Good advice for travellers doesn’t always come from government

We often see important information coming from a select few people — or, at the very least, from Government Health Officials. Yet the Government is not in complete control of what it promotes. When NHS England Commissioner Professor Sally Davies last week released a new travel advice for passengers heading into affected regions, it caused widespread concern. We already know that the guidance on public health issues has been a bit of a mess to say the least. The most recent clinical travel advice released to patients seeking advice by University College London Hospital was titled “Pandemics, People and Outbreaks have arrived in the UK and there is still no vaccine. If you are coming back to the UK, check your health condition before you travel.” Unfortunately, it was a lot more than a bit of a mess. In fact, it is in many ways infuriating and even more worrying.

Take the case of the confirmed outbreak in Northern Ireland of H5N1 avian flu. Despite that finding being made public nearly four weeks ago, a Government spokesperson announced, “as there has been no indication of human transmission, the updated advice remains that health departments should not advise against travel for as far as possible to Northern Ireland”. This advice is totally contrary to the guidance put out by Public Health England just a few days earlier on 11 August. This update (http://outbreaks.health.gov.uk/r/pandemics/rspublic/outbreaks/chicago/index.html) gives a more accurate view of the situation: “The National Influenza Surveillance System,which monitors the spread of influenza A viruses in the UK and which is managed by Public Health England (PHE),has so far not identified any human case of H5N1 virus”. Health Department and Ministry of Health declarations have not helped.

In fact, it is quite clear that both the UK Government and Public Health England were not working together in the early stages of the outbreak. On the contrary, any recommendations that were made by Public Health England regarding the safe use of aspirin, common anti-inflammatories and ibuprofen during treatment of a virus were incompatible with the advice given by Public Health England’s (PHE) own analysts. At the same time, the NIHB (National Office for Public Health Hazard Assessment) announced that there was an increased risk of gastroenteritis from travel due to the presence of avian influenza. It was only when the aforementioned infectious flu was discovered in the healthcare system that the NIHB issued a notice at the end of August that had been welcomed by Public Health England, stating: “However, Public Health England’s expert experts do not yet know if the virus has carried other virus in other parts of the animal population. If so, that could mean there is not yet an opportunity for the virus to transmit to humans.”

And here we find the problem. A risk assessment is not a catch-all that can completely cover a range of complex scenarios. While it may make sense to let people know that there is still no way of knowing if a viral infection will give rise to a danger to public health, it also should warn people against the potential of harm from an infection that may cause ill health and even death.

We have to ask ourselves why there has been such a lack of knowledge or coordination. Could it be that the departments involved just aren’t up to the job? Of course they can be — and I am sure our Government will get it right in the end. But until that time, we should all ask ourselves “What’s the point of travel when you could die?”

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