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