The outbreak of a new strain of flu in Mexico – a cross between ordinary human flu, swine flu and avian flu – is provoking alerts that we may finally be on the brink of the flu pandemic public health experts have been warning about for years. In the UK we are probably as well prepared as any other country.
However, that doesn’t mean things will be easy if this does turn out to be the big one. In January 2009, the British Medical Association, the Royal College of General Practitioners and the Department of Health issued joint guidance on “Preparing for Pandemic Influenza”. This suggests that an outbreak might take as little as two to four weeks to build from a few to 1000 cases and so far 1300 people have been admitted to hospital in Mexico City since 13th April. It goes on to suggest that it could reach the UK in another two to four weeks – there are already two individuals with suspicious symptoms in Glasgow and no doubt a plane full of people who were breathing in their germs who have not yet fallen ill.
The Guidance suggests that once in the UK, it is likely to spread to all major population centres within one or two weeks with its peak possibly only 50 days from initial entry. In previous pandemics between a quarter and a third of the population were infected. Estimates suggest that 4% of those infected will need hospital treatment with possibly up to 2% of those infected dying. Depending on the severity and nature of the epidemic, it is estimated that between 50,000 and 750,000 might die. Don’t even think what that will do to the already troubled forecasts for the economy.
Those who become ill will be advised not to visit their GPs but to call a special helpline. There will be advice to avoid crowded places – so that is commuting in London done for then. People will be advised not to come into work if they are ill – this will typically cause the worst havoc in organisations like the police where the norm is often for people to struggle in (being ill is a sign of weakness – the senior echelons of the Metropolitan Police seemed all to be suffering in the mini-outbreak of flu before Christmas – it is after all one of the wonders of air conditioning systems that they spread infections more quickly). Many organisations may find that up to half of their employees cannot come to work because they are ill, are caring for someone who is ill, or because their normal means of transport to work are no longer working.
The Guidance advises GP surgeries to develop photo-ID libraries of their staff so they can access any supplies that are rationed, such as fuel for home visits, and to set up an emergency box with torches, paper forms and other items that will be needed if mains electricity or computers go down.
Existing hospital capacity may only meet 20% to 25% of expected demand at the peak. Intensive care is likely to be overwhelmed. Prioritisation of all patients will be necessary on an individual basis.
Separate guidance advises Primary Care Trusts to ensure they have security on their doors to maintain order amongst those trying to access the (limited) supplies of anti-viral medicine.
I think I’ll go to bed with a hot water bottle now …..