‘And if that doesn’t do it?’
‘I see no reason why the measures in place won’t hold it. There are multiple response protocols depending upon the seriousness of the numbers and the epidemiological model’ The minister replied.
‘It hasn’t been contained in the origin countries using those protocols. We wouldn’t be meeting if it had.’
‘Simpson, without wishing to run the gauntlet of the PC brigade, I think it safe to say that our adherence to the letter of the protocols is likely to be considerably more rigorous than it was in those countries. Now, if…’
‘With respect Minister?’
‘Yes Walters? What is it?’
‘With respect Minister, shouldn’t there be a planned response beyond, well. Beyond crossing our fingers? If those measures don’t hold it?’
‘Your concern does you credit Walters but I think we have considered all the likely scenarios without moving into the provenance of horror films and disaster fiction.’ The minister held up a hand. ‘If, and I only raise the matter in deference to the concerns of our colleague here,’ he nodded in Walters direction, a smile touching lips but not eyes, ‘we shall meet again to consider further measures.’
The minister raised an eyebrow.
‘I mean at what threshold will we meet again? If the first level is breached or at the last level? Because we’ll need weeks of preparation. For beds, for disposal facilities for bedding, for quarantine regulations, movement control orders…’
‘I see where you are coming from Walters.’ The minister turned to his Permanent Under Secretary. ‘Derek, if you could just allay our friends fears please.’
‘Certainly Minister. Professor Walters, the measures we have been discussing concern the medical and social services response to any possible spread of the virus. As such we have, through the knowledge and advice of experts, of whom you have been pre-eminent, confirmed our previous response protocols and updated and integrated them with new measures where appropriate. There are other considerations the possible spread of the disease may raise and these have been considered in more appropriate fora, given their multifaceted nature. You may rest assured Professor Walters that their deliberations have taken into account all the concerns you mentioned and more.’
‘What considerations Minister? I merely meant those things that come under the remit of this committee. Beds, quarantine…’
The minister cut him off.
‘I know Alan. I know. I can’t go into the details here, I’d be trespassing on the Ministry of Justice’s territory and let us not forget that of the PM.’
‘But we’re the health committee reporting to COBRA on this. It’s surely our responsibility to plan for the ultimate contingency?’
‘If I may Minister?’ the PUS intervened.
The minister nodded
‘Whilst you are correct Professor Walters, that this committee has the responsibility to deal with any emergency arising in the form of a health threat to the UK, such as the current virus scare, there are obviously other agencies with interests in the knock on effects of such a potential threat to UK society. At a certain stage, which we hope is never reached, priorities may shift from a purely health care response to a more multi-agency involvement. At that point lead agency status may shift and given the delicate nature of some planning options it is felt that this forum may not necessarily be the best place for such contingency measures to be discussed fully. You may however, as the Minister has indicated, rest assured that should the time come, the advice of this committee and its experts would be fed into any options being considered by the full Cobra committee.’
‘Thank you Derek.’ The minister straightened his papers. ‘Now I think that concludes matters for the moment. However, we’ll schedule another meeting for a week’s time. Derek see that everyone is informed please.’
‘Not now Alan. People have busy schedules and we’ve used our allotted time. If you’d like a private word I’m sure we can arrange something through Jill. Okay?’
The people around the table stood and began to chat to one another or leave depending on how busy they wanted to appear in front of the minister. Professor Walters tried to intercept the minister before he could leave but Derek, the PUS intercepted him.
‘Don’t worry about seeing Jill. She’s nearly as busy as the Minister. Let me know a convenient time and I’ll sort something out for us.’
‘Don’t flannel me Derek. What the hell is this other committee that’s taking over the response planning?
‘Alan, no-one’s taking over. This is a health driven response and this committee is the lead body. And I think I can say without fear of contradiction that you are its lead authority. No-one knows more about the type of threat we face.’
‘Exactly. And I’m telling you we haven’t faced anything like this ever before. If what we are seeing elsewhere is anything to go by we will breach the thresholds. We should be beginning our response with a level three approach. Level one might work for flu but this is different, by an order of magnitude.’
