I am responsible, is not complacent and that I keep this threat uppermost in our minds, because of the inherent danger of the population coming to harm if this outbreak of swine flu follows a Spanish-flu-type pattern.

Photo of Sue Ramsey Sue Ramsey Sinn Féin

Go raibh maith agat, a LeasCheann Comhairle. Like other Members, I thank the Minister for his statement. I also take this opportunity to commend the Minister and his officials for their handling of the issue to date and their daily updates to MLAs. It is useful that the Minister’s Department can use Members as a conduit for providing information.

The Minister said that there may be an increase in the number of swine flu cases over the winter, given the recent patterns of major outbreaks of flu. Has the Minister considered increasing the number of people who are entitled to get the normal flu jab this winter to ensure that at least normal flu viruses are kept at bay and to prevent confusion between normal flu and swine flu? Given that cases of swine flu have been confirmed in England and Scotland and that one case has been confirmed on this island, is it inevitable that swine flu will hit here, and are we prepared for that?

Photo of Michael McGimpsey Michael McGimpsey UUP

The vaccine for the normal annual flu viruses will be issued again this autumn. Sometimes, the uptake by people for whom the vaccine is procured is disappointing. I expect, and hope, that the uptake this year will show a gain and be much stronger.

Looking ahead, I think that there is a threat of complacency and as is often the case, of appearing to wait for something to happen. Swine flu contains the inherent threat that it may follow the pattern of other viruses. If it does so, I hope that the benefits of all the measures that we have put in place will be demonstrated to everyone.

Photo of Claire McGill Claire McGill Sinn Féin

Go raibh maith agat, a LeasCheann Comhairle. I do not have a question. However, as I have the Floor, I commend the Minister and his officials on their actions. Go raibh maith agat.

Photo of John McCallister John McCallister UUP

I thank the Minister for his statement. Today marks his third appearance in the House within a week, and he also attended a meeting of the Committee for Health, Social Services and Public Safety.

Will the Minister pledge that he, the Department and staff throughout the Health Service will continue to make swine flu their number one priority and not allow themselves to be distracted by others in the House who may wish to sidetrack them? Will the focus remain on keeping people in Northern Ireland safe and on the work in which the Minister is involved nationally?

Photo of Michael McGimpsey Michael McGimpsey UUP

I assure the Member that swine flu is the number one priority. Whatever I may wish, the response of the World Health Organization means that I have no choice but to make it so and to work as one of the four home nations through COBRA. Swine flu is regarded as a national challenge, a national peril and a national threat. I will ensure that Northern Ireland is fully engaged and locked into the response.