avoiding public panic… – Slugger O’Toole
The death of a child from an infectious disease is shocking and heartbreaking in equal measure. It’s thankfully so rare nowadays that when it occurs, and the event is local, it understandably causes panic.
Over the past week, with the reported tragic death of Stella-Lily McCorkindale following a spike in Strep A infections locally and other child deaths across the UK (there have been an estimated 16 deaths to date), we went straight to panic mode. The pressure on out-of-hours GP services over the weekend of the 3rd December was unmanageably intense and by Tuesday, GPs surgeries were still being inundated with calls from concerned parents for help and most pharmacies were out of the most relevant antibiotics. The Belfast Hospital for Sick Children was forced to stop all planned surgeries and appointments as parents of over 200 children arrived seeking help. It was a huge problem for a service already under immense pressure.
I do not underestimate the risk to life caused by a spike in Strep A infections but I do wonder how an infection we know very well and can treat effectively should suddenly become a crisis. Once the public panicked, our ability to manage the surge in a; calm, disciplined and dispassionate way disappeared, and it became crisis management with all its attendant risks and inefficiencies. Every child with a runny nose, raised temperature or feeling out of sorts became a potential death about to happen and yes, I get that, I know how scary that is but I know it didn’t have to be that way.
Central to this crisis was not Strep A but the Media, and I think we need to take some lessons from what has just occurred and ensure it doesn’t happen this way again. I am concerned that, on some occasions and especially when it comes to health, sensationalism can get the better of editors and news-desk producers so that they are chasing a story that is perhaps exaggerated but will attract viewers and readers.
The fact is that Strep A occurs regularly, and we had a spike in infections 2017-2018 which across the UK had over 300 deaths mostly in older people. We always need to be vigilant and suspected cases should be treated as soon as possible with appropriate antibiotics. Public Health Agency gave out vital information in a timely fashion on how to spot the signs and symptoms and what action to take. There was no need to close down schools. But that seemed insufficient to many interviewers and reporters.
The Pharmacy network dispensed one month’s supply of liquid antibiotics in a few days and given the number of true infections this is hard to justify. As the panic progressed, GPs were told to have a high degree of suspicion with any cases presented and if in doubt prescribe. It is not a good policy to have such a blunderbuss approach to antibiotic prescribing since, in the future, there might be bacterial resistance that could lead to other deaths. There is, of course, a simple and highly accurate throat swab test for Strep A infection, and it is used in Wales as a Pharmacy First Service that, where available, massively reduces the inappropriate use of antibiotics and allows a focus on children who have the infection so they can be properly managed. This service is not commissioned locally, and perhaps when the panic dies down, there can be calm discussions on whether or not it would be appropriate as part of our transformed health service.
In the meantime, I would respectfully ask the local Media to think about how their reporting in this last week might have exacerbated the routine and well-established management of infection and turned it into a crisis where the system nearly lost control.
I am a pharmacist in Belfast.