OBSERVATIONS ON THE FOOT AND MOUTH DISEASE OUTBREAK

IN CUMBRIA 2001:

Alan Richardson B.Vet.Med., Ph.D., M.R.C.V.S.

 

"Foot and mouth disease finds you out." Professor Harry Burrow,

Royal Veterinary College, London, in a lecture to his students in 1963.

 

INTRODUCTION

 

Author's credentials

The author qualified as veterinary surgeon in 1963 and worked in veterinary practice and the Veterinary Investigation Service (MAFF) for twelve years. He was Director of the Sir William MacDonald Veterinary Laboratory, Hamilton, Victoria, Australia (1975-76) and subsequently worked in research and development for ICI Pharmaceuticals Ltd. His last professional appointment was as a Home Office Inspector under the 1986 Animals (Scientific Procedures) Act. He worked in the 1967 Foot and Mouth Disease (FMD) and came out of retirement to help in the 2001 outbreak in Cumbria.

 

Scope of the paper

Since the epidemic of 1967 there have been many changes in farming and the broader political and social scenes. My comments are confined to the initial response to the 2001outbreak, the veterinary protocols as first implemented and then as later modified. In particular the author wishes to compare them with the methods of 1967.

 

The 1967-8 epidemic

In 1967, a cadre of veterinary officers whose seniors had experience of FMD dealt with the epidemic. It was axiomatic that preventing the spread of the disease depended on swift diagnosis, slaughter of stock and disinfection of the infected premises. It was imperative to reduce to an absolute minimum the interval between the reporting of the disease and the disposal of carcasses and preliminary disinfection. It was understood that FMD would behave like a bush fire so the initial response had to be overwhelming in terms of the deployment of resources. It was impossible to act too quickly and every effort was made to reduce the duration of each operation to a minimum.

 

At the same time, it was recognised that measures to limit the movements of livestock and potentially fomite-contaminated materials would inflict economic hardship on the surrounding area. To minimise this, whilst still maintaining good biosecurity, infected areas were defined with care, and in the light of local knowledge.

 

The first FMD outbreaks in 1967 were in Hampshire and Northumberland and were so quickly dealt with there was little spread. The rumour among the junior veterinary staff was that the scale of the resources initially deployed, particularly by Dr Wilsden, Regional Veterinary Officer (RVO) in Northumberland, was considered excessive by MAFF administrators, who in the name of economy, ensured that the response to the Oswestry outbreak in the autumn was altogether muted. The result was a failure to contain the disease at the outset and hence its escape into an intensely stocked dairying area.

 

The lessons learned from that epidemic were set out in the report of the Duke of Northumberland's Committee and the public had every reason to suppose that its conclusions formed the basis of the policy and contingency plan in place in January 2001.

 

 

STATE OF READINESS IN 2001

 

The several days elapsing between the initial television report of the confirmation of disease at Burnside Farm, Heddon on the Wall, and the lighting of the pyre on that property indicated to the author that the speed of response was quite inadequate. He reported for duty to Carlisle on February 28th 2001 and wishes to stress that in the following comments, he absolves from criticism the Divisional Veterinary Manager (DVM), Mr Andrew Hayward, and his staff. He soon realised that Mr Hayward's hands were tied and, unlike the Divisional Veterinary Officers of 1967, had almost no local management discretion.

 

At the Carlisle office, on March 1st, there was inadequate office space and very few supplies of any kind. The author was obliged to buy all his kit (protective clothing, boots, buckets, etc.) at the local store, to which he went with two American volunteers. There was not a spare thermometer in the office, yet dozens of computers were being unloaded from a lorry. The first thing he was required to do was to read was a bulky COSHH assessment for disinfectants. The organisation was completely overwhelmed and the bemused confusion among the staff of all ranks proclaimed that there had been no contingency planning at all. This situation persisted for some weeks.

 

 

A COMPARISON OF WORKING METHODS: 1967 AND 2001

 

Office siting and staffing

In 1967, offices at Chester, Oswestry, Crewe and Macclesfield covered the counties of Shropshire and Cheshire. Each had a working radius of about 20 miles. The Macclesfield office, to which the author reported in early November, was staffed by two Divisional Veterinary Officers (DVO) three veterinary officers (VO) and about thirty temporary veterinary inspectors (TVI) drawn from practice and other parts of MAFF. There were also about six clerical and administrative staff. The DVOs reported to a Regional Veterinary Officer (RVO) responsible for two centres. There was thus a strong line management within a relatively small geographical area. Any TVI needing guidance could rely on his immediate superiors at all times. Phones were answered by veterinary staff who could instantly judge the urgency and import of every call. The office was manned from 8am to 11pm.

