Rates of swine flu infection are on the rise again here, with the number of reported cases tripling to around 1,500 in the space of a week. Publicly at least, health officials and others are putting a brave face on what a major pandemic could mean for Irish society.

They stress the need for calm, and repeatedly highlight how they are planning ahead to deal with any or all eventualities.

Yet as the latest figures indicate, the signs are that like in the UK, swine flu is beginning to have a tangible impact here.

Just last week, for example, the GAA was forced to cancel an All-Ireland minor football match between Down and Dublin after a large number of Down players became ill with suspected swine flu.

Meanwhile, at UCD, seven foreign students were placed in "quarantine" due to suspicions that they had the virus.

Clearly, there is a fine line between ensuring we are adequately prepared for a major pandemic, and overstating the risks associated with what to date has been a relatively mild virus in most cases.

But should the current strain of the disease grow more virulent and resistant to treatment, it would then become an altogether more worrying proposition.

Either way, it is necessary to ask the question: are we really prepared for swine flu?

HEALTH

At a press briefing in Government Buildings on Thursday evening, Dr Pat Doorley, director of public health with the HSE, reiterated the extent to which expert planning to tackle swine flu is continuing.

This includes building up stocks of materials such as gowns, goggles and gels, and ensuring continuity of supply in essentials such as food and linen for hospitals, he said.

It may also involve the prioritisation of services in order to free-up capacity. This could lead to the deferral of routine procedures and the early discharge of patients.

But according to nursing representatives, the HSE's own projections that up to 26,000 extra hospital admissions may be required at the peak of any swine flu pandemic - a figure which could rise - would lead to huge problems in the hospital system.

"There are around 13,000 acute beds in the healthcare system, and they are either closed or occupied. There are also regularly 300-400 people waiting on trolleys, and that is on a normal week," Dave Hughes, deputy general secretary of the Irish Nurses Organisation, says.

"All the other illnesses which the healthcare system has to deal with - the heart attacks, car accidents, etc - won't stop. So we're very worried. The present system simply couldn't cope with that level of admissions, particularly when you also factor in recent cutbacks in the number of short-term staff, including nurses.

"The potential to create enough space in the system is just not there, even with early discharge and other measures. Where are they going to go? Also, you are going to need to isolate them from other patients. So the numbers just don't add up."

In truth, however, the vast majority of swine flu sufferers will likely not require hospitalisation, and will be able to deal with their illness at home.

As a result, it is expected that many will turn to their GP for advice. Dr Eamonn Shanahan, spokesman for the Irish College of General Practitioners, says a key issue facing GPs is how to separate suspected swine flu sufferers from other patients.

Each practice has to formulate its own procedure for doing this, he suggests. This could include allocating a separate room for such patients to be examined in ? or even examinations taking place outside the surgery in patient's cars.

Just as in the hospital system, Shanahan says GPs might also have to create extra capacity by deferring more routine consultations in order to prioritise swine flu patients.

But it may not be possible for GPs to visit patients in their own homes, he warns, particularly if there is a significant shortage of manpower due to illness among medical staff themselves ? or a lack of available locums.

"You could probably get to two or three patients per hour in an urban area, less in a rural area, compared to around 15 who visit your surgery," he suggests.

Dr Ronan Boland, chair of the Irish Medical Organisation's GP committee, agrees that swine flu is a "concern for every GP in the country and I suspect every GP in the world".

"I think it is an evolving situation… If there are one million cases by Christmas, we most certainly will not be able to do house calls," he says.

EDUCATION

Any decision to close schools in advance of the autumn back-to-school period needs to be communicated at the earliest possible opportunity, according to the head of the state's largest second-level teachers' union, the Association of Secondary Teachers Ireland (ASTI).

The union's general secretary, John White, notes that it has been suggested by the World Health Organisation (WHO) and others that consideration be given to such a move.

Yet the ASTI has had no formal indication from HSE as to whether schools here will close, he says, although the Department of Health has told the Sunday Tribune that this is not currently planned.

