Influenza A(H1N1)
The next item of business is a statement by Nicola Sturgeon, on Influenza A(H1N1). The cabinet secretary will take questions at the end of her statement. Therefore, there should be no interventions or interruptions.
I am grateful for this opportunity—the first available to me—to update Parliament on the current situation arising from the A(H1N1) swine flu virus.
I apologise for the delay in distributing copies of the statement to the Opposition parties. Members will be aware that we are dealing with a quickly changing situation, and I wanted to give Parliament information that is as up to date as possible. I have endeavoured to update Opposition spokespeople as regularly as possible over the past few days and will continue to do so in the period ahead.
I want to update Parliament on what we know so far about the global situation, on the up-to-date position here in Scotland and on the extensive and wide-ranging actions that we are taking in response.
Members will be aware that on Sunday, the World Health Organization declared the situation a public health emergency of international concern, and that on Monday evening it raised its pandemic alert to level 4. I want to reassure members, and indeed the public, that that does not mean that we are in a pandemic situation or that a pandemic is inevitable. However, it does mean that the risk has increased and that our actions have to be stepped up in response.
Members will be aware that the outbreak began in Mexico in—as far as we know—March. There is an unknown number of cases in Mexico, although estimates put it at around 2,500. There have also been an estimated 159 deaths in Mexico. It is worth stressing, however, that so far only 26 of the cases in Mexico have been confirmed as being caused by the A(H1N1) virus. It is therefore possible that other causes of infection are also circulating in Mexico and causing illness to people there.
Beyond Mexico, and in addition to the two confirmed cases here in Scotland, more than 60 cases have been confirmed in a number of states in the United States of America. Thirteen cases have been confirmed in Canada, four in Spain, three in Germany, three in New Zealand, one in Israel, and one in Austria. Members will also be aware that, in the past couple of hours, three cases have been confirmed in England. One of those is a child, whose school has been closed as a result. Suspected cases have also been reported and are being investigated in a number of other countries, and—understandably and rightly—Governments across the world are monitoring the situation very closely. The most disturbing development today is, of course, the tragic report from the US that a 23-month-old child has died, apparently as a result of the virus.
I turn to the up-to-date position in Scotland. Members are aware that two individuals who returned from Mexico on 21 April and presented with symptoms to the national health service on Saturday were confirmed positive for swine flu on Monday. I am pleased to report that both individuals continue to recover well in hospital. A short while ago, I spoke to Iain Askham on the telephone. I passed on what I am sure are the very best wishes of the Parliament, and indeed the whole country, to him and his wife Dawn.
As soon as Iain and Dawn Askham presented with symptoms on Saturday and were admitted to Monklands hospital, action was taken quickly to identify and contact all those who had been in close contact with them since their return from Mexico. They totalled 22 people. All the contact group were given prophylactic antivirals and appropriate advice, and are being monitored. I reported yesterday that nine people from within the contact group were displaying mild symptoms. At the onset of their symptoms, they were treated further with antivirals and advised to stay at home. I am able to confirm that eight of those people have tested negative for influenza A. As swine flu is a strain of influenza A, that means that they do not have swine flu. From that group of nine, one test result remains outstanding. The test results therefore suggest that we have to date, as far as we know, managed to prevent the spread of infection within Scotland. At this stage—I stress "at this stage"—that is encouraging.
I also reported yesterday that 14 further cases were under investigation in a number of health board areas across Scotland. I should clarify that one of those was, in fact, a contact of the two confirmed cases, and not a new travel-related case as I indicated yesterday. The rest were all people who had travelled from Mexico or other affected areas. I confirm that five of those cases have also tested negative for influenza A and that another two have been declassified, which means that they are no longer suspect cases. The results from the remaining seven people remain outstanding, including the one who was a contact of the confirmed cases.
However, I have also to report that, as of 10 am today, a further 24 cases across Scotland are under investigation. They are in the following health board areas: Ayrshire and Arran, Greater Glasgow and Clyde, Grampian, Lanarkshire, Highland, and Lothian. All those cases are people with travel connections to Mexico or other affected areas. That means that, including cases outstanding from yesterday and new cases today, we have 32 cases under investigation. That still includes two of the 10 contacts—as the figure is now—of the confirmed cases that have shown symptoms. I stress, Presiding Officer, that these cases are being treated and investigated on a precautionary basis. They are not confirmed cases of swine flu.