In 2001, the Carlisle office initially served an area from the Scottish border to the Lune Tees line, about 100 by 100 miles. There was no professional line management and TVIs received their instructions from clerical staff. These instructions appeared only after lengthy in-putting of data into the computer system. There were inadequate phone lines and working space. Full time veterinary staff were no better informed than TVIs regarding HQ wishes. Even quite small matters depended upon HQ decisions and when their instructions were not available, nothing could be done. At first there was an attempt to work normal office hours.

 

MAFF's response to this state of affairs was to increase vastly the beurocracy, rather than impose a line-management with delegated responsibility. By summer, over 800 people were employed at Carlisle. Some simple comparisons show the fundamental flaws in the "big office" concept. A 1967 office with an operating radius of 20 miles covered 1,256 sq. miles. With 30 veterinarians, there was one for every 42 sq. miles. Initially, the Carlisle office was expected to cover (100 x 100) 10,000 sq. miles, though this was later reduced to an area roughly 70 by 60, or 4,200 sq. miles. To match the 1967 Cheshire manning level, the initial area needed 238 vets and the reduced area required 100. These personnel appear to have been eventually provided though they were managed in a way that much reduced their effectiveness (see below). Moreover, though the Carlisle office was new and large, it was not built to cope with such numbers - and could not. A veritable estate of portacabins was needed and as it steadily grew, the administrative chaos was considerable.

 

To these problems were added those inherent in the operating procedures for dealing with each case of suspect disease

Clinical protocols  negative cases

An early feature of any FMD outbreak is panic; many reports of suspect disease are received and all must be answered. Because HQ staff had not been able to form an opinion of a TVI's competence, they distrusted them all, even experienced people. This problem was aggravated by the requirement to serve Form A, placing the farm under restriction, at the very outset, before the sick stock had been examined. In 1967, this was not done unless the evidence of disease was strong. In 2001, once Form A was served, HQ staff were very reluctant to remove it for at least a day or so and this reduced the TVI's availability for other work and often imposed costs on the farmer. While HQ dithered, milk producers were obliged to discard hundreds of gallons of milk at their own expense. HQ also required the examination all stock, irrespective of the negative clinical findings in the index animals. This wasted more time. At a time when the switchboard was jammed with calls, the author was required to spend two days gathering sheep from 1,000 acres of marine marsh on account of a bullock dead of pneumonia. The Carlisle DVM was unable to intervene.

The most bizarre element in the new reporting protocol was the requirement to examine the suspect FMD case last of all, perhaps hours after first arriving at the farm. The instruction was to begin examining the outlying stock and work towards the suspects. On many Cumbrian farms this must have caused delays of several hours before any diagnosis. This ludicrous procedure was first justified on the spurious grounds of gathering "epidemiological" information but later admitted to be a requirement of Brussels. Once the full horror of the situation was grasped, it was no longer insisted upon.

 

Set out below, in Table 1, are comparisons of the salient features of the clinical protocols of 1967 and 2001and the times involved in implementing them. The 2001 estimates refer to early March and are by no means exceptional.

 

Table 1.

Activity times in clinically negative cases

 

1967

2001

 

 

Activity

hours

activity

Hours

 

 

 

 

Farmer reports suspect disease

0

 

24.0

DVO or VO allocates task to TVI

0.25

Office staff allocate task

6.0

TVI travels to farm

0.75

 

2.0

TVI examines the stock and reports to DVO

1.0

Serve Form A, examine all stock on farm

 

TVI departs on another task

 

Form A lifted only with HQ

 

 

 

permission

5.0

Totals

2.0

 

37.0

 

But negative diagnoses were, initially, almost always rejected by HQ, resulting in one or two days passing before Form A was lifted.

 

Clinical protocols  uncertain cases

The majority of suspect FMD cases pose few problems to a competent veterinarian. The inexperienced should be able to draw on a second opinion and to use laboratory tests. In 1967, uncertain cases were watched very carefully and within a matter of hours the outcome usually became clear. In positive cases typical lesions were seen; in negative cases they did not appear at all. Laboratory tests were available.

