Ten lessons for the next influenza pandemic—an English perspective

Fleming, Douglas; Durnall, H.

doi:10.4161/hv.8.1.18808

Cited by 13 publications

(7 citation statements)

References 25 publications

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“…We have the capability to characterise and monitor disease and use of therapies, and compare use according to guidance. 24 The RCGP RSC has produced a ‘weekly return’ of infections and respiratory disease since 1967, though over time it has expanded in terms of size, scope, sample collection and its capability with linking with other datasets. We can process large numbers of patients’ data rapidly.…”

Section: Methodsmentioning

confidence: 99%

Incidence and prevalence of cardiovascular disease in English primary care: a cross-sectional and follow-up study of the Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC)

et al. 2018

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ObjectivesTo describe incidence and prevalence of cardiovascular disease (CVD), its risk factors, medication prescribed to treat CVD and predictors of CVD within a nationally representative dataset.DesignCross-sectional study of adults with and without CVD.SettingThe Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) is an English primary care sentinel network. RCGP RSC is over 50 years old and one of the oldest in Europe. Practices receive feedback about data quality. This database is primarily used to conduct surveillance and research into influenza, infections and vaccine effectiveness but is also a rich resource for the study of non-communicable disease (NCD). The RCGP RSC network comprised 164 practices at the time of study.ResultsData were extracted from the records of 1 275 174 adults. Approximately a fifth (21.3%; 95% CI 21.2% to 21.4%) had CVD (myocardial infarction (MI), angina, atrial fibrillation (AF), peripheral arterial disease, stroke/transient ischaemic attack (TIA), congestive cardiac failure) or hypertension. Smoking, unsafe alcohol consumption and obesity were more common among people with CVD. Angiotensin system modulating drugs, 3-hydroxy-3-methylglutaryl-coenzyme (HMG-CoA) reductase inhibitors (statins) and calcium channel blockers were the most commonly prescribed CVD medications. Age-adjusted and gender-adjusted annual incidence for AF was 28.2/10 000 (95% CI 27.8 to 28.7); stroke/TIA 17.1/10 000 (95% CI 16.8 to 17.5) and MI 9.8/10 000 (95% CI 9.5 to 10.0). Logistic regression analyses confirmed established CVD risk factors were associated with CVD in the RCGP RSC network dataset.ConclusionsThe RCGP RSC database provides comprehensive information on risk factors, medical diagnosis, physiological measurements and prescription history that could be used in CVD research or pharmacoepidemiology. With the exception of MI, the prevalence of CVDs was higher than in other national data, possibly reflecting data quality. RCGP RSC is an underused resource for research into NCDs and their management and welcomes collaborative opportunities.

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Section: Methodsmentioning

confidence: 99%

Incidence and prevalence of cardiovascular disease in English primary care: a cross-sectional and follow-up study of the Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC)

et al. 2018

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“… 10 Point-of-care testing (POCT) for influenza has the potential to improve clinical decisions and patient outcomes as a result of a more appropriate use of antibiotics, antivirals, and infection control measures. 11 Additionally, POCT could provide information to enhance influenza disease surveillance and clinical research, particularly providing data to compare vaccines in clinically important subgroups, and antiviral therapy in real-world trials. 12 …”

Section: Introductionmentioning

confidence: 99%

Integrating molecular point-of-care testing for influenza into primary care: a mixed-methods feasibility study

et al. 2020

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BackgroundMolecular point-of-care testing (POCT) for influenza in primary care could influence clinical care and patient outcomes.AimTo assess the feasibility of incorporating influenza POCT into general practice in England.Design and settingA mixed-methods study conducted in six general practices that had not previously participated in respiratory virology sampling, which are part of the Royal College of General Practitioners Research and Surveillance Centre English sentinel surveillance network, from February 2019 to May 2019.MethodA sociotechnical perspective was adopted using the Public Health England POCT implementation toolkit and business process modelling notation to inform qualitative analysis. Quantitative data were collected about the number of samples taken, their representativeness, and the virology results obtained, comparing them with the rest of the sentinel system over the same weeks.ResultsA total of 312 POCTs were performed; 276 were used for quantitative analysis, of which 60 were positive for influenza and 216 were negative. The average swabbing rate was 0.4 per 1000 population and swab positivity was between 16.7% (n = 14/84) and 41.4% (n = 12/29). Given a positive influenza POCT result, the odds ratio of receiving an antiviral was 14.1 (95% confidence intervals [CI] = 2.9 to 70.0, P<0.001) and of receiving an antibiotic was 0.4 (95% CI = 0.2 to 0.8, P = 0.01), compared with patients with a negative result. Qualitative analysis showed that it was feasible for practices to implement POCT, but there is considerable variation in the processes used.ConclusionTesting for influenza using POCT is feasible in primary care and may improve antimicrobial use. However, further evidence from randomised trials of influenza POCT in general practice is needed.

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“…26 Finding the best way to inform people about the correct use of personal NPI and to provide medical advice for patients with influenza-like-symptoms was considered a critical aspect during the influenza A H1N1 outbreaks in New Zealand 33 and England. 34 To cope with pressures on primary care, the communication strategy included a dedicated emergency telephone-based facility and illustrated messages transferred via media. The need for a clear and well-defined communication strategy, among both the public and healthcare providers, also emerged during the influenza A H1N1 outbreaks in Mexico 30 and Canada, 35 where technology was considered important as a way to improve the coordination of the communication plan and avoid the variability and incongruities in developing guidelines.…”

Section: Bmj Global Healthmentioning

confidence: 99%

How health systems approached respiratory viral pandemics over time: a systematic review

et al. 2020

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BackgroundSeveral healthcare systems facing respiratory viral infections outbreaks, like COVID-19, have not been prepared to manage them. Public health mitigation solutions ranging from isolation of infected or suspected cases to implementation of national lockdowns have proven their effectiveness for the outbreak’s control. However, the adjustment of public health measures is crucial during transition phases to avoid new outbreaks. To address the need for designing evidence-based strategies, we performed a systematic review to identify healthcare systems interventions, experiences and recommendations that have been used to manage different respiratory viral infections outbreaks in the past.MethodsPubMed, Web of Science, Scopus and Cochrane were searched to retrieve eligible studies of any study design, published in English until 17 April 2020. Double-blinded screening process was conducted by titles/abstracts and subsequently eligible full texts were read and pertinent data were extracted. When applicable, quality assessment was conducted for the included articles. We performed a narrative synthesis of each implemented public health approaches.ResultsWe included a total of 24 articles addressing the public health approaches implemented for respiratory viral infections outbreaks for COVID-19, influenza A H1N1, MERS and severe acute respiratory syndrome . The identified approaches are ascribable to two main categories: healthcare system strategies and healthcare provider interventions. The key components of an effective response on respiratory viral outbreaks included the implementation of evidence-based contextual policies, intrahospital management actions, community healthcare facilities, non-pharmaceutical interventions, enhanced surveillance, workplace preventive measures, mental health interventions and communication plans.ConclusionThe identified healthcare system strategies applied worldwide to face epidemics or pandemics are a useful knowledge base to inform decision-makers about control measures to be used in the transition phases of COVID-19 and beyond.

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Ten lessons for the next influenza pandemic—an English perspective

Cited by 13 publications

References 25 publications

Incidence and prevalence of cardiovascular disease in English primary care: a cross-sectional and follow-up study of the Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC)

Incidence and prevalence of cardiovascular disease in English primary care: a cross-sectional and follow-up study of the Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC)

Integrating molecular point-of-care testing for influenza into primary care: a mixed-methods feasibility study

How health systems approached respiratory viral pandemics over time: a systematic review

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