13,000 Cayman Islands residents could be affected in a short time if an influenza pandemic hit these islands, a new government document predicts.
At the launch Monday night of a contingency plan for an influenza pandemic are, from left: Director of Hazard Management Cayman Islands Dr. Barbara Carby, Medical Officer for Health Dr. Kiran Kumar, Minister responsible for Health Anthony Eden and Governor Stuart Jack. |
Launched at a ceremony Monday, the Government’s contingency plan for an influenza pandemic predicts a pandemic could overwhelm some government agencies, necessitate the mass closing of schools, and require restrictions be placed on mass gatherings.
In response to the threat, the HSA is in the process of stockpiling an antiviral drug that could treat some of the population, and a new taskforce and committee have been established to coordinate the response in the event of any influenza pandemic.
The contingency plans warns that if an influenza pandemic were to start, it is inevitable the Cayman Islands will be affected, being a popular tourist destination in a time of rapid international travel.
‘The timing, extent and severity of a future pandemic remain uncertain, but experience from previous pandemics suggests it will spread rapidly to all parts of the globe causing sudden, sharp increases in illness and deaths over a matter of weeks. It could rapidly overwhelm health and other services, and have far reaching effects on daily life, businesses, and, consequently, national and global economies.’
The current pandemic threat stems from an unprecedented outbreak of avian influenza in Asia, the Middle East and Europe, caused by the H5N1 strain of influenza A virus. 250 million birds have been culled or died as a result of infection. 300 people have died; most worked with domestic poultry.
Currently, the influenza strand can pass from birds to humans, but has not yet shown an ability to transmit between humans. But there is a concern that the strain will eventually acquire this capability through genetic mutation. Human to human transmission would allow the virus to spread much more rapidly.
‘In the event of a pandemic, the rapid transmissibility of influenza viruses, the universal susceptibility of the world’s population to viruses that have not previously circulated, and the mobility of human populations mean that every corner of the globe and every element of society are likely to be touched,’ the document warns.
‘This has ramifications for not only the health and wellbeing of populations, but for the national and economic security of nations, and the functioning of civil societies. The scope and scale of the measures necessary to prepare for a pandemic are wide ranging.’
The plan
Scientists expect an influenza pandemic is most likely to emerge in South East Asia and could spread to the Cayman Islands in one to two months. It would take another two to three weeks to spread to the Sister Islands, the report warns.
Thereafter, activity could last three to five months, with a peak of cases at about six weeks. Subsequent attacks are likely to occur weeks to moths later, it says. The illness will affect more people, more severely, than the annual ‘seasonal’ influenza and about a quarter of the population may develop the illness, with 11 to 50 deaths or more likely by the end of the pandemic.
Preventing importation into the Cayman Islands is unlikely to be effective in stopping a flu pandemic, and closing all borders would be impractical, the report argues; even a 99.9 per cent restriction on travel into the country would only delay importation of the virus by up to two months.
However, restrictions on long distance national travel may slow the speed of the pandemic, the plan notes.
Upon being informed of a new influenza virus with pandemic potential, the Minister responsible for Health will contravene the Cayman Islands National Influenza Health Task Force to ensure the preparation of health services, while the Governor will convene the Cayman Islands National Influenza Pandemic Committee to review preparedness of all sectors.
Two cornerstones of combating any influenza pandemic would involve acquiring a vaccine and stockpiling antiviral drugs.
However, it will be impossible for a vaccine to be formulated until the pandemic virus strain becomes known. The effectiveness of a vaccine would not be known until it was in use, the document cautions.
The Cayman Islands would not manufacture its own vaccine, and it may take four to six months before a vaccine becomes available in sufficient quantity. According to the contingency plan, the Government is working closely with the Pan American Health Organisation, the World Health Organisation and the UK government to ensure adequate supply of the vaccine, although no specific details are provided.
The other main countermeasure, an antiviral drug called oseltamivir, is already being purchased by the HSA. The drug should shorten illness, reduce the severity of symptoms and reduce the need for hospitalization. The HSA plan to stockpile enough of the drug to be able to treat 25 per cent of the population in the event of a pandemic.
Based on WHO advice and UK proposals, the contingency plan predicts children and otherwise fit adults will be at a relatively greater risk, since some older people may have residual immunity resulting from exposure to a similar virus earlier in life.
The impact on health and human services would be intense and some entities would become overwhelmed. ‘It is estimated that 13,000 persons may be ill with influenza of which 6,500 might seek health care contact. Hospitalizations may vary between 40 – 176 and there might be 11 – 50 deaths during the pandemic, depending on the severity.’
Noting that any pandemic could lead to widespread absenteeism from workplaces, the report calls on businesses to implement continuity plans based on a cumulative total of 25 per cent of workers taking between five and eight days of work over a three to four month period.
The virus would spread particularly fast in schools, and 50 per cent of school children may be affected, it says. This could require schools to be closed. Restrictions on mass gatherings would also have to be considered, it says.
At a ceremony marking its launch Monday, Governor Stuart Jack described the plan as a comprehensive blueprint for how the Government of the Cayman Islands, working with the community, intends to prepare for, detect and respond to a possible flu pandemic.
‘Pandemic flu poses a grave danger to the world. Our ability to survive with the least disruption will be a function of how well we prepare, and how united we stand in our efforts. Here in the Cayman Islands we have seen the benefits of good preparation in dealing with hurricanes. Let’s do the same with this new challenge,’ he said.
In the past 100 years there have been three influenza pandemics. The ‘Spanish Flu’, in 1918-19 killed between 20 and 50 million people worldwide. In 1957-58, ‘Asian Flu’ caused about 70,000 deaths in the US alone, while in 1968-69, ‘Hong Kong Flu’ killed 34,000 people in the US. That virus is still in circulation today.
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