 

In the 2001 outbreak, many young, foreign and inexperienced veterinarians were manipulated, even bullied, by HQ staff without reference to experienced staff. After the election, HQ refused to allow laboratory methods to be used to resolve uncertain cases and TVIs were forced to "slaughter on suspicion" (SOS) or declare the animals free of FMD by serving Form B. The leader of the oppostion, Mr William Haig, first suggested this infamous and unnecessary manoeuvre in a pre-election radio interview and it was acted upon. Modern tests (ELISA) were never locally available, though a system for providing second opinions was later implemented at Carlisle.

 

Table 2 illustrates a comparison of the 1967 and 2001 methods for resolving uncertain cases.


Table 2

Activity times in clinically uncertain cases

 

1967

2001

 

 

activity

Hours

Activity

hours

 

 

 

 

Farmer reports suspect disease

 

 

 

DVO/VO allocates task

0.25

Office staff allocate task

30

TVI travels to farm

0.75

 

1.5

TVI examines stock and consults DVO and

1.0

Serve Form A, examine all stock

 

HQ. Form A served. All other stock inspected. Samples perhaps taken.

3.0

Samples not allowed

TVI forced to give a diagnosis

4.0

Farm kept under observation until a clinical resolution

36.0

Slaughter on suspicion

 

 

 

 

 

 

 

 

 

Totals

41.0

 

35.5

 

The SOS policy saved negligible time at a cost of many thousands of animals that were not diseased. A deplorable, if not perverse, aspect of this policy was HQ's refusal to allow laboratory methods to be used to resolve difficult cases, when previously they had demanded them for obvious clinical cases. It was made far worse by taking samples after the slaughter of SOS cases, which all too often suggested that a TVI had been coerced into a wrong decision.

 

Effect of reporting protocols on veterinary manpower

During the author's first week (Feb28th to March 6th) he kept a record of his activities, noting the time spent travelling and examining stock. These data were entered upon a spreadsheet which was used to simulate the effects of a) using a 1967 reporting protocol, b) assuming a radius of operation of 20 miles from the office, and c) combining these two paradigms to estimate the extra effort demanded by the 2001 system.

 

The details are given in Appendix 1, which also reveals how initial fears cause farmers to report many trivial complaints as suspect FMD. The results are summarised in Table 3. Seven FMD negative cases were seen during seven days, totalling 65.7 hours work and 873 car miles. In terms of hours per case, the 2001 methods required 9.4 hours compared to an estimated 2.5 hours for the 1967 system. Although these data are limited there is no reason to suppose they are atypical. The effect of the 2001 protocols was to require over three times as many veterinarians to do the same work as in 1967.

 

Table 3

Manpower effort required for seven FMD negative cases: 1967 compared to 2001

 

 

2001 actual

Assume 1967 reporting protocol.

Assume 1967 protocol & 20 miles radius

 

 

 

 

Day

hours

miles

hours

miles

hours

miles

 

 

 

 

 

 

 

1

9.66

76

3.0

 

3.0

20

2

7

105

2.5

 

1.5

20

3

9.5

220

2.5

 

1.5

20

4

10

155

10

Same miles

10

20

5

10

32

7

 

1.5

20

6

9.5

160

2.5

 

2.5

20

7

10

125

2.5

 

2.5

20

 

 

 

 

 

 

 

Totals

65.7

873

30

873

22.5

140

 

 

 

 

 

 

 

Effort per case

9.4

125

4.3

125

2.5

20

 

 

 

 

 

 

 

Differences per case

-

-

5.1 less

 

6.9 less

 

 

 

 

 

 

 

 

 

Protocols positive cases

Since FMD spreads very rapidly every effort must be made to reduce to an absolute minimum the time that sick animals remain alive, or their carcasses left exposed. In Cumbria, the first positive cases were dealt with so slowly that each affected farm undoubtedly generated a great virus challenge. Besides the delays caused by the shortcomings discussed above, further delay resulted from the reluctance of HQ to accept positive diagnoses on clinical grounds, even from very experienced veterinarians. Before the general election, HQ tried to resist positive diagnoses; even where there was little doubt, and insisted on laboratory confirmation. These tests took time and resulted in many sick animals remaining alive for days during which they produced large volumes of fomites and virus aerosols. The delays were aggravated by more delays at the single laboratory in southern England, which was soon overwhelmed with specimens. The author did not suffer any delay with his first case because he reported it in forthright terms to the reluctant HQ duty officer. But other veterinarians, especially the younger ones experiencing their first case, were obliged to see herds with, at first a few sick animals, eventually suffer 100% incidence of clinical disease before slaughter was allowed.

