Scenario 1

Background, preparation and planning
The current situation (week1)
A number of human cases of a new strain of flu A/H1N1 (commonly known as “swine flu”) have been reported in Mexico and the US (California and Texas) including some fatalities. WHO is coordinating the global response and is monitoring the threat of an influenza pandemic. We are currently at WHO Pandemic Alert Phase 3.

BBC Video clip about early response to swine flu in Mexico

Please remember that this is an exercise and while based on events in 2009 it is not happening now.

Background to the scenario
Concentrated planning in the UK in preparation for a future pandemic began in 2007. The world had been in WHO Phase 3 for a number of years in response to the emergence of avian influenza A/H5N1.

UK planning has largely focussed on the reasonable worst case scenario. Planning has taken place at a national level, and also at more local levels. In England this is now co-ordinated by Public Health England, while in Scotland this is coordinated by Health Protection Scotland, and by the Public Health departments of NHS Boards.

It was anticipated that the next pandemic virus would originate in South East Asia, the Middle East or Africa, and that the most likely candidate would be a virus of avian origin, either directly infecting humans or developing the ability to do so through infection in pigs or another mammalian host.

Planning assumptions
It was expected that:

  • The new pandemic virus would take two to four weeks to reach the UK from the source country
  • It would take a minimum of 6 months to develop an effective vaccine
  • Once here major population centres would be affected within 14 days.
  • Numbers of pandemic influenza cases would peak around 50 days after the virus reached the UK
  • Pandemic activity was expected to last for three to five months from arrival of the virus in the UK
  • Possible subsequent waves occurring weeks or months later, and a second wave could be more severe than the first.
  • A larger proportion of the population (including those not normally affected by influenza – i.e. fit and healthy young adults) would become more ill than is normally seen with seasonal influenza.
  • Up to 50% of the population might be ill over the duration of the pandemic,
  • Up to 4% of symptomatic patients could require hospitalisation, with 25% of these (1% of cases) requiring critical care.
  • Mortality was expected to be greater than in inter-pandemic years, with a potential maximum case fatality rate of 2.5% anything from 55,500 to 750,000 excess deaths were predicted across the UK. (The normal number of deaths from flu in the UK is 8,000-12,000 a year.


A number of papers have run stories over the past month on the possibility of pandemic flu hitting the UK. Many have concentrated on the South East Asian poultry industry and its workers. Few stories in mainstream media detail the symptoms of pandemic flu beyond ‘most live, others die’ type reporting

What you need to do now

Read through the information above and follow the links.

Go to Twitter and using the hashtag #fluscenario discuss what you think is important to learn from this information.

Towards the end of the week, try to send a Tweet that summarises the learning points from this scenario. The tutors will then collate the summaries and post that on Twitter and the blogs.

Please use these questions as a framework for your discussion – you do not need to try to answer them all
1. Why should we be concerned about flu?
2. What is the role of a doctor/the NHS in planning for events like these?
3. Pandemic flu is being planned for at a national level. What could you be doing now to help you and your organisation if pandemic flu were to reach the UK?
4. What social media accounts, organisations or individuals would you trust? Would you be happy to discuss over social networks with other Health Care Professionals or would you prefer a closed forum? How would you ensure reliable information?


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