Exercise Winter Willow

Liz McIntoshHealth DeskCivil Contingencies Secretariat Cabinet Office

Content

• Recap on planning and response

• Exercise programme for pandemic flu

• Exercise Winter Willow 1 and 2– Objectives– Staging– Scope– Possible issues at national level

Planning workstreams• Gathering information and getting it to those who need it, at all levels.• Modelling – the virus; its spread; its impact; response measures.• The medical response:

– Vaccines.– Anti-virals purchase, distribution and use.– Treatment protocols and clinical guidelines.– Ethics

• Policies on response in particular settings – schools; social care; prisons; transport.• Continued operation of the judicial process. • Management of the dead.• British nationals overseas.• Ensuring business continuity.• Communications.• Crisis management arrangements.• Stakeholder engagement – Category 1 responders and the private sector.• Exercises and other testing and assurance. • Wider international engagements with EU partners, the US and multilateral

organisations.

Crisis co-ordination

• National, regional and local structures to manage the consequences when/of the pandemic arrives:

– Department of Health – lead

– Civil Contingencies Committee (“COBR”) for central Government

• Based on understanding of the virus, COBR will issue firm advice on the full range of response policies

– Regional Civil Contingencies Committees.

– Local “multi-agency GOLD” crisis co-ordination arrangements

– International dimension – WHO; EU; G8.

WHO Alert PhasesPandemic alert period

Phase 3 Human infection(s) with a new subtype, but no human-tohuman spread, or at most rare instances of spread to a close contact

Phase 4 Small cluster(s) with limited human-to-human transmission but spread is highly localized, suggesting that the virus is not well adapted to humans.

Phase 5 Larger cluster(s) but human-to-human spread still localized, suggesting that the virus is becoming increasingly better adapted to humans, but may

not yet be fully transmissible (substantial pandemic risk).

Pandemic period

Phase 6 Pandemic: increased and sustained transmission in general population.

UK alert levels at WHO Phase 6

WHO Phase 6 Pandemic: increased and sustained transmission in general population.

UK:• Alert level 1 Cases only outside the UK (in a country

or countries with or without extensive UK travel/trade links)

• Alert level 2 New virus isolated in the UK • Alert level 3 Outbreak(s) in the UK • Alert level 4 Widespread activity across the UK

Testing plans – so far…• Regional and local level exercises since 2004, eg, in London in

2004;Yorkshire and Humberside and East Midlands in 2005; off the shelf HPA product ‘Coldplay’ (health sector focus).

• Two table top exercises to test the central Government response held in 2005.

• National level exercise held in June 2006 – Exercise Shared Goal – set at WHO Phase 5. CCC and CCC(O).

• EU wide exercise ‘Common Ground’ in autumn 2005.

• Private sector exercising, eg, financial sector market-wide exercise in autumn 2006.

• More to come next year and beyond….DH and medicines; another at EU level, one at UN level…

Winter Willow 1 and 2 – objectives:

• Familiarise Ministers and officials involved in central response with policy and response issues at WHO Phase 6 - UK alert levels 2 and 4

• Familiarise key players throughout the UK (regional and local) with government interactions during a response

• Stimulate and analyse impact upon the CNI

• Test information flows, real-time modelling and access to timely expert advice

• Identify gaps in response to inform future planning work

Winter Willow 1 – staging:

• Stage 1 – national level tabletop ie, CCC and CCC(O) to meet

• Builds on Ex Shared Goal scenario (June 2006)

• UK alert level 2 ie, first UK cases

• 30 January

• No regional or local play

• Decisions and outputs will be fed into WW2

Winter Willow 2 – staging: • Stage 2 – full national exercise over 2 days on 19 and 20

February• CCC and CCC(O) to meet both days• Builds on WW 1• UK alert level 4 ie, widespread cases in UK• To test UK response at local, regional and national levels

– RCCC/LRFs ‘multi-agency golds’– NHS– DAs – CNI sectors– ‘pool filming’ during Ex and real media via ‘mock press conferences’

after CCCs

• WHO, ECDC, EC to play as part of Excon

Winter Willow 2 – regional/local play:

Winter Willow 2 – NHS playStrategic Health Authorities and related health communities:

• East Midlands SHA + Leicestershire

• East of England SHA + East and NW Hertfordshire

• North East SHA + Northumberland, N’cle, N Tyneside, Gateshead, S Tyneside, Sunderland and Durham and Darlington

• London SHA + Lambeth

• South Central SHA + Thames Valley, Isle of Wight and Hampshire

• South East Coast SHA + West Sussex

• South West SHA + Avon

• West Midlands SHA + South Staffs

• Yorkshire and Humberside SHA + Hull

• North West SHA + East Lancs, Blackburn and Central Lancashire

Winter Willow 2 – CNI play (1)• Food sector:

o Range of manufacturers, retailers, primary producers, wholesalers

• Water sector:o Ranges of water companies and regulators

• Fuel sector:o Downstream oil

Winter Willow 2 – CNI play (2)

• Transport sector:o Range of transport operators – buses, trains, air

travel, marine

• Finance sector:o Simulated input based on 6-weeks market-wide

exercise (autumn 2006)

Possible issues at national level for WW2• …some exercise engineering to make sure there are

good range of issues on the table for COBR…• Looking ahead from early days of Alert Level 4

towards peak of UK epidemic (some weeks hence..)– Cases– Deaths….triggers for more radical measures?– Absences from work and impacts– Health service – Antiviral stocks– Outlook for essential services– Significant issues at local and regional levels– Impacts on economy– What can HMG do to manage and/or minimise impacts?

Thanks for your attention

Questions?