Chapter 6: Response?

All of the attendees at the COBRA meeting were staring at the Prime Minister. The news channels were blaring out the claims of Al Qaeda biological attacks, the release of a strain of bird flu that could infect humans, and Gordon Brown had sneezed. The Prime Minister gazed back at them calmly.

"Ladies and gentlemen, I don't think this is the time to lose our cool. It would seem we have a lot of work to do. Now, I suggest we take a comfort break to give the Chief Medical Officer time to join us. Anthony, some tea and coffee would be nice," he said.

Around the room, people stood to stretch their legs, some taking the opportunity for a quick trip to the toilets and the Permanent Secretary signalled to a junior civil servant to go and fetch the refreshments.

As they helped themselves to coffee another man entered the room. He was slightly stooped over, aged in his sixties, with white hair and glasses. He would have stood around five foot ten without the stoop and his frame was still lean and wiry, despite his age. This was the government's Chief Medical Officer (CMO), Sir Alec Grayson, once a leading cardio-thoracic surgeon.

"Alec, welcome. Grab yourself a coffee, we're just about to reconvene," said the Prime Minister.

Just as the meeting was coming to order, each of the attendees now with a cup of strong coffee in front of him or her, the Prime Minister's Private Secretary approached him and bent to whisper in his ear. The Prime Minster looked thoughtful for a moment and then clearly made a decision.

"Have them put her through on the screens now Derek," he said.

The Private Secretary scuttled back to his seat and held a blackberry up to his ear, giving instructions to whoever was on the other end of the line. The level of noise in the room began to rise once more as people began to speculate on what was happening now. Within minutes however, their questions were answered when one of the screens flickered and then displayed the head and shoulders of the German Chancellor, Angela Merkel.

"Madam Chancellor, forgive me for being presumptuous. I'm assuming your call is about the situation with bird flu and thought it appropriate to speak to you immediately. As you can see I have my experts gathered around me and we are discussing that very issue and what we can do. I hope you don't mind speaking with all of them present?"

"Not at all Prime Minister, I am just about to join a similar meeting here in Berlin. I believe you have already spoken to President Bush, I've just finished speaking to him too and he confirmed for me that the reports about outbreaks in the UK are accurate. I can also confirm that the news reports you will have been monitoring are true. We are experiencing a massive outbreak of bird flu right across Germany and it seems there is nothing we can do to halt it. So far there have been no reports of any spread of the virus into the population as Al Qaeda seem to be predicting."

"I'm just about to ask my Chief Medical Officer when we might expect to see the first signs of people with the virus if indeed it has mutated and is able to infect humans," said the Prime Minister.

He paused and looked at the CMO and Sir Alec took a breath before replying.

"The virus would show up in birds much quicker than in people, Prime Minister, simply because of the smaller body mass and the physiology involved. However, given the numbers of dead birds we are seeing I'm assuming the virus was released several days ago. Normal incubation would mean the first signs could be showing in humans later on today or possibly tomorrow. The elderly and infirm might be the first to display symptoms, as their bodies defence systems will already be weak."

"It is a frightening prospect. Anyway Prime Minister, I will not intrude upon your meeting any longer, I just thought it was important to let you know the position here. I will now go and meet my experts too. Good afternoon," said the German Chancellor, her face drawn and tired looking.

Once the German Chancellor had signed off the Prime Minister called COBRA to order once again.

"Okay folks, you've heard the CMO's assessment. I want ideas on what preventative action we can take, what plans we can set in motion to avoid this turning into a disaster."

The CMO interrupted him.

"I'm sorry Prime Minister, I've not made myself clear. Given the scale of the impact, both in terms of numbers of birds and the geographical spread, there is nothing you can do now to prevent it. If the virus can infect humans it already has and we are simply waiting for it to incubate. You probably should take steps to close down all international travel so that we aren't running the risk of exposing other countries that are not yet infected, but other than that there's nothing.

"We can't immunise because we don't have a vaccine. There's no known treatment that will kill the virus once it has been contracted. In theory a total lock down will ensure anyone who has not yet been exposed to the virus will remain clean, but again, how could you do that effectively in all of our major cities? Could the armed forces enforce a complete curfew, marshal law? How would people get food if they couldn't leave their houses? It's just not feasible."

The Prime Minister's shoulders slumped at this. He had been bracing himself for the possibility of a major disaster, but to be told there was nothing he could do to limit its impact, that he was basically impotent, was a crushing blow for a man used to wielding power and getting his own way.

"Alec, what are we facing?" he asked at last.

"It depends on the just how virulent this strain is," replied the CMO, "if it has a similar profile to bird flu then we could see as much as 80% fatalities. With a population of just over 60 million, that could translate into 48 million dead.

The sheer scale of his words caused silence in the room.

The Prime Minister paled and it was almost as if he was crumpling from the inside he was so visibly deflated. Again it was a credit to the man's courage that they could all see him recover immediately from his momentary lapse and he pulled himself together.

"I can't believe all the time, energy and resources we have pumped in to emergency planing are all coming to nothing," the Prime Minister said sadly. "Home Secretary, how long to close down all international travel?" he asked.

"We could probably achieve that in a matter of an hour Prime Minister. There are emergency codes that we can use. They weren't designed with this in mind, but they'll work just as effectively."

"Okay, do it please," he ordered.

"Prime Minister, I have to caution against such a move, without any explanation for it, it's bound to spark a panic," the Home Secretary objected.

"I think you're underestimating the British public, I'm sure they will know precisely why we are taking this step and they will rally round. We also have a responsibility to try and safeguard other countries if we can. We are citizens of the world and although the CMO is telling us we can do nothing for our own countrymen, we might be able to do some good for others."

"Prime Minister, there are other practical matters we need to discuss. If this does turn out to be a human pandemic we are going to very quickly find things grinding to a halt. People who fulfil vital roles are going to be missing. Public transport will fail, no deliveries to supermarkets, failure of energy and water supplies. The National Health Service will be swamped with the sick and a good percentage of the NHS staff will themselves be sick and unable to treat anybody. If there are a large number of deaths then there will be a secondary public health issue from the number of bodies," said the CMO.

The way he was able to rhyme all these things off so dispassionately was a mark of his medical training, but the reaction of the others in the room was not as stoic.

"Yes CMO, I can see what you mean. Haven't we worked up some scenarios on this? It seems we have been talking about the possibility of a flu pandemic for years now, surely we have undertaken some modelling?" asked the Prime Minister.

"At that level of fatalities it all becomes something of a pointless exercise Prime Minister. There aren't enough people left alive to sustain anything by way of a reasonably sophisticated society. No army, no police service, nothing but the complete breakdown of society as we know it. Not even enough people to clean up the dead, there would be just too many bodies. So we haven't gone too deeply into it," replied the Home Secretary.

"Sweet Jesus, whose decision was that? That's simply defeatism and I won't have it. I want contingency plans drawn up by all government departments immediately. If this comes to pass it might well be the case that a large percentage of our population will not survive, but again, let me stress; we still have a responsibility to those that will.

"Everyone of us in this room might perish, but we can still do the best we can to serve the British public. Even those infected would surely have a few days before they succumbed? Much could be achieved in that time. I want plans for recovery of as many bodies as possible and a way to fight secondary health issues from dead bodies. I want plans for switching as much of our utilities to run automatically, for as long as possible.

"Even if our worst nightmares come to pass I want the British survivors to have every chance. Make it so ladies and gentlemen and do it quickly.

The sheer authority of the man had returned. His ability to inspire and motivate was evident as all round the room the meeting attendees had changed from pale, anxious and fearful to purposeful, energised and ready to try and make a contribution.