Scientific advice and evidence in emergencies - Science and Technology Committee Contents


Memorandum submitted by the Government Office for Science and the Cabinet Office (SAGE 00)

Letter to the Clerk of the Committee from the Cabinet Office, 14 September 2010

  I write in regard to the questions that the House of Commons Science and Technology Committee has set out as part of its inquiry into "Scientific Advice and Evidence in Emergencies".

  I attach a memorandum, preparation of which has involved the Department of Health, Department for Transport, Department for the Environment, Food and Rural Affairs, Home Office, Department for Energy and Climate Change, Centre for Protection of National Infrastructure, Department for Business, Innovation and Skills, Ministry of Defence and the Devolved Administrations.

Propriety and Ethics Team

Cabinet Office

Memorandum

Planning for Emergencies

  The management of the risks of civil emergencies in the United Kingdom is coordinated by the Cabinet Office. The Civil Contingencies Act 2004, together with its supporting statutory[1] and non-statutory[2] guidance, provide the framework for civil protection activity by local emergency planners and responders around the country. The Cabinet Office works in partnership with other Government departments and the Devolved Administrations.

  The Civil Contingencies Act defines the meaning of emergency as an event or situation which threatens serious damage to human welfare, or the environment, in a place in the United Kingdom; or war, or terrorism, which threatens serious damage to the security of the UK. It defines the duties of local emergency responders inter alia to assess the risk of emergencies, to maintain plans, and to maintain arrangements to warn and provide information and advice to the public.

  Since 2004 the Government, through the Civil Contingencies Secretariat (CCS) in the Cabinet Office, has maintained a capacity at the national level to provide guidance and support to local emergency responders in these areas, through a National Risk Assessment process, and a national Resilience Capability Programme. Since 2008, a National Risk Register has been published, indicating the main kinds of emergency for which communities and local commercial organisations may wish to prepare themselves. This is in addition to the primary function of the CCS to coordinate the crisis management response to terrorist and other civil emergencies.

  The National Risk Assessment and Register, and the crisis management response, are all underpinned by scientific advice coordinated by the Government Office for Science (GO-Science), under the Government Chief Scientific Adviser.[3] The GCSA provides advice directly to Ministers and uses the Scientific Advisory Group for Emergencies (SAGE) mechanism (detailed below) to ensure that the advice given is coherent, robust, identifies key areas of uncertainty and is externally peer reviewed wherever possible.

The National Risk Assessment and Risk Register

  The National Risk Assessment process (NRA) is a comprehensive, classified assessment of the most significant emergencies (malicious and non-malicious) that people in the United Kingdom could face over the next five years. This confidential assessment draws on expertise from a wide range of departments and agencies of Government. It is used for planning for emergencies at a Government level, and to provide guidance to local emergency planners and responders on the kinds of risks which they may need to assess and plan for in their local area. The objectives are: to assist in the prioritisation of risks for emergency planning purposes; to enable reasonable quantitative and qualitative estimates to be made of the likely consequences that need to be planned for; and to facilitate risk communication in both these areas (weight and impact) to be communicated to those planning for emergencies, in the public, private and community and volunteer sectors.

  The NRA is updated annually. There are three stages to the assessment: the identification of risks; assessment of the likelihood of the risks occurring and their impact; and comparison of the risks. All three stages involve consultation of Subject Matter Experts and a standard process is used that is designed to ensure that the assessment of all individual risks is, to the extent possible, on a comparable basis:

    — Risks are identified by consulting, through Government departments, a wide range of experts who are able to take an informed view of the seriousness of the risks according to the criteria in the Civil Contingencies Act. After initial scrutiny, most proposals are taken forward into a detailed assessment phase; some may kept under review.

    — The assessment is done on the basis of an agreed "reasonable worst case scenario". This concept is designed to exclude theoretically possible scenarios which have so little probability of occurring that planning for them would be likely to lead to disproportionate use of resources. They are not predictions of what will happen or the most likely manifestation of a particular type of hazard.

    — Risks are assessed using objective historical, statistical and scientific data where they are available; where possible, the assessment looks forward to take account of known or probable developments over the next five years. In the case of the risks of terrorist or other malicious attacks, the risks are assessed more subjectively. The willingness and motivation of individuals or groups to carry out attacks is assessed and balanced against what is known of their capability and capacity, and the vulnerability of their intended victims or targets.

    — Impacts are assessed against five main criteria: the numbers of fatalities that are likely to be directly attributable to the emergency; the extent of human illnesses or injury over a period following the onset of an emergency; social disruption, under ten headings designed to measure significant disruption to people's daily lives; economic damage; and the potential for significant outrage and anxiety to be caused to communities.

  Most types of risk are reviewed every year, but some at longer intervals by experts within Government departments most affected. Existing structures within these departments provide independent scientific or technical advice, eg the Pandemic Influenza Preparedness Programme (PIPP) in DH which advises on pandemic flu, which feeds into the assessment process through this inter-departmental working group.

  Since 2008, an unclassified version of the National Risk Assessment, The National Risk Register (NRR) has been produced, designed to assist individuals and communities interested in improving their own preparedness for emergencies. The NRR[4] is publicly available and provides an indication of the types of risks the UK faces and an indication of what the Government is doing to prepare for them.[5]

Concept of Operations for the UK Central Government Response to Emergencies

  Responding to Emergencies: The UK Central Government Response: Concept of Operations (Conops) guidance[6] also sets out the guiding principles and a framework for emergency management. Wherever possible, preparations, planning, response and recovery are local-led drawing on local expertise and knowledge.[7] But the scale, complexity and/or severity of some emergencies mean that these local resources are overwhelmed and assistance is needed from Government. If an emergency impacts on multiple sectors, as is often the case, collaboration between Government departments is required. This function is fulfilled by the Cabinet Office Briefing Room (COBR) which facilitates collaboration and aims to ensure an effective, efficient response.

  When COBR is activated a Lead Government Department (LGD) is appointed to provide leadership. LGD's are appointed using a pre-determined list of department roles and responsibilities. Where the lead is unclear (eg because the emergency affects a number of sectors equally) the default is a Cabinet Office lead.

  Where an emergency occurs in Scotland, Wales, or Northern Ireland and falls within the competence of the relevant Devolved Administration, they will lead the response in their territory reporting through the relevant minister to the devolved legislature. In such circumstances there will often be little if any involvement for UK Government departments. Where an emergency occurs in Scotland, Wales, or Northern Ireland but competence is reserved to the UK Government (and therefore the UK Parliament), the relevant UK Government department will lead the response liaising closely with the relevant Devolved Administration(s).

