CitationDownload as .RIS
Emerald Group Publishing Limited
Copyright © 2009, Emerald Group Publishing Limited
Article Type: Internet review From: Health Education, Volume 109, Issue 6
At the time of writing, late July 2009, the swine flu pandemic is continuing its advance. Fortunately, although the virus is proving to be highly infectious, it is now agreed that the forecast mortality rates were somewhat exaggerated. The symptoms may be unpleasant for a week or so, but for most people, the consequences will not be serious. What is interesting from an internet perspective is that this is the first time governments have sought to use the internet to help deal with a pandemic of global proportions. Indeed, in the UK, the British government has taken the unprecedented step of using the internet as the primary way of dealing with the spread of the virus. Information, rather than medicine, is seen as being the best way for people to “treat” themselves. Globally, the internet is being used in many interesting and diverse ways to help populations cope with this threat. In this review we will look at some of these innovations and if you are reading this following publication of the journal in October 2009, you may well have some idea about the success of this approach.
National Pandemic Flu
Realising that the swine flu virus was not the killer it was predicted to be, the UK government’s belated response was to use the internet to provide the population with the information they needed to cope with the situation. Some people will simply require reassurance, others may want to check out symptoms and yet others may want to know how they can get treatment. Needless to say, the initial attempts to provide this type of information, on a population scale, flopped miserably when the web site crashed under the shear volume of attempted access. This has now been remedied and the National Pandemic Flu web site acts as a gate way to a number of different information sources across the UK. The primary information source is via NHS Choices (www.nhs.uk/AlertsEmergencies/Pages/Pandemicflualert.aspx) from where users can read about swine flu symptoms, find the latest news on the pandemic, and learn about key actions to take to minimise the risk of contracting the disease. There are also information leaflets available in other languages as well as English, there is an audio version of the leaflet, and large print versions can also be downloaded. For people who think they may have contracted swine flu there is an online treatment and assessment tool which appears to work well and for those who are diagnosed as having the disease an authorisation code is issued which can be used, rather like a prescription, to collect antiviral teatments from designated collection points. This use of the internet to diagnose, prescribe and issue medicinal treatments is another first for a UK government. Obviously there are inherent dangers in this, over-prescribing being the least of them. Anti-viral drugs can have unpleasant side-effects, sometimes worse than the symptoms themselves, and many people of course may well misdiagnose thus leaving themselves exposed to these side-effects.
Selling medicinal “treatments” over the internet isn’t a new idea, the snake oil salesmen picked up on that a long time ago. But for governments to adopt this as a way of dealing with a pandemic is new, cerainly in the UK, and it will be interesting, perhaps worrying, to see how this develops when the swine flu pandemic has been and gone. Will the self-diagnosis and teatment via the Internet be extended to deal with other types of health problems?
This web site is the United States equivalent to the UK site discussed above and therefore warrents comparison. Rather than being a web site designed specifically for swine flu, what this site does is to provide links to a variety of resources that are deemed relevant to the particular issue. Sometimes this works, other times it doesn’t. For example, as with the UK web site a Health Check tool is provided, but clicking on the link takes the user to a third party web site called freeMD (www.freemd.com) where the user meets a virtual doctor, actually an interactive YouTube clip. Although it appears that the virtual doctor asks questions related to swine flu, for example temperature, age, aches and pains, it becomes obvious at the end of the assessment that these questions were generic and not particularly related to swine flu at all. In my case the diagnosis turned out to be meningitis or encephalitis, with no mention of flu, swine or otherwise. The outcome of this assessment tool is simply a summary of the answers given that can be printed and taken to the users’ doctor, there is no suggestion that treatment or drugs might be prescibed. The UK equivalent health check tool is designed specifically to assess for swine flu and in that it is far superior to the one available via this web site.
The web site gets other things wrong as well. Under the heading of Diagnosis/Symptoms, the user might expect to find a simple checklist of symptoms that can be used to inform self-diagnosis. What is actually provided is a link to a fact sheet dealing with something called the swine influenza test kit. This is obviously something that is used in he USA to help diagnose swine flu and this fact sheet explains how this kit is used by medics and what the results mean. It talks a lot about negatives and false positives but is says very little about the symptoms of swine flu. Perhaps one of the few good thing that can be said about this web site is that it provides a link to the Centre for Disease Control (www.cdc.gov/h1n1flu/qa.htm) where a wealth of information is available, though it should be understood that much of it is aimed at health professionals rather than lay people.
Australian Government Health Emergency
This web site is desgined around the different groups who all have an interest in swine flu but whose perspectives will vary. Thus the user will find sections for Health Professionals, Schools and the Childcare Community, Business and Workplace as well as Individuals and Households. It should be stated at the outset that much of this web site deals with the bureaucracy of dealing with a pandemic so much of the content is in the form of official policy documents that will be of little interest to lay users. However the sections dealing with Individuals and Households, and Schools and Childcare do give very good accounts of the symptoms of swine flu, how it spreads and most importantly how people can best protect themselves and others. This information is presented without any elaboration, there are no YouTube videos, no leaflets or posters to download, and certainly no online health assessment tools. Indeed this web site is marked by the lack of “wiz-bang” interactivity, but this doesn’t detract from the content which is informative and presented in a user friendly style. For those who like the minimalist approach,it is worth a look.
Swine Flu for Kids
Kidshealth is actually three web sites in one with the health topics covered from the perspective of parents, teens and young children. Arguably, because of the media coverage and the fact that a number of children have died from swine flu, young children may feel particularly vulnerable. This web site will help young children and their parents to better understand swine flu and its implications.
The content is simple without being simplistic. Difficult terminology, e.g. virus and pandemic are explained in a way that can be easily understood by children. The origins of swine flu are described though this might put children off pigs for ever! Perhaps the most important part of this web site helps children to understand how they can avoid the disease through basic hygiene procedures like always washing hands, avoiding sharing drinks with other children, and not putting fingers into mouths. It also suggests that children should avoid other people who are sick though this might be difficult for younger children to understand if their parents are the ones who are suffering from the illness.
The web site actually goes beyond swine flu and educates children about flu in general, what germs are and how they spread disease and why good hygeine can protect children from many different types of disease.
For parents this web site presents the same information as for children but it does so in greater depth and with an emphasis on identifying swine flu symptoms in children, particularly those who might be more vulnerable, i.e. those with chronic respiratory conditions.
Finally, the web site does try to present the problem positively by pointing out that the chance of contracting the disease is small, the symptoms rarely life threatening, and recovery usually speedy. It suggests that parents should try to reassure children that despite the negative publicity swine flu has attracted, there is no need to panic and that most people will recover from the illness after a week or so. This reassuring element is an important feature of this web site and perhaps something that is missing from others.
The web site is based in North America and this is reflected in some of the terminology used, for example “shots” instead of injections or vaccinations. But this is a minor point and parents and children from other parts of the world will find the content useful and easily accessible.