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Two thirds of doctors in UK say the NHS could not cope with bird flu epidemic

BMJ 2006; 333 doi: (Published 28 September 2006) Cite this as: BMJ 2006;333:674
  1. Andrew Cole
  1. London

    More than a third of doctors (38%) in United Kingdom believe that the government is not ready for a pandemic of avian influenza, a new survey has found, and more than two thirds (68%) fear that the NHS could not cope with an outbreak on the same scale as the 1918 Spanish flu outbreak.

    The survey—which was conducted by the newspaper Hospital Doctor and Medix, an information website for doctors—of over 1000 GPs and hospital doctors also showed that just over a fifth (22%) feel that they are personally prepared for a pandemic, while 37% said they are badly or very badly prepared.

    More than half (56%) had not received any information from either the Department of Health or their trust about planning for a pandemic of bird flu, although 70% said they knew about its virology and progression.

    A quarter of respondents admitted they hadn't made sufficient personal preparations, and 11% had taken no action because they believed there to be no threat. Just over a third of doctors thought that a pandemic would strike in the next three years, and 14% estimated that the number of deaths would not exceed 50 000 in UK. A third of the doctors thought that the number affected would be greater than 50 000, while a half were not prepared to make a prediction.

    The doctors felt that the government's top priority should be better communication of its plans to medical staff. Its next priorities should be investing in research into a vaccine, better communications with the public, and stockpiling of antiviral drugs.

    But Lindsey Davies, the health department's national director of pandemic flu preparedness, stressed this week that antiviral drugs were no panacea. “We don't know if antivirals will necessarily work against the strain of virus that emerges,” she told a conference on the subject in London organised by the science publisher Elsevier.

    Even if antivirals were successful, Professor Davies added, people would still become ill, although the risks of complications and deaths would probably be lessened, as would infectivity.

    Some very difficult questions needed to be answered about how antivirals were to be used, she said. In particular, what quantity should be bought in advance? Who should have priority in receiving the drugs? And should the drugs be used for prevention or only for first line treatment?

    At the moment it was planned to use them for treatment only, but this was being reviewed all the time and might change in the future.

    There was a chance, she said, that if all the government's measures worked it may be possible to reduce the effects of a pandemic to those of an ordinary bad flu season. “But we're not naive enough to think we can carry on business as usual. Of course, there will be a huge impact.”

    At the moment the projection was that a pandemic could lead to as many as 50 000 deaths, but the highest estimates were that as many as 750 000 people in UK would be killed and more than a million people hospitalised.

    The health department is revising its contingency plans and expects to publish them for consultation at the start of next year. “We have to learn to cope with the fact that the analysis and understanding of this are changing all the time, so our plans must too—even if that seems inconvenient and difficult at times,” Professor Davies said.

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