Scientific Advisory Group for Emergencies (SAGE)

  One of COBR's key functions is to ensure that there is a common understanding of the evolving situation and that there is a sufficient evidence base for decision making. For many emergencies this will involve the provision of scientific and technical advice. For such occasions the LGD or the Cabinet Office, in consultation with GO-Science, may activate a Scientific Advisory Group for Emergencies (SAGE) which aims to provide timely and coordinated scientific advice by bringing together key experts.

  As with COBR, SAGE is designed to be both flexible and scalable. The arrangement is that SAGE provides the lead for commissioning and assessing scientific advice from a range of expert bodies. SAGE is usually chaired by the Government's Chief Scientific Adviser (GCSA) or a departmental CSA as appropriate. Where there is a strong departmental lead a co-chair may be appointed; and the chair and co-chairs may change in the transition from the response phase of an emergency to the recovery phase. Secretariat support is provided by the LGD, the Devolved Administration (DA)—if in their area—or by the Cabinet Office and GO-Science where the LGD is unclear.

  The membership of SAGE and any expert groups is specific to each emergency. Pre-existing scientific groups and networks will be utilised, where they exist and have appropriate expertise. Where existing groups do not exist, the GCSA or relevant officials would identify appropriate experts in consultation with National Academies, Learned Societies and other relevant professional organisations and institutions. The precise membership of SAGE may change as emergency develops or as the UK moves into the recovery stage.

  The main role of SAGE is to ensure that there is a sufficient evidence base for decision making and to provide timely and coordinated advice. Within this remit the specific focus of SAGE and its sub-groups may evolve during the course of an emergency. It provides strategic scientific advice for the UK and so if devolved issues are involved, due consideration should be given to the DAs.

Scientific and Technical Advice Cells (STAC)

  At the local level emergencies are coordinated by Strategic Coordinating Groups (SCGs). These groups may also require science advice in some emergencies. Where SAGE has not been activated, scientific and technical advice is provided to the SCG by local Scientific and Technical Advice Cells (STAC). The decision to set up this group is the responsibility of the local SCG.

  In the event of wide-area emergencies where more than one SCG might require scientific advice, consideration would be given to how best to provide local access to specialist scientific advice recognising the limited number of "experts" that might be available nationally and the need to maintain consistency between the UK wide, national, regional and local response.

  In some cases, this might best be provided by disseminating widely strategic advice from the SAGE. In others, it might be appropriate to set up a support centre to provide operational advice on request to local areas. Where SAGE has been activated, the strategic advice it provides should, once endorsed be applied in a consistent manner regionally and locally.

Testing and Exercising

  A framework is in place to test the central Government response to the wide range of threats and hazards facing the UK. Exercises involving the activation of COBR are delivered up to three times per year and their primary objectives include the provision of science advice in an emergency.

Case Studies

  The attached case studies provide further details on the specific emergencies or potential emergencies that the Committee has indicated the inquiry will consider. These are (i) the swine flu pandemic in 2009, (ii) the Icelandic volcanic ash eruptions in 2010, and the potential emergency situations that are (iii) solar storms and (iv) cyber attacks.

CASE STUDY 1: H1N1 (SWINE FLU) PANDEMIC INFLUENZA

Background

  The UK has been preparing for an influenza pandemic for some years. In January 2002, the Chief Medical Officer for England published "Getting ahead of the Curve: A strategy for combating infectious diseases",[8] which identified a new pandemic as a particular disease threat. When the first National Risk Assessment was produced in 2005, human pandemic influenza was therefore identified as a significant risk; and it has been consistently identified as among the highest risks, when both likelihood and impact are taken into account, during annual reviews of the NRA. This was reflected in the first public National Risk Register (NRR), published in 2008.

  The Department of Health (DH) is the lead Government department for the risk of an outbreak of infectious disease, working with the Cabinet Office whose Civil Contingencies Secretariat leads on overall preparedness for emergencies. The Department of Health is responsible for identifying and assessing the risks, and for determining policy in preparing for a pandemic.

Current risk assessment and preparations for emergencies

  The current risk assessment identifies as the "reasonable worst case" a flu pandemic caused by the emergence of a new human influenza virus, with a clinical attack rate of 25% to 50% of the population spread over one or more waves, and with a case fatality rate of up to 2.5%. This is assessed to have a medium high likelihood of occurring over the next five years, and is based on scientific assessment of pandemics over the past 100 years and the emerging threats of new viruses such as Highly Pathogenic Avian Influenza (H5N1). More detailed planning assumptions are at Appendix A.

  The UK was considered by the World Health Organisation to be among the best prepared countries in the world for an influenza pandemic. The planning framework for preparedness is the joint Department of Health and Cabinet Office publication "Pandemic flu: A national framework for responding to an influenza pandemic" published in November 2007 following extensive work at national, regional and local level to consider the risks and impacts, including wider socio-economic impacts, of a pandemic on the case illustrated by the worst case scenario. The framework provides the Government's strategic approach for responding to an influenza pandemic and background information and guidance to public and private organisations developing response plans.

  Each of the Devolved Administrations has developed its own pandemic preparedness plan, fully consistent with the UK-wide National Framework, to reflect its own particular circumstance.

  This Framework is currently under revision to ensure lessons learned during the 2009 H1N1 pandemic are captured for future pandemics. The current planning assumptions are being reviewed as part of this process to ensure the underpinning science is robust and the "reasonable worst case" assumptions remain valid. The revision is due to be published by March 2011.

Scientific input into preparing for a pandemic

  Following the publication of the UK influenza pandemic contingency plan in 2005, a Scientific Advisory Group on Pandemic Influenza (SAG) was set up to advise UK health departments or directorates on the scientific evidence base for health-related pandemic influenza policies.

  Under the auspices of the SAG, five scientific papers were developed in 2006, dealing with the risk of a pandemic originating from an H5N1 virus, and clinical countermeasures (antivirals, vaccines, antibiotics and facemasks). These papers underwent significant peer review by national and international scientific reviewers in early 2007. These were then further reviewed at a colloquium, convened by the Secretary of State for Health, of national and international scientific experts in April 2007. The papers were agreed by the SAG as reflecting a comprehensive and state of the art summary as of June 2007. This evidence base is currently being reviewed by the Department of Health. Any revisions to the evidence base will be published alongside the revised National Framework by March 2011.

