Flu surge pressures NHS as positivity rises in children (Full Transcript)

[00:00:23] Speaker 1: This really is quite a substantial amount of impact that the flu is having on healthcare services on hospitals across the whole country. What we're seeing is substantially higher numbers of admissions than we had this time last year for the flu. It is continuing to rise here at quite a significant rate. The numbers were 55% higher this week than they were last week, which does continue to go on a trajectory that NHS England have been telling us could result in potentially the largest number of people in hospital with flu that we have seen, and obviously that is a huge concern in terms of how we look after patients, how we make sure that we have the capacity, because we know that right now hospitals are already about 95% full, so it's going to be a challenging time.

[00:01:19] Speaker 2: Right, stay there Dr McKay, thank you very much indeed for that. Let's bring in Dr Lindsay Broadbent, a lecturer in virology at Surrey University. A number of people this afternoon, Dr Broadbent asking, is it Covid flu or is it a cold? I mean it's a pretty simple question, but it can be quite confusing can't it, with some of the symptoms similar between all of those?

[00:01:44] Speaker 3: Yes it can, a lot of respiratory viruses share very similar symptoms. I think one thing that we can say about flu is that it tends to be a more severe illness for a lot of people, particularly compared to a cold. So it's things like fever, aches and pains, fatigue, if you're experiencing those kind of symptoms it may be flu rather than your general cold.

[00:02:10] Speaker 2: All right, thank you very much for that. Let me just bring in my colleague Catherine here and get some of the questions that you've been sending in, which has been great to read them. One of the questions Catherine is from Adam in Salford and he asks, with the increase in flu cases, why are there no vaccines available for people? I've tried to book in Greater Manchester to get vaccinated privately in Boots and Superdrug, he mentions yet there are no appointments available. I mean is there a shortage?

[00:02:43] Speaker 4: Department of Health and Social Care says no, there is not a shortage. Everyone who's eligible for the vaccine and a free way should be able to get it quickly. People like Adam who are paying privately for it, they might have to shop around. So some pharmacies might have had such a run on it they're temporarily out of stock but overall there shouldn't be any kind of shortage. All right, I hope he gets it soon.

[00:03:04] Speaker 2: Yes, let's just ask that question as well to Lisa Summers in Scotland. And Lisa, what is the situation in Scotland in terms of vaccines for flu? Are there enough to go around?

[00:03:16] Speaker 5: Certainly it's a similar picture as Cath was saying in terms of NHS free vaccines. We're told that there are plenty of supplies here for people that are eligible to get them and they are putting on extra sort of drop-in clinics, pop-up clinics to try to make sure that people that maybe have struggled to get an appointment can get one. But what we're hearing from pharmacies here in Scotland is that actually many of them, or not all of them, but some of them are many of them are short on supplies, some of them have run out of supplies already. They say in part that's because people are coming to them that might be eligible for an NHS jag but because of convenience or because it's a bit confusing sometimes in different parts of Scotland to work out where you should go for your NHS jag, they've come and decided to pay for them. So we have heard of some chemists, some pharmacists running out of stocks but in the main there are plenty of supplies if you qualify for a free jag and you could still shop around and be able to get one privately if you want one.

[00:04:09] Speaker 2: All right, thank you very much indeed for that. I know you've got a lot of work this afternoon to cover this story in Scotland, so thank you very much for joining us here this afternoon. Dr Lindsay Broadbent, you're a lecturer in virology at Surrey University. Just tell us a bit, because there have been some people asking about the type of strain of this particular flu virus. Can you just simplify it for us as much as possible?

[00:04:36] Speaker 3: Flu is a very weird virus. It's divided into two main groups, A's and B's, and the one we're talking about this year is an A-type virus, and when we're talking about an A-type virus, it's those ones we hear of like H1N1 and H3N2, and the one that is predominantly infecting people this year is H3N2. But flu viruses can mutate, and they can mutate all the time, and they mutate into these little groups, and we call those cleds and subcleds, and the reason we're a little bit worried about this virus in particular is that this belongs to subcled K, so there are some mutations in that virus that we're paying particularly close attention to, and we're particularly for vaccine efficacy and those kind of antiviral treatments and making sure those are still working. We have very early data, we need more data to know accurately how effective the vaccine and the antiviral treatments are for these mutations, but we do know that for H3N2, so that the big family of this virus, they are still effective.

