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State Papers: Northern Ireland pandemic plan feared rapid spread as China opened up

Health officials still thought they would have months to prepare for a pandemic which emerged in the far east


Dr Elizabeth Mitchell

Dr Elizabeth Mitchell

Dr Elizabeth Mitchell

Officials considering the possibility of an influenza pandemic in the late 1990s expected to have months to prepare for a virus reaching the UK — but noted that increasing global travel and the opening up of China could speed transmission westwards.

Whitehall’s Department of Health decided to review the UK’s flu pandemic planning in 1998 in response to the H5N1 influenza outbreak in Hong King the previous year.

Dr Mitchell’s draft plan said that “in general, it is unlikely that the spread of influenza can be halted, but some slowing could possibly be achieved by reducing unnecessary, especially long distance, travel, and by encouraging people suffering from the disease to stay at home. Closing schools is likely to cause some problems, especially for working parents, but would be an option to be considered, particularly if teacher absenteeism reached levels at which schools could not function.”

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She suggested that the spread of the virus in hospital could be reduced by “a policy of, as far as possible, admitting patients with influenza only if they have medical complications”.

Dr Mitchell said that non-urgent hospital admissions, including serious but non-critical operations, might have to be suspended to free up beds.

She said that the emergence of a new viral strain of flu against which a high proportion of the population has no immunity could spread worldwide in about six months.

Intervals between past pandemics ranged from 11 to 42 years, “with no recognisable pattern”, she said, and most pandemics would mean “activity can be expected to last 6-8 weeks”.

However, the UK plan noted that most influenza viruses emerged in the far east and the opening up of China to trade and tourism could speed the transmission of the virus to the UK, as could the increasing international movement of people using more rapid forms of transportation.

Dr Mitchell’s plan said that immunisation with appropriately formulated influenza vaccine can reduce the impact of influenza, particularly among those population groups most at risk of serious illness or death.

“An early priority of contingency arrangements will therefore be necessary to secure supplies of vaccine against the new strain and to immunise as many people as possible.”

The UK-wide pandemic plan showed that Whitehall’s medics and scientists thought that a pandemic may be at hand.

It said: “The following conditions co-existing suggest that a pandemic is imminent — the emergence of a new strain of influenza virus which has a marked antigenic shift — a new virus; a high proportion of susceptible people in the population, ie with no immunity to the new virus either from vaccination or from previous infection with a similar virus; evidence that the new virus can spread and cause human disease.”

The document added: “Typically, new shifted strains of influenza virus have emerged in the Far East and spread via Asia or the Antipodes towards Europe.

“If this occurs, some warning is likely before a new strain appears in the United Kingdom, although spread may be very rapid.”

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