I would now like to outline the action that the Scottish Government has been taking, and is taking, to respond to the situation. As members will appreciate, at this stage our top priority is to prevent and disrupt the spread of infection in Scotland. We are therefore treating all suspected cases in line with the precautionary principle. That means that all cases are assumed to be positive until they are shown to be negative. We are contact tracing for all suspected cases, and we are ensuring that there is appropriate management of all contacts. Based on the test results that we have so far, we are cautiously optimistic that our approach is showing some signs of success. However, we are by no means complacent and we remain absolutely focused and vigilant.
Our second priority is to try to learn as much as we can to contribute to both our own and the international understanding of the epidemiology of this virus. Our extensive contact tracing of suspected cases—something that not all countries do as systematically as we do—puts us in a potentially strong position to learn more about the virus and how it behaves. That, of course, is vital in helping to shape our future response to it. I spoke yesterday to Dr Margaret Chan, the director general of the World Health Organization, who agreed that our work will be important in informing the international understanding of swine flu. Health Protection Scotland continues to work closely with the WHO.
It stands to reason that our overarching priority is to ensure that we as a country are fully prepared for anything that might lie ahead of us. Along with other parts of the United Kingdom, Scotland has been preparing for a flu pandemic for several years. Our pandemic flu framework has been in place since November 2007, and all NHS boards have their own plans in place. According to the World Health Organization, we are among the best-prepared countries in the world.
As part of our wider planning, we have established a stockpile of antiviral drugs. We have sufficient doses available to us now to treat half the population if necessary—although I stress that we are a long, long way from requiring that coverage. As a result of the decision—to which we have been party—to increase stocks across the UK, our stocks of antivirals will, in the period ahead, increase significantly beyond that. The antivirals Tamiflu and Relenza are proving to be effective against the virus.
We are working with NHS boards and NHS 24 to develop quickly a system that ensures patient access to antivirals where that is necessary and appropriate, and planning is well advanced to move antivirals from central stockpiles to local distribution points. We also have a stockpile of 9 million surgical face-masks and almost half a million high-fidelity respiratory face-masks for use by health care workers. Action is under way at UK level to significantly increase stockpiles of face-masks. We also have advance agreements in place with manufacturers should a vaccine for the virus be developed, although members will appreciate that that may well still be some time away.
We are involved in developing the UK-wide communications strategy to advise people on the actions that they should take to minimise the risk to themselves and others. Television and radio advertisements will start to be aired in the next couple of days, and the leaflet for door-to-door distribution is due to be printed tonight and will be available from Tuesday next week. Updated information is also available to the public on the Health Protection Scotland website and, of course, NHS 24 can provide information to anyone who may be concerned.
We have also been working with the UK authorities to provide appropriate information to travellers arriving in the UK or, indeed, in Scotland. Airport checks have been increased, as the Prime Minister said at lunch time, in order to identify people coming into the country with symptoms. On that point, it is worth noting that the UK Government, as of yesterday, is advising against all but essential travel to Mexico.
I hope that this has been obvious in my remarks so far, but I would also like to assure members that we are working very closely and constructively with colleagues in the UK Government and in the devolved Administrations in Wales and Northern Ireland to ensure that our response is consistent, co-ordinated and effective. I have spoken to Alan Johnson regularly since Sunday and have greatly appreciated his co-operation on a number of issues. The Minister for Public Health and Sport attended the UK ministerial civil contingencies meeting by phone link on Monday, and I did so yesterday and again this morning. Within the Scottish Government, we have activated our own emergency response procedures and have put in place the necessary resources to ensure that the situation is effectively managed. The Scottish Cabinet committee on civil contingencies has met at least once daily since Sunday.
As a Government, we are working as hard as we can with our partners to respond as effectively as possible to the developing situation. Of course, there are also simple but very effective things that members of the public can do to limit the spread and impact of the virus. Washing hands frequently and using tissues to cover the mouth and nose for coughs and sneezes will be the most effective things that people can do to protect themselves and others from this and any other virus.
