Preparedness against sars in norway
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Preparedness against SARS in Norway. Preben Aavitsland Department of Infectious Disease Epidemiology Division of Infectious Disease Control Norwegian Institute of Public Health (May 22, 2003). Current strategy against SARS. Detect cases Isolate cases Trace contacts Follow up contacts

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Preparedness against SARS in Norway

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Preparedness against sars in norway

Preparedness against SARSin Norway

Preben Aavitsland

Department of Infectious Disease EpidemiologyDivision of Infectious Disease Control

Norwegian Institute of Public Health

(May 22, 2003)


Current strategy against sars

Current strategy against SARS

  • Detect cases

  • Isolate cases

  • Trace contacts

  • Follow up contacts

    • Based on available knowledge

    • May be adjusted

    • Lowest effective level


The roles of niph communicable diseases control act 7 9

The roles of NIPH(Communicable Diseases Control Act § 7-9)

  • Surveillance

    • In Norway

    • Internationally

  • Guidance and services

    • General guidance on infectious disease control

    • Reference laboratories

    • Vaccination programme

  • Research


Surveillance for sars

Surveillance for SARS

  • Starting March 16

    • mandatory reportable to NIPH

    • phone 22 04 23 48 plus fax/letter

  • According to WHO definitions

  • Reporting to EU, WHO


Guidance and services for sars

Guidance and services for SARS

  • Guidance to public, health services and authorities

    • www.fhi.no

    • ”MSIS-rapport”

    • Epidemiologist on call 22 04 23 48

    • Telephone, e-mail

    • Public hotline 22 04 22 00

    • Conferences

    • Mass media

  • Reference lab

    • appointed by MoH


Research

Research

  • Virology

  • Specific immunoglobulin (with Affitech)

  • Vaccine (with Bionor)

  • Scenarios


Are we prepared

Are we prepared?


Positive features of norwegian society

Well organised

Knowledgeable population

Wealthy people and government

Sparsely populated

Good health system

Advanced science

Democracy

Free press

Trust in Government

Strong state

Modern communicable disease law

Not dependent on tourism

Positive features of Norwegian society


Negative features of norwegian society

Complacency?

Never had a problem like this

Never tested our preparedness

Not mentally prepared for extreme measures

Egoistic?

Xenophobic?

Infectious disease epidemiology not very well developed

Used to 100% security; accept no less

Negative features of Norwegian society


Scenario

Scenario

  • Municipality of 5000

  • Man 45, fever, malaise and diarrhoea after trip business trip to Singapore

  • Patient’s delay two days

  • Been to cafeteria, cinema, work place, friends’ homes etc. while mildly sick


Scenario continued

Scenario continued

  • Admitted to hospital for diarrhoea

  • 300 beds, 1000 employees

  • Misdiagnosed as enteritis for two days in hospital

  • Waited in emergency room

  • Been in single room and X-ray department

  • Episodes of diarrhoea in bed


Do we have the municipal capacities

Do we have the municipal capacities?

  • Personell

    • for contact tracing and follow up

    • for dealing with mass media

    • for dealing with the worried well

  • Gloves, masks, gowns

  • Thermometers

  • Ambulance for bringing the next patients to hospital


Do we have the hospital capacities

Do we have the hospital capacities?

  • Personnel

    • for caring for many patients

    • for replacing sick staff and contact staff

    • for contact tracing and follow up

    • for dealing with mass media

    • for dealing with the worried well

    • for supporting health care personnel

  • Gloves, masks, gowns

  • Isolation rooms

  • ICU beds, respirators


Do we have the national capacities

Do we have the national capacities?

  • Personnel

    • for supporting the health services

    • for informing the public

    • for dealing with mass media

    • for dealing with the worried well

    • for conducting surveillance


Conclusion

Conclusion

  • Strategy is clear

    • Detect and isolate cases

    • Trace and follow up contacts

  • Information level is high

  • Norway is seemingly well prepared

  • SARS is an extreme threat

  • Extreme capacities may be needed

  • Are we prepared for ”the big one”?


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