 

The speed with which valuations were carried out, though as rapid as could be managed, was a source of further delay. The paperwork was clumsy and antique and no use was made of lap-top computers or electronic notebooks. MAFF's documentation was clumsy and tedious and required at least an hour's concentrated work from the TVI in the farm kitchen at a time of great stress and constant interruption. Several forms had to be completed in triplicate and in the early March there was a dearth of carbon papers. A TVI was issued with photocopied forms weighing almost 1 kg. One specimen shown at Appendix 2 has a column for the value of carcases salvaged after slaughter, an economy not practised since the Second World War.

 

In 1967, a policeman was stationed on the farm gate to prevent egress of persons and materials until preliminary disinfection was completed. On-farm burial allowed contractors to begin digging a pit before valuation and slaughter were completed. Where overnight delays were expected, the TVI valued and killed sick animals and disinfected their carcasses. Preliminary disinfection was by a fire engine into which five gallons of Jeyes' Fluid were poured. The firemen soaked the whole environment, buildings, yard etc as soon as the animals were gone and then disinfected the contractor's machines. It was usually completed within 48 hours of diagnosis.

 

In 2001, policemen and fire engines were not available and the intervention of the Environmental Agency effectively rendered rapid carcase disposal impossible. TVIs had no authority to value animals and no means of killing them. Sick animals continued to generate virus for several hours and even days. Even when MAFF provided contractors, preliminary disinfection was long delayed and in the absence of a policeman, it is certain that some farmers and members of their families left and returned to the premises without adequate disinfection. Table 4 shows comparisons of estimates of the activity times in positive cases in Cheshire in 1967 with Cumbria in March 2001.

 

Table 4

Activity times in positive FMD cases

 

1967

2001 (March)

 

 

activity

hours

activity

hours

 

 

 

 

Suspect case reported. TVI instructed by VO

0.25

Office allocation

30

TVI travels to farm

0.75

 

0.75

TVI examines stock, consults DVO and HQ

1.0

Serve Form A, examine ALL stock

5.0

Form A served

 

Consult HQ Samples sent to lab. Await results

72 hours plus

TVI values sick stock, kills and disinfects them

1.0

Sick animals remain alive  more become sick

 

Valuation and slaughter

8.0

 

8.0

Burial on farm at time of slaughter

4.0

No burial, carcasses not disinfected

 

 

 

for up to a week

120

Preliminary disinfection

4.0

Not done for several days

 

 

 

 

 

Total hours

19

 

235.75

 

 

 

 

Total days

1 to 2

 

Up to 10

The figure at the bottom of column four (10 days) most eloquently demonstrates the complete failure to control the epidemic in the first six to eight weeks.

 

Infected areas and licensed movements

Animal movement restrictions inflict economic hardship; therefore the extent of the restricted area must be a compromise between the need to contain the disease and reducing what we may call "collateral damage". Allowing movement under licence mitigates that damage.

 

In 1967, areas were defined to include an abattoir. The licensing was centred on the local office where veterinary staff assessed the risks and issued licences quickly. If necessary, veterinarians immediately went to farms, assessed the risk, issued the licence and often personally supervised the movements, within the day.

 

In 2001, almost the whole country was put under restriction, including the Orkneys from which animals could not be moved for many months, even though they never posed any risk. There were many fewer abattoirs due to massive closures, but even so, safe and reasonable movements to abattoirs were not allowed for months. In Cumbria many thousands of feeding-sheep and lambing flocks were kept out on bare ground through inclement weather until their owners went bankrupt or the sheep were removed in the cull. Even when movements were allowed, the beaurocratic delays were considerable. The procedures, laid own in detail from HQ, required several days to process the paperwork. Even in June, the interval from a farmer applying for a licence to the movement taking place was between one and two weeks.

