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WITH the UK having been preoccupied with real emergencies caused by storms and flooding, the results of a simulation exercise to test the country's preparedness for another type of emergency are in danger of being overlooked. Nevertheless, the results of ‘Exercise Walnut’, which was held last year to test contingency planning for an animal disease outbreak, are worthy of note. The AHVLA has just published a report on the lessons identified during the exercise, which simulated an outbreak of classical swine fever (CSF).1 The conclusions make interesting, if in some ways familiar, reading.
This is by no means the first time the UK's contingency plans for an exotic animal disease outbreak have been tested. Such exercises have been carried out periodically since the foot-and-mouth disease (FMD) outbreak of 2001, to try to make sure that the experiences of that year are not repeated. Previous exercises have included Exercise Hornbeam, in 2004, testing plans for dealing with FMD; Exercise Hawthorn, in 2006, simulating an avian influenza outbreak; and Exercise Silver Birch, in 2010, again testing preparedness for an FMD outbreak. In addition, contingency plans have been put to the test in real disease situations, most notably in 2007 when, at one point, Great Britain found itself having to deal with three exotic disease outbreaks simultaneously (highly pathogenic avian influenza, FMD and bluetongue).
More than 500 people participated in Exercise Walnut, which involved various preparatory exercises and culminated in a two-day, real-time exercise in June last year. It simulated a medium- to large-scale outbreak of CSF and aimed to test the response of all four administrations of the UK. It is in the nature of such exercises that they set out to identify what might go wrong rather than what went right, so some comfort may be drawn from the report's conclusion that ‘Exercise Walnut provided a very effective examination of the different administrations’ contingency plans in the event of an outbreak of CSF and provides reassurance that the UK could respond effectively to an outbreak of this disease.’ Nevertheless, CSF is not the only disease threatening the UK and some of the lessons identified during the exercise give cause for concern.
Not least among these are those relating to the necessary redeployment of AHVLA staff to local disease control centres and how this might impinge on ‘business as usual’ activities, as well as comments drawing attention to a shortage of field staff who are trained and experienced in dealing with pigs. Concerns about the availability of suitably trained personnel are reinforced by a warning from a representative of the Pig Veterinary Society who took part in the exercise. This was not to expect large numbers of private practitioners with experience of pigs to be readily available in the event of a national disease outbreak, because there are not many pig specialists available in Great Britain and most of these would have other work to attend to.
Pig medicine is relatively specialised, so shortages might be expected in this field. However, finding enough suitably trained vets proved to be a problem during the early stages of the FMD crisis in 2001, and has been highlighted as a potential problem in every contingency exercise that has been conducted since. Given all the changes that have occurred both in practice and the AHVLA in recent years, it could be even more of a problem in the event of a large-scale disease outbreak today. It remains worrying that, after the experiences of 2001, and in view of the findings of exercises Hornbeam, Hawthorn and Silver Birch, the importance of ensuring that enough suitably trained people are readily on hand to help deal with an outbreak still seems to have escaped our planners; a case, perhaps, of not seeing the wood for the trees.
Another concern relates to a recommendation in the report that ‘there needs to be an opportunity for the pig industry to brief officials at the start of an outbreak and to provide background data on the pig industry’. This, apparently, is in response to concerns expressed during the exercise that ‘the data on the number and location of pig premises used to inform the epidemiological modelling was out of date and so did not provide a current interpretation of the pig industry’. Epidemiological modelling, which is used to inform control measures, can only be as good as the data on which it is based and, while it clearly makes sense to have a briefing at the start of an outbreak, it would be nice to think that such information could be kept up to date as a matter of course.
The report makes the point that ‘reduced resources across UK government and its delivery partners has seen a major revision in outbreak response structures’ and teams, and notes that some of the lessons identified during Exercise Walnut ‘will reflect concerns of some unfamiliar with the complete outbreak response and the lessons point to a requirement for further training rather than a revision of current plans’. That may be true, but, bearing in mind all the changes taking place in and around the AHVLA, it also serves to highlight that it is not enough just to have plans in place; people need to be familiar with those plans, and you need the people and resources to implement them.
The report identifies 11 ‘main lessons’ in all and it must be hoped that these are acted on. In the meantime, the administrations of the UK must carry on refining and testing their plans. Crucially, they must also make sure that sufficient resources are available to put them into effect when necessary. The threat of a real disease outbreak is never far away, as illustrated only last month by an outbreak of low pathogenic H5N1 avian influenza in the Netherlands.