  In 2007, the "Overarching Government strategy to respond to an Influenza Pandemic—Analysis of the scientific evidence base"[9] was published by the Cabinet Office. This paper summarised the evidence base, on which the National Framework and the key planning assumptions are based. The paper drew on available scientific papers, modelling, economic assessments, real events, social sciences and international comparisons.

  Following the publication of these scientific evidence base papers the role of the SAG was reviewed and membership of the group was expanded to include a wider range of scientific disciplines including traditional infectious diseases-related sciences such as virology and immunology, and also sciences such as risk management, behavioural sciences and diagnostics; an independent chair, Professor Sir Gordon Duff, was appointed. At this point, the group was known as the Scientific Pandemic Influenza Advisory Committee (SPI). The minutes of its meetings are published on the Department of Health website.[10]

  Health departments/directorate also receive advice from the Joint Committee on Vaccination and Immunisation (JCVI) and the Advisory Committee on Dangerous Pathogens, and work closely with the Government's Chief Scientific Adviser and the Government Office for Science to ensure that Government is making best use of expert scientific advice in this area.

International scientific input

  Coordinating preparedness for emergencies such as pandemic influenza can advance international resilience through development and use of information-sharing networks, by facilitating consistency of operational plans, and by establishing mutual trust. The international institutional architecture, multilateral and bilateral ties enable effective inter-Governmental and inter-agency coordination.

  This co-ordination also enabled a series of international conferences of ministers and senior officials focusing on high-level policy, most recently in April 2010 as hosted by the Government of Vietnam. In association with these, the major global inter-governmental agencies hosted a series of specialised technical consultation meetings to address influenza and wider related scientific issues. This has helped to ensure rapid sharing of information across veterinary and human health sectors; enabled progress on policy challenges including new virus sample-sharing arrangements; and stimulated close inter-agency collaboration on emerging zoonotic diseases more generally.

  UK scientists play significant roles in many of the international advisory bodies, such as the World Health Organization (WHO) and European Centre for Disease Control and Prevention (ECDC), and have strong connections with key national bodies such as the Centre for Disease Control and Prevention (CDC) in the US.

Scientific input into responding to the 2009 H1N1 pandemic influenza

  The Chief Medical Officer, Sir Liam Donaldson, and Government's Chief Scientific Adviser, Professor Sir John Beddington both attended ministerial meetings during the 2009 pandemic. In order to inform decisions during the 2009 pandemic, Ministers needed advice on:

    — The progress of the pandemic.

    — The clinical impact of the pandemic.

    — Antivirals.

    — Vaccination.

    — Communication.

    — Behavioural responses.

  Initially, the Scientific Pandemic Influenza Advisory Committee (SPI) took the lead in providing preliminary advice on these issues, pending the establishment of a Scientific Advisory Group for Emergencies (SAGE) on 5 May 2010.

  Scientific Advisory Group for Emergencies (SAGE) —Meetings of SAGE were chaired jointly by the Government's Chief Scientific Adviser and the chair of SPI, Professor Sir Gordon Duff. SAGE oversaw the scientific contribution to the national management of the pandemic. It received updates from the Health Protection Agency (HPA) on case numbers, surveillance, epidemiology and severity throughout England, and received similar updates from the Devolved Administrations and the European Centre for Disease Control and Prevention (ECDC). There were 22 meetings of SAGE between May 2009 and January 2010. Committee members were not remunerated for their work on SAGE and gave up a great deal of time to attend meetings and support the work of the committee despite being under pressure in their day jobs.

  A number of key advisory bodies and panels fed advice into SAGE that was used to produce consolidated advice to Ministers on key issues.

  The three existing SPI sub-committees on Modelling (SPI Modelling and its Operational sub-group (SPI-M & SPI-M-O)); Behaviour and communications (SPI-B&C) and Clinical Countermeasures (SPI-CC) met throughout the outbreak and gave regular reports into SAGE on their activities. SPI-M-O provided advice to SAGE on the current situation, information on key parameters (case fatality rate, clinical attack rate, hospitalisation) and the implications of these numbers for the purposes of planning assumptions. SPI-B&C also provided advice to Government Departments on behavioural and communication matters relating to the health response to an influenza pandemic. SPI-CC provided advice to SAGE on science and technical matters relating to clinical countermeasures, such as antivirals and antibiotics.

  A number of other advisory groups contributed to both DH policy development and SAGE advice including: The Pandemic Influenza Clinical and Operational Advisory Group's Clinical Sub-Group (PICO-CGS), which provided expert clinical advice recommendations to support the health and social care response to an influenza pandemic in the UK; Influenza Clinical Information Network (FLU-CIN) Strategy Group provided advice on the clinical management of patients in hospital with pandemic influenza.

  Additional ad hoc advice was also provided through SAGE by the HPA, the Advisory Committee on Dangerous Pathogens (ACDP) and the Advisory Committee on the Safety of Blood, Tissues and Organs (SaBTO). In addition, the Medicines and Healthcare products Regulatory Agency (MHRA) provided ongoing advice to SAGE on the safety of antivirals and vaccines through the enhanced reporting systems it put in place during the pandemic in addition to the yellow card reporting system.

  The Joint Committee on Vaccination and Immunisation (JCVI), which is the statutory body on vaccination and immunisation, was also asked to provided advice on matters relating to pandemic vaccination directly to Ministers. Key JCVI advice was scrutinised by SAGE prior to recommendations being made to Ministers. The chair of JCVI was a member of SAGE.

  The Devolved Administrations had observers on each committee. Experts on the committees came from across the UK and consisted of Government officials, leading academics, clinicians and other health professionals.

International scientific input

  During the H1N1 2009 pandemic, strong bilateral relationships with Australia, Canada and USA facilitated rapid sharing of new epidemiological and clinical data on the A/H1N1 virus as the 2009-10 pandemic developed. Strong links with international organisations such and WHO and ECDC also contributed to SAGE discussions and advice to Officials and Ministers.

Review of the UK response to 2009 H1N1 pandemic influenza

  In March 2010, the four UK health ministers commissioned Dame Deirdre Hine to review the UK strategy for responding to the H1N1 pandemic flu. The scope included consideration of cross-cutting issues affecting the strategic decisions, including scientific advice. Dame Deirdre's report[11] was published on 1 July 2010. It contains a chapter on the scientific advice during the response.

