Tom Nolan: The flu will be back after the break

Two swine flu call centres in England will close on Sunday with the loss of 1200 jobs reports The Guardian. Demand for Tamiflu has plummeted: it peaked on 27 July with nearly 39,000 authorisations for the use of Tamiflu while on 16 August there were only 3396. According to the HPA there were only 11,000 new cases of swine flu last week and the GP consultation rates have dropped from a peak of 35 consultations per 100,000 of the population to under 5 (similar to the rate in January this year for seasonal flu). 59 people in the UK are reported to have died from the virus so far.

Time for a break?

With everything seemingly back to normal it’s tempting to forget all about swine flu. But we shouldn’t get too comfortable, as the RCGP mentioned in its weekly flu update: this quiet time should be used to prepare for the next wave of flu. But what more can be done? We’ve already had a dress rehearsal this summer and clinicians’ knowledge, skills and organisation regarding swine flu are now fine-tuned. Perhaps the best thing people can do is take a hard earned break to recharge the batteries for the winter ahead.

Have you got your flu treatment kit?

The web is full of strange theories about swine flu and even stranger remedies. Take the Flu Treatment Kit, drawn up at the time of bird flu panic, and now doing the rounds for H1N1. It was devised by Grattan Woodson MD, a physician in the US.

It starts off with some essential drugs that no flu-fearing person would live without:

  • Diphenhydramine (Benadryl®) 25mg capsules # 100 (for treatment of flu symptoms)
  • Robitussin DM Cough Syrup® or its generic equivalent (12 oz) (for treatment of cough)
  • Acetaminophen 500mg (Tylenol®) # 100 tablets (for treatment of flu symptoms)
  • Loperamide 2mg # 100 tables (for diarrhea and abdominal cramps)
  • Meclizine 25mg # 100 tablets (for nausea and vomiting)
  • Ibuprofen 200mg (Motrin®) # 100 tablets (for treatment of flu symptoms)

But five different remedies are not going to get you through of course. You also need a shed load of paraphernalia. Here is a sample of the things you should buy:

  • N-95 masks #20 (2boxes) (to reduce diseases spread to and from the patient) [Don’t forget to fit test them.]
  • 50 gallon sturdy plastic garbage container with top (used to store clean water for drinking) [what’s wrong with a tap?]
  • Petroleum jelly 4oz 3 (for lubrication of tubes, suppositories, and skin treatment and protection) [tubes? Suppositories? I dread to think what’s coming next…]
  • Cocoa butter, pure 2 oz 4 (for making suppositories and skin treatment and protection)
  • Two Electronic thermometers (to measure temperature) [two, because you can never be too sure]
  • Humidifier (for increasing the relative humidity of the air breathed by the patient)
  • Pill cutter (to make it easier to reduce the dose of medications if desired)
  • 1 box of Latex gloves # 100, (to help reduce contamination and spread of the virus and bacteria) [will come in handy for the suppositories too]
  • Household bleach, unscented 2 gal (for purifying water and cleaning contaminated items) [is purifying water with bleach a good idea? I think I’ll take my chances with the tap.]
  • Caffeine-containing tea, bags or dry loose: 1 lb (for treatment of respiratory symptoms) [are we going to make some sort of tea inhaler?]
  • Two 8 oz plastic baby bottles with rubber nipples (for administering Oral Rehydration Solution to severely ill) [why not go the whole hog and get a drip, or a ventilator?]
  • Two 16 oz plastic squeeze bottles with swivel nozzles (for administering Oral Rehydration Solution to the ill) [the swivel nozzle is the HDU of plastic bottles, the baby bottle with rubber nipple being the ITU]

The rest of the guide features useful tips such as that if your patient becomes cyanotic that is “a very bad sign and is often associated with a rapid death”, and if you’re showing signs of DIC “death is likely”. It’s especially likely if all you have to treat it with is some cough mixture, tea bags and a selection of plastic bottles.

To read the full list of things you need to buy and the rest of the guide click here.

 Tom Nolan is a GP trainee, London