‘Well that’s one opinion.’
‘From the “lead authority”.’
The PUS looked around. The room was nearly empty now. He put a hand on Walters’ elbow.
‘Hang on here a second.’ he said quietly and with that swiftly ushered the remaining few members out of the room. He shut the committee room door behind him.
‘Have a seat Professor.’
The pair sat at the head of the table.
‘Now. This is off the record and if I read any of it outside this room, even if it’s only in the Tunbridge Wells Gardening Society blog, you’re finished. Understand?’
‘I’m not being threatened.’
‘Yes you are actually. Think of it as a threat warning.’
Walters face turned white and he started to rise from his seat.
The two men locked eyes and Walters sat.
‘Now. You are quite right. It is very likely that we will need to go further than level one and fast. But to jump right in is going to panic everyone. They’ll all start running all over the place and that will make matters a damned sight worse. This needs managing. We need to put in place some non-health measures first before we move to that scenario.’
‘Yes. You mentioned quarantine. We really need to stop movement in and out of the country completely.’
‘But you can’t…’
‘We know, but we may have to. At first we need some other possible movement and containment controls. People from high risk areas may have to be refused entry. Or if they turn up on the doorstep we may need to ‘quarantine them’.
‘Yes. Put them in some sort of secure accommodation until we know whether they are a threat or not.’
‘But we’re supposed to be helping them.’
‘Well there are some very promising trials with…’
‘We know. You covered that. How long to get that into scale production?’
‘Well if we short circuit some of the human trials possibly we could ramp up in 6 months.’
‘The lead authority. We had a look at the figures you did last year when we asked for a worst case prognosis for this sort of event. Your worst case said we’d probably be dead by now. Your best case gave us 6 months. That means your best case makes that response time useless.
‘And we can’t be sure the US is going to release the methodology in any case.’
‘They have to!’
‘No. What hasn’t been publicly released is that although it’s a private company that made the breakthrough, it’s a wholly owned Government cover for the biological response programme. This is a CIA operation to counter the work the Soviets were doing in the 1980s.’
‘But that’s silly. I know about those programmes. The Russians stopped them after the Wall came down.’
‘Possibly. But the Americans thought it as well to continue looking for a vaccine or a cure.’ The PUS paused for a second. ‘Given the time it’s taken to get this far, not a bad decision I’d say.’
‘But this isn’t a weaponised outbreak.’
‘Probably not. Have you seen any samples yet?’
‘No but the epidemiology isn’t right.’
‘Maybe not, but it isn’t consistent with previous outbreaks either.’
‘Well not precisely but there are so many new factors, travel patterns for a start.’
‘I’m not arguing. But the point is, whatever the reason it’s as virulent as the most virulent form and as contagious as the most contagious form. You are the one that wants to move to more extreme methods.’
‘Yes but in clinical treatment terms.’
‘This is more than a medical problem. It may not even be a medical problem.’
‘Not a medical problem?’
‘It may be outwith your ambit. It’s more likely a security and policing matter.’
‘But we should treat this. We can contain it and…’
‘Suffer what? A 90% death rate?’
‘No. That’s in vastly different public health conditions than here.’
‘And how long do you think it will be before all that breaks down? No this is going to make 9/11 look like a picnic. We are going to need full emergency powers to control the people. Of course there will be a medical response. And a public health response. But it’s going to have to be targeted to key services on the one hand and backed up by force on the other.’
‘That sounds very like martial law.’
‘It does a bit doesn’t it.’ The PUS selected a piece of paper and pushed it in front of Walters. ‘And this is the first notice I’ve served under the new rules.’
Walters went even paler as he read it.
‘And if I don’t comply?’
‘There’s a new treatment and containment centre opening in mid Wales. They’ll need someone to do what they can. You wanted quarantine arrangements didn’t you?’
‘And if I do?’
‘Well there is a small stock of vaccine, and we need the best brains working with us.’ The PUS leaned over. ‘Just sign there please Alan.’