Obstacles to obtaining reliable, timely scientific advice

  SAGE and its sub-groups considered all pertinent data from both UK and international sources as soon as it was made available to them. During the first wave of the outbreak, there was significant uncertainly regarding key parameters, such as the clinical attack rate, which made modelling the progress of the pandemic difficult. This was due, in part, to the relative mildness of the disease (a large proportion of those infected showed limited or no signs of the disease) and the level of pre-existing immunity in the population. It was not until a fieldable test to confirm H1N1 could be developed, and a serology baseline performed, that these factors could be confirmed. This information was key to understanding the future development and impact of the outbreak. By the end of the first wave, data became available and these parameters were clearer and modelling provided accurate figures.

  A decision on the amount of vaccine to procure needed to be made early in the outbreak, to ensure that the vaccine was produced in time to be useful. This meant that the decision had to be made during a period when there was still significant uncertainty about the nature of the virus. Dame Deirdre Hine recommended in her review that the four Chief Medical Officers commission further work to support key decision-making early in a pandemic by January 2011. The Department of Health is taking forward this work.

Research base

  Prior to the pandemic, the Department of Health had developed a prioritised list of research for departmental funding and communication to other funders. These priorities were rapidly reviewed in response to the H1N1 outbreak leading to SAGE identifying its high-priority areas for research on 9 June 2009. The National Institute for Health Research (NIHR) fast-tracked the commissioning of research in these areas. By 19 August 2009, 14 research proposals were funded, at a cost of £2.25 million.

  Collaboration between all the main UK funders of research continued during the H1N1 2009 pandemic. The Wellcome Trust maintained a website of all research funded in response to the pandemic.[12]

H1N1 current situation update

  The Health Protection Agency (HPA) continue to monitor the ongoing situation regarding pandemic viruses mainly using information reported up to the World Health Organization from affected countries. The headlines from this information, along with the UK situation, are then published in the HPA weekly National influenza report. The HPA also recently convened a flu threat assessment meeting which reviewed the current global situation and implications for the forthcoming winter season.

CASE STUDY 2: VOLCANIC ASH DISRUPTION (APRIL/MAY 2010)

Background

  On 20 March 2010 the Eyjafjallajökull volcano in Iceland erupted from a side-fissure. Due to the low intensity and location of this initial activity, impacts were at this stage, limited to Iceland. On 14 April 2010, the location of the eruption moved to the central crater and intensified. Unlike the side-fissure this new vent was covered by a glacier which meant there was significant interaction between the magma that was being ejected and water in the form of melted ice. This interaction created an explosive eruption with an eruption column to 11km and highly effective fragmentation of material. These factors together with the unusually unfavourable weather conditions led to significant ash incursions over the UK and Northern Europe between the 15 and 21 April and significant disruption to civil aviation, with commensurate side-effects. On 11 May 2010 volcanic activity at Eyjafjallajökull significantly reduced. A full timeline of geological events at Eyjafjallajökull can be found at: http://www.earthice.hi.is/page/ies_EYJO_compiled.

Risk assessments and monitoring prior to April 2010

  In the 1990's, the International Civil Aviation Organization (ICAO), set up an International Airways Volcano Watch (IAVW). This was in response to a number of reports of commercial aircraft experiencing technical difficulties whilst operating in ash plumes, This included the set up of nine Volcanic Ash Advisory Centres (VAAC) located around the world which had the responsibility for coordinating and disseminating information on volcanic ash that might endanger aircraft.

  The London VAAC, run by the UK Met Office has responsibility for monitoring Iceland, the UK and the North-East area of the North Atlantic. The Met Office is also one of eight globally located Regional Specialised Meteorological Centres for atmospheric modelling for environmental emergency response that are operated under the auspices of the World Meteorological Organisation. As part of this they developed an atmospheric dispersion model (Numerical Atmospheric-dispersion Modelling Environment or NAME). NAME is a sophisticated and flexible model which can be used for a number of purposes, including the prediction of volcanic ash plume dispersal. The Met Office's world leading modelling capability, along with a close working relationship with the Icelandic Meteorological Office which itself is in close contact with the University of Iceland, enables it to fulfil its VAAC functions. This pre-existing work and expertise was essential to the response to the volcanic ash disruption of April 2010.

  For national emergency planning purposes, the risk of disruption to aviation caused by a natural disaster occurring overseas was kept under review annually for the National Risk Assessment (NRA), from 2005 to 2008. No review was undertaken in 2009.

The provision of scientific advice during the April/May volcanic ash disruption

  On 20 March 2010 when Eyjafjallajökull first erupted, in addition to performing their usual VAAC functions, the Met Office notified the Civil Contingencies Secretariat (CCS) of the emerging risk in accordance with established procedure. This notification triggered a Health Protection Agency (HPA) and Scottish Government assessment of the potential health risks of this eruption. The Government Chief Scientific Adviser discussed this issue with the Cabinet Office on 15 April, and it was clear that scientific advice would be needed to deal with the situation, and assess how it was likely to develop in the coming days. On the Saturday (17 April) Sir John Beddington met with officials from CCS to update them on his discussions with the scientific experts and, at the Prime Minister's request, Sir John Beddington went to number 10 on the Sunday evening (18 April) to update him on developments.

  In accordance with the Government's approach to the engagement of scientific advice in civil contingencies, the Scientific Advisory Group for Emergencies (SAGE) was activated to support COBR, with the Government Chief Scientific Adviser in the chair. Two lead Government departments (LGD) were identified: the Department for Transport (DfT) for responding to transport disruptions and the Foreign and Commonwealth Office (FCO) for managing the repatriation of UK nationals. To ensure a coordinated cross-Government approach to SAGE GO-Science acted as the lead for this group.

  SAGE members included both independent and Government experts, Chief Scientific Advisers from several Government departments and a representative from the Civil Aviation Authority. Initial teleconferences were held with members on the 20 April and the first SAGE meeting was on the 21 April. In total there were four volcanic ash SAGE meetings, all chaired by the GCSA. It is to the credit of SAGE members that effective advice was quickly available in such a short timescale. SAGE provided advice to COBR on the latest behaviour of the volcano and the current weather patterns, and how the situation was likely to develop over the coming days. SAGE also advised on the likely medium to longer term developments such as potential changes in volcanic eruption. SAGE ensured that the geology and meteorology underpinning these assessments was robust, and that any uncertainties were clearly identified.

