pandemic preparedness the provincial view

Pandemic Preparedness

The Public Health View

Dr. Bonnie Henry

British Columbian Center for Disease Control

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The Provincial Planning Process

The BC Ministry of Health in conjunction with the

BC Ministry of Health Living and Sport has

engaged several organizations across the

Province to define and document the BC

operational pandemic plans.

The BC Centre for Disease control as functional

responsibility to document the plans for a

number of areas of Public Health Pandemic

Planning

Public Health Pandemic Plans

The following is a list of the Public Health Pandemic Planning documents currently under creation Public Health Measures

Public Health Surveillance

Vaccine Priority Groups

Vaccine Storage, Transfer and Distribution

Childhood Immunization scale-up and scale down

Public Health CommunicationsThere are several planning streams underway at the same time in clinical care and health human resources planning.

Public Health Measures

The BC CDC has undertaken a full literature

review of all potential public health measures

which may be used to slow the spread of the

influenza virus.

Some of these measures include travel restrictions,

hand and personal hygiene practices, patient

isolation, contact quarantine, modified work practices,

antiviral use, mask use, information and

communications to professionals and the public, as

well as social gathering restrictions.

Public Health Measures Continued

A review of the measures from a scientific basis

was undertaken to ensure that only measures

which would provide the greatest benefit to the

population would be recommended.

A pragmatic review of the selected measures

would then be undertaken to understand the

ability to actually comply with these

recommendations going forward.

Public Health Measure Selection

Vaccine Priority Groups

Another area of work is centered around the consideration of vaccine priority groups.

Ethical Considerations are a cornerstone around any discussion about Vaccine Priority Groups

From the Public Health Perspective the following Assumptions have been made: There will be sufficient vaccine to offer to every citizen

of BC for their first dose in the first shipment of vaccine from GSK

The use of priority groups will be used to help prioritize clinic activities as opposed to ration vaccine products

Vaccine Priority Groups Continued

A priority group that will be predetermined is

Health Care Workers

Other priority groups will be defined at the

time of the Pandemic using epidemiologic

intelligence and specific risk factor information

An important caveat to this information is that the

formula for the decision making process will be

determined at this time to enable timely decision

making in the event of a Pandemic.

Update on other PH Plans

Public Health Surveillance

Vaccine Storage, Transfer and Distribution

Childhood Immunization scale-up and scale

down

Public Health Communications

There are several planning streams underway at

the same time in clinical care and health human

resources planning.

Psychosocial Planning

A planning guide has been created to aid in the following goals Protect and promote the psychosocial wellbeing and

resilience of Health Care Workers

Mitigate prevent or treat the mental health issues that may arise in HCW’s in the context of a pandemic

Support HCW’s willingness and ability to continue in their workplace

Improve HWC’s support and adherence to risk management measures

Augment the health care system’s capacity to repsond effectively over time to the pandemic crisis

Questions???

Pandemic Planning and Physicians:

A Missing Link ?

Dr. Graham Dodd, MSc., MD., CCFP(EM)

Emergency Physician, Consultant

Royal Inland Hospital, Kamloops, BC

Interior Health Authority

Friday, April 24, 2009

• CBC National News

– Outbreak of “swine flu”

– Pandemic ??

– PHO’s – “we are well prepared and monitoring”

– Hospitals and physicians are initiating their

pandemic plans...

– Sx: fever, sore throat, cough – see your family MD

Who’s “we” ?

Questions

1. Are we ( front-line physicians) aware of risk for pandemic ?

2. Are we knowledgeable about pandemic and the treatments for pandemic ?

3. Are we aware of current pandemic plans ?

4. Are we prepared to manage a pandemic ?

5. Are we sufficiently engaged in pandemic planning ?

The Real Question...

• Have front-line (clinical) Canadian physicians been sufficiently engaged in pandemic planning and are we currently prepared to manage a pandemic today ?– Downtown Vancouver

– Campbell River

– Revelstoke

• Who’s aware ?

• Who’s engaged ?

• Practiced ?

• Functional ?

The Real Question...

Are We Aware of Current Pandemic

Plans ?

Dodd, 2009, draft

– Quantitative survey sent to 200 MD’s

– BC Interior – TCS HSA

– Dec 08 – Jan 09

– >65% response rate

Pilot Study

Do we think pandemic will occur ?

Dodd, 2009, draft

Do we consider ourselves knowledgeable ?

Dodd, 2009, draft

Could we respond ?

Dodd, 2009, draft

Do you feel your Health Authority

is prepared for pandemic ?

Dodd, 2009, draft

• Family MD’s Ottawa (n= 274 – 41% r.r.)

