# 1103
Six months ago the UK held what was billed as `the largest emergency exercise since the cold war', a massive bird flu drill called Operation Winter Willow. Since then, there has been little official comment on how that drill went.
Yesterday, the Home Office released a PDF file called Exercise Winter Willow - Lesson Learned document [PDF 138KB, 22 pages] on their UK Resilience web site.
From the executive summary, the authors have identified some key areas that the exercise revealed needed more attention. They include:
Communication with the public
Post –exercise feedback indicated that many people thought that public messages needed to be refined and that communications from central government departments and agencies needed to be better co-ordinated to ensure clarity and consistency.
For example, the central message of “business as usual” needed refining in the context of possible school closures and other measures that government might provide advice on. The message needed to be more sophisticated and would need to change as the pandemic developed.
The Exercise also highlighted the need for better engagement with the public and communities and particularly community responsibility for vulnerable people.
There was a need for clearer advice to the public on the use of antiviral drugs, facemasks and other measures and on the stocking of home supplies.
Further Policy Development
In testing the practical aspects of implementation of plans, there were a number of areas where policy issues need clarification or further development. Work on these areas is already underway under the management of the National Pandemic Influenza Working Group and progress will be reflected in the revised UK National Framework for Responding to an Influenza Pandemic. Key areas included:
• Travel advice (International) – the Foreign and Commonwealth Office (FCO) advice will relate to affected countries and their neighbours whilst WHO advice will focus on affected areas.• Science advice – a review of the scientific evidence base for pandemic preparedness planning and clarifying the role of the Department of Health Science Advisory Group during a pandemic.
• Demand for countermeasures – work on the management of the surge in demand for medical supplies such as masks and antibiotics, and the arrangements for access and distribution to the public of antiviral drugs.
• High mortality issues – further detailed guidance to help local planning for the operational aspects of increased death rates during a pandemic and to ensure that faith issues are not overlooked.
• School closure advice – further work on the practical aspects of the implementation of school closures and the wider implications.
• Human resources – the Department for Work and Pensions (DWP) is working on arrangements for sickness certification and the payment of benefits during a pandemic. The Department of Health is exploring ways of sharing best practice on workforce guidance.
• Relaxation of regulations and targets – the Cabinet Office is leading work on the possibility of co-ordinated relaxation of some specific regulations and targets during a pandemic.
The value of an exercise like Winter Willow is that it can show officials, and the public, where more work needs to be done to prepare for a pandemic.
Not surprisingly, there is a lot of work yet to be done in the UK. The good news is, the government appears to be taking all of this very seriously.
In some ways, the UK is far ahead of many other countries when it comes to pandemic planning.
They actually have, on hand, enough antivirals to treat 25% of their people (minimum 10-pill course of treatment), and are discussing buying more. They've actually held a nationwide exercise, something most countries have yet to do. And they've negotiated a deal with vaccine manufacturers to ensure that their citizens will receive vaccine when it finally becomes available.
They, like everyone else, have a long way to go in pandemic preparedness. And whether their plans will hold up in a severe pandemic remains to be seen.
But at least they've started.
