By Paul Coleman
London Intelligence,
May 2020
'We need to be confident that our planning and responses are sufficiently flexible to deal with every eventuality,' says Selbie.
'Ensuring the country is fully prepared and able to respond quickly and effectively is a top priority for Public Health England, and, of course, for the government.'
Threat
The PHE report, prepared by Nick Phin, John Simpson, Gaynor Marshall, Hilary Moulsdale and Mike Laing, also states: 'Pandemic influenza has been classified by the Cabinet Office as the number one threat to the UK population.'
In their report the PHE quintet warn: 'As a guide, the impact could range from a 1918-type pandemic, where severe disease was mainly in young adults, to a 2009 pandemic, where the illness was mild in most groups of the population.'
In their report the PHE quintet warn: 'As a guide, the impact could range from a 1918-type pandemic, where severe disease was mainly in young adults, to a 2009 pandemic, where the illness was mild in most groups of the population.'
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| PHE Chief Executive Duncan Selbie (Image: PHE) |
H1N1
By 'mild', the PHE quintet mean that the H1N1 pandemic of 2009 killed between 151,700 and 575,400 people around the world.
Waves
By 'mild', the PHE quintet mean that the H1N1 pandemic of 2009 killed between 151,700 and 575,400 people around the world.
Less than one tenth of 1% of people infected with symptoms died, according to World Health Organisation estimates.
The PHE quintet state: 'The 2009 H1N1 pandemic certainly tested our plans for dealing with new pandemic strains. Fortunately, it was a mild one.'
1918-19
The PHE quintet state: 'The 2009 H1N1 pandemic certainly tested our plans for dealing with new pandemic strains. Fortunately, it was a mild one.'
1918-19
However, the PHE's reference to the possible return of a 1918-19 type of pandemic - as a worst-case scenario - ought to have prompted all UK politicians to act.
The 'Spanish Flu' pandemic of 1918-19 killed at least 50 million people worldwide - and possibly as many as 100 million.
It spread in just under two years, killing ten times as many people who died actually fighting in World War I.
Many of those who died horribly from the 1918-19 avian flu were strong, young adults.
The 'Spanish Flu' pandemic of 1918-19 killed at least 50 million people worldwide - and possibly as many as 100 million.
It spread in just under two years, killing ten times as many people who died actually fighting in World War I.
Many of those who died horribly from the 1918-19 avian flu were strong, young adults.
Waves
The 1918-19 avian flu pandemic consisted of two waves.
Both waves spread rapidly; firstly amongst young men fighting in World War I and then to poorer people living in bad housing in densely populated cities.
Both waves spread rapidly; firstly amongst young men fighting in World War I and then to poorer people living in bad housing in densely populated cities.
The pandemic quickly became global, transmitted mainly by soldiers, travelling on ships and trains.
It killed an estimated 17 million people in India alone.
Up to 3% of all people infected with flu symptoms died.
Londoners
The virus killed 10% of 300,000 British troops infected towards the end of World War I.
It killed an estimated 17 million people in India alone.
Up to 3% of all people infected with flu symptoms died.
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| The 1918-19 avian flu pandemic first spread at a Kansas army base in the USA (Source: Florence Nightingale Museum) |
Londoners
The virus killed 10% of 300,000 British troops infected towards the end of World War I.
It also killed at least 18,000 Londoners, according to the Museum of London.
London hospitals were overrun with infected people.
Many doctors and nurses died.
The pandemic compelled a Conservative-Liberal coalition government to create the first ever ministry of health in 1919.
Health and care
Phin and his colleagues recommended in their Pandemic Influenza Response Plan 2014 that government and the NHS prepare for a 2009-type pandemic and a worst-case scenario 1918-19 pandemic.
They listed an array of measures involving almost every branch of government and all hospitals and care homes.
Notably, these measures included the provision of 'personal protective equipment' to staff in 'health and communal care settings'.
London hospitals were overrun with infected people.
Many doctors and nurses died.
The pandemic compelled a Conservative-Liberal coalition government to create the first ever ministry of health in 1919.
