Questions for the government about the UK's preparedness for an H5N1 pandemic

The UK is, according to the UN and other health sources, one of the best prepared for such an outbreak, but compared to the very best we still could be doing more.

For example, how come we have ordered 14.3 million doses of the antiviral drug "Tamiflu", despite the H5N1 virus already showing some resistance to this, but Relenza, another drug with known abilities to fighting viral infections has not been ordered (despite the American government going ahead and ordering several million doses for use in the US).

Why have the government only ordered an immediate 3.5 million doses of a human H5N1 vaccine on the basis that "there is no guarantee that it will provide full immunity from an eventual mutation of the H5N1 flu vaccine", but we are still ordering 14.3 million doses of Tamiflu, and we have far less of a guarantee that Tamiflu will have any effect at all.

Recent research shows that early versions of a human H5N1 vaccine tested against the first clade (variant or type) of the H5N1 before it mutated, were given almost 100% protection. But when cells from these people were exposed to a mutated H5N1 from a clade elsewhere in South East Asia, it showed a strong level of resistance to this version of flu. Although it did not give 100% cover, it would have the effect of turning the H5N1 virus from a flu that kills 55% of victims to one that kills at the normal rate of a typical annual flu (less than half of one percent). If this is correct, why are the government not ordering and stockpiling these vaccines so as to be able to immunise people immediately against the "killer" version of H5N1 when it mutates in to a version easily transmissable between humans ?

When H5N1 does hit and become a Pandemic, it will take four months to produce a full vaccine that will work, and then it is predicted that the UK ould only produce about 1.5 million doses in the first 6 months, meaning that millions of people will remain exposed. Canada, aware of the fact that there will be a worldwide shortage of vaccine making facilities has invested in new vaccine technology meaning that they have guaranteed to provide 40 million does (one per head of their population) within the first four months of a breakout. Why are the UK government not doing the same ?

A number of companies are already producing H5N1 vaccines which are in full clinical trials but as yet the UK government has not announced they will be purchasing them. What is the UK government's position on buying in more stocks ?

Basically, when pandemic flu hits you can expect a pretty swift break down in law and order. Schools will be closed, businesses are working on the basis of a 35% absentee rate. Food shortage can be expected as production will be hit. Essentially, a swift breakdown in society and "New Orleans" style "every man for himself" attitude will start to emerge very quickly unless the UK government can very swiftly start immunisations, and not just to essential services.

In know this seems all very doom and gloom, but the government's own figures show that they are working on the basis of 560,000 deaths from a flu pandemic. Surely more could be done ? After all 560,000 deaths is 1% of the population. This is very conservative as some bird flu experts expect a 10% death rate. If people knew that some experts are predicting a worst case scenario of 1 in every 10 people dying in a flu pandemic by 2012, would they want the money spent on the Olympics or on a preventative flu vaccine ? My guess is that sport will not be a concern.

Oh, and before someone posts to tell me that only 250 people have caught bird flu since 1997, yes, you are right. But a similar number died in the years running up to the 1919 flu pandemic, and that year more people were killed than died in the whole of the First World War.