AS the swine flu pandemic dies down, the question on everyone’s lips seems to be the same: “What was all the fuss about?”

Misanthropes who imagined the pandemic playing out like Stephen King’s novel The Stand, with a handful of survivors wandering the deserted streets of a devastated world, were sorely disappointed. The end of the world certainly wasn’t nigh.

Swine flu, from a news perspective at least, was the biggest damp squib of a story since the millennium bug failed to cause planes to fall out of the sky and prison security systems to fail, releasing hordes of prisoners into the night to mingle ominously with new year revellers.

But this time the media, locally at least, can’t be blamed for the hype. Dr Richard Harling, director of public health for NHS Worcestershire, the organisation which oversaw the response to swine flu locally, has thanked regional media for their professionalism in reporting the pandemic.

Some of the more lurid tales surfaced at the start of the outbreak in Mexico last March (before it had been declared a pandemic by the World Health Organisation in June) when there was less understanding of the nature of the H1N1 strain.

The health service also has to plan for the worst-case scenario which can make grim, apocalyptic and, with the luxury of hindsight, somewhat absurd reading.

In Worcestershire alone there were predictions last January that a flu pandemic could kill 7,000 people and the grimly utilitarian sounding Worcestershire Excess Deaths Co-ordinating Group, comprising the coroner, police, fire service and funeral directors, was set up to deal with the aftermath.

Despite my best efforts, I was never able to set up a meeting with the leaders of this group, perhaps (I am speculating) because such a morbid slant on emergency planning could be a source of public alarm and panic. There is a fine line between informing people and scaring them witless.

The pandemic in Worcestershire contributed to the deaths of five people – roughly the same number who die of ordinary, seasonal flu.

Even at its height in July and the second wave, peaking at the end of October, there were, at most, one or two people in intensive care beds in Worcestershire hospitals with swine flu.

But if the authorities had not acted swiftly, it is possible that more people could have died.

Dr Harling said: “There was a lot of stories from Mexico about the health system and the whole of society on the verge of collapse.

“We had a new virus with unknown potential with some reports that it was quite serious – and one of the fundamental things about flu pandemics is that they are by their nature unpredictable.

“Quite reasonably back then, there was a concern that the impact of this new virus was unknown and could be potentially quite severe. Therefore health services internationally did everything possible to prepare for it and respond to it.”

Dr Harling, who believes the pandemic presented a catch-22 situation, said: “You can do the responsible thing, which is to gear up and get everything in place and treat it as a genuine threat – running the risk that the response looks disproportionate if it turns out not to be as bad as first thought.

“The other option is to cross your fingers and hope that it’s not that bad. The risk there is that if it does turn out to be serious, you have lost weeks and months in terms of your response. You could also lose lives.

“You’re damned if you do and damned if you don’t. The fact that it hasn’t turned out as badly as expected doesn’t mean it was over-egged. It just means we got lucky.”

Only 33 per cent of county NHS staff accepted the vaccine, which reflects people’s perception of the mildness of the virus or possible concerns about side effects.

Nevertheless, swine flu did kill people – often those with chronic underlying health problems. The virus was one of the main contributing factors in the death of Andy Bishop, aged 36, of Nunnery Avenue, Droitwich, in July last year. The day before his 37th birthday, he was the first man in Worcestershire to die with swine flu.

But the pandemic was not serious enough for health bosses to suspend routine clinics to free up GP time or double the number of intensive care beds, as planned.

At the height of the pandemic, when it was no longer possible to contain the virus, six antiviral collection points in Worcester, Malvern, Pershore, Bromsgrove, Redditch and Kidderminster were offering Tamiflu to “flu friends”, with up to 1,800 doses handed out in a single week, tailing off to 55 in the last week of January.

Staff at NHS Worcestershire put in 16-hour days and Dr Harling has praised the hard work and the “Blitz spirit” of workers faced with a huge logistical project.

At one point during the height, Dr Harling was working so hard that he was told by NHS Worcestershire chairman Dr Bryan Smith that he looked like he had swine flu himself.

The organisation’s own chief executive Paul Bates had swine flu and was off work for a fortnight at the end of last October. From his sick bed he lamented that he was not himself eligible for the vaccine.

There is also no doubt that swine flu added to the pressure on the health service following the coldest, harshest winter in 30 years.

Lessons have been learned. A national review is planned but Dr Harling says that locally, letters could have been prepared when cases developed in schools and parental consent obtained for children to have antivirals more quickly.

He also says NHS Worcestershire was not geared up for the volume of calls from the public and clinicians and that more work could be done on GP-based continuity arrangements so surgeries can “buddy up” in the event of staff shortages.

But if the virus does mutate, Dr Harling and his team have had the perfect dress rehearsal. If a more lethal strain sweeps the nation, the health service in general has no excuse for being ill-prepared.