Flu jabs to be rolled out earlier to prevent Coronavirus double whammy

Flu jabs are likely to be rolled out earlier than usual this winter in a bid to ensure that any coronavirus 'second peak' doesn't coincide with flu season.

Dr Virgina Pearson, Director of Public Health Devon, told the Devon County Council Health and Adult Care scrutiny committee on Tuesday that immunisation ahead of this winter would also likely see more people vaccinated.

A big concern for the NHS would be if there was a second wave of coronavirus that struck at the same time as an outbreak of influenza, particularly given the overlap in symptoms between the two diseases, and questions at the meeting were raised about how the NHS plans to cope with the ordinary winter pressures it faces.

But Dr Paul Johnson, Clinical Chair of NHS Devon Clinical Commissioning Group, said that if the social distancing measures were still in place this winter, he would expect that to actually help reduce the number of flu cases as close contacts between people would be less.

Asking questions, councillor Nick Way said: "I hope that shortly we find an antidote to the horrible COVID-19 that the world is facing, but we do need to something about the flu this winter, and if we do get a spike and an increase in problems with covid, how will we deal with ordinary flu and immunisation? We definitely need some sort of program to persuade people to get immunised."

In response, Dr Johnson said that while it was possible there could be a second peak that coincided with winter flu, there was no evidence at the moment of any increase in cases happening, with all the measures currently heading in the right direction.

He added: "It would be an added complication if covid coexisted with flu due to the overlap of symptoms, but we do have the Nightingale Hospital in Exeter to cope if we did. But the social distancing measures will have a benefit on the decreasing number of flu cases that we see."

Dr Pearson added: "We will probably start the immunisation strategy earlier than usual, maybe by about two months and to increase the people it covers and lower the age limit to become eligible."

Exeter's new Nightingale Hospital is still being built in Sowton with it set to open, if needed in July, although the number of patients in hospital with coronavirus on Tuesday in Devon could be counted on one hand, with no patients in Derriford Hospital and none in Devon on a ventilator.

Councillor Paul Crabb asked: "In the absence of covid, could it remain as a hospital to help the NHS with winter pressures? Is that what is still being hoping to be achieved as it seems a good idea?"

Sonja Manton, interim director of commissioning said that while the Nightingale Hospital was part of the coronavirus response and if required will accept patients in July, the numbers are still very low but they are keeping an eye of things as they can change quickly.

She added: "As for the winter, no decisions have made but about how we use this for the best capacity, while we plan for potential surges."

The report of Dr Tim Golby, Associate Director of Commissioning ,to the meeting, talked about how the NHS coped with the winter pressures in 2019/20, although Dr Golby said: "It feels like a different world now from the world we were operating in on January."

He added that through the winter the service was under pressure but the activity to manage it went as planned.

But he said that while there was now far less pressure on emergency departments in hospitals as there's was pre-covid, due to social distancing guidelines they cannot accommodate the same number people in the same way at present.

His report added: "NHS 111 and 999 continued to be prioritised as the preferred way for the public to enter the urgent and emergency system, and overall a call increase of 2.41% into the 111 service has been experienced demonstrating that the strategic intention to ask the public to use this service is succeeding.

"The introduction of the new service had some positive benefits which were realised over the winter period. The level of clinical involvement in all the calls increased, this was important as it allowed for the review of dispositions and the introduction of clinical intervention to offer alternatives for people who were at risk of being directed unnecessarily to ED or for an ambulance.

"All under-fives were offered a clinical conversation or appointment automatically as were all over 80's. For young children a greater level of assurance for parents and for older people the opportunity to 'unpick' more complex problems and come to a holistic answer. This has been well received and led to the reduction of unnecessary ED or ambulance dispositions."

A&E attendances across the hospitals in North, South and East Devon have reduced, the report said, with levels slightly below 2018/19 even before the massive reduction in attendances in March once coronavirus lockdown measures were introduced.

Emergency admissions though this year had risen across all acute hospitals with the exception of north Devon, with all four trusts seeing an increase in a spike in admissions in December-January, before falling back in February.

The spike in admissions in Exeter and Torbay were above 2018/19 levels for the same period and in North Devon saw the lower number of admissions in 2019/20 for the preceding months rise up to 2018/19 levels as a result of the increase. Plymouth's figures remained below the previous year but also saw the same increase.