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Independents' Day

Should we be holding swine flu parties?

Given the H1N1 virus is seemingly so contagious and so mild, should we be mimicking the old approach to chicken pox and holding swine flu parties?

Given the H1N1 virus is seemingly so contagious and so mild, should we be mimicking the old approach to chicken pox and holding swine flu parties?

In my spare time, I am a jobbing Baritone. I am lucky to be able to sing in a rather good choir that has a varied and challenging repertoire. There are two bass sections, the boom-boom basses (who sing like they are at a rugby club function) and the higher, lyric basses. It will not surprise you to know that I class myself as a lyric bass.

As an amateur choir, it contains all sorts of people - students, lecturers, cartoonists, lawyers and media people. And Doctors. There are 6 doctors - three consultants and three GPs, and recently I was sitting next to the second sopranos and right next to one of my colleagues who is a GP in a different area of the region.

When we had finished talking about holidays and music - being doctors - we started to talk shop, and specifically about swine flu. It was interesting comparing how this whole business had been covered in different PCTs and the advice we have had. I told her that our experience in our tiny corner of this sceptr'd isle was that it was mild, very infectious and affected younger patients. I told her that, frankly, it was little different from chicken pox.

She had more experience, working in an area that effectively has it as an endemic virus. It would seem that she had been told (or had decided for herself`) that it was pointless following complex algorithms. Her observation was that people were getting diagnosed having come up to the surgery (infecting a whole waiting room of patients in the process) and she and her colleagues were managing it as standard influenza. She hadn't given out any Tamiflu at all.

So far I've had 2 patients who I have seen with symptoms. One lady had just returned from Phuket in Thailand and had read about this ‘terrible' flu in Mexico. At this point it was still just in Mexico. My immediate thought was that she hadn't been paying much attention in her geography lessons. Clearly she is of the old-fashioned view that foreigners begin at Calais and ‘abroad is abroad'. The second young man had not left the environs of Jobbing Doctor's practice area for 8 months, had a snotty nose and was afebrile. Lots of people mentioned they were worried about it, but had no real symptoms.

I do understand that the public health people need to get the information ‘out'. But my in box is being overwhelmed with constant messages and instructions, and the latest algorithms (for there are more than one) includes such vague symptoms that hundreds of patients might have the illness. Fever, cough, sore throat, sickness, diarrhoea. These are symptoms of thousands of viruses.

I am becoming seriously relaxed about it, as is my colleague. We are being told now that it is out there in the community, and we should just start behaving in a way that we should use our clinical judgement and make decisions on the basis of a clinical assessment. There is little point in arranging to have swabs done on anyone as this is overwhelming the labs and costing millions in resources.

In my area there is still a very old-fashioned approach to infectious illness, and a pragmatism within the population that is not seen in the minor functionaries in the PCT or the Health Protection Agency. In my early days people used to hold German Measles parties so that all the kids could get it, and also there is a culture of feeling happy about Chicken pox.

Maybe we should encourage people to hold swine flu parties?

Just a thought.

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