BIRD FLU: THE SECRET CABINET DOCUMENT

Bird flu: the secret Cabinet document
JAMES KIRKUP POLITICAL EDITOR

* More than 700,000 could die in worst-case bird flu scenario
* The figures were disclosed in a Cabinet Office briefing paper
* Army could be "too stretched to help" due to international commitments

Key quote "Scientific modelling suggests that it may only take 2-3 weeks from the virus first entering the UK to its being widespread," - Cabinet Office paper

Story in full THE death toll from a bird flu pandemic in Britain could be more than 700,000, according to a confidential government report seen by The Scotsman.

The figure - far higher than previously stated - is contained in a Cabinet Office briefing paper prepared for emergency planning officials, which warns that the virus could strike the country in multiple "waves".

It also says the armed forces may not be available to help in an emergency because of Britain's extensive international military deployments.

Although ministers promised to order enough vaccine for the entire UK population, the document says that effective drugs "would not be available until at least four to six months after a pandemic had struck, which could be well after the first wave of illness in the UK".

Key health workers would be guaranteed the vaccine, but "other sectors should not assume priority access to pandemic vaccine", it warns.

The Cabinet Office paper has been circulated only to "Category 1 responders" - emergency services chiefs, local authorities, NHS officials and others responsible for drawing up contingency plans. It details the preparations under way for a flu pandemic arising in a number of ways, including the mutation of the H5N1 virus among birds.

The document warns that, once such an infection arrives in Britain, it could take only two weeks to become widespread. Issued in late February, it contains the latest updated projections for the spread of a "novel" form of the common flu virus to which people would have no immunity.

One of its central themes is the possibility that the virus could mutate again after an initial widespread infection, producing further pandemic waves. Those projections include a "reasonable worst-case scenario" in which multiple waves of the virus infect a total of 50 per cent of the population. At worst, the disease would be as powerful as the strain that caused the 1918 global pandemic, killing 2.5 per cent of those infected.

"This combination would give rise to an estimated 709,300 excess deaths in the UK across the whole period of the pandemic, spread across one or more waves," the Cabinet Office paper concludes.

However, that death toll is at the extreme of the scenarios considered by government scientists. The "base case", which experts believe most likely, is for an estimated 53,700 excess deaths from a multi-wave pandemic.

According to the Cabinet Office's civil contingencies secretariat, a flu pandemic is one of the greatest current threats to the UK. A mutated strain of the H5N1 avian flu virus is one possible source of such an infection, but however the new strain arises, it is projected to spread rapidly.

"Scientific modelling suggests that it may only take 2-3 weeks from the virus first entering the UK to its being widespread," the Cabinet Office paper states.

Some disaster scenarios constructed by independent experts foresee troops being called in to help manage a mass flu infection. But the Cabinet Office warns there can be no guarantee that the armed forces will be able to help.

"Planning for an influenza pandemic should take into account that military support may not be available if local units are deployed on operations," the paper says. "Nor should it be assumed that local units have personnel available with either the skill or equipment to undertake specialist tasks."

That could leave local councils having to cope with problems such as disposing of thousands of extra corpses that would overwhelm normal mortuary capacity and result in bodies being stockpiled before mass burials.

"A key point for local planning is likely to be the identification of potential sites for the location of facilities for the temporary storage of bodies, prior to funerals taking place," the document says.

The possibility of responding with mass burials is raised in a second leaked document, this one prepared by the Home Office.

It uses a "prudent worst-case" death toll of 320,000.

In such an event, Home Office planners estimate that bodies could be stored for up to 18 weeks before being buried.

The paper accepts that the prospect of mass burial may cause public anxiety and says: "Common burial stirs up images of the burial pits used in the great plague of 1665 - where in London 70,000 people died."

In fact, the mass burials envisaged would more closely resemble temporary sites used after major wars. The dead would be consigned to individual coffins and buried in discreet graves, with names clearly marked, in unconsecrated fields.

After the pandemic had passed, the coffins could then be disinterred and reburied in formal ceremonies elsewhere.

Government departments yesterday declined to comment on the leaked documents, but the Home Office issued a statement about emergency planning.

"The government is taking seriously the possible threat of an influenza pandemic in the light of the global situation and the possibility that a novel strain of the influenza virus could emerge," it said.

"Prudent precautionary planning is under way across all elements of the response, including the health service, other essential services and local authorities."
The key points

• The "reasonable worst-case scenario" of repeated "waves" of infection would mean 709,300 deaths from flu. The "base case" would mean 53,700 deaths.

• Planners must not rely on the armed forces being able to help with emergency management.

• Once the flu virus mutates into a "novel" strain, widespread infection could be reached in two weeks.

• An effective vaccine would not be available until at least four-to-six months after a pandemic. Only health service staff can be sure of priority access.

• The huge death toll could swamp mortuaries. Authorities should plan to stockpile bodies then bury them en masse.

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