New (Post Pandemic 2009) UK Influenza Pandemic Preparedness Strategy
Following an earlier consultation document issued in March 2011 the UK’s Secretary of State for Health, along with the UK’s developed administrations (N. Ireland, Scotland and Wales) published a new influenza pandemic strategy on 10 November. The responses to the consultation were published at the same time.
This is a UK-wide strategy, jointly produced by Department of Health in London and the government’s Cabinet Office. It has also been developed jointly across the four nations of the UK, with professional, NHS, social care and public health organisations, and based on advice from clinical, scientific and other experts. The strategy is not a pandemic plan rather it is intended to inform the development of updated operational plans by local organisations and emergency planners.
There are a number of key changes to the previous approach, reflecting the lessons learned following the 2009 influenza pandemic, the recommendations of a National Independent Review and responses to the consultation. Chief intentions among the changes are the following:
- Develop better plans for the initial response to a new influenza pandemic, when the focus should be on rapid and accurate assessment of the nature of the influenza virus and its effects, both clinically and in relation to wider public health implications.
- Put in place plans to ensure a response that is proportionate to meet the differing demands of pandemic influenza viruses of milder and more severe impact, rather than just focusing on the “worst case” planning assumptions.
- Take greater account of age-specific and other differences in the rate and pattern of spread of the disease across the UK and internationally.
- Further explore statistical population-based surveillance, such as serology, to measure the severity of a pandemic in its early stages.
- Take better account of the learning from behavioural scientists about how people are likely to think, feel and behave during an influenza pandemic.
- Develop better plans for managing the end of an influenza pandemic – the recovery phase and preparation for subsequent seasonal influenza outbreaks.
From workshops that ECDC undertook in September this year with European Member States and the WHO Regional office for Europe it is clear that a number of EU and other Member States are in the midst of updating their pandemic plans in the light of 2009 pandemic experience. These are taking into account the many national evaluations (listed on the ECDC site), the Fineberg Report to WHO(2) as well as publications by ECDC(3) and WHO Regional office for Europe(4). These plans are starting to bridge the difficult gap between existing plans, which tended to prepare for more severe pandemics, and preparing for most benign kind of pandemic represented by 2009.(5)
The September Workshops agreed on a number of common lessons that had to be implemented in all plans: a more risk based approach, early assessment, a need to develop hospital-based surveillance reviewing operational plans in the pandemic. However there were also a number of areas where joint-work will be needed to be undertaken namely on: defining severity, plans for early assessment, preparing common scenarios (planning assumptions), communication issues etc. Other national plans are expected to appear (ECDC will list them under the ECDC Pandemic Preparedness site) as will a new all-Risks approach under the European Commission – the Health Security Initiative. What is not clear at present is what WHO in Geneva is going to do about these issues and some member states are waiting for such guidance before updating.
Details of new national plans are most welcome and should be sent to email@example.com along with questions or comments.
1. UK Influenza Pandemic Preparedness Strategy 2011, Departments of Health UK 10 November 2011
2. WHO Report of the Review Committee (the Fineberg Committee) on the Functioning of the International Health Regulations (2005) and on Pandemic Influenza A (H1N1) 2009, Final submitted to the World Health Assembly 2011
3. Nicoll A, Sprenger M. Learning lessons from the 2009 pandemic: putting infections in their proper place. Eur J Epidemiol 2011; 10.1007/s10654-011-9575-4
4. WHO Regional Office for Europe Recommendations for good practice in pandemic preparedness: identified through evaluation of the response to pandemic (H1N1) 2009