 

Nothing better illustrates the confusion and paralysis resulting from the centralisation of management than an incident on March 13th when the author sought clarification over a licence request for the movement of boar semen. The responsible clerk advised him that MAFF managers had told her to watch the television at 3 pm, when the Prime Minister would deal with the matter from the steps of 10, Downing Street.

 

DISCUSSION

 

Three-km. cull

In 1967, a surveillance team built up a relationship with the farmers within a one-mile radius of the infected premises (IP) and monitored their farms very closely. Each veterinarian got to know his people and their livestock well. Lateral spread was detected and dealt with at once. Herds and flocks that were not affected were not killed. Dangerous contacts were indeed often killed, but only after a local assessment; nose to nose contact across fences being the common criterion.

 

In 2001, the 3 km. cull seems to have been the idea of epidemiological mathematical modellers who could have no idea of the logistical effort needed to kill and dispose of the carcasses, nor of the economic losses and distress resulting from their prescription. Nor was this stratagem necessary, as all previous experience had shown. When the slaughter on suspicion policy became known, the distress was greatly increased when farmers realised that their livelihoods, and often their life's work, hung upon the competence of an unknown veterinarian, examining a neighbour's stock. The anxiety was increased when he reflected that this veterinarian was possibly young, from overseas and perhaps inexperienced and unfamiliar with the range of lesions to be found in British livestock. This cull was induced by panic and ignorance and born of the failure to be prepared.

 

Slaughter on Suspicion (SOS)

In 1967, there was no such thing. The clinical diagnosis of FMD does not present insuperable problems to competent veterinarians and where there are doubts, second opinions should be available. With vague clinical histories and atypical lesions, the issue may be resolved by laboratory methods and/or by simply waiting, with the farm under restriction. Indeed, the delay can be used to put slaughter and disposal teams on standby.

 

In practice, in 2001, once the SOS policy was adopted, the discovery of any FMD-like lesion of any aetiology might lead to the slaughter of large numbers of healthy stock. On the other hand, a TVI could be induced by HQ to regard a vaguely sick animal as posing no threat. The author was thus pressurised, indeed threatened, by HQ to decide that an uncertain case was negative, or to slaughter on suspicion. He refused to do either and insisted on waiting. Within four hours the animal had typical FMD lesions. On another occasion, he was put under pressure to kill stock from which he could not rule out the possibility of disease, pending the examination of many more sheep, lab tests and/or a careful "wait and see". Again, HQ demands were resisted and the case proved not to be FMD. This stubbornness saved a pedigree, scrapie-resistant, hefted, fell flock; five contiguous fell flocks and two neighbouring dairy herds. It is very likely that young, overseas veterinarians would have followed HQ directions.

 

The SOS policy was in every respect against the professional code of the Royal College of Veterinary Surgeons (RCVS), and that it was enforced by members of the RCVS at the behest of those who paid their salaries raises serious ethical issues for the profession. In the civil service there is a distinction drawn between the advice given by professionals and the executive action taken by officials. The function is analogous to a reflex arc with the professional acting as the sensory component and the executive the motor. It was long ago realised that to require both functions from the same personnel would lead to error, most obviously from the perception of motor difficulties urging sensory functions into wishful thinking. Nevertheless, within the civil service, there is a widely understood, but never written, rule that professionals must only give the advice that officials wish to hear. Civil Service scientists must have a nose for what the officials require before deciding how to couch their advice. Adroit exponents of this art may expect to be rewarded. In the case of SOS, the policy decided upon by ministers required a whole-time veterinarian to instruct a fellow professional to disregard his professional training and ethical obligations and make guesses for which he would be held responsible. It has become notorious that under such pressure, many veterinarians opted to slaughter stock subsequently shown to be serologically negative.

 

General

All the evidence presented here, and available elsewhere, suggests that the FMD slaughter policy as set out by the Northumberland Committee was retained in outline, while the means for implementing it were down-graded to impotence. How and when this was done will a matter of public interest. It is certain that the contingency plan in place in January 2001 was quite inadequate.

