Pandemic Preparedness The Provincial View


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Pandemic Preparedness The Provincial View

  1. 1. Pandemic Preparedness The Public Health View Dr. Bonnie Henry British Columbian Center for Disease Control
  2. 2. 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
  3. 3. 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 Communications There are several planning streams underway at the same time in clinical care and health human resources planning.
  4. 4. 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.
  5. 5. 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.
  6. 6. Public Health Measure Selection
  7. 7. 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
  8. 8. 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.
  9. 9. 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.
  10. 10. 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
  11. 11. Questions???
  12. 12. 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
  13. 13. 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
  14. 14. Who’s “we” ?
  15. 15. 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 ?
  16. 16. 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
  17. 17. The Real Question... • Who’s aware ? • Who’s engaged ? • Practiced ? • Functional ?
  18. 18. Are We Aware of Current Pandemic Plans ? Dodd, 2009, draft
  19. 19. Pilot Study – Quantitative survey sent to 200 MD’s – BC Interior – TCS HSA – Dec 08 – Jan 09 – >65% response rate
  20. 20. Do we think pandemic will occur ? Dodd, 2009, draft
  21. 21. Do we consider ourselves knowledgeable ? Dodd, 2009, draft
  22. 22. Could we respond ? Dodd, 2009, draft
  23. 23. Do you feel your Health Authority is prepared for pandemic ? Dodd, 2009, draft
  24. 24. Physician Sentiment • 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)
  25. 25. 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 ?
  26. 26. Next Steps Dodd, 2009, draft
  27. 27. Conclusion: Opportunities to Engage MD’s • Front-line MD’s : • Pandemic: • Aware of the plan • More than just plans • Educated of the plan • More than just drugs • Partners in the plan • Implement the plan • Opportunity: – Linkages – DEM – Champions Link Strategic Plans to Operational Plans
  28. 28. Thank You
  29. 29. The Corporate Perspective EPICC Forum - April 29, 2009 MDG Crisis Management Consulting Inc.
  30. 30. Basic Pandemic Planning Principles  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 MDG Crisis Management Consulting Inc.
  31. 31. Pandemic Planning Goals  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 MDG Crisis Management Consulting Inc.
  32. 32. Planning Fundamentals  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 MDG Crisis Management Consulting Inc.
  33. 33. 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 Crisis Management Consulting Inc.
  34. 34. General Planning Strategy  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 MDG Crisis Management Consulting Inc.
  35. 35. Situation Management  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 MDG Crisis Management Consulting Inc.
  36. 36. 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 Crisis Management Consulting Inc.
  37. 37. Corporate Strategies 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 Crisis Management Consulting Inc.
  38. 38. Corporate Strategies 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 Crisis Management Consulting Inc.
  39. 39. Corporate Strategies 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 Crisis Management Consulting Inc.
  40. 40. Corporate Strategies  Employee Assistance Program  External Partnerships  Vendor Management  Customer Management  Immunization Process MDG Crisis Management Consulting Inc.
  41. 41. Summary  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 MDG Crisis Management Consulting Inc.
  42. 42. MDG Crisis Management Consulting Inc Mary Genyk 204-391-0512 MDG Crisis Management Consulting Inc.