Health and care
Phin and his colleagues recommended in their Pandemic Influenza Response Plan 2014 that government and the NHS prepare for a 2009-type pandemic and a worst-case scenario 1918-19 pandemic.
They listed an array of measures involving almost every branch of government and all hospitals and care homes.
Notably, these measures included the provision of 'personal protective equipment' to staff in 'health and communal care settings'.
Cygnus
What happened also to Exercise Cygnus?
PHE had scheduled this extensive pandemic response simulation for October 2014.
Local NHS trusts were waiting for this multi-agency pandemic flu exercise involving 'local resilience forums'.
However, it is said this had to be postponed due to the Ebola outbreak in West Africa.
Exercise Cygnus eventually took place in October 2016, delayed further by the May 2015 general election and the June 2016 Brexit referendum.
The simulation is said to have revealed shortages of intensive care beds, essential equipment and mortuary capacity.
Yet the full conclusions of Exercise Cygnus were never published.
Later warning
Worst-case scenario
Terrible
What happened also to Exercise Cygnus?
PHE had scheduled this extensive pandemic response simulation for October 2014.
Local NHS trusts were waiting for this multi-agency pandemic flu exercise involving 'local resilience forums'.
However, it is said this had to be postponed due to the Ebola outbreak in West Africa.
Exercise Cygnus eventually took place in October 2016, delayed further by the May 2015 general election and the June 2016 Brexit referendum.
The simulation is said to have revealed shortages of intensive care beds, essential equipment and mortuary capacity.
Yet the full conclusions of Exercise Cygnus were never published.
Later warning
The Global Health Council also warned in March 2018 that flu pandemic is the number one health risk to the world's population, estimating three hundred million could die over just two years.
Other virologists in 2018 warned that a 21st Century virus would transmit much faster and further as it would be borne by infected people travelling by air, contaminating further people at airports.
A new virus, they said, could criss-cross the world in just 24 hours.
Worst-case scenario
The scientific consensus in 2018 was that a 21st Century flu pandemic would kill 1% of all infected people.
Scientists estimated that if one third of British people caught a deadly new influenza, then a 1 per cent fatality rate would result in some 200,000 people dying.
Trouble
Trouble
Professor Wendy Barclay of Imperial College London, an expert in the field of respiratory influenza viruses, spoke in 2018 about the PHE's plan, notably about its warning of a repeat of the 1918-19 pandemic as a worst-case scenario.
"You have to plan for the worst-case scenario, because if that one comes and you're not ready for it, then you're in big trouble," said Barclay.
"It's reassuring to say we have ways of dealing with influenza pandemics today which were not available in 1918. But I think if we saw anything like a one per cent fatality rate then it would be a terrible experience for everyone."
Barclay said this whilst holding the Pandemic Influenza Response Plan 2014 in her hand.
Barclay said this whilst holding the Pandemic Influenza Response Plan 2014 in her hand.
Terrible
Two years on, we are now in the midst of the ongoing terrible carnage of Covid-19.
The UK government says the pandemic has officially killed 37,048 people (as of Tuesday 26 May) - the highest number of deaths in any European country.
The Office for National Statistics say the death toll is likely to be over 47,000 people.
All of this we now know.
But we still know little about the UK government's response to the PHE's Pandemic Influenza Response Plan 2014.
David Cameron was Prime Minister and Jeremy Hunt was Health Secretary.
What attention did these two key politicians also pay to the later warnings made by Barclay and other scientists?
Emergency
What also happened to the actual authors of Pandemic Influenza Response Plan 2014?
Nick Phin is now deputy director of PHE's National Infection Service.
The UK government says the pandemic has officially killed 37,048 people (as of Tuesday 26 May) - the highest number of deaths in any European country.
The Office for National Statistics say the death toll is likely to be over 47,000 people.
Other estimates put the UK death toll at over 65,000 people.
Essential
Essential
Covid-19 is now believed to have killed 235 health and social care workers, according to Nursing Notes.
Covid-19 has also killed bus drivers, postal service workers and other workers in essential sectors.All of this we now know.
But we still know little about the UK government's response to the PHE's Pandemic Influenza Response Plan 2014.
