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4. How will pandemic flu affect the UK?
4.1 Predicting the impact
'Although the next influenza pandemic in the UK may cause considerable illness and death, great uncertainty is associated with any estimate of the pandemic's potential impact.'
UK Pandemic Influenza Contingency Plan 2005
If a pandemic flu strain is causing outbreaks overseas, it will almost certainly reach the UK. Once it reaches our shores, it is expected to spread throughout the country in a matter of weeks causing much more illness and higher death rates than those associated with 'ordinary' flu. This will result in intense pressure on health and other essential services and disruption to many aspects of daily life.
It is currently impossible to predict when the flu pandemic will begin. It is also difficult to predict its impact with any accuracy. A great deal of uncertainty is associated with estimating the scale of illness, death rates and the identification of those likely to be most affected.
4.2. Scale and severity of illness
4.2.1 Illness and deaths at the global level
4.2.1 Illness and deaths at the global level
Experts predict that the global death toll could range from anything between 2 million to over 50 million deaths worldwide. Studies by the US Centers for Disease Control and Prevention reduce that range to between 2 million to 7.4 million deaths worldwide. However, narrowing down the range cannot be done with any confidence until the pandemic is under way. The level of preparedness in each country will also influence the final death toll.
While the precise figures are not known, the burden on health systems is likely to be considerable. In high-income countries alone (including the UK), which represent 15% of the world's population, experts anticipate around 280,000-650,000 deaths, 134-233 million hospital visits and 1.5-5.2 million hospital admissions.
The impact is likely to be more severe in developing countries whose health systems are already overburdened.
4.2.2 Illness and deaths in the UK
4.2.2 Illness and deaths in the UK
For planning purposes The World Health Organization advises that national plans are based on a cumulative clinical attack rate of 25%, compared to the attack rate of 5-10% associated with 'ordinary' flu. A clinical attack rate is the percentage of the total population who become infected and exhibit symptoms of the virus.
- Experts predict that the next pandemic is likely to affect around a quarter of the UK population with over 50,000 additional deaths occurring over one or more waves lasting around three months each.
- Of the total UK population (circa 59 million), an estimated 14.5 million people will become ill.
- This is expected to lead to an increase in general practitioners consultations from around one million during the 'ordinary' flu season to around six million during a pandemic.
- Hospital admissions for acute respiratory and related conditions are likely to increase by around 25%, with around 19,000 new patients a week requiring hospital admission at the peak.
Hospitalisations and deaths will be higher if the elderly are most affected and lower if adults aged 15-64 are affected.
Table 4.1 Estimated deaths and hospitalisations during an influenza pandemic
| Expected deaths | Expected hospitalisations | |
|---|---|---|
| Global | 2-50 million | 6.4-28.1 million |
| High-income countries | 280,000-650,000 | 1.5-5.2 million |
| UK | A minimum of 50,000 | A minimum of 80,000 |
| USA | 89,000-207,000 | 314,000-734,000 |
4.3 Impact on health services
As the above figures indicate, a flu pandemic will place great pressure on health and social services due to the increased burden of patients with flu requiring treatment and the depletion of the workforce due to illness and other disruption. This could mean delays in dealing with other medical conditions, as sometimes occurs during a particularly bad epidemic of 'ordinary' flu. Non-urgent work will have to be prioritisedduring the peak weeks and some work cancelled because of pressure on beds, staff and resources.
NHS-specific contingency plans will include planning for large and sudden increases in the numbers of patients and the minimising of staff absenteeism due to illness. NHS staff are currently being trained in how to cope with an outbreak of pandemic flu and how to manage the increased demands that will be placed on them.
4.4 Impact on business
A flu pandemic is likely to affect all age groups, with more than 10% of the population likely to lose working days.
- The UK plan assumes that 25% of the UK workforce will take 5-8 working days off over a three-month period.
- During the peak of the pandemic, estimates suggest that absenteeism will double in the private sector and increase by two-thirds in the public sector.
This has important implications for business continuity. Advice for employers on how to maintain business continuity is available at
.
4.5. Impact on schools and services
4.5.1 Schools
4.5.1 Schools
Pandemic flu is likely to spread rapidly in schools and other closed communities leading to potential closures. Schools could also be affected by staff absenteeism and disruption to transport services.
4.5.2 Services
4.5.2 Services
Pandemic flu will impact all services including police, fire, the military, fuel supply, food production, distribution and transport, prisons, education and businesses. All are likely to be affected by staff sickness, travel restrictions and other potentially disruptive countermeasures.
The civil emergency response is covered by other contingency plans which will come into effect should they be required. These will ensure the maintenance of essential services, transport, food distribution, pharmaceutical supplies, utilities and communications, the maintenance of public order and the role of the police and armed services.
How will pandemic flu affect the UK?: Summary
- We do not know with any certainty who will be most affected, how many people will become ill or how many people with die.
- What we do know is that the next pandemic is likely to be associated with a much higher degree of illness and many more deaths than 'ordinary' flu and cause considerable social and economic disruption.
- Worldwide experts predict anything between 2 million and 50 million deaths.
- There may be in excess of 50,000 additional deaths in the UK.
- For more information on the impact of pandemic flu, visit:
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