 

The control of FMD is a veterinary practice that calls for a range of veterinary skills, not merely those of clinical diagnosis. It is not a matter for amateurs, however gifted, nor for non-clinical scientists and certainly not for administrators. It requires the rapid integration of several functions by trained professionals. Some of these need not be veterinarians, but they must be competent and whatever their area of expertise, they require training in FMD control. In the lecture by Professor Burrow mentioned at the start of this paper, Burrow amplified his comment to say that the control of FMD tested severely every aspect of public polity and administration, for deficiencies would be cruelly exposed. And so they have.

 

It is difficult to believe that persons with past experience of FMD could have subscribed to the administrative system that was supposed to cope with FMD in 2001. The clinical protocols defied common sense, let alone the imperative to act quickly. One must conclude that MAFF officials have either received erroneous advice, or have chosen to ignore sound advice. It is almost certain that the advent of information technology (computers) and improvements in biological technology (lab tests) led them to carry out a long-cherished desire to reduce the powers and numbers of the State Veterinary Service and to create a tightly-operated, highly-centralised system under their own control and without local veterinary management. Even so, they gave no thought to how this new system would work in practice and the paperwork upon which it depended remained ancient and unreformed.

 

It is not enough for the government to claim that it has eradicated the disease by October 2001, as if that were the sole criterion of success. The cost has been enormous, the waste has been enormous and the suffering, both animal and human has been enormous. Much of it was unnecessary. It is to be hoped that those charged with enquiring into the various aspects of the 2001 epidemic will not shrink from challenging their terms of reference which will almost certainly be couched so as to preclude criticism of the MAFF/DEFRA mandarins who have been responsible for this catastrophe.


 

APPENDIX ONE

 

Table A1

Activity times in the first week of March

 

 

cases

1

2

3

4

5

6

7

miles

hours

diagnosis

 

 

 

 

 

 

 

 

 

 

 

 

dates

28-2

A

 

 

 

 

 

 

76

9.66

A. Ovine polyarthritis

 

1-3

 

B

 

 

 

 

 

105

7.0

B. Sheep with cut lip

 

2-3

 

B

C

 

 

 

 

220

9.5

C. Bullock with pneumonia

 

3-3

 

 

C

D

 

 

 

155

10.0

D. Silage palatability, cows

 

4-3

 

 

 

D

E

 

 

32

10.0

E. Orf in lambs

 

5-3

 

 

 

 

 

F

 

160

9.5

F. Cow, cut tongue

 

6-3

 

 

 

 

 

F

G

125

10

G. sheep tracing

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Totals

873

65.7

 

 

 

 

 

 

Miles per case

125

 

 

 

 

 

 

 

Hours per case

 

9.4

 

 

 

Table A2

The same case-load assuming a 1967 reporting protocol:

Times reduced but mileage the same

 

 

cases

1

2

3

4

5

6

7

miles

hours

diagnosis

 

 

 

 

 

 

 

 

 

 

 

 

dates

28-2

A

 

 

 

 

 

 

76

3.0

A.

 

1-3

 

B

 

 

 

 

 

105

2.5

B.

 

2-3

 

B

C

 

 

 

 

220

2.5

C.

 

3-3

 

 

C

D

 

 

 

155

10.0

D.

 

4-3

 

 

 

D

E

 

 

32

7.0

E.

 

5-3

 

 

 

 

 

F

 

160

2.5

F.

 

6-3

 

 

 

 

 

F

G

125

2.5

G.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Totals

873

30.0

 

 

 

 

 

 

Miles per case

125

 

 

 

 

 

 

 

Hours per case

 

4.3

 

 

 

Table A3

The same caseload with 1967 reporting protocols and

times further reduced by presuming a 20 mile operating radius

 

 

cases

1

2

3

4

5

6

7

miles

hours

diagnosis

 

 

 

 

 

 

 

 

 

 

 

 

dates

28-2

A

 

 

 

 

 

 

20

2.5

A.

 

1-3

 

B

 

 

 

 

 

20

1.0

B.

 

2-3

 

B

C

 

 

 

 

20

1.0

C.

 

3-3

 

 

C

D

 

 

 

20

8.0

D.

 

4-3

 

 

 

D

E

 

 

20

1.0

E.

 

5-3

 

 

 

 

 

F

 

20

2.0

F.

 

6-3

 

 

 

 

 

F

G

20

2.0

G.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Totals

140

17.5

 

 

 

 

 

 

Miles per case

20

 

 

 

 

 

 

 

Hours per case

 

2.5