Saturday 11 July 2009

Flu Pandemics and Health Panics

Ed: Is it me, or is there something of the 'Corporal Jones' ("Don't panic! Don't panic!") about this ad clerum (a letter to all the Diocesan Clergy). OK, so we're at an eight-year low for influenza, but really, face masks and aprons for clergy sick-visiting? Still, I'm beginning to see why we need a sixth bishop in Chelmsford (as is currently being proposed).

The Bishop of Chelmsford

Ad Clerum

July 8th 2009

To all clergy in the Diocese of Chelmsford

The Department of Health has announced that the management of the Swine Flu Pandemic has changed from the 'Containment' to 'Treatment' phase. This has implications for the churches' response to the pandemic, and I am therefore issuing new directions to all parish clergy on how to respond to the various needs which will arise as a result of this.

1. Churches should continue to take services and conduct business as normal, and use stringent hygiene measures for use with the chalice or common cup: the use of antibacterial gel is recommended before handling the bread and chalices, as well as wiping the chalice with a clean, dry purificator between communicants. There is no immediate need to change this policy. Should Government advice change with a further increase in the level of alert, you will be notified, and further advice will be given. If you are able to check the Diocesan website, any changes will immediately be placed there. Please note that the practice of intinction (dipping the bread in the wine) and giving communion directly onto the tongue are strongly discouraged. These customs increase the possibility of spreading the virus.

2. Clergy should be asked to give clear advice (in Sunday Notices, parish magazines etc) to members of their congregation who may be showing flu-like symptoms not to attend church services or other meetings. (Symptoms do not normally last for more than 7-10 days.) Hygiene in church should continue to be taken very seriously, and churches may wish to consider providing bins for used tissues (not the open waste-paper bin type, but a closed top, pedal or swing top bin.) Further information can be found on www.nhsdirect.nhs.uk

3. Some churches have a stoup for holy water near the entrance to the church door, and people are invited to dip a finger in this, and to make the sign of the cross as a reminder of their baptism. The water contained in stoups can easily become a source of infection and a means of rapidly spreading the virus. This practice should be suspended. Holy water stoups should be emptied and cleaned thoroughly, and not used until the pandemic alert is over.

4. The "Flu Friend" (or Flu Buddy") system will provide help for people who have been diagnosed positive for Swine Flu. Parishes are in a unique position to be able to offer help for congregation members and parishioners. The incumbent, parish administrator, or some other suitable person may be able to act as "Flu Friend Co-ordinator" in the parish, and their details could be posted in Parish Magazines, Pewslips, etc. Suitable people may be recruited to fulfil this role. This would mean that if someone receives a positive diagnosis for Swine Flu, they could contact that "Flu Friend Co-ordinator" who could put them in touch with a local "Flu Friend". This person would be able to pick up prescribed medication on their behalf (a voucher or individual code is given when a positive diagnosis is made) and deliver it to them. In some cases, where people live on their own, they may also need some help with shopping. Clear guidance is available for "Flu Friends", but they should be advised not to enter the house, or to have direct contact with the infected person.

5. Pastoral visits and Home Communion for people who have been infected, by clergy or pastoral assistants is strongly discouraged. Contact by telephone, internet, or other means is to be encouraged! The risk of infection is very high, and a priest making a series of pastoral visits could spread infection, as well as being susceptible to becoming infected.

6. Special caution is urged when taking Holy Communion to Residential Homes. If anyone in the community has flu-like symptoms, it may be prudent to give communion in only one kind to the congregation, or those receiving communion in their own rooms. The priest alone should drink wine from the chalice. Congregations may need assurance that in receiving Holy Communion in one kind in no way suggests that they are not receiving the fullness of Christ’s presence in the Sacrament.

7. When a pastoral visit is absolutely necessary - if someone is so ill that they may be close to death, then very great care must be taken to prevent exposure to the virus. The virus is currently perceived as relatively mild, and for most people the symptoms will not be life-threatening, though people who are at high risk, because of a compromised immune system, or other health conditions may be more vulnerable. It must be noted that such people are likely to remain at home, as hospitals will not have the capacity to isolate and care for large numbers of people who are infected with the virus. In these cases clergy visiting infected people should wear personal protection equipment, including sterile gloves, apron, and face mask. If a priest gives communion (host only) without wearing sterile gloves, they should wash carefully with hot water and antibacterial soap immediately afterwards. If a priest anoints someone who has the symptoms of pandemic flu, special precautions should be taken. Never dip your finger back in the oil during the anointing, and do not use the same purificator at separate anointings. It is a good idea to use a swab of cotton wool for each separate anointing, and dispose of it safely afterwards.

