Transcript Preparedness against SARS in Norway

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
– Based on available knowledge
– May be adjusted
– Lowest effective level
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
• 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 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
•
•
•
•
Virology
Specific immunoglobulin (with Affitech)
Vaccine (with Bionor)
Scenarios
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
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
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
• 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?
• 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?
• 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?
• 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
• 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”?