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Science
A STRAIN ON THE SYSTEM
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Wednesdays 29 January - 12 February 2003 9.00-9.30pm

How well prepared are we for dealing with an unexpected disaster? In a series of three programmes, Sue Broom investigates how a combination of science and planning should help us combat threats to our safety and security.

Policeman wearing mask

1. Biological and Chemical Attack

When the Government announced recently that hundreds of key medical and military personnel were to be vaccinated against smallpox, it sent an unambiguous message to the population at large: we would be unwise to ignore the threat of a terrorist attack.

In the first programme, Sue Broom looks at the central role science is playing in our struggle against biological and chemical attack. As the terrorist threat increases, Sue discovers how hospitals are preparing to cope with a terrorist attack. Emergency Health Planner Alan Bailey and Chief Emergency Planning Officer Patrick Cunningham describe how the emergency services would react if there was a deliberate release of a chemical or biological agent. Sue also hears from Dr Virginia Murray, Head of the Chemical Incident Response Service, which gives advice to hospitals and emergency services about a variety of chemical agents, and from Dr Dilys Morgan, an epidemiologist with the Communicable Disease Surveillance Centre which has the task of monitoring biological agents.

But important as it is to have a good scientific understanding of biological and chemical weapons, the effectiveness of the science would be severely compromised without proper planning and efficient channels of communication. In July 2001, the Civil Contingencies Secretariat was formed to improve the 'resilience' of central Government when faced with 'disruptive challenges'. Charged with drawing together the different strands of Government activity, the CCS also has a 'horizon scanning' responsibility so that the relevant authorities have early warning of imminent threat. Deputy Chief Medical Officer Dr Pat Troop describes other steps Government is taking to combat the threat of biological or chemical attack. Sue also talks to Simon Bucks from the Media Emergency Forum, which set up to consider how best to inform people about civil emergencies.

Given the necessarily unpredictable nature of a terrorist attack, how well prepared is the UK for chemical or biological attack? Is the combination of science and contingency planning enough to combat the terrorist threat?

Listen again to programme 1 Listen again to programme 1

2. Foot and Mouth

In the second programme, Sue Broom evaluates the scientific and bureaucratic lessons learned in the 2001 Foot and Mouth epidemic and how improved contingency planning and better science might help us prevent such devastating outbreaks in the future.

When, after 32 weeks, Foot and Mouth Disease epidemic was finally eradicated, 6 million animals had been slaughtered and the Government's Audit Office estimated the outbreak had cost the country more than eight billion pounds. During and after the epidemic, questions were raised about the Government's handling of the crisis: why did it take so long to eradicate the disease? Was slaughter the only solution? Was the action cost effective?

Sue talks to veterinarian Peter Jinman and Herefordshire farmer Andrew Havard who lost 184 cattle and 500 sheep in the epidemic. Head of the State Veterinary Service, Martin Atkinson, describes the new Contingency Plans currently being drawn up the Department of Environment, Food and Rural Affairs. Research scientists like David Paton and Andrew King at the Institute for Animal Health are working on new vaccines and speedier 'pen-side' diagnostics which will confirm the existence of the virus in hours rather than days. Sue also talks to Sir Brian Follett whose Royal Society report, Infectious Diseases In Livestock, argues that we should make greater use of quantitative modelling to help us predict how an outbreak might develop.

But however well prepared we might be for another outbreak of Foot and Mouth Disease, veterinarians warn that other diseases like Bluetongue, Rinderpest and Swine fever could have an equally devastating impact on livestock farming.

Listen again to programme 2 Listen again to programme 2

3. Pandemics

The Spanish Flu pandemic of 1918 was responsible for over 20 million deaths, more than occurred in the First World War. But if there was another outbreak, would we be able to prevent many deaths? In the final part of the series, Sue Broom looks at plans in place to prevent the next pandemic and finds out whether we are any better prepared now than we were in 1918.

Experts believe that even with today's level of preparation, anti viral drugs and vaccine programmes, a pandemic would result in 5 million deaths globally. Other predictions suggest that the death toll could rise beyond 1918 proportions as the virus could spread around the globe in less than 5 months. The last pandemic occurred in the late 1960s, but it was nowhere near as disastrous as the one in 1918. It was the actions of the Hong Kong government, slaughtering millions of chickens to prevent the spread of avian flu, that averted a human pandemic in 1997.

Governments and health organisations are all planning for the worst. But with only limited stocks of anti viral drugs and a time scale of nearly 6 months to produce a new vaccine, governments will have to make choices as to who receives treatment and when. Will it be doctors, politicians, the young or the old, and as people succumb to the virus how will health services and society as a whole deal with the pandemic?

To answer these questions, Sue talks to Dr Ian Goodman, a sentinel GP who is on the look-out for early signs of a flu pandemic, and to Dr Klaus Stohr in Geneva leads the World Health Organisation's Influenza Programme. She also hears from Dr John Wood at the National Institute for Biological Standards; Dr Pat Troop, Deputy Chief Medical Officer; John Oxford, Professor of Virology at St Bartholomew's Hospital and to Maria Zambon, Head of the Influenza Laboratory at the Public Health Laboratory Service.

Influenza is a disease that causes significant illness and death around the globe each year. The virus can constantly change its antigenic make up in a series of "drifts" making life long immunity impossible. Constantly changing the yearly vaccine - a process overseen by the World Health Organisation - prevents serious loss of life.

The virus becomes very dangerous when it undergoes an antigenic "shift" - a process that prevents the immune system recognising the virus as a threat and rendering the vaccines - based on the old virus - next to useless. These unpredictable "shifts" usually occur in the Far East and may allow the virus to jump species and mean the threat of a global pandemic is always present.

Listen again to programme 3 Listen again to programme 3

Let us hear your thoughts about the issues raised in this series on the Radio 4 Science Message Board.

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