GPC clinical and prescribing lead Dr Andrew Green has advised GPs to start preparing contingency plans for a possible flu pandemic before it is ‘too late’.
This should involve collaboration between practices, service restrictions and the prioritisation of vaccines for ‘vulnerable’ elderly patients.
Speaking to GPonline, Dr Green said: ‘We never know when the next flu pandemic will strike. [However] the shortest period between 20th century pandemics was 12 years, and we are already nine years after the last one, so all practices should be dusting off their pandemic plans now.’
He added that the ‘constantly changing’ nature of the flu virus combined with the influence of modern travel making it easier for infection to spread means that ‘by the time the viral mutation has occurred there will be no time to start preparations’.
As such, practices should be drawing up procedures to work out how they can continue to provide essential services with ‘fewer than half of [their] staff available’.
‘This would certainly involve collaboration with other practices and restrictions of non-urgent activities,’ Dr Green said.
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'Complex' flu season
GPonline reported last week that GP leaders fear the upcoming flu season will be more ‘complex’ than in previous years, and could prove challenging for practices and patients. This is due to NHS England recommending different vaccines for different ‘at risk’ groups and because the new adjuvanted vaccine FLUAD, which has been recommended for patients aged 65 and over for the first time this year, is subject to a ‘phased’ delivery process.
Public Health England (PHE) has also confirmed that the adjuvanted vaccine does not protect against the B/Yamagata strain of flu (also known as ‘Japanese flu’), which claimed thousands of lives last winter.
A PHE spokesperson said: ‘The adjuvanted vaccine includes two types of flu A strain and one of flu B (B/Victoria lineage viruses), while the quadrivalent includes two types of A and two B strains (B/Yamagata and B/Victoria lineage viruses). Flu B strains generally affect younger age groups while we know flu A strains are more likely to make those aged 65 and over unwell.’
PHE said that FLUAD remains the ‘most effective’ option available to older patients. Dr Green said that the fact that the vaccine does not cover all four strains of flu should not increase the likelihood of a pandemic.
‘Clinically, [providing the adjuvanted vaccine to over-65s] is the right thing to do,’ he said. ‘If a pandemic occurs it will do so whatever the vaccine contains. As we don’t know what strains will cause problems this winter, it is vital patients in at-risk groups continue to be vaccinated.
‘The priority here is to ensure that vulnerable elderly people get the vaccine which is most effective,’ he concluded.
The RCGP has urged all GPs to have a flu jab this winter to avoid spreading the virus to colleagues and patients.