– 18% felt prepared for pandemic

– 75% willing to help (Hogg, et al., 2006: Can Fam Phys, 52:1255-1260)

• Family MD’s U.S. (n = 614 – 63% r.r.)

– <25% felt prepared

– <17% hospitals prepared (Chen, et. Al. 2002: J Fam Pract 51: 745-750)

Physician Sentiment

Treatment

• Vaccines - not acute issue

• Antivirals– Prophylaxis – broad / narrow

• High risk groups – HC workers ?

– Post Exposure - access

– Diagnosis – who needs

– Distribution – how / model (MD Rx. Vs other)

– Practice Consistency

– April 2009

• ? Use

• ? Overuse / stock-depletion

• Antibiotics ?

Next Steps

Dodd, 2009, draft

Conclusion: Opportunities to Engage MD’s

• Front-line MD’s :

• Aware of the plan

• Educated of the plan

• Partners in the plan

• Implement the plan

• Pandemic:

• More than just plans

• More than just drugs

• Opportunity:

– Linkages

– DEM

– ChampionsLink Strategic Plans

to Operational Plans

Thank You

MDG

Crisis Management Consulting Inc.

The Corporate Perspective

EPICC Forum - April 29, 2009

MDG


Ensure the health and well being of employees,

customers and business partners

Minimize business interruption

Minimize and/or anticipate financial impact

Customers are requesting to SEE plans

Customers are expecting services to be

available to support their requirements during

the pandemic

Due diligence

Basic Pandemic Planning Principles

MDG


Identify assess and mitigate the impact to the

organization

Reduce the spread of the infection within the

organization

Continuity of essential functions with large number of

employees absent from the workplace

Ensure timely accurate information is provided to

employees, customers, public and other stakeholders

Pandemic Planning Goals

MDG


Identify the threats

Develop prevention and mitigation strategies

Develop basic planning assumptions

Identify the essential functions and personnel

Develop human resource strategies

Develop communication strategies

Develop operational emergency plans

Develop plans for managing a pandemic situation in the

workplace

Consider ethical and legal implications in all aspects of planning

Exercise the plan

Planning Fundamentals

MDG


Planning Challenges

Inevitable but unpredictable in timing, nature or

severity

Accurate and timely Information

Efficacy of pharmacologic intervention

Effectiveness of personal protective equipment

Preparedness level of supply chain

Ethical and legal issues

Employee Concerns

MDG


Reduce the spread of disease amongst the

workforce

Maintain business continuity during several

periods of high absenteeism

Minimize staff absenteeism other than for

personal illness

Share workload/resources to cover periods of peak

influenza activity

Mitigate dependencies on critical suppliers

General Planning Strategy

MDG


Critical business functions identified and

prioritized

Alternate work strategies

Virtual command and control activation

Coordination of information at regional,

provincial, national & international levels

Resource management

Functional plan management

Situation Management

MDG


Corporate Strategies

Communication

Pre-pandemic and during pandemic

Establish availability of event, threat and

situation analysis reports and directives

from external stakeholders

Communicate pandemic preparedness to

employees, customers and stakeholders

Educate employees on the plan and prevention

strategies

MDG



Infection Control

Personal hygiene practices

Housekeeping

Air Handling

Personal protective equipment

Social distancing

Managing staff that become ill at work

Restricting work place entry

MDG



Pharmacological Intervention - Antiviral Strategy

Determine medication recommended for treatment

Establish appropriate treatment option

Establish employee eligibility & participation

options

Efficacy of medication

Cost & purchase options

Stockpiling, purchasing, dispensing

Ethical & legal concerns

MDG



Policies

Existing polices utilized where possible

Circumstances reviewed during the event as

required

Compensation Benefits Long Term Disability

Sick Leave Bereavement Travel

Absenteeism Vacation Tele-working

Relocation Privacy Health & Safety

Cleaning/Maintenance Succession Planning Hiring/Rehiring

Quarantine Temporary Shut Down

MDG


Employee Assistance Program

External Partnerships

Vendor Management

Customer Management

Immunization Process


MDG


Businesses have a responsibility to plan for known

threats and to take reasonable mitigation measures

The plan must contain multiple strategies to:

ensure the health and well being of employees, customers

and business partners

understand and mitigate the impact of the financial and

service implications

A sound pandemic plan is an important extension of

the existing business continuity plan

The plan must be robust but also flexible enough to

allow for changes

Summary

MDG


MDG Crisis Management Consulting Inc

Mary Genyk

204-391-0512

[email protected]

pandemic preparedness the provincial view

Documents

public health communications

public health perspective

health authorityis

pandemic crisis

bc operational pandemic

health human resources

bcinterior health authority

mental health issues