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UK HEALTH DEPARTMENTS' UK INFLUENZA PANDEMIC CONTINGENCY PLAN: SCOTTISH EXECUTIVE HEALTH DEPARTMENT INFLUENZA PANDEMIC CONTINGENCY PLAN

EXECUTIVE SUMMARY

Pandemics of influenza have swept the world from time to time throughout history, three times in the last century. They have caused widespread illness, a large number of deaths, including among children and young adults, and huge societal disruption, concentrated in just a few weeks. There is currently rising concern that a new influenza virus with pandemic potential will emerge and spread and a further pandemic can be expected. Around a quarter of the population could be affected with over 50,000 deaths in the UK alone. This would be over one or more waves each lasting around 3 months.

This document outlines Scotland's plan for responding to an influenza pandemic within an overall UK context. It is based on the framework recommended by the World Health Organisation for national pandemic plans. The response is divided into phases, starting with work to be done before a pandemic happens, followed by a step-wise escalating response as a pandemic evolves.

The prime objectives are to save lives, reduce the health impact of a pandemic and minimise disruption to essential services while maintaining business continuity and reducing the general societal disruption that is likely to ensue.

Strong leadership, organisation and co-ordination and clear lines of accountability and communication will be key to preparing for and responding to a pandemic. At a UK level the Department of Health (England) ( DH) is the lead Government Department, supported at UK level by the Health Protection Agency. The Department of Health (England) will

The Scottish Executive Health Department ( SEHD), supported by Health Protection Scotland ( HPS) will

The 4 UK Health Departments will be advised by a UK National Influenza Pandemic Committee ( UKNPIC). Additionally SEHD will convene a Scottish Pandemic Influenza Co-ordinating Group ( SPICG) to advise on the strategic implementation of the health response in Scotland. Once the pandemic is confirmed, UK cross-Government co-ordination and liaison with the Devolved Administrations for the civil emergency response will be provided through the Civil Contingencies Committee.

A pandemic will require a co-ordinated response from a range of organisations in Scotland. The Ministerial Group on Civil Contingencies ( MGCC) will provide strategic direction for the response in Scotland. Co-ordination of the health and non-health activities will be ensured by the Scottish Emergencies Co-ordinating Committee ( SECC). The SECC brings together senior officials from Scottish Executive Departments, and chief officers from other organisations which will be involved in responding to a pandemic, such as the NHS, police and local authorities. SECC is also responsible for briefing the Ministerial Group on the pandemic. SECC will be briefed by the SE officials on the Scottish Executive Emergency Action Team ( SE-EAT). The Phases of an influenza pandemic, the mechanism for declaring a pandemic, and the immediate action to be taken are set out in Section 3..

The roles and responsibilities of the key organisations at UK national, Scottish, other Devolved Administrations, English regional and local levels are described in Section 6. These organisations need to develop their own plans covering their part of the response and consistent both with the UK plan and with their own plans for other relevant emergencies. A framework for NHS organisations, and a check list for other organisations, will be developed alongside to this plan.

Two key medical interventions may help to reduce the health impact: immunisation, and the use of antiviral drugs active against influenza. Both vaccine and drugs are likely to be in limited supply and will need to be used in the most effective way according to nationally agreed principles and protocols.

A vaccine specifically against a new pandemic influenza strain can only be made once that strain is known. Preparatory work will be undertaken which should facilitate development of a suitable vaccine when the need arises but even routine influenza vaccines take several months to manufacture, and there may be additional technical difficulties in the development of a pandemic vaccine because of the particular properties of the virus. This means that it will take time before vaccine can be produced on a large scale and it may not be available at all for the first wave. Clear, transparent policies are described for prioritising its use as and when it becomes available.

In the meantime, antiviral drugs will be used to gain maximum benefit according to their availability. The Department of Health, in liaison with the Scottish Executive Health Department and other Devolved Health Departments, is actively working on building up stockpiles of suitable antiviral drugs and on strategies for their optimal use. Assessment of their effectiveness in use will be important during all phases of the response to further inform these strategies.

In the event that medical interventions such as vaccines and antiviral drugs are absent or in limited supply or prove ineffective, other public health or social interventions may help limit or slow the spread of the disease. Measures such as hand washing, isolation of cases, effective handling of contacts and limiting non-essential travel and mass gatherings of people may 'buy' valuable time, particularly in the early phases. Real time modelling and any new evidence will be used to assess whether such measures should be used.

Communications are a crucial element of the response. Information flows will be vast, and many groups, not least the public, will need clear, accurate information and advice about what actions they can take and assurance that their concerns are being addressed.

A pandemic is, by definition, an international event. The UK, and Scotland within a UK framework, have certain international obligations in communicable disease control, to the World Health Organisation and the European Union. The UK also expects to play a full part in supporting these organisations in their efforts to control an influenza pandemic.

Preparedness planning is an ongoing activity and this plan will be regularly reviewed and updated, as implementation issues are discussed with stakeholders.

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