[00:05:45] Speaker 2: All right, for the moment, do stay with us. Let's just bring you a bit of breaking news we've had in the last few moments. We've got some more data from the UK Health Security Agency. They say the positivity rate of influenza flu increased to 21% in the week ending the 10th of December. That's up from 17% last week. The positivity rate is the percentage of tests for an illness that come back positive, and this new line we've got, it says children and young people aged 5 to 14 had the highest positivity rates at 45.9%, and that's an increase as well. Can you put that into context for us?

[00:06:35] Speaker 4: Well, essentially, this is a sign of what's going on in the community that we can see that last week, essentially, they were saying that the tests that were going forward, 17% of them was being seen as positive. Now, that has increased overall to 21%. When we're looking at children, again, there's been an increase. Last week, it was 43.6%, which is a high percentage. This week, it's gone up to 45.9%. We're approaching 50% of children who are getting tested for flu, testing positive for it. All right.

[00:07:08] Speaker 2: One of the questions that keeps coming up is, is it too late? If somebody hasn't had the flu vaccine, is it too late to get it?

[00:07:16] Speaker 4: Here's my lovely stat for you on that. It takes two weeks to be fully effective. Two weeks today, Christmas Day. If you have it today, you will be protected for Christmas.

[00:07:25] Speaker 2: You'll get that protection. Also, who needs a flu jab? That's something else that keeps coming up.

[00:07:31] Speaker 4: Yeah. This is a really interesting question. There's two different answers to this. One is the free vaccines for people who are eligible for it on the NHS. There's a list, anyone 65 or over, people with certain long-term health conditions, pregnant women, people in care homes, also carers, or people that live with someone with a weakened immune system. Children are eligible from it, basically, all the way from age two, right up to year 11 at school, so 16, 17, and frontline health workers. All of those people don't have to pay for it. Then there's the question for the rest of us, people who are healthy, might not be eligible for it, is should they consider paying for it? So you can go to a chemist and pay between £15 and £25 for a vaccine. I mean, the official advice is vaccination is the best protection against getting potentially very ill, and it helps protect people around you.

[00:08:24] Speaker 2: All right. For the moment, stay there. Let's read another question and put another question to Dr Leila McKay, who is Director of Policy at NHS Confederation. Let me just read this one to you, if you can answer it. It's from Jenny Sine in Milton Keynes. The question, I'm just getting over a second dose of flu, and that's after having a jab a few months ago. Are you seeing similar instances of this happening? I don't know if you can answer that kind of more of a NHS-wide answer to that.

[00:09:03] Speaker 1: Honestly, I'm not working in a clinical role at the moment. Data has not come in on that at the moment, so I haven't heard of it as being a significant trend for the moment. But of course, when we talk about superflu, superflu is a sort of slang term. It can mean various things, and sometimes it can mean you get the flu and then you get another virus, and the two of them together make you particularly unwell. That said, I haven't seen anything specific about that that is particular to this year.

[00:09:35] Speaker 2: All right. Let me just put something else to you, another comment about how are hospitals preparing?

[00:09:41] Speaker 6: How do they prepare for such an outbreak like this?

