Malta plans four-day mass vaccination

Plans are in place to vaccinate about 90 per cent of the Maltese population over four days during the influenza pandemic, National Influenza Pandemic Standing Committee chairman Tanya Melillo said yesterday.

The specific vaccine for the virus causing the pandemic, however, will not be available in Malta before six months after a global pandemic is declared.

"In those six months it will be crucial for us to do our utmost to delay and slow down the spread of disease to enable us to cope," she said.

Plans are in place to block off part of the hospital for flu patients and to provide primary care at the eight government health centres, where antivirals will be accessible.

Earlier this summer the Health Ministry announced a number of measures in preparation for the pandemic. The country would be getting enough vaccine doses against the pandemic virus for 90 per cent of the population as well as stocking up on the antiviral oseltamivir for 25 per cent of the population.

Speaking during the Second European Influenza Conference, organised by the European Scientific Working Group on Influenza (ESWI), Dr Melillo said a major concern was that if a decision was taken to base use of antivirals on clinical symptoms there would probably not be enough supplies.

On the other hand, she continued, if laboratory testing was added to the decision strategy, "we will not have the manpower to do all the tests we need and there will be unavoidable delays in treatment."

Antivirals will be crucial during a pandemic, especially in the first months when the vaccine is not available, because when taken within 48 hours from the onset of symptoms, they shorten the period of illness, reduce the severity of symptoms and could lead to a reduction in complications.

Awareness about the influenza pandemic has led to about 10 per cent of the Maltese people booking antivirals privately.

This year has also seen a steep increase in bookings for the seasonal influenza vaccine. Dr Melillo - who was the only Maltese speaker in the high-level conference - said that while last year 13 per cent of the local population took the vaccine, between 60 and 65 per cent were expected to take it this year.

She said that without help and collaboration, a small island like Malta would not be able to cope on its own during the pandemic. She stressed the need for a guaranteed continuous supply of food, basic necessities, fuel and energy, expert advice and the access to additional medicines and medicinal supplies.

"Once the virus reaches our shores, the only way to try and reduce the spread of infection will be to take drastic public health measures like closing schools, churches, places of entertainment and stopping all functions where people gather," she said.

With regard to the closure of borders, Dr Melillo said that this could effectively keep the pandemic virus away from Maltese shores.

However, when asked whether the country, whose economy depends heavily on tourism and trade, could really afford to do that, she replied: "We depend almost entirely on other countries for our food and basic necessities.

"If other European countries will be unable to export to us during the pandemic we could possibly experience delays in food and fuel supplies."

Dr Melillo highlighted other difficulties that Malta was facing in its bid to prepare for a pandemic, which experts believe could hit the world at any time.

These included the fact that Malta has only one state hospital which reaches full capacity all year round.

She said it will be impossible to have an adequate primary care service during a pandemic because general practitioners work single-handedly and will not have any backup if they fall ill.

"They will be unable to see their patients in their small clinics to avoid further spread of infection and so they would have to go to the patients' home themselves.

This is further compounded by the fact that the local culture is that patients want to be seen by a doctor at the slightest onset of symptoms.

"During a pandemic every person who coughs or sneezes will want to be seen by his doctor and will expect a visit. Our GPs will not be able to cope with such an increase in workload," she said.

The pandemic was described by leading flu vaccines expert David Fedson as a "dry Katrina" which, while less destructive, would cause more damage.

The conference, which started on Sunday, ends today. About 800 influenza experts are attending.