Up to 650,000 people could die in England and Wales if there were a flu pandemic, according to a Home Office document that outlines plans for dealing with an outbreak, including measures for mass burials and refrigerated storage of bodies.

Ways of dealing with mass casualties are likely to be overwhelmed at the height of a pandemic, with up to 22% extra deaths at its height, the report warns.

The document, Planning For A Possible Influenza Epidemic, is intended for a range of agencies, to help improve their readiness for any outbreak, and is open for consultation until the end of November. The plans will apply if a new strain of "ordinary" flu emerged, or if avian flu passed easily from birds to humans.

The officials say that even under prudent projections there could be 320,000 deaths. "Cemetery managers are likely to want to move to provision of common graves, which would allow interments to be undertaken more quickly." Coffin makers might have to limit the types and sizes of coffins to meet the demand.

NHS trusts and local authorities would plan the extra mortuaries, which would involve temporary shelters, and nurses and retired doctors could be licensed to sign death certificates.
Press Association