[00:09:45] Speaker 1: Well, as you can imagine, part of it is about trying to make sure that urgent and emergency care works as well as possible. And interestingly, how to make sure it works really well is to try and make sure that people can be discharged from hospital. I'm sure that you've all heard there can sometimes be challenges when people have got better, they're ready to go home, but actually because of other delays, for example, maybe in social care or community care, trying to sort out things to do with people's housing, sometimes they're not able to get out, and that can cause a bit of a backlog as people are coming in the front door with their flu and they're trying to get into the hospital. So there's a lot of work being done, not just in the sort of general practice in accident and emergency, but very much in the how do we get people discharged? How do we clear those beds so that more people can get admitted? There's obviously quite a lot of focus as well on infection control. We heard earlier that hospitals are putting in various mechanisms to try and reduce the risk of spread of these things in hospitals. So there's quite a lot of work on that. Every year, the NHS sees this rise in winter viruses, and they are quite good at implementing these various things. But when hospitals get really, really full, that is when it becomes challenging. And what we're hearing is that the numbers of people in the hospital with flu right now are predicted to rise, potentially rise really significantly. I heard one estimate that it could go up from currently, where about 2,600 people are in the hospital with flu, could go all the way up, exceed the usual records, which are about 5,000, all the way up to potentially 8,000. Now, time will tell whether that happens. And of course, it will depend on what other viruses are going on at the same time as to how challenging that will be. But I think that we can all predict that it is going to be pretty challenging.

[00:11:47] Speaker 2: All right. That's really interesting. Thank you very much for that. Dr. Broadbent, let me bring you in because a lot of people have been asking, what is the advice on masks? What is the situation with that?

[00:12:03] Speaker 3: It's very difficult to know how effective masks are at preventing the spread of different viruses. It's a very hard question to actually study. But I think what we would say is that if you feel ill, and if you're going to be around people, particularly people that are more vulnerable, it may be worthwhile following some of those advices that we've heard from previous years from COVID, things like wear a mask, good ventilation, washing your hands. And particularly if you're attending hospital as well, if you're visiting people in hospital or you have an appointment, it might be worthwhile wearing a mask. So we're certainly not suggesting that everyone should go back to wearing a mask all the time. But in certain situations, they could be very beneficial.

[00:12:51] Speaker 2: All right. Thank you very much for answering that question. Let me just bring in Catherine to answer this question. Jonathan from New Molden has sent this question in. Is there a vaccine for this new flu strain?

[00:13:07] Speaker 4: So what happens with vaccines is they, like the flu, they change every year and experts in advance basically try and bet on what they think the strain is going to be this year. This year, it's not an ideal match. So that doesn't mean that it doesn't work, but it means that because we've had this change in the virus this year, it's not going to be absolutely perfect. However, just because it's drifted, it's the evidence so far, and it is early evidence, is showing that it is really helping to keep people out of hospital. So some figures for you here. The early analysis is that for adults, it's giving you sort of 30% to 40% protection from hospital admission. For children, 70% to 75%, which is good news for all of us, by the way, because if children aren't getting it, they're not spreading it to us. Those figures are pretty much standard for flu season. So even though we're quite early in the flu season and things could change, actually, it's pretty much par for the course, the vaccine efficacy this time around, so far.

[00:14:05] Speaker 2: All right. We have had a question. I'm going to put this question actually to Dr. Lindsay Broadbent, lecturer in virology, as we've said, at Surrey University. This question has come from Jenny Smales from York. Why can't I get a flu jab for my asthmatic 16-year-old? Always had one, but GPs now say doesn't meet government criteria. I would pay, but pharmacies can't take under 18s. Do you know the answer to that one?

[00:14:35] Speaker 3: I think that would probably be a question for clinicians. I certainly don't know the guidelines around kind of the administration of the vaccines. That would be a question for a GP. All right. Yeah.

[00:14:48] Speaker 4: If a child is 16 and they're still at school, they should be up to year 11. They should be eligible to be getting it at school. So I don't know what the problem is there, but it should be quite easily fixable.

[00:14:57] Speaker 2: And parents or guardians should be getting an email from the school telling them to sign a form to give consent.

[00:15:03] Speaker 4: And that can be the nasal spray from those kids or the jab.

[00:15:06] Speaker 2: All right. Let's just put this comment. We've had a number of comments actually on this to Dr. Layla McKay. People will be looking at pictures of hospitals and hearing about what's going on with the situation in the rising flu cases. What is the message to patients who haven't got flu, who are perhaps worried about going into hospital?

