April 10, 2006

Influenza Pandemic Contingency Plans

Writing about Why H5N1 isn't to be taken so lightly from From tractors to reactors

This has been covered elsewhere on the blogs, so I won't repeat it all here but this comment was getting too long, so it's now a trackback.

I've just scanned through the Health Department's Flu Pandemic Contingency Plan . While it does seem they are aware of the issue there are some worrying things in there. Firstly, there doesn't seem to be any description of what will actually be done. There is a whole page of actual plan which is entirely devoted to convening comitees, reviewing proceedures, forming sub-groups and sending information around. This is all for after the WHO announces a 'Phase 5' pandemic alert, which basically translates to 'Holy shit, here it comes, we're all gonna die' and doesn't stike me as the time to be turning into Vogons.

Also, they say this:

In the event of a novel influenza virus causing significant outbreaks of
human illness elsewhere in the world, it is unlikely that the UK could
prevent importation (except by closing all borders); even a 99.9%
restriction of travel into the country would only be expected to delay
importation of the virus by up to two months.

They've written the "except by closing all borders" in brackets as if it's an absolutely proposterous idea. Is it? Am I the only one who thinks that an international pandemic with a possible fatality rate of as much as 50% is not a good enough reason to shut down all travel in and out of the country? Even if it only holds it off for a few months, as they point out futher up in the report this is about the time it takes to start producing a vaccine which otherwise wouldn't be ready until well after the first wave has been and gone. Civil liberties are a great thing, but you can't use them if you're dead.

Also as far as I can tell, thought I haven't read it properly, they are working on a 0.37% predicted fatality rate, with the maximum they even considered being about 2.5%. The New Scientist articles seem think that it could be anywhere between 0 and 50%.

- 4 comments by 1 or more people Not publicly viewable

  1. But if the virus mutates into a form that can easily spread between humans it would theoretically still be able to reside in birds (maybe not causing disease for the bird anymore but still as a reservoir). And birds don't respect boundaries/border closures. Its the age old problem of diseases that are transmitted through vectors and have animal reservoirs. You're going to have a hard time controlling the vector, and this posses as much threat as human-human contact in some respects. So maybe they're acknowledging that the effects of closing borders would be more damaging (economically etc) than positive?

    10 Apr 2006, 11:45

  2. I think those percentage figures are actually different statistics.

    The Health Department's 0.37–2.5% fatality rate is a percentage of the entire population. New Scientist's "up to 50%" is a percentage of the people infected by the virus.

    10 Apr 2006, 12:19

  3. Hmm, actually it's not very clear from the Health Department's PDF. The figures in the table are for "Range of possible excess deaths based on various permutations of case fatality and clinical attack rates", with a note that there are usually 12,000 deaths a week in the UK. So I guess the 0.37–2.5% case fatality rate would be the percentage of (infected) people to die in any given week? Still a different statistic though, I think.

    10 Apr 2006, 12:28

  4. Eilish: Good point, I hadn't thought of that. Still, it would help wouldn't it? Although it seems the avian form has eventually reached here of its own accord, it has taken quite some time to do so and I would imagine the human-human spread is much faster. Surely now is the time we ought to be thinking about this sort of thing and doing lots of research and modelling to try and gain as much information as possible, in preparation.

    As for the stats, I can't pretend I understand what is being presented in the report. I do think we at least need to be aware, and considering the fact, that it might turn out to be a catastrophic scale pandemic, 'apocalyptic' as Max Hammond put it in his blog. Granted, this is a worse case scenario but it is possible in the same way that it is possible that it might be barely an issue since there is some hope that the jump to being a virulent human-human virus will severly reduce the fatality rate seen in the H5N1 form.

    10 Apr 2006, 13:10

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