  Sub-groups were created as required to take-forward individual workstreams. Existing science advisory groups and experts were engaged as necessary. Many departments provided assessments of the potential impacts of the volcanic plume to SAGE. For example, the Department for Health and the Health Protection Agency (HPA) worked with other relevant departments and agencies, including the Devolved Administrations, the Met Office and WHO to agree the current health risk (if any) and prepare for any possible changes to this assessment. Examples are provided in Appendix B, which summarises the risks to animal health and the environment (from the Defra Scientific Advisory Group), and Appendix C on MOD monitoring of the volcanic plume. The progress and findings of each sub-group were reported and discussed at SAGE meetings. In addition to the formal sub-groups virtual working and ad-hoc meetings were used to collate and discuss advice.

  There was a lot of media interest and public concern at the time. The GCSA and several SAGE members briefed representatives of the airline industry on the science behind this incident at an industry briefing day organised by the CAA.

  International engagement, particularly with the Icelandic authorities, formed a key component of SAGE's work. Existing relationships, particularly between the Iceland Meteorological Office,[13] the Institute of Earth Sciences (University of Iceland), the British Geological Survey and the UK Met Office were key to this engagement. A Memorandum of Understanding (MoU) between the UK and Iceland is being drafted to strengthen cooperation in assessing and monitoring volcanic hazards. The UK also provided a significant contribution to the EU's European Volcanic Ash Experts Group, led by the Spanish Presidency through the office of the Department for Transport Chief Scientific Adviser. UK scientists are also heavily involved in a range of activities and workshops across Europe focusing on the impact of eruptive explosions, particularly on aviation.

The use of scientific information during the April/May volcanic ash disruption

  The ways in which scientific advice was used during the emergency is summarised below.

Early warning, monitoring and modelling

  Icelandic authorities and UK experts from BGS collaborated to use existing monitoring networks in Iceland to gain as much information as possible on the Eyjafjallajökull eruption. These measurements were augmented by additional instruments supplied by the UK to Iceland that increase the density of measurements around Eyjafjallajökull and Katla. This included the use of seismic monitoring and crust deformation measurements which provided some indication of current volcanic behaviour and supported assessment of possible future developments. In addition to monitoring in Iceland, rainwater and herbage samples were also collected across the UK and analysed to identify if elevated levels of contaminants were occurring that could cause widespread impacts, such as environmental and health effects. Existing routine monitoring of air quality continued throughout the incident. The Defra science group, worked with the Scottish Environmental Protection Agency, Scottish Government, Welsh Assembly Government and Department of Agriculture and Rural Development (DARD) as well as the Agri-Food and Biosciences Institute (AFBI) in Northern Ireland to ensure that environmental sampling and analysis strategy was consistent in terms of methodology and procedures across the UK.

  A range of empirical data was provided by volcanologists and atmospheric scientists (both British and Icelandic), including observations from the ground, satellite imagery and airborne measurements. Where appropriate, additional observations and data were input into the pre-existing NAME model. Maps of ash concentration, at a range of flight levels, were produced from this modelling. Observations of airborne volcanic ash proved challenging, both in the vicinity of the volcano and at a distance, because of the limited number of observation sites. Separate observations from ground based LIDAR,[14] airborne measurements (collected by NERC) and satellite imagery were used to validate the outputs of the model. This indicated that the outputs were good and within an order of magnitude, though it should be noted that even this level of accuracy presents challenges when outputs are to be used to define flight zones. NAME was used to provide 24 hour forecasts with air traffic control and COBR. As CAA, in discussion with the airlines and international aviation partners, developed modified procedures for safe flight operation in ash plumes, the outputs of the NAME model were adapted to provide additional information as required. The creation of flight zones determined by ash concentrations, rather than based on the presence or absence of ash as required by ICAO, increased the demands on the modelling. The Met Office continued to improve the outputs of NAME to produce maps showing concentrations for each respective flight zone.

Assessing the emerging risk

  As with all emergencies the evolving risk and future prognosis was assessed to help inform decision making through-out the volcanic ash disruption of April 2010. This included the assessment of for instance the immediate risks posed by an eruption of neighbouring volcano, Katla, which historical records indicate could accompany or follow an eruption at Eyjafjallajökull.

  Scientific experts (led by relevant experts from SAGE) were asked to identify the key factors that would influence whether Icelandic volcanic eruptions could have consequences in the UK and the extent, scale and nature of these disruptions.

  SAGE used this information to develop a range of plausible indicative scenarios, and to identify knowledge gaps to attempt to reduce the uncertainty in these scenarios. Ad hoc groups were set up to explore:

    — the potential link between Eyjafjallajökull and Katla eruptions to determine the probability of a Katla eruption following closely on activity at Eyjafjallajökull;

    — historical and geological records to determine the most likely duration and intensity of Eyjafjallajökull (and possible Katla) eruptions; and

    — climatic records, to determine the likelihood of unfavourable weather conditions (predominantly NW flow) coinciding with Icelandic volcanic eruptions.

Understanding aircraft engine ash tolerances

  Until May 2010 ICAO international guidance advised that aircraft avoid ash. Until the Eyjafjallajökull eruption these guidelines had been considered sufficient as aircraft had been able to re-route around ash incursions which were generally localised. The ash incursion generated by the 2010 Eyjafjallajökull eruption covered one of the most congested airspace regions in the world over Europe and the trans-Atlantic routes between Europe and North America, making re-routing virtually impossible.

  As engine ash tolerances were unknown, the Civil Aviations Authority (CAA) took the lead in incrementally improving the understanding of aircraft operations in ash. In doing this they engaged with aircraft and engine manufactures and other European and International regulators. As understanding increased, the DfT Chief Scientific Adviser peer reviewed this emerging advice through a DfT science group, and reported to SAGE. Further details on the work of CAA and the DfT science group can be found in appendix D.

Assessing the risk of volcanic hazards more generally

  SAGE has initiated work to assess the longer-term risks posed by volcanic hazards of this kind, as part of the review of these risks in the National Risk Assessment. This review has examined the main categories of risk (explosive eruptions like Eyjafjallajökull that eject mainly ash; and effusive eruptions which eject mainly lava and gas). It has assessed what is the reasonable worst case for an explosive eruption, and for an effusive eruption. Given the historical precedent of the 1783-84 effusive eruption of Laki, it has also considered what the likely sulphur dioxide levels from a modern Laki-type eruption might be. In accordance with the usual risk assessment process, the relative, and indicative, probabilities attaching to the main scenarios are being calculated; and an assessment being made of the main impacts of each in terms of public health and social welfare, and economic activity. When complete, the results will be included as appropriate in the National Risk Assessment and public Risk Register.

CASE STUDY 3: SEVERE SPACE WEATHER

Background

  Space weather includes a variety of solar phenomena that disturb the upper atmosphere and near-space environment of the Earth and damage space and ground-based technologies.

