The cost of the research study on public engagement was £59,000. After the publication of the “National Framework for responding to an influenza pandemic” in the autumn, we will further test the public’s reactions to many issues in pandemic planning and decision-making. This will include issues of prioritisation of access, should that be necessary, to clinical countermeasures. Work continues on the design of a public engagement programme to facilitate this process.
NHS Blood and Transplant (NHSBT), together with the Department modelling team, have created a series of planning assumptions based on the best available estimates of demand for blood, the experience within NHSBT and that of other blood services, and the best possible estimate of supply under these conditions. While supply is dependent upon donors continuing to make altruistic gestures during the pandemic the current estimate based on these assumptions is that, in the worst case scenario, supply could fall by about 20 to 30 per cent.
Likewise, the estimates that can be made for demand are based on best available evidence and current knowledge. NHSBT's conservative estimate is that current demand for red cells could fall by about 10 to 25 per cent., while the demand for fresh frozen plasma and platelets could reduce by lesser amounts, although it is possible that demand could fall further.
NHSBT has a well-developed emergency planning system, which includes specific plans covering pandemic influenza. NHSBT's plans are regularly reviewed and updated to keep them in line with the latest emerging guidance.
It is not possible to determine the precise number of deaths due to influenza in a population because influenza itself is rarely the direct cause of death. Influenza may be complicated by bacterial infections, such as pneumonia, or may worsen an underlying illness, such as heart disease, and death results from the subsequent illness. In addition, by the time someone whose illness began with influenza gets to hospital, or dies, no evidence is apparent that the individual had influenza.
As a result, estimates of the number of deaths resulting from influenza epidemics are based on the number of deaths from all causes occurring during a period when influenza is circulating in the community, from which is subtracted the total number of deaths that would have been expected to have occurred in the absence of on influenza epidemic. This is generally referred to as the number of excess deaths due to influenza.
Estimates for excess deaths from influenza in England and Wales have been made by the Health Protection Agency for the 1988-89 to 2005-06 influenza seasons, and are given in the following table:
Influenza season Number of excess deaths 1988-89 358 1989-90 26,945 1990-91 8,125 1991-92 5,967 1992-93 1,687 1993-94 14,544 1994-95 2,480 1995-96 16,241 1996-97 21,770 1997-98 0 1998-99 17,982 1999-2000 22,040 2000-01 1,067 2001-02 7,078 2002-03 6,559 2003-04 5,207 2004-05 1,795 2005-06 0
Number of excess deaths
Flu vaccine uptake in those aged 65 and over since 2000-01 is shown in the following table. Data were not held centrally prior to 2000-01.
Uptake in those aged 65 and over (Percentage) 2000-01 65.4 2001-02 67.5 2002-03 68.6 2003-04 71.0 2004-05 71.5 2005-06 75.3 2006-07 74.0
Uptake in those aged 65 and over (Percentage)
Epidemic years have been classified as those in which "higher than average seasonal activity" has occurred. Since 1979, the following seasons would be classified as epidemic using this definition: 1989-90, 1993-94, 1996-97, 1998-99 and 1999-2000.