Michael White on swine flu and infectious attitudes

They include ministerial warnings against well meaning parents holding “flu parties” so that little Tamsin and Giles can get it over with (don’t do it, says father of three and health secretary Andy Burnham) and panic in Fleet Street: “Swine flu could bring UK to a halt” as victims all take two weeks off work, predicted one weekend headline.

Two weeks off is better than eternity. The first UK death of a patient with no underlying medical problems occurred the other day just as I was reading Hilary Mantel’s new historical novel, Wolf Hall. In it a key character’s children die in one of the 16th century’s regular summer visits to London by the “sweating sickness” - the plague.

Mantel is a good enough writer to distress the reader by such scenes. So far it looks as if H1N1 (as Tory medico Andrew Murrison prefers to call it) is not going to be the killer once feared (it’s “largely mild”), though with mutating viruses you can never tell. But, like the 20th century pandemics, the young seem to be more vulnerable.

Overall, the politicians have been more sensible than the media. No surprise there then. Whitehall was cross this week after reports that the NHS is preparing to vaccinate the entire 60 million population when fast-tracked imported supplies of antibiotics start arriving shortly.

“We’ve never said we’d restrict it, the same as winter flu vaccine,” I was told. The same prioritisation will be used. There should be enough to cover 30 per cent of the population by late September.

Mr Burnham made an oral statement to MPs on 2 July, the day he said experts were predicting 100,000 cases a day by late August and announced a policy shift from containment to treatment based strategy. Schools should no longer routinely close to prevent spread: many have broken up anyway.

Antivirals for prophylactic purposes (ie anti-spread, but how MPs prefer the grand word) will be “targeted” on NHS staff and other vulnerable groups. Surprisingly few have actually been given out, shadow health secretary Andrew Lansley discovered. Mr Burnham admits his approach is “cautious.”

A week later Handy Andy Burnham gave the first of what will be weekly written updates, including an explanation of revised monitoring procedures. For the Opposition it is a delicate balance. A bit like Afghanistan (where the young are also vulnerable), it means holding government to account while not scoring cheap political points.

Candid Andy Lansley complained at the weekend that the national flu helpline has been slow to get working and that the antiviral distribution has been poor. The Times got hold of a memo which suggested that “muddle thinking” in Whitehall over Tamiflu vouchers would hamper distribution which - as Lib Dem Sandra Gidley points out - is harder in rural areas.

One sensitive point seems to be working friction: liaison between the four UK health administrations (Scotland has been guided by Cobra, Whitehall’s civil emergency committee).

But the big test will surely come if GPs, primary care trusts (some better prepared than others) and hospitals are overwhelmed by a combination of patients (2,000 hospitalisations a day are projected) and staff sickness.

Mr Burnham has issued guidance on when to start cancelling elective surgery locally. In China, both imperial and communist, emperors are judged on how they deal with flood and earthquake. My impression is that Emperor Burnham is doing OK.

He will need luck. An August pandemic is a good start. MPs are away.