Planning for the H1N1 flu pandemic
Karen Floyd, Emergency Preparedness Coordinator, left, and Tracy Fattore, Regional Director of Risk Management, are working closely with NHS’s external partners to prepare the hospital’s pandemic plan.
Key facts about the H1N1 Flu Virus:
- Most cases are mild and many patients recover quickly. Although survival rates are high, some patients require aggressive treatment, including ventilators to breath.
- As of Sept. 3, there were 4,062 lab confirmed cases of H1N1 flu in Ontario, and 23 deaths.
- There have been 21 lab confirmed cases of H1N1 in Niagara, and one death associated with H1N1.
- In Ontario, 366 people have been hospitalized as of Sept. 3.
- Unlike the illness itself, deaths have mostly been reported among people with underlying health conditions. Death has been a tragic but rare outcome.
- Pregnant women and people with underlying medical conditions are at a higher risk of developing complications due to the H1N1 flu, however the likelihood of contracting the virus is no different from that of the general public.
- Spread of H1N1 flu is thought to occur like with seasonal flu, mainly from person to person through coughing or sneezing. People can also become infected by touching contaminated objects or surfaces with flu viruses on it and then touching their mouth or nose.
- Environmental factors that contribute to the spread of H1N1 include overcrowding, poor hand hygiene, and either no access or limited access to primary care.
Source: Ministry of Health and Long-Term Care, Niagara Health System
H1N1 flu virus is a respiratory illness. Symptoms include:
- Fever
- Fatigue
- Lack of appetite
- Cough
- Sore throat
- Diarrhea and vomiting (in some cases)
Take the following precautions to prevent and reduce the spread of H1N1
- Clean hands regularly
- Cough into your elbow, arm/sleeve or tissue
- Clean and disinfect surfaces, toys and objects
- Practice personal space of two metres if someone in your household is ill
- Avoid touching your eyes, nose or mouth to spread germs
- Stay home if you’re ill
Source: Niagara Region Public Health
Where to find more information:
A hospital needs to be ready for anything. Anytime. Anywhere.
Chemical spill, multi-vehicle accident, a fire in one of our buildings. Preparing for an emergency is critical to the safety and wellbeing of Niagara Health’s patients and staff.
So, too, is planning for a pandemic influenza outbreak to ensure the hospital is able to respond to a surge in demand for care while at the same time protect its workers from illness.
As we head into the fall, Niagara Health System is preparing for a pandemic as the second wave of the H1N1 flu virus is expected to hit in addition to the annual impacts of seasonal influenza.
“The whole premise for a pandemic is that you are dealing with thousands of patients,” says Tracy Fattore, Regional Director of Risk Management. “We have to be prepared for the surge of patients who will require care and ensure our staff members who care for these patients are protected from a health and safety point of view.”
Like other emergency preparedness planning, Niagara Health works closely with its healthcare partners to ensure its response to an influenza pandemic is properly coordinated across all government levels (local, provincial, federal) and with other emergency services (police, fire, ambulance).
Tracy also sits on the Ontario Hospital Association’s Health Emergency Preparedness Advisory Committee, which provides leadership to hospitals regarding emergency preparedness management and better system coordination in the healthcare system between government, hospitals and other providers.
“In the case of pandemic planning, the NHS works closely with our external partners at Niagara Region Public Health to ensure our plan dovetails with theirs, since Public Health will be taking the lead locally,” says Karen Floyd, Emergency Preparedness Coordinator with Niagara Health.
As the regional lead agency, Niagara Region Public Health will coordinate response activities in Niagara. The overall provincial response will be managed from the Provincial Emergency Operations Centre, along with the Ministry of Health and Long-Term Care’s Emergency Management Unit.
The NHS’s pandemic plan sets out roles and responsibilities of the hospital and its staff based on legislation applicable to emergency or disaster situations.
