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

1. Pandemic InfluenzaCatherine Donovan, MD. MHSc.CIPHI, Newfoundland and Labrador, Oct 25, 2005 Eastern Region 2002-2005

2. 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

3. 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)

4. 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??

5. Regional Committee • Communicable Disease Control • Infection Control • Nursing • Environmental Health • Medical Officer of Health

6. 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

7. INTERNATIONAL PLANS (2000) World Health Organization (WHO) 5 Part Plan: • Emergency Planning • Surveillance • Vaccines & Antivirals • Communications • Health Services

8. CANADIAN PLAN (2000) • Aligned with WHO Plan: 5 Parts • In 6 Phases • 0. Interpandemic Preparedness • 1. Onset of Pandemic • 2. Regional & Multi-regional Epidemics • 3. End of First Wave • 4. Second & Later Waves • 5. End of Pandemic

9. PROVINCIAL (2000) • Aligned with WHO & Canadian Plan • Uses 5 Part WHO Components With • Canadian 6 Phases. IE • 0. Interpandemic Period 1.Emergency Planning 2.Surveillance 3.Vaccines & Antivirals 4.Communications 5.Health services

10. 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

11. 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

12. 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

13. 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

14. 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)

15. H&CS, EasternPandemic Influenza Action Plan

16. Annual Review • Focus on Interpandemic Period • Review Status of activity under each part: emergency planning, surveillance, etc. • Identify outstanding issues • Report to province

17. 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

18. 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

19. 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

20. 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

21. 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”

22. “The real epidemic is fear” MACLEAN’S, October 3,2005

23. THE END