Pandemic Influenza

Catherine Donovan, MD. MHSc.CIPHI, Newfoundland and Labrador, Oct 25, 2005

Eastern Region 2002-2005

PANDEMIC INFLUENZA (A quick review)

• Respiratory Illness with Significant

Complications and Deaths • Worldwide Outbreak• Major Change in Existing Types of

Viruses• Prolonged Course with 2 or More

Phases

WHY THE CONCERN

• History• 11,000-58,000 Deaths in Canada• Health Care Costs: $330M - $1.4B• Societal Costs: $5B - $38B• Scarce HealthCare Resources• Social Disruption• Avian Influenza (H5N1)

Eastern Process

• Establish Regional Planning Committee (2000)• Community Presentation (2001)• Draft Pandemic Influenza Plan Framework (2001)• Identify Gaps/Unanswered Questions (2001)• Organizational Action Plans(2001)• Annual Review of Framework (2002-2004)• Regional Communicable Disease Advisory

Committee (2004)• Communicable Disease Emergency Preparedness

Framework (2004)• Paper exercise??

Regional Committee

• Communicable Disease Control

• Infection Control

• Nursing

• Environmental Health

• Medical Officer of Health

Principles to Guide Planning

• Enhance Existing Plans to Address Unique Needs For Pandemic Influenza

• Evaluate Plans Within Context Of Provincial / National Plan

• Focus on Community or Areas Preparedness

INTERNATIONAL PLANS (2000)

World Health Organization (WHO) 5 Part Plan:Emergency PlanningSurveillanceVaccines & AntiviralsCommunicationsHealth Services

CANADIAN PLAN (2000)

• Aligned with WHO Plan: 5 Parts • In 6 Phases

0. Interpandemic Preparedness1. Onset of Pandemic2. Regional & Multi-regional Epidemics3. End of First Wave4. Second & Later Waves5. End of Pandemic

PROVINCIAL (2000)

• Aligned with WHO & Canadian Plan • Uses 5 Part WHO Components With Canadian 6 Phases. IE 0. Interpandemic Period

1.Emergency Planning2.Surveillance3.Vaccines & Antivirals4.Communications5.Health services

KEY STRATEGIES IN PLANNING

• Focus on Prevention• Preparation for Prolonged Event• Preparation for Essential Workers• Enhance Surveillance• Enhance Accessibility of Vaccine/Antivirals• Alter Vaccine Priority • Communication

Community Workshop Agenda May 3, 2001

• Welcome

• Introduction to Pandemic Influenza

• Influenza the Clinical Picture

• Influenza the Historical Perspective

• Disaster Planning in the Eastern Region

• Using the Media for Communication

• Small Group Discussion

• Feedback/Wrap-up

WORKSHOP DISCUSSION QUESTIONS

• Essential Services & Employees• With Ill Employees How Would You Cope

• Role of Your Organization in an Outbreak and in Planning

• Participation in Immunization Campaign

Framework (July 2001)

• Followed National/Provincial Format ( 6 Phases, 5 Key areas

• Identified areas for action in each phase for Planning, Surveillance, Vaccines/Anti-virals, Communications Health Services

• Action would occur within existing organizational plans

• Identified issues that required provincial action

Issues

• Increased accessibility to publicly funded immunization program

• Liability issues, IE alternate care providers and spaces

• Minimum standards of service in the event of closure of services

• Payment for private provision of services/resources in emergency setting

• Stock piling of drugs and equipment• Rapid licensing or exemptions (facilities, workers)

H&CS, EasternPandemic Influenza Action Plan

Phase 0 Interpandemic

Strategic Issue

Action Required Lead Comment

Emergency Planning

1. Information session for regional Management

2. Information session for CHNs

CD

PH, FB

complete

Annual Review

• Focus on Interpandemic Period

• Review Status of activity under each part: emergency planning, surveillance, etc.

• Identify outstanding issues

• Report to province

Regional Communicable Disease Advisory Committee

• Mandate: Facilitate prevention & control of communicable diseases in the Eastern Region through inter-organization collaboration

• Responsibilities:– Facilitate regional planning– Effective communication– Coordination of responses to outbreaks– Provide advice to partner organizations

Communicable Disease Emergency Response Framework

• Template similar to Pandemic Influenza

• 6 Phases, 5 Parts

• Includes Communicable Diseases Emergency Communications Plan

• Appended to Health & Community Services, Eastern Emergency Response Plan

1.Outstanding Issues

• Status of provincial planning and response to regional questions

• Support for municipal planning• Overall framework in which public

health is an integral part• Investment of time and resources into

planning• Provincial Communication Strategy

2. Outstanding Issues

• Universal Immunization Program• Electronic Transmission of Surveillance

data• Review of Acts to assess authority• Management of fatalities and death

certificates.• Liability issues• Compensation for Emergency Services

3. Outstanding issues

• Refusal to work

• Working students (training)

• Emergency licensing (workers/facilities)

• Stock piling

• Gaps in resources (for planning & to address increased workload during pandemic). “ No surge capacity”

“The real epidemic is fear”

MACLEAN’S, October 3,2005

THE END