"We're not formally meeting with them in relation to it. I think swine flu has kind of developed rapidly… I think as with all situations like this, which can be subject to misinformation and rumour, schools need clear and simple advice on the matter," White says.

"I would say the HSE and the department should form a view so that there is clarity for schools on the matter, and so there isn't any confusion and inconsistency across schools."

But he warns that there is a 'tipping point' on the number of substitute teachers who could be brought into a school in the event of a large number of staff being absent with swine flu.

This is because schools need to be operated as "ordered institutions" so you "can't just bring in a whole crowd of people", he says.

At third level, plans are already well advanced to deal with flu cases. As the quarantine example at UCD so clearly illustrates, these plans are now beginning to kick in as students from around the world start to arrive at, or return to, college campuses.

In fact, Trinity College Dublin is so concerned about the potential impact of returning students that it may decide to shut its doors to the public as early as next month, in order to limit the potential spread of the virus.

UCD's own flu pandemic plan also predicts that a 20% absenteeism rate among staff could seriously impact on its ability to function normally.

The pre-school age group - children aged five and under - are among those most at risk from swine flu.

Yet according to the National Children's Nurseries Association, it is not currently envisaged that creches and preschools will be asked to close.

It advocates a "common-sense" approach to the issue when it comes to spotting potential cases. But it is also aware that the impact of any decision to close childcare facilities could have a significant impact on families. This is particularly true where both parents are working. "If a childcare service is forced to close down then the parent/carer will have to find alternative care," it notes. "If this is not possible then parents will not be able to go to work and children will miss out on socialisation, curriculum and interaction with their peers."

TOURISM AND THE WIDER ECONOMY

While almost 30,000 restaurants in Mexico city were forced to close during the height of its initial swine flu outbreak last April, there has been no suggestion that a similar course of action may need to be pursued here, according to the Restaurants Association of Ireland. Its chief executive, Adrian Cummins, says he has not received any indication that staff may be asked to wear masks, or to limit their service to takeaway food only, as was the case in Mexico.

Instead, he says, his focus is on taking the necessary steps to help prevent the spread of infection, while also ensuring businesses continue to function in a scenario where experts suggest up to 30% of restaurant staff could be absent due to illness.

At Dublin Airport, by comparison, a spokeswoman would not speculate as to whether it might be required to close due to swine flu, and declined to release a copy of its contingency plan.

Asked if the DAA expects to have to deal with high rates of absenteeism among its staff, she said it was "very difficult to say at this point. The DAA will make every effort to ensure the airport operates as smoothly as possible and contingency plans have been formulated to ensure this will be the case," she added.

Yet just last month, the HSE asked all businesses and major organisations to appoint a swine flu co-ordinator to cope with projected absenteeism rates of 15%.

According to Pat Delaney, director of business sectors with Ibec, there is a strong need to get the message across that, despite any pandemic, Ireland remains "open for business".

"Our view is that our members are well prepared, are extremely well prepared for this. Companies have been here before, it's not new to us, for example foot-and-mouth disease or the pork dioxin scare," he says. "So while it's a threat, that's all it is. The response to the threat is what is important."

But uncertainty remains as to whether individuals who have self-diagnosed (rather than visiting their GP) will be entitled to take fully-paid sick leave without a medical certificate.

Delaney says businesses clearly don't want swine flu "turning into a charter for people to stay at home".

"No employer would want to see their employee suffer from hardship. Once they are certified a company's normal policies and procedures for illness would apply," he says.

"It is very important people get certifiable evidence that they are unable to go to work and that is what certification provides – it says that you must not go to work."

Patricia Callan, director of the Small Firms Association, agrees. She has been advising her members about the need to have business continuity plans in place if swine flu hits their business.

This is particularly true of owner-managers, she says, who may need to ensure they can keep working from home if they contract swine flu themselves. But Callan notes that swine flu could be used as an excuse for absenteeism, with "people who have sniffles saying they have swine flu".

"In general terms absenteeism tends to be less in smaller companies, but at the same time it's a very clear risk," she says.

"There is never a situation where a company would want somebody to come in with the ordinary flu. But if you self-diagnose and stay away from work, that's not acceptable either."