Pandemic influenza and the Thames Valley contingency plan

1
Pandemic influenza and theThames Valley
contingency plan

• Dr Tom Porter
• SpR in Public Health, Slough PCT
• 11 April 2006

2
Introduction

• Pandemic influenza
• Contrast with avian influenza
• Thames Valley planning

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Pandemic influenza

• Novel type of influenza
• No prior immunity in humans
• ? Spreads rapidly throughout world
• Patterns
• Historically 11-42 years (last pandemic 1968/9)
• Any time of year / all ages
• May hit in waves 2-4 months each
• Source
• Animal reservoir
• Pass into humans
• Spread easily between humans

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Pandemic influenza

• Clinical
• 10-25 of the population affected (clinical
  attack rate)
• Fever, muscle aches (myalgia), respiratory
  symptoms
• Vast majority (gt95)
• Mild illness
• Recover in 5 days
• Death (mortality/case fatality) 0.2-2.5
• Excess deaths in Thames Valley 2000

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Pandemic influenza

• Consequences
• Overburdened health service
• More people unwell than normal
• Excess deaths
• Staff absences in health service
• Staff unwell
• Staff looking after unwell relatives
• Widespread disruption
• Staff absences
• Transport, groceries etc

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Avian influenza

• As the name implies A disease of birds!
• Current H5N1 subtype
• Can cross species barrier (pass into humans)
• Very rare
• Requires extensive contact with infected birds
• Cannot pass between humans easily
• So not a pandemic
• Potentially could mutate
• May not happen
• Timescales?

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Thames Valley planning

• Three tier approach
• Tier 1 Thames Valley (TVIPC)
• Tier 2 County/Locality
• Tier 3 Individual organisations e.g. PCT
• Plans at each tier
• Should not duplicate each other
• Overall aims of plans
• Minimize spread of disease
• Ensure continuity of health service response
• Advise reassure public / protect staff
• Treat with antivirals where possible

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DH
RRF/LRF
GOSE
TVIPC
Partners
Tier 1
County/locality committeesBerks/BucksMK/Oxon
Partners
Tier 2
Individual organisationsPCTs, Ambulance Trusts
etc.
Partners
Tier 3
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Thames Valley planning

• Thames Valley Influenza Pandemic Committee
• Meeting regularly since November 2005
• Maintains TVSHA influenza pandemic plan
• Strategic plan
• Topics include
• Role of TVIPC between and during pandemics
• Command and control structure
• Mutual aid
• Comms plan
• Payment procurement arrangements for PPE etc
• Testing arrangements

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Thames Valley planning

• TVIPC (cont)
• Subgroup
• Personal protective equipment (PPE) and antiviral
  issues
• Testing
• Last tabletop exercise 4 April 2006
• Plans integrate with major incident heirarchy
  (next slide)

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Health response
Multiagency response
Gold strategiccommand
TVSHA/TVIPC
Silver tacticalcommand
County/Locality committees
Bronze operationalcommand
Acute Trusts, PCTs, Ambulance Trusts etc.
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Summary

• Pandemic influenza
• Cyclical, all ages, any time of year
• Main problem is morbidity not mortality
• Current bird flu may not cause a pandemic
• Thames Valley planning
• Three tiers TV/County/Individual organisation
• Integrates with emergency planning

Any questions?