I fully understand that people throughout Scotland will be concerned by recent developments. Nonetheless, I reassure Parliament and the public that the risk to the public is, at this stage, low and that we are working very hard to keep it that way. The death of a child in the United States is a tragic and extremely concerning development that requires further investigation. However, the fact remains that, outside Mexico, all other cases of the virus have been mild and have not led to severe illness. That is and should be reassuring to the public.
Nevertheless, we continue to be vigilant in monitoring the situation, and we are taking the threat extremely seriously. The NHS in Scotland, in partnership with other organisations such as local authorities, is already dealing vigorously with this outbreak—I thank the NHS staff who are already involved in the effort—and we are activating our plans to protect the public, which have been developed over a number of years.
I will endeavour to keep Parliament fully updated on what will continue to be a developing situation. At this stage, I am happy to answer the questions that I know members will have.
As the cabinet secretary has indicated, she will now take questions on any issues that are raised by her statement. We have around 30 minutes for such questions.
I thank the cabinet secretary for the advance copy of her statement. I appreciate that it may, in an ever-changing situation, have been difficult to circulate the statement as far in advance as she wished. I also thank her for the regular updates that she is prepared to make and her willingness to have that communication with Opposition spokespeople.
I add our best wishes to the Askhams, to whom the cabinet secretary has spoken. We wish them well. We welcome the quick action that was taken by them and the action that was taken by the staff in the NHS and the Scottish Government to ensure that the prepared plans—which, as the cabinet secretary said, have been developed over a number of years—were put in place. Those of us who have been involved in the process at various stages hoped that we would not have to put those plans into operation, although we recognised the reality that, at some point, it was likely that we would have to use them. I put on record our support for what is needed to ensure that things progress as they need to in order to minimise the risk to the public.
I wonder whether the cabinet secretary can say a bit more about the contact tracing. Is she satisfied that every effort has been made and that the people who needed to be contacted and traced have been?
At what stage would she envisage additional resources having to be made available so that, rather than simply contacting and treating people where possible, other containment measures would be introduced, given the WHO's view on how difficult that will be globally?
Will the cabinet secretary give Parliament further information regarding potential patient access to antivirals, where that is appropriate? She mentioned in the statement that planning is well advanced to move the central stock piles to local distribution points. At what stage does she envisage those movements being authorised? Is she satisfied that it will, given the global situation, be possible to obtain additional antivirals and other items such as face-masks at this point in time?
I thank Cathy Jamieson for her questions, for her constructive approach over recent days and for the support she has given us as we have tried to deal with this emerging situation. She is absolutely right to emphasise contact tracing. In the early stages of the virus when, as she points out, the WHO thinks it is no longer possible to contain it within Mexico, we should nevertheless strive to contain it and disrupt its spread within Scotland. That is where a considerable degree of our focus has been since the weekend.
The contacts of the two confirmed cases were traced quickly. We are as satisfied as we can be that all their close contacts have been traced. They were then given appropriate management and treatment. As other contacts or new cases become symptomatic, we will go through the same process with them.
Contact tracing and appropriate treatment of contacts is important for two reasons: principally, to try to stop the spread of the virus and secondly, because we are in the early stages of this virus and nobody anywhere in the world fully understands how it works, all the information we can get at this stage will be helpful in developing that understanding. We are not the only ones who are engaged in contact tracing: the same process is under way in England, but not all countries do it as rigorously as we do, which puts us in a very strong position to learn from this virus and contribute to international understanding of it.
With regard to her point on patient access to antivirals, that is absolutely crucial. At the moment we are treating people who present with symptoms and who are assessed as being at risk. There is a Health Protection Scotland algorithm to help with that process. People are being given antivirals as a prophylactic, and people with symptoms are also treated with antivirals.
As I said in my statement, the process is under way to move stockpiles from central points to local distribution points. That is to ensure that if we need the antivirals to start flowing to people—it is hoped that we will not—it can happen quickly and effectively.
In my statement, I mentioned that we have stocks to treat 50 per cent of the population. We hope to be able to increase that significantly: I hope that we could take our stocks to more than 4 million doses of antivirals, but all this is under constant review as we continue to respond to a situation that is, as Cathy Jamieson rightly said, changing quickly.
