# 2631
When you make plans to deal with a pandemic, it is essential that you first develop a set of assumptions. A fictional scenario that, while not expected to be totally accurate, represents what you expect and gives you something to plan to.
We've seen a wide variance between what some states and regions are planning for, and what others are. Since nobody can see the future, one guess today about the severity of the next pandemic is pretty much as valid as the next.
Most governments, however, have modeled their assumptions off of the 1918 Spanish flu. Here in the US, we use somewhere around a 30% attack rate, and a CFR (Case Fatality Ratio) of around 2%.
And most importantly, the vast majority of these infections, it is hoped, will be mild enough that the victims can be treated at home.
Whether that is wildly optimistic, or reasonable, is unknowable right now. But regardless of their actual condition or number, it is unlikely that more than a very small percentage of the sick could be accommodated in hospitals.
While none of the flu experts that I've spoken with believe that this represents the `worst-case scenario', many believe these are `reasonable' assumptions.
In the UK, doctors have been warned that during the peak of a pandemic, they could expect to see 14,000 Briton's infected out of each 100,000 population.
While we could argue over whether planning for 1.4% of the population being sick at the peak of a pandemic is realistic or not, it scarcely matters.
Even at that level, according to the Royal College of General Practitioners, it would put their health care system under `unprecedented pressure'.
GPs been advised to `buddy-up' with neighboring surgeries, to set up separate waiting rooms for non-infected patients, and to be willing to share resources and staff amongst themselves during a crisis.
Surgeries are being given until the end of March to develop emergency pandemic plans.
This report from the BBC.
GPs flu pandemic workload warning
A flu pandemic is overdue, experts say
GP surgeries have been told to prepare for seeing nearly 200 extra patients a week in the height of a flu pandemic.
The Royal College of GPs and British Medical Association guidance said surgeries should "buddy up" with neighbouring ones to share resources.
And they said UK GPs may even need to set up separate waiting rooms for flu patients and draft in retired doctors to help with death certification.
Experts have been predicting a flu pandemic is long overdue.
These are very different from the seasonal flu outbreak that has been seen recently.
Pandemics are global outbreaks and tend to occur three or four times a century, killing millions.
The worst one in the 20th century was in 1918 which caused 250,000 deaths in the UK alone.
Imminent
Scientists believe the likely source of a future pandemic could be bird flu mutating into a deadly human strain.
If such an event happened, it is estimated up to 700,000 people could die in the UK.
But the guidance produced for GPs warned they would end up treating many more patients.
Up to a half of the population could end up being infected with flu during a pandemic of which a third could need GP care.
Such a scenario would mean more than 14,000 cases per 100,000 of the population - the equivalent of 186 cases for the average three-doctor surgery during the peak of the outbreak.
During a pandemic the NHS would have to work differently - it's a major health emergency and as such requires a totally different way of helping patients
Laurence Buckman, of the British Medical Association