David Cameron was Prime Minister and Jeremy Hunt was Health Secretary.
What attention did these two key politicians also pay to the later warnings made by Barclay and other scientists?
Emergency
What also happened to the actual authors of Pandemic Influenza Response Plan 2014?
Nick Phin is now deputy director of PHE's National Infection Service.
John Simpson is deputy director of PHE's Health Protection Directorate and is head of the Emergency Response Department.
Hilary Moulsdale is exercise manager in emergency preparedness and response, based at Porton Down, the emergency response department for England.
Gaynor Marshall retired as manager of supra regional emergency preparedness manager and national support in September 2014.
Gaynor Marshall retired as manager of supra regional emergency preparedness manager and national support in September 2014.
Duncan Selbie is still PHE chief executive.
Scientists
A government spokesman said in April 2020: "This is an unprecedented global pandemic and we have take the right steps at the right time to combat it. Our response at all times is guided by the best scientific advice."
Government politicians daily mantra they are vigorously 'following the science' and 'listening to scientists'.
Nevertheless, the UK government remains heavily criticised in May 2020 for presiding over the Covid-19 deaths of large numbers of elderly care home residents and for failing to provide personal protective equipment for staff in hospitals and care homes.
Foresight
'Hindsight is a wonderful thing,' politicians often tell the people when the people challenge them about past mistakes that cause present miseries.
Politicians use the cosy hindsight homily to excuse their procrastination and inaction.
UK government politicians could have chosen to abide by another homily; 'pray for the best and prepare for the worst.'
Myth
So, how did successive UK governments since 2014 respond to the 'best scientific advice' gifted to them by the authors of the Pandemic Influenza Response Plan 2014?
Did they complacently rely on a blind faith in anti-viral drugs, antibiotics and existing public health plans?
Accountable
NHS doctors and nurses are drilled daily about how they must own up to errors in real time in order to prevent unnecessary risks that might lead to a loss of life.
UK government politicians, who dictate on policy and pay to those doctors and nurses, behave antithetically to this code.
The British political class instinctively seeks to cover up fatal errors facilitated by their own clouded judgement.
Will government politicians ever be rendered accountable for their response to the scientific foresight contained in the Pandemic Influenza Response Plan 2014?
© Paul Coleman, London Intelligence ® London, May 2020.
Government politicians daily mantra they are vigorously 'following the science' and 'listening to scientists'.
Nevertheless, the UK government remains heavily criticised in May 2020 for presiding over the Covid-19 deaths of large numbers of elderly care home residents and for failing to provide personal protective equipment for staff in hospitals and care homes.
Foresight
'Hindsight is a wonderful thing,' politicians often tell the people when the people challenge them about past mistakes that cause present miseries.
Politicians use the cosy hindsight homily to excuse their procrastination and inaction.
UK government politicians could have chosen to abide by another homily; 'pray for the best and prepare for the worst.'
Myth
So, how did successive UK governments since 2014 respond to the 'best scientific advice' gifted to them by the authors of the Pandemic Influenza Response Plan 2014?
Did they complacently rely on a blind faith in anti-viral drugs, antibiotics and existing public health plans?
Did they actually believe in the blithering myth of Britain's island nation exceptionalism; of the kind that blathers, 'No virus, please, we're British.'
Or were politicians too busy pursuing their personal political ambitions and agendas?
NHS doctors and nurses are drilled daily about how they must own up to errors in real time in order to prevent unnecessary risks that might lead to a loss of life.
UK government politicians, who dictate on policy and pay to those doctors and nurses, behave antithetically to this code.
The British political class instinctively seeks to cover up fatal errors facilitated by their own clouded judgement.
Will government politicians ever be rendered accountable for their response to the scientific foresight contained in the Pandemic Influenza Response Plan 2014?
Sources:
The Flu That Killed 50 Million, BBC TV, September 2018.
Nursing Notes
Museum of London
Florence Nightingale Museum
Nursing Notes
Museum of London
Florence Nightingale Museum
© Paul Coleman, London Intelligence ® London, May 2020.