I thank the health secretary for the advance copy of her statement; for keeping me and my party informed since the outbreak and for the previous briefing from the chief medical officer and Shona Robison on pandemic flu, which has been very helpful.
Why is it likely to take between six months and a year to identify this strain and manufacture the vaccine, as was confirmed in Westminster on Monday? Does that length of time create any further problems for Scotland?
What measures will be taken to ensure that NHS 24 can cope with the significant increase in demand for advice, particularly at peak times? Will there be a national distribution system for the delivery of Tamiflu and Relenza? Will that be planned, given that people are being told not to visit their general practitioners' surgeries?
Given that many oil workers from Scotland are based around the Gulf of Mexico, what is the cabinet secretary doing to work with oil companies to give them advice and support on prevention and treatment?
I thank Mary Scanlon—as I thanked Cathy Jamieson—for her support during the past few days.
Mary Scanlon raises an important point that is currently of huge interest not only to us in Scotland, but to people throughout the world: the question of how quickly a vaccine for the virus can be developed. For reasons that she will understand, I cannot answer that question definitively, but I am sure that vaccine manufacturers, working with international experts, will be doing everything they can to expedite that process.
There are a couple of issues. First, the experts have to understand the virus sufficiently to create the vaccine; and secondly—as members on the Health and Sport Committee will be aware—manufacturers are already in the cycle of preparing and producing the seasonal flu vaccine. At some stage—this is a decision that would be guided and taken by the World Health Organization—manufacture will have to be shifted from the seasonal flu vaccination to a vaccination for the new virus.
As I said in my statement, it is important that we in Scotland and throughout the UK have advance agreements in place with manufacturers so that we know that as soon as there is a vaccine, we will be able to access stocks of it. Everything that we can do just now to slow down any spread of the virus buys us time along the road to a vaccine's being ready for use.
Mary Scanlon made important points about the distribution of antivirals. We will oversee the stock and distribution of antivirals nationally, but delivery to patients will be done on a local basis, because it is best managed that way. The member is right that we are advising people who have symptoms—particularly those who have connections to Mexico—to stay at home and not to go to their GPs.
For the cases that are under investigation just now, antivirals will be delivered to them. If the outbreak should become bigger—let us hope that it does not—we will have to seek to encourage people's friends or family members, or people in health boards, or a bit of both, to continue that delivery.
Those issues require great planning, but the work that we have done around pandemic flu has advanced that planning. NHS 24 has more call handlers on duty just now, as there has been about a 25 per cent increase in calls. It is also setting up a dedicated support service, which will be accessed via the regular number, to divert people who have swine flu concerns to people who can give them specialist help. I did not mention that in my statement because we are still working on it—I will update members more fully later. Lastly, we are working with everyone in the private sector to try to ensure that they are prepared and are giving the right advice to their workers.
I thank the cabinet secretary for keeping me and my party advised of developments in the outbreak during the weekend, and for the advance copy of her statement. As I was the minister during the foot-and-mouth disease outbreak, I recall—perhaps like no other member—the very real difficulties that are involved in being able to keep Parliament advised and ensuring that it is given the most up-to-date information.
I and the other Liberal Democrats hope that the frank and measured way in which the cabinet secretary has been dealing with the matter, and the up-front way in which she is giving information to the public, will allow the public to realise that the Government is handling the matter, and that any anxieties that they have should be kept in perspective. That is terribly important in such a situation, in which we know that people who have understandable anxieties can become a little overexcited. I hope that the actions that the cabinet secretary has taken will be recognised by the public in that way.
The cabinet secretary made it clear in her statement that she has a stockpile of surgical face-masks in addition to the antivirals. At the weekend—perhaps unfortunately—one or two people who claimed to have knowledge in health were rather dismissive of the efficacy of face-masks. I am sure that the cabinet secretary is aware of that, and I give her the opportunity to explain the circumstances in which she would deploy the masks and how effective she thinks they might be.
I thank Ross Finnie for his comments and, as for other Opposition spokespeople, for his support over the past couple of days and, indeed, for his words of wisdom, given his experience.