  The largest recorded space weather episode is known as the Carrington event that happened in 1859. Since then, a number of similar but smaller solar events have occurred, the most recent in 2003, which had impacts upon power networks, airline flights and spacecraft operations.

  Indications that the severity of future space weather events may be much greater than those experienced in 1921, 1989, and 2003, led to this being identified as a risk to be assessed during preparation of NRA 2010. When complete, this new assessment will enable appropriate planning for the impacts of this hazard, which are likely to affect the electricity transmission sector, satellite and other telecommunications sectors.

Current NRA risk assessment

  The reasonable worst case scenario (a plausible yet challenging manifestation of this phenomenon) has been agreed with the cross-Government Risk Assessment Group, which has drawn on the expertise of the Science and Technologies Facilities Council, through the Rutherford-Appleton Laboratory. The British Geological Survey, which first highlighted the potentially growing risk, was also involved in the assessment.

  The "reasonable worst case scenario" in the next five years was assessed to be more severe than previously expected. Work is continuing with space scientists, the satellite industry, representatives from the National Grid, Government departments and other agencies to understand fully the potential impact. This includes both the direct impact on infrastructure and technologies vulnerable to different space weather phenomena and also the secondary effects on sectors reliant upon these technologies

Involvement of scientific advice in assessing impacts of severe space weather

  Early work to assess impacts has centred upon the National Grid system and hence the assessment for this sector is further advanced than for other sectors. Initial discussions with space scientists, Government departments and the National Grid have focused on identifying elements of the electricity transmission hardware that could be vulnerable to solar-generated geomagnetic storms of a significantly greater severity than those experienced in recent decades. Experts from the British Geological Survey, the Rutherford-Appleton Laboratory, Oxford and the Electric Infrastructure Security council have also been part of consultations examining National Grid geomagnetic forecasting and monitoring capabilities and the contingency measures the network have in place in the event of severe space weather. DECC's Chief Scientific Adviser has also asked DECC's Scientific Advisory Group to advise on the risks to the electricity distribution network.

  Solar winds and radiation storms can temporarily disrupt and/or permanently damage satellites and spacecraft that support key applications including communication, position, location and timing systems such as GPS, and Earth observation, including meteorology and security surveillance applications. Work to assess the impacts in this sector in the Cabinet Office has involved central Departments, Defence Science and Technology Laboratories and the Centre for the Protection of National Infrastructure (CPNI) and the UK space industry. CPNI are currently undertaking an investigation looking specifically at dependencies of UK infrastructure upon satellite technology. The findings of both these studies will inform wider discussions between space scientists, the national infrastructure and satellite industries about resilience to space weather hazards.

  The UK Space Agency supports several spacecraft currently observing the Sun. Data from these observations assist in assessing the risks to the Earth's technologies and infrastructure.

International co-ordination

  Relevant Government departments have been in discussions with US members of the EIS council who have provided a perspective of the risk to US-based power network infrastructure. There has also been engagement with counterparts in USA, Sweden and EU raising awareness of the need to prepare for geomagnetic storms collaboratively. HMG continues to explore potential ways to enhance international coordination in circumstances such as these.

Future work

  Once an agreed cross-Government understanding of the main impacts of severe space weather is achieved, a full risk description and assessment will be added to the National Risk Assessment.

  The assessment will also inform 2011 Sector Resilience Plans, which are produced annually, by each lead department, as part of an ongoing assessment to increase Government's understanding of the level of resilience of the UK's critical infrastructure to natural hazards. Plans are developed for the nine infrastructure sectors: Water, Energy, Transport, Communications, Health, Emergency Services, Finance, Food and Government. The Plan should alert Ministers to any perceived vulnerabilities and set out a programme of measures (an action plan) to improve resilience where necessary.

CASE STUDY 4: CYBER ATTACKS

Background

  As the UK and our critical national infrastructure become increasingly dependent on cyber activity, we also become more exposed to the rapidly evolving range of threats and risks.

  The Government has been taking action to secure cyber space for several years. CESG, the Information Assurance arm of Government Communications Headquarters (GCHQ), uses its expertise in this fast moving arena of cyber security to provide help and support to Government in dealing with these risks. The Centre for the Protection of National Infrastructure (CPNI) provides advice on protective security measures and direct technical support to organisations within the national infrastructure. Individual Government departments are currently responsible for the protection of their own systems and infrastructure.

  The UK's Cyber Security Strategy was published in June 2009. The key aims of the strategy are to: reduce risks from the UK's use of cyber space; exploit opportunities in cyber space; and improve cyber knowledge, capabilities and decision-making. In the wake of this, the Office of Cyber Security (OCS) situated in Cabinet Office, and Cyber Security Operations Centre (CSOC) were set up to provide strategic leadership in the cyber domain, monitor developments in cyber space, analyse trends and improve the collective response to cyber incidents.

Current Risk Assessment

  Since 2005 cyber threat risks have been extensively covered in the National Risk Assessment (NRA). In the 2010 NRA there are nine separate cyber risks which, broadly, fall into two categories: cyber attacks on confidential or sensitive data; and cyber attacks on infrastructure. To prepare and mitigate the threat of attacks on infrastructure CPNI provides advice on good practice on protective security and on communications resilience using industry expertise and good practice network design principles. CPNI has also established a broad network of information exchanges to ensure effective engagement with critical infrastructure providers, including the exchange of threat and vulnerability information.

  As part of the annual refresh of the NRA, each cyber risk is re-evaluated in terms of its likelihood and impact and any changes are reflected in the NRA and associated planning assumptions documents. As is standard for risk of malicious damage in the NRA, the assessment of likelihood will take into account an objective assessment of the capacity of those intent on causing harm through cyber attacks and the vulnerability of their intended targets. In Autumn 2010 the Civil Contingencies Secretariat (CCS) will be facilitating a full review of the cyber risks in the NRA to ensure that the NRA continues accurately to reflect the latest assessments across Government of the range of plausible cyber threats to the UK. In doing so the CCS will draw on scientific advice including scenario planning, horizon scanning and technology watch activities undertaken by OCS and by other departments and agencies.

  Individual departments consider cyber threats as part of their own information assurance and business continuity planning activities. For example, the Ministry of Defence has assessed the impact of cyber attack in a wide range of scenarios to inform ongoing work on the Strategic Defence and Security Review. In doing so MOD has drawn extensively on scientific advice on the nature of the current and future threat, alongside operational analysis and scenario planning techniques.

