Ireland "needs two more years of focused work" up to 2009 to be fully prepared for a flu pandemic.
It also needs to have in place an out-of-hours service to respond if there was an outbreak, a new report by the European Centre for Disease Prevention and Control (ECDC) said yesterday.
Most other European countries are in a similar position, needing two to three years' work before they could be "confident they can respond well to a pandemic", the influenza co-ordinator of the ECDC, Prof Angus Nicoll, said.
Prof Nicoll praised efforts made in Ireland over the past two years, saying there were some "notable strengths", including a high level of political commitment and a central planning group which produced a national pandemic influenza plan in January.
However, it also highlights some serious deficiencies saying staffing levels at the National Influenza Centre/National Virus Reference Laboratory could not be regarded as "safe".
The report says it "was notable that the centre had a single
member of consultant medical staff working with a strong, able and
enthusiastic team under him", but adds: "This arrangement of a
single, consultant
cannot be regarded as safe for a national virological service
and consideration now needs to be given to bringing the senior
staff numbers more in line with other countries and to more
succession planning for staff in the NIC."
The lack of an out-of-hours service to investigate an outbreak
is also highlighted. "Ireland does not currently have the capacity
to respond effectively out of hours to an outbreak either at
domestic
level or to the EU's early warning system for outbreaks at
EU/World Health Organisation level," the report says.
It adds that there is "a definite and urgent need for an out-ofhours service" and that it understands all parties accept the need for such a service.
The report, which is a joint assessment of Ireland's preparedness by the EU agency and the Department of Health, states thatthe assessment team recognises "the resourcing of pandemic preparedness has to be managed within overall staffing resources and with regard to other competing demands and has to be based on making the best use of existing resources".
This reference to making the best use of resources is repeated several times.
The report also questions whether there are enough staff at local level to deal with an outbreak. "It should be considered whether the public health manpower is adequate at the local level for supporting a response to pandemic influenza," it states.
It says the HSE should draw up an audit system to assess local preparedness and praises efforts being made at Waterford Regional Hospital to prepare a local plan. On legal issues it states that a review of infectious disease regulations should be progressed within the Department of Health "as a matter of urgency".
Speaking at the report's launch, the chief medical officer of
the Department of Health, Dr Jim Kiely, said he did not believe a
lack of isolation facilities would be a problem in the event of an
outbreak. "We are confident that the vast majority of people who
suffer within a pandemic situation can be managed either at home in
the community or as general patients in the hospital without
recourse to isolation
facilities," Dr Kiely said.
The HSE and the Department of Health also issued a statement outlining progress made since the ECDC group visited at the end of February. It says the quantity of antivirals in stock is now enough to treat almost two million people and this "compares very favourably" with other countries.
However, the assessment report states: "As in many other EU countries, it remains to be clarified how the antivirals will be delivered in a timely manner to the public when and where they need them." It is estimated that a minimum of 6,700 people would die in Ireland if a pandemic similar to the Spanish Flu outbreak of 1918 occurred. Prof Nicoll said this was "a conservative estimate" and Irish authorities were basing plans on higher numbers.