Ross Finnie puts his finger on an important point about giving the public as much information as possible. I believe that the way to keep the right balance between understandable concern and ensuring a lack of panic and alarm is to treat the public with respect and to give them information. They can judge for themselves the degree of risk. People around the country have—as far as I have been able to judge in the past few days—kept things in perspective, which is very helpful. There is sometimes a tension between wanting to give out information and patient confidentiality. We will require to continue to manage that tension, but I will continue to work on the basis of giving out as much information as possible—certainly to Parliament, as it is Parliament's right to have it, and, by extension, to the wider public.
The point about face-masks is important. Ross Finnie is absolutely right about the limitations of surgical face-masks, even for health care workers. However, for health care workers who are not in close contact of the kind that a surgeon doing an operation would have, for example—face-masks can provide some protection from patients with symptoms. There is no doubt, however, that high-fidelity respiratory face-masks provide the greatest protection to health care workers. The focus at UK level is very much on increasing the stockpile of those masks. That is important work. There are more general issues about the public's use of face-masks. Our priority is to ensure access to face-masks for health care workers. That will continue to be a priority and the broader issues will continue to be kept under review.
We come to open questions. I cannot go beyond 19 minutes past 3—the next debate is already oversubscribed. Please keep questions and answers as brief as possible.
The cabinet secretary told BBC Radio Scotland yesterday that those who had developed symptoms of the illness had had "close contact" with Iain and Dawn Askham. That included work colleagues. I wonder what concern there might be that the wider Polmont area, where Mr and Mrs Askham reside, is at particular or greater risk of infection compared with the rest of the general population. Should local people be taking any additional precautions?
I am guided by clinical and expert advice on this: it is close contact with symptomatic people that presents the greatest risk. That is why our focus is on tracing and identifying close contacts.
On risk to the wider public, first I repeat that it is close contacts that present the greatest risk; also, we should take some encouragement that so many of the close contacts have proved to be negative for the flu. That should reassure us, to some extent, that the wider population in that area were not at risk from those two individuals having the virus.
Beyond that, I reiterate what I said in my statement: to reduce the risk to themselves and others, the general population, in the Forth valley area and anywhere else in Scotland, should wash their hands and not cough and splutter over other people. If there is one consistent message that all of us in the Parliament would do well to go out and give to members of the public, believe me, it is that one—it will probably be more effective than most other things that we try to do.
I thank the minister for taking time to keep me up to date regarding the Forth valley situation; it is very much appreciated. Given the World Health Organization's statement that the disease is not containable, can she confirm that the Government is using all its resources to contact all the relevant people who have been in contact with my constituents and others, including the patients who were attended by the out-of-hours GP on the evening when he visited my constituents?
Cathy Peattie is right to highlight the opinion of the World Health Organization, which is that the virus is not containable. We are seeing the evidence of that in many countries across the world just now. However, that does not mean that we cannot contain it within Scotland, and indeed within the UK. We cannot, of course, guarantee that we can do so but we should still, at this stage, be doing everything that we can to ensure that the possibility of that is maximised.
I assure Cathy Peattie that we are doing, and did, everything possible to trace all the close contacts of the two people who were subsequently confirmed to be positive. From what we know from the evidence so far, that action may have been crucial in limiting the spread of the virus from them to other people in Scotland. We will continue to take a precautionary approach until things move to a stage at which we think that that is not appropriate, but such an approach is certainly appropriate at the moment.
In her statement, the cabinet secretary mentioned the health board areas in which people are being investigated for suspected swine flu. Does she have any further information about the pattern of the spread of the infection? Are any groups more at risk than others?
Those questions are of huge interest not just to us, but to countries throughout the world with which the World Health Organization deals. However, nobody yet knows enough about the virus, its epidemiology, its behaviour and the groups that it affects and impacts on to answer them. That is the honest answer.
Obviously, one thing that we are determined to do should there be any further transmission of the virus—this will be made possible by contact tracing—is to try to establish as much information as we can in Scotland about such matters. I hope that there will not be any more transmission of the virus and that that will not be possible, but if there is, the information that we gather should put us in a position to understand it further. From my discussions earlier in the week with Margaret Chan from the WHO—I think that I discussed the matter with her yesterday—I know that gathering information is a key focus for the WHO in trying to understand the virus further.
