The Health Services Executive (HSE), which is co-ordinating the plan, has drawn up 100 implementation actions in the event of an outbreak of avian flu, which could claim the lives of up to 10,000 Irish people.

“We are planning for a Doomsday scenario,” said Gavin Maguire, head of the National Office for Emergency Planning. He said the government is taking steps to cover the possibility of a significant outbreak, even though the current threat is low and the timing and severity of a flu pandemic is impossible to predict.

In the event that a pandemic does occur, the key measures will include:

• Infected people will be treated in their homes by GPs, nurses and public health experts.
• Gardai will be deployed to transport and secure vaccines to prevent panicking crowds from trying to get antiviral drugs, the main defence in the initial stages of an outbreak.
• Non-critically ill patients will be treated in specialist “flu hospitals”.
• Several centres will be used to care for afflicted patients, including military hospitals, disused medical facilities, nursing homes and former children’s homes that can handle large numbers.
• Non-emergency surgery in acute hospitals will be cancelled to make room for the critically ill and dying, who will require intensive care.
• “Key workers” will be among the first to be vaccinated, using a list that government departments have been asked to draw up. These include healthcare workers, gardai and firefighters, as well as food, electricity and water suppliers.

  Experts fear a flu pandemic, possibly emerging as bird flu, would kill millions of people worldwide. In a worst-case scenario, up to 200,000 Irish people will require medical assistance, but most sick patients will be treated in their own homes.

  Last week Liam Donaldson, Britain’s Chief Medical Officer, attacked health authorities for complacency in its preparations for a lethal flu pandemic that he says is now a “biological inevitability”. He is planning to issue a “protect and survive” leaflet to every household in England and Wales, and has instructed hospitals to inform him of contingency plans for coping with mass casualties.

  The plan for “home quarantine” is the cornerstone of the Irish government’s contingency strategy. Other family members will not be asked to remain in their homes unless they show signs of the illness.

  “We have to prepare for the worst,” said Maguire. “The number of people who could contract pandemic flu, let alone die from it, won’t be enough to activate half the measures we are putting in place.”

  The government has moved to allay public fears over the availability of antivirals, primarily the drug Tamiflu, which can drastically reduce symptoms and mortality if given within the first 48 hours.

  It has ordered 1m doses of Tamiflu, enough to treat a quarter of the population, as per international guidelines. In the event of a pandemic, it is likely that only infected people will be given the antivirals.

  The state’s plan has been praised by Zsuzsanna Jakab, the newly appointed head of the European Centre for Disease Control, who said last week that Ireland appeared to be among “the best prepared countries” to deal with a pandemic.

  Publicity about bird flu has led to an increase in demand for antivirals, but the government says there is no reason for undue concern. “The only issue in town is the antivirals,” said Maguire. “I can understand why people would feel comforted by having a pack of Tamiflu in the cupboard, but there will be enough antivirals for everyone who becomes ill.”

  A subcommittee, comprised of coroners, undertakers and mortuary workers, is also assessing Ireland’s capacity to deal with an excessive number of deaths, and the government is considering whether it needs to introduce emergency powers to ensure it can safeguard human life in the event of civil unrest and a breakdown in public order.

  A pandemic would place enormous strain on the exchequer. Early next year the HSE will present a breakdown of how much it will cost to resource and implement the flu plan, which is likely to require a supplementary budget.

  Last week, Ireland received its first sample of the H5N1 avian flu virus, as part of an exercise by the National Virus Reference Laboratory to test if it could detect the virus. It managed to identify the H5N1 virus, among a batch of other flu samples, in less than seven hours.

  “The exercise was an outstanding success,” said William Hall, director of the NVRL and chair of the government’s influenza pandemic expert group. Hall insisted that Ireland is now adequately prepared should an outbreak occur.

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