Response to Cyber Incidents

  A variety of mechanisms exist in the UK, both within HMG and the private sector, to identify and respond to cyber-related emergencies. Relationships between the primary emergency response teams covering the Government infrastructure (GOVCERTUK and MODCERT), critical national infrastructure (CSIRT and many private sector CERTS) and central Government departments are strong. Government departments responsible for sectors of the critical national infrastructure have established links to infrastructure providers which allows information to be exchanged and action to be taken. CSOC has defined and shared an incident management process that enables CSOC to coordinate stakeholder activity in the event of a serious incident, with OCS (and relevant lead Government department/s) attending COBR as necessary

  The identification and response process to cyber incidents requires the use of techniques from computer science (software instrumentation, code analysis) and the use of scientific method to draw conclusions about the probable cause of the incident and the nature of the most effective mitigation. CSOC is able to draw on scientific advice across Government including expertise within GCHQ and the Defence Science and Technology Laboratory (Dstl). CSOC has developed and continues to develop relationships across the UK cyber community in order to support this activity with common situational awareness. Exercise White Noise (conducted by BIS in November 2009) highlighted the benefits of technical contributions at a high level. However further work needs to be done to develop mechanisms to identify scientific and technical experts in industry and academia.

  Individual departments have made arrangements to respond to cyber attacks on their own systems and infrastructure. For example, the Ministry of Defence Global Operations and Security Control Centre (GOSCC) provides a focus for the monitoring of attacks against defence systems, and the co-ordination of MOD response actions. The GOSCC works closely with the CSOC to ensure a consistent and effective national response. The MOD is able to draw on specialist scientific advice from the Cyber and Influence science and technology centre within Dstl, as well as from a broader network of strategic partnerships with information infrastructure and system providers

  These mechanisms have been tested in several genuine cyber incidents of limited scale. A number of cyber-specific exercises are being coordinated by CSOC, including UK play in the US-led CyberStorm III international exercise later in 2010. Activity will test existing response mechanisms in CSOC, the CERTs, HMG, law enforcement, and aspects of the UK critical national infrastructure provided by the private sector. A second exercise involving the UK telecoms sector will also take place later this year, and further exercises are planned for 2011.

Strategic Co-ordination

  OCS leads the co-ordination of the UKs cyber security strategy, as part of this OCS is developing a private sector engagement strategy and associated science and technology plan. OCS also work with the Research Councils, Technology Strategy Board and individual departments (such as MOD and GCHQ) to ensure a co-ordinated approach to research and development in this area.

International Coordination

  OCS lead international engagement on Cyber issues with other nations and have established strong links with the US, Australia and European Allies on Cyber matters. GCHQ, CPNI and the Ministry of Defence also maintain close liaison links with their international colleagues.

  The geographic independence of cyber attacks makes international cooperation and coordination vital. CSOC has started to develop relationships with a variety of international partners and intends to participate in further international exercises and knowledge exchanges.

APPENDIX A

PANDEMIC INFLUENZA—REASONABLE WORST CASE NATIONAL PLANNING SCENARIO

  The reasonable worst case is a concept developed for emergency planning in the UK. This concept is designed to exclude theoretically possible scenarios, which have so little probability of occurring that planning for them would lead to a disproportionate use of resources. They are not predictions of what will happen but of the worst that might realistically happen, and therefore we would expect most pandemics to be less severe and less widespread than the reasonable worst case. By planning for the reasonable worst case planners are assured that they have a high probability of meeting the demands posed by the hazard should it occur.

    — Up to 50% of the population ill (with infection attack rates up to 80-85%) (Department of Health 2006c).

    — Of which, from 10% up to 25% are expected to have complications, half of these bacteriological. (With possibly as little as a 35% overlap between the "at risk groups" and those who actually get complications (Meier et al. 2000).)

    — Peak illness rates of around 10-12% (measured in new clinical cases per week as a proportion of the population) in each of the weeks in the peak fortnight (Department of Health 2005).

    — Absences rates for illness reach 15-20% in the peak weeks (at a 50% overall clinical attack rate, assuming an average seven working day absence for those without complications, 10 for those with, and some allowance for those at home caring for children (Department of Health 2006b)).

    — Case hospitalisation demand rates up to 4% with an average six day length of stay.

    — but, of which 25% could, if the capacity existed, require intensive care for 10 days.

    — Case fatality ratios up to 2.5%.

APPENDIX B

VOLCANIC ASH—THE WORK OF THE DEFRA SAG

  Professor Bob Watson (CSA, Defra) and Dr Miles Parker (Deputy CSA, Defra) convened an advisory network of approximately 40 experts, from an extensive range of disciplines, and held the first of a series of daily teleconferences on the 16 April. At the initial teleconference the hazards and environmental media at risk were identified. Fluorine was identified as the main substance of concern in the ash. At an elevated level fluorine is hazardous to human and livestock health. Fluorosis (a condition relating to the increase in levels of fluoride) is a recognised cause of mortality of livestock in other volcanic eruptions. In response DEFRA and colleagues from the Devolved Administrations, put in place a UK wide sampling and analysis strategy of environmental samples including rainwater and herbage samples. Existing routine monitoring of air quality continued throughout the incident.

  Sulphur dioxide was identified as a substance of concern but low risk in this case. An increase in the atmospheric levels of sulphur would have been picked up by the routine acid rain monitoring programme and hourly ambient air sampling for SO2. If these parameters had increased, herbage samples would have been analysed for sulphur.

  The DEFRA Science Advisory group provided regular updates on the key issues (air quality, drinking water quality, environmental water and grazing land) to SAGE members. Analysis of environmental samples returned no significant levels of SO2 or fluorine or increased PM10 values.

  If significant ash deposition did occur DEFRA would need to consider if other chemical elements were an issue. This would be based on information of ash analysis from Iceland as well as ash deposited in the UK. Whilst we do not currently know what determinants we would need to test for and whether or not the UK has the analytical capabilities for these, likely determinants would be sulphur and heavy metals. Identified capabilities already exist for these.

  Regarding air quality, alerts would be raised with the Health Protection Agency (HPA) if hourly PM10 (particulate matter below 10 micrometers in diameter) values exceed 500 mcrg./m3 and there is confirmatory evidence in neighboring sites showing similar increases and/or there is evidence of SO2 exceeding 1,000 mcrg/m3 over 15 mins.