Will the cabinet secretary join me in thanking specifically the staff at Monklands hospital, which is in my constituency, for the professional way in which they have responded to providing care in the only diagnosed cases of the AH1N1 virus? During the severe acute respiratory syndrome outbreak, many medical professionals who treated the individuals who had contracted that virus also became ill. What action has been taken to protect medical professionals at Monklands hospital who are treating cases and may have to treat further cases? What contingencies are in place should medical staff shortages arise?
I thank Karen Whitefield for thanking the staff at Monklands hospital, which gives me the opportunity to do likewise. It cannot have been easy for anybody in that hospital to have found themselves not only dealing with the first two confirmed cases of swine flu in the UK over the past few days, but doing so in the understandable glare of the media. They have done a sterling job, and I know that all members will want to thank them for that.
Karen Whitefield raises the important issue of the protection of health care workers. It is vital to protect our health care workers for their own sake and because we need to ensure that our health service is equipped to cope at a time of greater pressure. All the staff at Monklands hospital who have dealt with our two cases over the past few days—those two people have, of course, been in isolation at the hospital—will have worn personal protective equipment, which is important. If things develop further, ensuring that we provide the right equipment—including the right face-masks—and perhaps, depending on how things develop, providing routine antivirals for staff working in the NHS, will be vital. All those matters are under review. However, at this stage, I put firmly on the record my thanks to and admiration of NHS staff.
As the cabinet secretary is aware, Tamiflu is available over the counter in New Zealand. There may be pros and cons relating to the use of that drug and I am not aware of the inoculation regime that is in place in New Zealand, but will she consider the circumstances and reasoning that lay behind the decision to make that drug available in that manner?
Given how things are developing and are likely to develop, we will keep all such issues under review, as people would expect us to do. There is probably no issue on which our views should be set and to which we are not prepared to respond as appropriate. We will certainly learn from things that other countries are doing where that is appropriate. However, my view at this stage is that we need to ensure that our stocks of antivirals are directed at people whom we think most need them to try to prevent and alleviate symptoms or to reduce them once they have started. It is important to target the use of antivirals rather than inadvertently encourage members of the public who do not need treatment with them to try to access them. We will, of course, keep that issue and every issue under review.
I welcome the non-alarmist tone of the question-and-answer session. Reflecting on Karen Whitefield's question about hospital staff, will there be any changes in hospital procedures and routines for patients who are in hospital and who might feel particularly vulnerable—we do not know whether they are—or for people who enter hospital in the future?
Given that the two patients with whom we are concerned have been in hospital, it is right and understandable that the focus is on hospital staff. I set out for Karen Whitefield the protection that has been available to staff in the past few days. It is important to point out to other patients in Monklands hospital or people who are likely to go to the hospital that those two patients are in isolation and are getting better. Their period of infectiousness is probably passing, if it has not already passed.
That said, we should appreciate that it is likely that the biggest initial pressure on the NHS would be on primary care, rather than hospital care. The pattern so far is that people throughout the world outside Mexico have experienced relatively mild symptoms. If that continues—let us hope that it does—we would not expect large numbers of people to be admitted to hospital; instead, people would be treated in the community. At present, we must ensure that primary care services and NHS 24 are properly equipped to cope. However, the valid points that Christine Grahame raises about hospital staff will remain under review, as will other issues.
As the cabinet secretary said, there are many issues to do with the virus that are not yet clear, such as its degree of contagion and the rates of mortality, so we are at the beginning of something rather than well through it. It is clear that we should work for the best, which is containment, but prepare for the worst. In 2000, the Health and Community Care Committee produced a report on influenza, for which I had the privilege of being the reporter to the committee. Preparation and testing of the system through exercise winter willow put us in one of the best positions in the world, which is excellent.
In preparing for the possibility that things might get worse, does every NHS board have a register of retired NHS staff, including doctors, nurses, paramedics and porters, all of whom should surely now stand by to be ready to help backfill for staff who fall ill or who are exhausted? Does the cabinet secretary agree that internet purchase of antivirals is not recommended, because the products are often not appropriate or suitable, and that people should not rush to the internet to purchase such products? Does she also agree that we should refer to the virus as an AH1N1 virus and stop using the term "swine flu"? That is in part because we are not sure that it is swine flu and also because the term suggests that pork and pork products might not be completely safe. We should reassure the public that those products are totally safe and that there is no evidence of any problem.
