Ministers across the UK have agreed that it is time to move from containment into the treatment phase.

Dear colleague,

As you will be aware, on 11 June the World Health Organisation raised its alert level to 6, recognising that A(H1N1) swine flu has spread to pandemic levels around the globe.

In the majority of UK cases the virus has been generally mild, but has proven to be more severe in a small number of cases, and more recently the UK has sadly seen the first deaths associated with swine flu in those with underlying health conditions.

I am writing to you today to update you on our approach to managing this pandemic following an important announcement by Secretary of State for Health Andy Burnham, earlier today.

Before I do, I want to emphasise that the response from the NHS, HPA and GPs has been very good. As little was known about the new virus when the outbreak started, it was sensible to take all possible measures to slow its spread while we learned more. For example swabbing patients suspected of having swine flu to confirm the diagnosis, offering them antivirals to relieve symptoms of the virus and tracing their close contacts to offer them antivirals as a preventative measure. This ‘containment’ phase has helped slow the spread of the virus and offered us the time to build up medical supplies and make significant progress towards developing a vaccine.

The virus is increasingly widespread within the UK and is expected to continue to spread. In the last week, we have seen a significant increase in the number of cases with some areas having to cope with many more cases than others.

We always knew that we could not contain or prevent the spread indefinitely and that is why today Ministers across the UK have agreed that it is time to move from containment into the treatment phase. This will mean that we will:

  • Rely on symptoms rather than swabbing to diagnose the virus. We will continue to swab a small number of patients to ensure we continue to get up to date information about the virus.
  • Stop tracing close contacts of those diagnosed with swine flu.
  • Only offer antivirals to those diagnosed with swine flu.

The link in this email www.dh.gov.uk/swineflutreatmentphase takes you to a document ‘From containment to treatment’ which sets out in more detail the approach to managing the pandemic to date, what a treatment approach means and what this new approach means for people with swine flu.

Ian Dalton, National Director of NHS Flu Resilience has written today to all NHS Chief Executives and Chairs making clear the next steps they need to take in preparing for a potential wider spread of the virus.

As you may be aware, the Department of Health has signed contracts to purchase sufficient vaccine to vaccinate the entire population with the first deliveries arriving in August, and at least 60 million doses are expected by the end of the year. Decisions are yet to be made about who will be prioritised to receive the first doses of the vaccine, but I anticipate that frontline staff will be considered alongside other high priority groups in order to protect them, their families and their patients.

Every NHS organisation has been asked to appoint a lead director to ensure that we are as prepared as we can be for the weeks and months ahead. If you have any concerns or questions about our approach going forward, please speak with them.

Finally, I want to thank you for all your work to respond to the early stages of this pandemic.

Yours sincerely

David Nicholson CBE

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