APPENDIX C

VOLCANIC ASH—THE WORK OF THE MINISTRY OF DEFENCE

  The hazards to the MOD from the volcanic ash cloud revolved around the potential impact of flying military aircraft (including fast jets, heavy lift aircraft and helicopters) through the clouds and this entailed sampling the clouds to determine their composition. In also entailed establishing an accurate method of determining in real time where the dangerous particles were at dangerous levels of concentration within the clouds. The identification of these hazards was based on known previous incidents of aircraft experiencing engine problems during or shortly after flight through clouds of volcanic ash.

  The Ministry of Defence provided information on the contents of the ash cloud through samples taken of the cloud using a coherent swabbing regime designed to rigorous scientific standards by the Defence Science and Technology Laboratory (Dstl) and the Materials Integrity Group (MIG), part of 1710 Naval Air Squadron.

  MOD's primary conduit for relaying scientific advice to wider Government in an emergency such as the volcanic ash cloud is the MOD Chief Scientific Adviser's (CSA) presence on the SAGE. In addition, in this emergency, the MOD's CSA took on responsibility for co-ordinating MOD's S&T response to the ash cloud and for feeding that in to wider Government scientific advice SAGE.

  The Ministry of Defence's own ad-hoc coordination measures, such as the MOD's Chief Scientific Adviser's (CSA) seminar, also facilitated the sharing of knowledge and ideas, and to establish contact between involved parties. Links with private-sector organisations worked well. The MOD CSA hosted a seminar day attended by representatives of DSTL, the Met Office, the RAF and Joint Helicopter Command, Rolls Royce, Academia, the Materials Integrity Group and MOD Defence Science and Technology (DST) to enhance knowledge transfer.

  In addition, representatives of MOD DST attended meeting of the Civil Contingencies Committee (Officials) (CCC(O)) to relay details of Government response back to the relevant sections of the scientific community.

  MOD is therefore now better prepared for a similar situation in the following respects:

    1. The initially developed rapid pragmatic fit for purpose method for identifying volcanic ash contamination is currently being further developed as a more scientifically rigorous process as the contaminating ash composition and distribution becomes better understood.

    2. Dstl are familiar with the nature of the measuring equipment required and able to provide it at short notice.

    3. The contacts within the network of those who would be involved in any future similar incident are better-established.

APPENDIX D

VOLCANIC ASH—THE WORK OF THE DFT SCIENCE GROUP AND THE CAA

  Aircraft and engine manufacturers are responsible for determining what level of ash their products can safely tolerate. Urgent confirmation was needed on whether such a zero tolerance of volcanic ash was necessary to maintain flight safety. From the outset of the crisis, the CAA took the lead in coordinating international efforts with aircraft and engine manufacturers as well as airlines and other regulators to develop new measures to reduce airspace closures caused by volcanic ash. This led to the establishment of a wider area in which it is safe to fly, consistent with the framework agreed by EU Transport Ministers on 19 April—this area being ash concentrations between 200 microgrammes/m3 and 2,000 microgrammes/m3, commonly referred to as the "Enhanced Procedures Zone" (EPZ). Manufacturers issued guidance to the operators of their products on the enhanced procedures applicable to their products and operators then submitted safety cases to the CAA to support flight operations in the EPZ.

  By 17 May, subsequent work had established a further new area of operations—the "Time Limited Zone"—for operations for a limited time at higher ash densities between 2,000 microgrammes/m3 and 4,000 microgrammes/m3. Again, to operate in this zone, airlines need to present the CAA with a safety case that includes the agreement of their aircraft and engine manufacturers. These tolerable limits were agreed by the aircraft and engine manufacturers on the basis of new research and analysis based on evidence gained from this and previous ash encounters. The no-fly zone (concentrations above 4,000 microgrammes/m3) is under constant review based on scientifically reliable data available to CAA, industry and other regulatory agencies.

  CAA, the UK's independent aviation regulator, attended SAGE and kept the group informed of key developments, including evidence-based cases for zoning arrangements. The DfT's CSA established an aviation sub-group, involving aviation, meteorology, volcanologist, geology and engineering experts to peer review the evidence processes to establish threshold for safe flying in volcanic ash. The subgroup reported outputs and recommendations to SAGE.

  In addition, the CAA established a "Blue Skies Group" bringing together a range of experts, including SAGE representatives, in aviation, meteorology, geology and volcanology to consider the long term opportunities for improved management of the impact on aviation of ash contamination. The group reached a range of conclusions on managing safety using visible ash, ash accumulation rates and average ash density contours, and recommended further work on improving the methodology for modelling eruptive strength and increasing the usability to the aviation community of forecasting dispersion products. The recommendations of the Blue Skies Group are being addressed by the CAA, Met Office and engine manufacturers in a range of follow-up initiatives to maximise the volume of airspace that may remain open to airlines in the event of further Icelandic volcanic eruptions. These initiatives, in broad terms, seek to establish levels of ash in the atmosphere, the effect of such levels of ash on aircraft and the means to manage the risk.

  The CAA is also taking a leading role in the work of the ICAO Volcanic Ash Task Force (IVATF), which has followed work at the ICAO Regional level to refine contingency plans for the ICAO Europe/North Atlantic Region, which is also working to develop means to safely manage flights in the vicinity of ash and minimise flight disruption.

Government Office for Science and the Cabinet Office

14 September 2010







1   Emergency Preparedness-Guidance on Party 1 of the Civil Contingencies Act 2004, its associated Regulations and non-statutory arrangements Back

2   Emergency Response and Recovery Back

3   This includes advice on social sciences, engineering and technology. Back

4   http://www.cabinetoffice.gov.uk/intelligence-security-resilience/civil-contingencies-uk-resilience/national_risk_register.aspx Back

5   The risk assessment process is described at chapter 5 of the NRR. Back

6   http://www.cabinetoffice.gov.uk/media/349120/conops-2010.pdf Back

7   Responders, as defined by the Civil Contingencies Act (2004) have a statutory duty to prepare for emergencies. Back

8   http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4007697 Back

9   http://www.cabinetoffice.gov.uk/ukresilience/pandemicflu/evidence.aspx Back

10   http://www.dh.gov.uk/ab/SPI/index.htm Back

11   http://www.cabinetoffice.gov.uk/media/416533/the2009influenzapandemic-review.pdf Back

12   http://www.wellcome.ac.uk/About-us/Policy/Spotlight-issues/Influenza/UK-pandemic-H1N1-projects/index.htm Back

13   The Icelandic Met. Office have national responsibility for response to volcanic events in Iceland Back

14   Light Detection and Ranging. Back


 
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