I stand to be corrected, but I think that I was a member of the Health and Community Care Committee when Richard Simpson produced his excellent report on pandemic flu planning. There is no doubt that much of that informed the subsequent plans that the previous Government and this Government have put in place, which have ensured that we are, as the WHO has said, one of the best prepared countries in the world. Richard Simpson is right that we are working and hoping fervently for the best, but we are preparing for the worst, because it would be irresponsible not to do so.
On Richard Simpson's specific question about whether every NHS board has a register of retired staff, I will check that and get back to him. However, should we get to that worst-case scenario—let us hope that we do not—his point about utilising retired staff would be important. I know that he has raised that issue previously in the Parliament.
Richard Simpson is right about internet purchase of antivirals, which is not necessary for several reasons. If people in Scotland require antivirals, they will be provided by the NHS. I therefore encourage people who feel that they might be at risk or might have symptoms to telephone NHS 24 or their GP. If they need antivirals, they will get them on the NHS.
I know that the WHO has had debates about the terminology. I will go with the expert view on what to call the virus. My main focus is on trying to beat the virus and ensure that it does not do any damage in Scotland. The member's point about pork is absolutely correct. The Cabinet Secretary for Rural Affairs and the Environment was here earlier and he would want me to make this point: pork and pork products are safe and we should not allow any implication that they are otherwise.
I thank the cabinet secretary for keeping me informed about the situation and I congratulate NHS Scotland on its state of preparedness. I, too, am interested in antivirals and I suggest that it would be worth while issuing a statement that would make people understand what antivirals are. For example, we have said that Tamiflu and Relenza are proving effective against the virus. Was that just good fortune? We did not seem to have the same notice of swine flu that we had of bird flu. It might be worth while explaining to the public what an antiviral is.
That is an important point. I was just trying to find among my papers the draft of the information leaflet that is due to go door to door to every household in the UK next week. From my memory of reading the leaflet this morning, I am pretty sure that it explains about antivirals and why they are important. I think that it gives all the information that Margo MacDonald helpfully suggests the public should have.
I welcome the cabinet secretary's confirmation of the positive and constructive engagement on the issue between the Scottish Government, the UK Government and the other devolved Administrations. Now that suspected cases have been confirmed throughout Europe, are discussions taking place with our colleagues in the European Union and those other countries that are affected?
That is another important point. As we have seen, the virus does not respect boundaries or borders so we have to work together in a UK, European and global sense. Tomorrow in Luxembourg, there will be a meeting of European health ministers. Alan Johnson, the Secretary of State for Health in England, has agreed to the participation in that meeting of the Scottish Government. I cannot yet tell the member whether the Minister for Public Health or I will attend that meeting; as members will appreciate, that will depend very much on the situation at home. However, I assure Shirley-Anne Somerville that one of us will be in attendance because it is important that we are part of those discussions to ensure a co-ordinated European response.
I and others acknowledge the on-going hard work of the cabinet secretary, her team and all health care workers in Scotland. I hear what has been said about the stockpiling of the antiviral drugs Tamiflu and Relenza, but there is concern about antibiotics, which have not been stockpiled, as was said on the BBC news this morning. What is the cabinet secretary's view on the need to stockpile antibiotics given the potential for secondary bacterial infection, such as pneumococcal and other bacterial infections, that follow on in many flu cases?
Helen Eadie raises an important and legitimate point. Before I answer, I remind members that as well as the stockpile of antivirals that we have, NHS boards have their own supplies of antivirals. Because those will not be sufficient if there is a big outbreak of the virus, we need stockpiles.
The need for antibiotics if, for example, people develop complications from pneumonia, was discussed at the COBRA meeting—Cabinet Office briefing room A—this morning. In that UK context, we are in discussions about the procurement of several items such as antivirals, face-masks and antibiotics. I hope that that gives Helen Eadie an assurance that such considerations are very much on our radar screen.