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New Developments in Alberta Pandemic Influenza Planning

New Developments in Alberta Pandemic Influenza Planning. Tarrant Annual Meeting. Agnes Honish Alberta Health and Wellness February 24 2005. Milestones for Pandemic. March 2000 Plan begins September 2002 Alberta Pandemic Influenza Contingency Plan September 2002 Stakeholder Meeting

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New Developments in Alberta Pandemic Influenza Planning

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  1. New Developments in Alberta Pandemic Influenza Planning Tarrant Annual Meeting Agnes Honish Alberta Health and Wellness February 24 2005

  2. Milestones for Pandemic • March 2000 Plan begins • September 2002Alberta Pandemic Influenza Contingency Plan • September 2002 Stakeholder Meeting • September 2003 Three Subcommittees Reports (Infection control., antivirals, clinical guidelines)

  3. C D E R P Over-Arching Plan SARS Chapters Pandemic flu Smallpox ?

  4. Milestones for Pandemic (cont.) • April 2004 AHW internal exercise of plan Current Year: • Stockpile of supplies • Self care • Web site • RHA Visits • Exercise • Antivirals • Workforce

  5. Current Areas Of Work • Command and Control (Emergency Response) • Self-Care Strategy • Coordination with regional plans • Funding for antiviral drugs

  6. Self-Care Strategy • Foundation for health services response • Rely on Albertans to care for themselves and their families as long as possible • Self-care forms the base of the ‘medical care pyramid’ during pandemic • Challenge to implement – need for a Self-Care Strategy

  7. Communication and Coordination with RHA Plans • 17 regions submitted plans in 2002 • Based on checklists supplied provincially • Coordinate AHW plan with regional plans – synchronization points • Now 9 regions (April 2003) • ICS system provincially

  8. AHW-RHAs How do we work Together

  9. Role of Antiviral Drugs • Prior to the availability of vaccine, antiviral drugs will be the only intervention available • Used both to treat influenza and prevent illness • Can be stockpiled in preparation for pandemic • Global shortage • Requires 18-24 months manufacturing lead time • No Canadian manufacturer

  10. Background – H5N1 • Deadly strain that is sweeping through Asia, recent activity in Vietnam with poultry outbreaks and human cases • Widespread distribution, not controllable • A small number of human cases, majority of cases have been fatal • 1 cluster with suspected human-to-human spread • Heightened level of concern • Potential to ignite the next pandemic

  11. Antivirals and H5N1 • H5N1 resistant to Amantadine • Oseltamivir – protective efficacy in the 70-90% range • Reduced duration of illness 1-2 days • Lack of published data on complications and death but CDC expert group estimates that NI will reduce mortality, LRI and hospitalization by 1/3

  12. PIC Priority Groups (1) • Based on nat’l goals of pandemic preparedness • Reduced overall morbidity and mortality • Minimize societal disruption • Three main purposes of antivirals • Rx of cases that present within 48 hr • Prophylaxis for the duration of the wave • Outbreak control (Rx and Px)

  13. PIC Priority Groups (2) • Rx of persons hospitalized with flu • Rx of ill HCWs and ESWs • Px of front-line HCWs • Rx of high risk in the community • Px of remaining essential HCWs • Control of outbreaks in institutions (Rx and Px) • Px of essential ESWs • Px of high risk persons in hospital (non-flu) • Px of high risks persons in the community

  14. Purchase Antiviral Drugs • Purchase a national stockpile of 16 million doses of oseltamivir (Tamiflu™) • Enough for 2 million Canadians • Alberta has moved forward to purchase an initial provincial stockpile of 1.6 M doses

  15. Ability to Mount/Sustain Response Human Resources – Health Workforce Mobilization • Health professionals providing services outside of existing scope of practice • Mobilizing the non-active workforce e.g. retired nurses/physicians • Issues: liability redeployment licensure compensation training/skill conscription AHW lead: Health Workforce Division Working through the Federation of Regulated Health Professions (-30 members)

  16. Influenza-Specific Medical Supplies Policy • 2001 Health Services Subcommittee – medical supply list* (prevent, control and care for population) • General Assumptions • Population-based volume projections with 25% attack rate • Three levels of care: acute, triage and community • Treatment and immunization supplies *excludes equipment (e.g. ventilators), support services, antivirals

  17. New National Initiatives • Change of Pandemic Planning Phases from 6 to 3 • Equitable method to calculate antiviral drugs for priority groups

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