Devon Community Resilience Influenza Pandemics Richard Clarke Emergency Preparedness Manager Public Health England South West Centre
What is a pandemic? 2 Devon Community Resilience - Influenza Pandemics
What is a pandemic? World Health Organization definition: the worldwide spread of a new disease. An influenza pandemic occurs when a new influenza virus emerges and spreads around the world, and most people do not have immunity. 3 Devon Community Resilience - Influenza Pandemics
How does it start? 4 Devon Community Resilience - Influenza Pandemics
How does it start? Three types of influenza virus A, B and C Influenza A causes most winter epidemics and can affect a wide range of animal species as well as humans Pandemic influenza occurs when an influenza A virus subtype emerges or re-emerges which is markedly different from recently circulating strains It is able to spread widely because few people immunity It is readily transmissible from person to person and capable of causing illness in a large proportion of those infected 5 Devon Community Resilience - Influenza Pandemics
How is it spread? 6 Devon Community Resilience - Influenza Pandemics
Spread by: How is it spread? Droplets of infected respiratory secretions produced when an infected person talks, coughs or sneezes Touching surfaces contaminated with infectious droplets Aerosol generating medical procedures Incubation period will be in the range of one to four days (typically two to three) 7 Devon Community Resilience - Influenza Pandemics
How infectious is it? Adults infectious for up to five days from the onset of symptoms Longer periods have been found, particularly in those who are immunosuppressed Children may be infectious for up to seven days Some people can be infected, develop immunity, and have minimal or no symptoms but may still be able to pass on the virus 8 Devon Community Resilience - Influenza Pandemics
How does it affect people? Members of the population will exhibit a wide spectrum of illness ranging from minor symptoms to pneumonia and death Most people will return to normal within 7-10 days All ages are likely to be affected but those with certain underlying medical conditions, pregnant women, children and younger adults could be at relatively greater risk The exact pattern will only become apparent as the pandemic progresses 9 Devon Community Resilience - Influenza Pandemics
Previous Pandemics 10 Devon Community Resilience - Influenza Pandemics
Previous Pandemics Year Estimated excess mortality worldwide Age groups most affected 1918-1919 - Spanish Flu 20 50 million Young adults 1957-1958 - Asian Flu 1 4 million Children 1968-1969 - Hong Kong Flu 1 4 million All age groups 2009-2010 - Swine Flu Less than one million Children (5-14), young adults and pregnant women 11 Devon Community Resilience - Influenza Pandemics
Planning Assumptions 1 Could emerge at any time, anywhere in the world Likely to reach the UK very quickly Not possible to stop the spread or to eradicate the virus as it will spread too rapidly and too widely From arrival in UK probably one to two weeks until cases and small clusters of disease occur across the country Activity may last for three to five months depending on the season May be subsequent substantial activity weeks or months apart Pandemic virus likely to re-emerge as a seasonal flu virus 12 Devon Community Resilience - Influenza Pandemics
Planning Assumptions 2 50% of population may display symptoms ranging from mild to severe Up to 30% of symptomatic patients may require assessment and treatment in primary care (GP, Pharmacy) 1-4% of symptomatic patients may require hospital care with increased demand for intensive care services Up to 2.5% of those with symptoms could die if treatment proved ineffective 13 Devon Community Resilience - Influenza Pandemics
Planning Assumptions 3 Proportion of total cases Week 14 Devon Community Resilience - Influenza Pandemics
Planning Assumptions 4 Health and social care more demand, less resources Prioritisation of critical care services do the most for the most Staff absenteeism through illness or caring responsibilities (dependents ill, school closures, other disruption) Increased mortality = pressure on mortuaries, funeral directors, crematoria and burials Supply chain disruption 15 Devon Community Resilience - Influenza Pandemics
UK Planning Guidance and links to further information on GOV.UK website: www.gov.uk/guidance/pandemic-flu Lead government department: Department of Health and Social Care UK Influenza Pandemic Preparedness Strategy 16 Devon Community Resilience - Influenza Pandemics
Detection Assessment Treatment Escalation Recovery UK Pandemic Phases Phases are not linear, may not follow in strict order, and it is possible to move back and forth or jump phases 17 Devon Community Resilience - Influenza Pandemics
UK Pandemic Phases On declaration of WHO phase 4 or a WHO Public Health Emergency of International Concern Detection Assessment Treatment Escalation Recovery Intelligence gathering from countries already affected Enhanced surveillance within the UK Development of diagnostics specific to the new virus Information and communications to public and professionals 18 Devon Community Resilience - Influenza Pandemics
UK Pandemic Phases Once novel influenza virus identified in patients in the UK Detection Assessment Treatment Escalation Recovery Collection and analysis of clinical and epidemiological information on which to base early estimates of impact and severity in UK Reduce risk of transmission and infection by: actively finding cases self isolation of cases and suspected cases treatment of cases / suspected cases use of antiviral prophylaxis for close / vulnerable contacts 19 Devon Community Resilience - Influenza Pandemics
UK Pandemic Phases Sustained community transmission of the virus - cases not linked to known or previously identified cases Detection Assessment Treatment Escalation Recovery National Pandemic Flu Service Anti-Viral Collection Points Consideration of measures to disrupt local transmission e.g. localised school closures Prepare for targeted vaccinations as vaccine becomes available 20 Devon Community Resilience - Influenza Pandemics
UK Pandemic Phases Demand for services start to exceed available capacity Detection Assessment Treatment Escalation Recovery Decisions likely to be made at a regional or local level as not all parts of the UK will be affected at the same time or to the same degree Escalation of surge arrangements Prioritisation and triage of services to maintain essential services De-escalation when situation improves 21 Devon Community Resilience - Influenza Pandemics
Detection Assessment Treatment Escalation Recovery UK Pandemic Phases Activity significantly reduced or within acceptable parameters and capacity able to meet demand Restoration of business as usual services Catch up with activity that may have been scaled-down e.g. reschedule routine operations Post-incident review of response Take steps to address staff exhaustion Plan and prepare for a resurgence of influenza Continue targeted vaccination Prepare for post-pandemic seasonal influenza 22 Devon Community Resilience - Influenza Pandemics
What can the community do? 23 Devon Community Resilience - Influenza Pandemics
What can the community do? You can t stop it! Can you support people and help reduce pressure on health and social care services? Disseminate public messages: Choose well Catch it! Bin it! Kill it! Good Neighbours Flu friends Anti-Viral Collection Points (ACPs) Vaccination Seasonal and Pandemic 24 Devon Community Resilience - Influenza Pandemics
Thank You Any Questions? Richard Clarke Emergency Preparedness Manager Public Health England South West Centre