NHS is developing the hospital’s H1N1 plan based on the existing pandemic plan and regular updates provided by Niagara Region Public Health, Ontario Public Health Agency, the Ontario Health Plan for an Influenza Pandemic, the Canadian Pandemic Influenza Plan and the World Health Organization. This plan will continue to be a work in progress as new information comes to light about the new strain of H1N1.
New procedures for screening and personal protection, consistent with Ministry guidelines, were adopted by NHS earlier this year when the H1N1 flu virus was first introduced in April. These procedures continue to be assessed as part of the plan, along with other strategies for patient screening, triage and assessment in the Emergency Department. Also being studied is the impact the increased demand for care will have on the Intensive Care Unit, Diagnostic Imaging and Laboratory Services, patient care areas expected to feel the greatest impact of the surge in patient activity.
“In addition to ensuring the hospital is prepared to manage the surge in demand for care, NHS also has to take all possible steps to ensure our staff members are protected from illness,” says Frank Demizio, Vice President Patient Services responsible for Infection Control.
Regional Director of Risk Management
A vaccine is expected to be approved and available in late fall 2009, and all hospital employees who are in contact with patients will be considered a priority for immunization. Public Health and physicians’ offices will also be holding clinics to vaccinate members of the public.
The next wave of the pandemic is expected to last eight weeks, with the outbreak at its peak during the fourth, fifth and sixth weeks.
Niagara Region Public Health will be investing in a surveillance system that will link into the NHS’s Emergency Department registration system. Trigger points will alert health providers early on to signs related to the H1N1 virus that need to be investigated, such as a small but steady increase in patients with influenza-like illness.
Response to hospital care will be consistent with the increase in demand.
An increase in patient volumes of five to 10% will be considered a minor surge in demand for care, at which time the NHS’s Command Centre and pandemic plan would be put into operation. A moderate surge is considered when volumes increase by 11 to 15%; a major surge is a 16-20% increase, and a large-scale emergency would be declared if the increase in patient volumes reaches beyond 20%.
The primary challenge in a pandemic will be capacity across NHS sites to care for the increased volume of patients. At the height of a pandemic, non-life threatening hospital services could be curtailed, consolidated or suspended to divert resources – people, equipment, supplies and facilities – to essential services. Services deferred may include elective surgeries and outpatient clinics, and decisions would be overseen by a Decision Review Team made up of key medical leaders. These decisions would be based on a careful and compassionate assessment of patients’ conditions and any directives issues by the Provincial Emergency Operations Centre.
President & CEO
“A revised visiting policy would likely be implemented that is compassionate and flexible to meet the need for changing priorities while maintaining the overall safety of the patients, staff, physicians, visitors, volunteers and the general public,” says President and CEO Debbie Sevenpifer.
“We appreciate that families and visitors will be concerned about their loved ones and will want to visit, and the visiting policy will reflect that while protecting the health and safety of everyone,” she says. “As this policy is developed, it will be shared with the public as part of our extensive communications efforts that will be underway.”
At this stage in the planning, there are various opportunities available to the NHS’s 6,000 physicians, staff and volunteers through the source•net Intranet to review the plan and provide feedback. Education and training continues and will be offered using a variety of methods, including source•net, lunch-and-learn sessions and other strategies. The hand hygiene sessions being offered by the NHS and via public messaging provide a great means for staff and the public to understand their role in preventing the transmission of viruses, including H1N1. Good hand hygiene is the cornerstone to preventing the spread of influenza.
“We continue to work closely with Niagara Region Public Health, the Regional Infection Control Network, Ontario Hospital Association and our Infection Prevention and Control staff to monitor the situation closely,” says Frank. “We are committed to keeping our staff, volunteers and physicians informed with updates as we are made aware of new information.”
The public is encouraged to practice proper hand hygiene and educate themselves about the H1N1 flu virus. Niagara Region Public Health keeps its site up to date with the latest information and provides links to other key sources of information.
“I think the best advice we could give people is not to panic but to keep themselves informed,” says Tracy. «
