Good news and bad news in the flu furore

The worst of the outbreak may be over, but there are still no plans for a comprehensive vaccination

The good news is that we appear to be over the worst of this year's flu outbreak.

The bad news (for worried parents like me) is that there is still no sign of the flu vaccine being made available to children and the under-fives in particular.

I aired my frustrations about being unable to vaccinate my 20-month-old daughter against this potentially fatal but utterly preventable disease on this blog earlier in the week – saying that I couldn't help feeling that it was all ultimately down to saving money.

On Thursday, I was given the opportunity to put these concerns directly to the NHS director of immunisation, Professor David Salisbury.

He spoke to me as the latest figures show seven confirmed deaths of children under five from flu since September, against 11 deaths in the five-to-14-year-old age range, 59 deaths among those aged 15-44, 78 deaths in those aged 45-64 and 55 deaths among the over-65s.

The cumulative total number of confirmed flu deaths since September currently stands at 254 – a sharp increase on last week's total of 112. But because of a two-week time lag in the death statistics filtering through, that sharp increase reflects the peak (fingers crossed) of the disease a few weeks ago, rather than the current picture.

I said to Professor Salisbury that it is all very well saying that children are at a comparitively low risk of dying from flu, but that this will provide little comfort for parents grieving the loss of those who have died from this preventable illness.

He said:

Supply of vaccine is driven by customers. If customers order the vaccine, industry then increases supply. It's not a capacity issue, it's an issue to do with what is the best use of the resources that we have available to us.

He said that the latest information was that those identified as being in the high-risk groups – who are being offered the vaccine on the NHS – are around 20 times more likely to die from influenza than others. So, he said, that is why the vaccine is being offered on a risk basis, rather than one based on age – as happened last year, when those aged under five were offered the jab.

Those in the high-risk groups include over-65s, pregnant women and those with certain underlying health conditions.

Recorded numbers of people with flu-like symptoms have dipped since last week and the number of people in NHS critical care beds with flu symptoms on 20 January dropped to 418, down from 661 a week ago. Some 20 in critical care with flu were under-fives.

For those worried parents (like me), whose children don't fall into an at-risk category, the only thing to do is hope that supplies return to private clinics – which have been offering the jab for between £10 and £25 a pop – or else keep pestering your GP.

Prof Salisbury said to me that NHS high command only makes recommendations, but that it is up to GPs to make their own clinical judgements.

Dominic Ponsford is the editor of Press Gazette.

Dominic Ponsford is editor of Press Gazette

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The rise of the green mayor – Sadiq Khan and the politics of clean energy

At an event at Tate Modern, Sadiq Khan pledged to clean up London's act.

On Thursday night, deep in the bowls of Tate Modern’s turbine hall, London Mayor Sadiq Khan renewed his promise to make the capital a world leader in clean energy and air. Yet his focus was as much on people as power plants – in particular, the need for local authorities to lead where central governments will not.

Khan was there to introduce the screening of a new documentary, From the Ashes, about the demise of the American coal industry. As he noted, Britain continues to battle against the legacy of fossil fuels: “In London today we burn very little coal but we are facing new air pollution challenges brought about for different reasons." 

At a time when the world's leaders are struggling to keep international agreements on climate change afloat, what can mayors do? Khan has pledged to buy only hybrid and zero-emissions buses from next year, and is working towards London becoming a zero carbon city.

Khan has, of course, also gained heroic status for being a bête noire of climate-change-denier-in-chief Donald Trump. On the US president's withdrawal from the Paris Agreement, Khan quipped: “If only he had withdrawn from Twitter.” He had more favourable things to say about the former mayor of New York and climate change activist Michael Bloomberg, who Khan said hailed from “the second greatest city in the world.”

Yet behind his humour was a serious point. Local authorities are having to pick up where both countries' central governments are leaving a void – in improving our air and supporting renewable technology and jobs. Most concerning of all, perhaps, is the way that interest groups representing business are slashing away at the regulations which protect public health, and claiming it as a virtue.

In the UK, documents leaked to Greenpeace’s energy desk show that a government-backed initiative considered proposals for reducing EU rules on fire-safety on the very day of the Grenfell Tower fire. The director of this Red Tape Initiative, Nick Tyrone, told the Guardian that these proposals were rejected. Yet government attempts to water down other EU regulations, such as the energy efficiency directive, still stand.

In America, this blame-game is even more highly charged. Republicans have sworn to replace what they describe as Obama’s “war on coal” with a war on regulation. “I am taking historic steps to lift the restrictions on American energy, to reverse government intrusion, and to cancel job-killing regulations,” Trump announced in March. While he has vowed “to promote clean air and clear water,” he has almost simultaneously signed an order to unravel the Clean Water Rule.

This rhetoric is hurting the very people it claims to protect: miners. From the Ashes shows the many ways that the industry harms wider public health, from water contamination, to air pollution. It also makes a strong case that the American coal industry is in terminal decline, regardless of possibile interventions from government or carbon capture.

Charities like Bloomberg can only do so much to pick up the pieces. The foundation, which helped fund the film, now not only helps support job training programs in coal communities after the Trump administration pulled their funding, but in recent weeks it also promised $15m to UN efforts to tackle climate change – again to help cover Trump's withdrawal from Paris Agreement. “I'm a bit worried about how many cards we're going to have to keep adding to the end of the film”, joked Antha Williams, a Bloomberg representative at the screening, with gallows humour.

Hope also lies with local governments and mayors. The publication of the mayor’s own environment strategy is coming “soon”. Speaking in panel discussion after the film, his deputy mayor for environment and energy, Shirley Rodrigues, described the move to a cleaner future as "an inevitable transition".

Confronting the troubled legacies of our fossil fuel past will not be easy. "We have our own experiences here of our coal mining communities being devastated by the closure of their mines," said Khan. But clean air begins with clean politics; maintaining old ways at the price of health is not one any government must pay. 

'From The Ashes' will premiere on National Geograhpic in the United Kingdom at 9pm on Tuesday, June 27th.

India Bourke is an environment writer and editorial assistant at the New Statesman.

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