[00:15:31] Speaker 1: Well, the NHS is used to dealing with challenges like flu, like other viruses, and will have good mechanisms in place. Now, when you need to seek health care, do think about what that right health care is to seek, whether it's going to your GP, whether it's going for 111 or an urgent care centre, or if it is an emergency, then accident and emergency. And just think carefully about where the right place is to seek help for you. And yeah, ultimately, do make sure that you do seek help if you need it. If you are becoming unwell, then it is the right thing to do to seek that help. And the NHS particularly recommends that you should go straight to the hospital if you get sudden chest pain, if you have difficulty breathing, or if you were to start coughing up lots of blood. I think that's helpful to know. But ultimately, the NHS is aware of the situation, it has planned, it is ready for you.

[00:16:33] Speaker 6: So if you need health care, then do access that health care. Right, Catherine, let's just bring you in again. What are the symptoms for flu?

[00:16:41] Speaker 4: It is worth reminding people about this. So the thing to say about the flu is it is that nasty virus. You can expect fevers, muscle aches, exhaustion. Someone once summed it up to me as, if someone put 100 pounds at the bottom of your bed, you'd be too tired to go and get it. I always think that's a really good marker. The other thing about the flu is the symptoms tend to come on quite quickly. Now, for most of us, it's the kind of thing, a couple of weeks bed rest, we get better. But it can be a really serious illness, especially if you're vulnerable, if you've got some kind of long-term health condition. We do see every year it developing into serious complications like pneumonia. And there are always deaths from flu. On a not too bad year, you'd be looking at a few thousand. On really bad years, over 20,000. So that is why people are worried about it now.

[00:17:28] Speaker 2: And when you've got flu, and I know I've had flu in the past, I'm sure you have as well. It's awful. I guess the question is, it's quite difficult to know when you should be seeking medical help, because you do feel so awful, don't you? But what is the point when you should be seeking medical help?

[00:17:46] Speaker 4: Well, it's that point that we just heard. It's about who to seek medical help from. So if you are worried, the first port of call, unless this is something like you are not breathing, you're getting chest pain, is your GP or NHS 111. If it's for something that feels like an emergency, then obviously go down that 999 route.

[00:18:03] Speaker 2: All right. Let's just put one more question to Dr. Lindsay Broadbent. Are we expecting the virus to spread more slowly after this early spike? Do you know the answer to that one?

[00:18:17] Speaker 3: Because so many people have been infected quite quickly, we may see a slowdown. And as we heard from Scotland, it seems like that may be happening in Scotland. It's too early to say yet if this is an early peak that we'll see come down quite quickly, or if we're going to see quite a sustained flu season. We don't know yet. There are a lot of factors at play here. How many people are infected? How many people are vaccinated? There's a lot of things to consider. And I think it's just too early to tell.

[00:18:49] Speaker 2: All right. Let's just sum up then, Catherine, the situation in hospitals across the UK, flu cases arising, just how bad is it?

[00:18:58] Speaker 4: So with the flu itself, we're looking at in England this average of 2,660 patients in hospital a day. And those figures, by the way, there's a bit of a lag. So by now, it will be even higher. Some NHS bosses are predicting that that could go up to 5,000 or even 8,000, which is higher than anything we have seen in recent years. But the thing to remember as well is this time of year for the NHS, it is under pressure. It's not the only winter virus going around. Norovirus, for example, there's a few hundred people in hospital with that. But that's gone up by about a third in a week as well. And let's not forget that next week, there are still due to be strikes by resident doctors. All of this adds to pressure at a time when the NHS is at its very busiest. All right.

[00:19:44] Speaker 2: Thank you. Let's thank our guests, Dr. Layla McKay, Director of Policy at NHS Confederation, and also Dr. Lindsay Broadbent, Lecturer in Virology at Surrey University. And of course, Catherine Burns, the BBC's health correspondent. Thank you very much indeed for all your expert advice and also answering those questions. Thanks to you two for sending those questions in to us throughout the day today. This is a story that is going to continue, no doubt, up until Christmas and beyond. And you can get more on this on the BBC News health site and also on the BBC News app. For now, bye-bye. Bye-bye.

[00:20:36] Speaker 1: Bye.