It is not our intention at this stage to cause panic, or to exaggerate the seriousness of the situation. I believe that the measures I have outlined above will assist the churches in providing appropriate support in our congregations and parishes, whilst doing all that we are reasonably able to, to combat the spread of the infection.

With my prayers as we all struggle to respond, as well as we are able, to the difficult situation we are facing in this major health alert.

+John Chelmsford

PANDEMIC FLU

Checklist


1. Receiving Communion.

· Provide antibacterial gel for ablutions before handling bread or communion wafers

· Notify the congregation that they should not dip their communion wafers in the Chalice

· Do not give communion directly onto the tongue

· Wipe the chalice with a clean purificator between each communicant. If the purificator becomes damp, use a new purificator.

· Clean chalices thoroughly with hot soapy water after use.

· Do not use chalices of pottery/ceramic or semi-porous material.

· People may, if they so wish, receive communion in one kind.

2. Congregation members with symptoms

· Advise congregation members who have flu-like symptoms to stay at home (Verbal notices, as well as Newsletters, parish magazines, etc.)

· Provide bins in churches (with lids) for people to dispose of soiled tissues

· Place posters in toilet facilities (“Catch it, Bin it, Kill it”). Posters in A3 and A4 formats can be downloaded from the Department of Helath website: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_080839

3. Holy Water Stoups

· Empty and thoroughly clean Holy Water stoups, and ensure that these are not used until you are advised that these may once again be used.

4. Flu Friend

· Appoint a “Flu Friend Co-ordinator” and volunteer “Flu Friends”.

5. Ministry to the Sick

· Provide Personal Protective Equipment (PPE) in case this is needed for ministry to the sick. Gloves, facemasks, aprons are available from internet suppliers.

· Ensure cotton wool is available if anointing is needed.

· Carry bottles of antibacterial gel for personal use.

When posting your comments please give a full name and location. Comments without this information may be deleted.

8 comments:

  1. Most of this sounds fairly sensible, we're working on this as a church at the moment, so it's quite helpful to have something like this to refer to.
    David Keen, Yeovil

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  2. David, I just think, "It's 'flu, for goodness sake. It comes around every few years. People get it. Unfortunately, some die - but most don't. You feel like crap for a few days, then you get over it."

    This just feels like panic combined with hubris. The most bizarre thing to all this, as far as I'm concerned, is that the government ever thought it could be 'contained'. It can't. Probably you'll get it. Probably so will I. It'll probably be good for the race as a whole, whatever happens to us individually.

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  3. Thanks, John, for giving this a wider circulation. I hope that people take the recommendations seriously - as this is a serious issue.

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  4. If someone in my church dies after contracting flu from contact at a church service, then I'll feel a lot worse than 'crap'! At current rates of mortality (about 0.5%), combined with the forecast infection rate, there's a strong chance that folk in my community could die from this. A bit of extra effort a hygiene doesn't seem too high a price to pay to stop that happening.

    I'm not sure if I'm being over-cautious, having never lived through a proper epidemic before, so my approach may be down to inexperience, and a desire to play safe, as much as anything else.

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  5. David and Chris, the thing that strikes me about this is the notion that we can stop, or even significantly slow down, the rate of 'flu spread by 'hygiene measures'. I had an e-mail this morning from two clergy colleagues in London, one probably with flu and the other where most of his family had it. I guess they were both in church on Sunday. If either of them shook hands with people, this may have been enough to spread the disease. Moreover, my understanding is that people with 'flu are 'contagious' before they are 'symptomatic'.

    Of course, if one knows one has 'flu, one ought to keep away from other people - but by then the damage is done. I can't see why we don't just accept this as a normal hazard of life, rather than treating it as if it were a threat to civilization (on the back of a hyped media story).

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  6. The Bishop of Rochester has issued an almost identical letter to all the clrgy - perhaps the Bp. of Chelmsford is merely following a party line decided on by all the Bishops.

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  7. The Bishop of Manchester has said that he has the stuff ready to send out (presumably the same as Chelmsford and Rochester) but he hasn't sent it because he really doesn't want to.

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  8. Ruth Gledhill has now posted some more details on this, which gives some indication as to which guidelines are national and what's specific to Chelmsford.
    http://timescolumns.typepad.com/gledhill/2009/07/cofe-bishops-issue-swine-flu-warnings.html

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