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GPs should ‘dust off’ pandemic plans this flu season, warns leading medic

GP surgeries should ‘dust off’ their plans to stop a flu pandemic ahead of winter, a leading medic has warned.

Dr Andrew Green, clinical and prescribing lead for the General Practice Committee, urged doctors to step up their preparations.

He said the flu virus is constantly mutating to become stronger and that the ease of global travel makes the threat of a pandemic high.

Government officials have previously warned an outbreak of a mutated influenza strain is on the horizon and poses a bigger threat to humanity than terrorism.

It comes amid fears among virologists that the next flu pandemic could be deadlier than the Spanish one that struck a century ago

A mutated strain was behind the 1918 Spanish flu pandemic, which killed up to 100 million people – three times more than World War 1.  

In an interview with GPOnline about the upcoming flu season, Dr Green said: ‘We never know when the next flu pandemic will strike.

‘[However] the shortest period between 20th century pandemics was 12 years, and we are already nine years after the last one.’

Because of this, Dr Green added ‘all practices should be dusting off their pandemic plans now’ in case this winter is the year of another huge outbreak.

Flu viruses are constantly changing proteins on their surface to avoid detection by the body’s immune system – making it more deadly.

This transformation is called an ‘antigenic shift’ if it’s large enough, and can lead to a pandemic. This was responsible for the swine flu outbreak in 2009.


The 1918 flu pandemic was unusually deadly and the first of two involving the H1N1 influenza virus.

It infected 500 million people globally, more than one-third of the world’s population, including people on remote Pacific islands and in the Arctic.

It resulted in the deaths of an estimated three to five per cent of the world’s population, making it one of the deadliest natural disasters in human history.

Spanish Flu resulted in the deaths of an estimated three to five per cent of the world's population, making it one of the deadliest natural disasters in human history. This image shows soldiers from Fort Riley, Kansas, ill with the virus

Spanish Flu resulted in the deaths of an estimated three to five per cent of the world’s population, making it one of the deadliest natural disasters in human history. This image shows soldiers from Fort Riley, Kansas, ill with the virus

Within months it had killed three times as many as World War I and did it more quickly than any other illness in recorded history.

Most influenza outbreaks disproportionately kill juvenile, elderly, or already weakened patients.

By contrast, the 1918 pandemic predominantly killed previously healthy young adults.

To maintain morale, wartime censors minimised early reports of illness and mortality in Germany, Britain, France, and the United States.

However, newspapers were free to report the epidemic’s effects in Spain.

This created a false impression of Spain as being especially hard hit, leading to the pandemic’s nickname Spanish flu.

The close quarters and massive troop movements of World War I hastened the pandemic and probably both increased transmission and augmented mutation, researchers believe.

The true global mortality rate from the pandemic is not known, but an estimated 10 per cent to 20 per cent of those who were infected died.

This would lead to a death toll of between 50 to 100 million people.

Dr Green warned that this natural process, alongside the ease of global travel, makes it easy for the flu to spread quickly.

He called for practices to begin making plans as to how they can continue to provide essential services with a depleted workforce this winter.

Professor Robert Dingwall, a virologist at Nottingham Trent University, also warned the flu is a ‘very unstable virus’.

He told The Sun Online: ‘It changes a little bit from one year to the next, which is why the vaccine has to be reformulated every year.

‘But every once in a while there is a really big change, which is what happened in 1918 [the Spanish flu pandemic.’

Professor Dingwall added if this happens ‘there is no resistance in the population because nobody has ever seen anything like it before’.

He estimated if a pandemic of the same size of that seen in 1918 struck the UK this winter, it could kill 400 million across the world.

Professor Dingwall also said it would strike 10 million in the UK and make it difficult to keep ‘public services running and supermarkets stocked’.

The flu season in the UK and the rest of the Northern Hemisphere tends to mirror what has happened in Australia and the Southern Hemisphere.

The same strains of the virus will circulate north in time for the British flu season, which typically begins in November and lasts until March.

Studies have suggested the H3N2 strain, used in the jab created by World Health Organization scientists, has mutated to evade detection.

The virus was seen in the flu outbreak that struck the UK last winter, considered to be the worst in seven years by statisticians.

The WHO creates the vaccines in March, based on which flu strains they expected to be in circulation. They are then doled out in September.

The warnings of a new pandemic come after England’s top nurse warned some NHS staff won’t get the flu jab because they believe it will make them ill.

Professor Jane Cummings last week said ‘myths’ persist around the vaccine, including among doctors and nurses, with the ‘big one’ being it gives people flu.

All NHS staff have already been told to get the jab or risk being banned from treating vulnerable patients this winter.

The Cabinet Office already lists a pandemic influenza as the biggest threat on the UK’s Risk Register – ahead of terrorism and cyber-attacks. 


The rocketing number of flu cases in the UK and across the world was put down to a surge in four aggressive subtypes that attacked the population simultaneously.

One included the so-called ‘Aussie flu’, a strain of influenza A which triggered triple the number of expected cases in Australia during the country’s winter.

Experts feared the virulent H3N2 strain, which reached the UK, could prove as deadly to humanity as the Hong Kong flu in 1968, which killed one million people.

Another was a strain of influenza B, called Yamagata and dubbed ‘Japanese flu’, which was blamed for the majority of cases during the UK’s winter.

Its rapid spread raised concerns because it was not covered in a vaccine given to the elderly. However, experts claim it was less severe.

Usually, just one subtype, of either influenza A or B, is responsible for the majority of cases. The bug spreads easily in the cold weather.