Don't panic about swine flu, says expert who probed spy case

Swine flu still instils fear, but a British pandemic expert's advice is simple: do not panic, if you develop symptoms, stay at home, and if not, just go about your normal life.

Nigel Lightfoot, chief advisor on emergency preparedness and head of the pandemic influenza programme at the UK's Health Promotion Agency, believes Malta has coped well the emergence of the H1N1 virus, which has reached 160 countries and killed almost 800 worldwide.

Prof. Lightfoot said people did not need Tamiflu, the antiviral used to treat influenza, unless they fell within the vulnerable groups such as people with chronic respiratory, liver or kidney diseases, neuromuscular disorders that compromised breathing, pregnant women, or children under five. And even then, it was at the doctor's discretion.

In Malta, several people questioned the government's decision to stop treating everybody who contracted the virus with Tamiflu, concerned that the move was merely based on a limited supply.

This was shrugged off by Health Promotion and Disease Prevention department director Charmaine Gauci who said taking antivirals unnecessarily could lead to a resistant virus.

Prof. Lightfoot said that in the UK, the government decided that Tamiflu would be available if a doctor believed a patient needed it. Prof. Lightfoot happened to be holidaying in Malta just before the first cases of swine flu surfaced. He was then roped in to give a lecture to 300 health professionals at Mater Dei Hospital on the influenza.

He has been in contact with the island's health authorities and leading virologists for years, which gives him expert insight into the mechanisms in place.

Queen Elizabeth II awarded Prof. Lightfoot a CBE in the New Year's Honours List in recognition of his services to public health; among them coordinating the public's protection when Russian security agent Alexander Litvinenko was poisoned with the radioactive polonium-210 in London in 2006.

Relaxing barefoot in the kitchen of his rented home in Żebbuġ while his Maltese wife grills red peppers for lunch, it is hard to imagine this grey-haired, easy-going gentleman scouring London to trace the contamination.

But it is this affable nature and insistence on keeping the public informed to enable them to make their own risk assessment that kept the panic under control.

Prof. Lightfoot's team was called in by police shortly before Litvinenko's death, and he spent 18 hours a day, six days a week following the contaminated trail of polonium across London - on buses, aircraft, sushi bars, hotels - to test for radiation.

"It was about telling the truth, sharing what you know and what you don't, so the public is able to make a decision on how it affects them", he said, adding he could not comment further because there was a Crown Prosecution case.

"We could have frightened the whole population in the run-up to Christmas. If we created panic it would have been terrible. You have to tell the truth, it's the principle of risk communication," he added. This was the same philosophy he adopted when the swine flu pandemic hit.

"There's a fine balance between getting that done and frightening the public", he said, adding that all the planning and preparation put in place for the bird flu, H5N1, had served everybody well.

He stressed that swine flu was no more deadly than the seasonal winter influenza - that had a mortality rate of 0.1 per cent - except this time everyone was susceptible since there was no vaccine available to protect against it.

Prof. Lightfoot said the incubation period of swine flu was three to seven days, which meant it did not make sense to try and prevent it entering the country by stopping people at ports of entry and testing their temperature.

It was also a myth that masks protected against contracting the virus. They were "ineffective" once they became damp through breathing, which was about 10 minutes, because they allowed viruses to pass through.

Having returned to the UK last Friday, Prof. Lightfoot will be working on projects of global health security, looking at early warnings of influenza, and chemical, biological and radio nuclear warfare defence, which was one of his areas of specialisation.

"My whole career has been doctored with working out these unusual events... It's a big detective game."