Transcript Getting Started

Pandemic Emergency Toolkit
Are you ready?
Getting Started
 All residents have a role in preparing for a
public health emergency – like pandemic
influenza
 The community Tool Kit provides information
on how to prepare for public health
emergencies.
Getting started
 Goals of community Tool Kit:
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Increase knowledge about pandemic influenza
Provide information on how to prepare for a
pandemic
Start discussions how communities can work
to prepare for a pandemic
Agenda
 Influenza overview
 Historical recount of pandemic influenza
 Future view of a pandemic
 Individual, Family, and Community
emergency preparedness.
What is Influenza?
 Influenza is a respiratory infection caused by
the influenza virus
 In Canada, the flu season runs from
November to April and up to 25% of
Canadians may be infected with influenza
 Influenza can kill, particularly people who are
older and people with other serious medical
conditions
The Influenza (Flu) viruses
 3 types : A, B, C (mild)
 A or B cause epidemics almost every
winter
 10-20% of people affected, 3 500 deaths
 Influenza A divided in subtypes : 15
different H subtypes, 9 N subtypes
 Vaccines : current A sub-types + B strains
 Animal reservoirs : birds, pigs susceptible
to swine, bird and human influenza viruses
What does Pandemic Mean?
 Pandemic: occurring over a wide geographic
area and affecting an exceptionally high
proportion of the population
 By affecting many people, pandemic
influenza could well overwhelm health
services
 In addition, other aspects of society could be
affected, simply because of a lack of staff due
to illness
How the Flu Virus can change
 Two different ways :
Antigenic « drift » (A and B) : small
changes in the virus that happen
continually over time. This is why we can
catch the flu more than one time in a
lifetime, why vaccine composition is
constantly modified
 Antigenic « shift » (A only) : abrupt, major
change in the Influenza A viruses. Most
people have little or no protection against
the new virus.
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What happens in a pandemic?
 If this new virus (with an H and/or an N
component from the avian virus) is able to
infect humans AND spread from person to
person, an influenza pandemic can occur.
 It is possible for the genes of two influenza
viruses to mix and create a new virus.
 PANDEMIC = everywhere on earth, limited in
time.
How does virus get transmitted?
 Contact with feces, blood, sputum and tears
from infected animals and birds.
History of Pandemic Influenza
 Previous pandemics in the 20th century
occurred in 1918-19 (“Spanish”), 1957-58
and 1968-69 (“Hong-Kong”)
 In 1918-1919, an estimated 30-50,000
Canadians died, part of 20-40 million
deaths around the world
 While most deaths from influenza occur
among the elderly, the highest number of
deaths in the 1918-19 epidemic occurred
among people aged 20-40
 The 1968-1969 pandemic caused less
deaths than observed in a “regular” flu
season.
The estimated impact of a pandemic
in Canada
 “Normal” flu season affects 10-20% of people
 pandemic influenza could affect 30-50% and
be more severe
 Between 4.5-10.6 million Canadians infected
 Between 11,000-58,000 deaths (vs 160,000
in 1918)
 Economic impact $10-24 Billion
 Heath care system overwhelmed…
Pandemic Planning Components
7 Components of the Pandemic Influenza
Plan
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Surveillance
Public health measures
Use of antivirals
Vaccination
Emergency services
Health services
Communications
Planning for Influenza
 Planning for pandemic influenza involves
federal, provincial, territorial and community
officials
 Planning is dynamic – the plan is not
completed and put on a shelf but must be
regularly tested (annually before September)
and updated in light of new information or
interventions to prevent and treat influenza
Pandemic Influenza – How will we
know it is coming?
 Novel (new) virus likely cause of pandemic
 Novel/new virus likely to arise in Asia due to
crowded living conditions and people living
close to livestock animals (e.g. pigs &
chickens)
 Surveillance systems detect novel/new
viruses
 Health Canada supports these activities and
receives information from World Health
Organization (WHO) and others
Pandemic Influenza – How will we
know it is coming?
 Estimated lead-time for pandemic strain to
reach Canada : 3 months (surveillance)
 WHO declares pandemic phases 4, 5, 6…
Novel/new virus likely to arise in Asia due to
crowded living conditions and people living
close to livestock animals (e.g. pigs &
chickens)
WHO Pandemic Phases - 2006
The initial reaction :
quarantine and isolation
 A naturel reaction, but ineffective
High contagiousness
 No acquired immunity
 High number of infected individuals
 Potential for discrimination and harm
 Lose sight of effective components of
pandemic planning to reduce spread
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Public Health Measures
 Increasing awareness in individuals and communities:
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personal hygiene, personal protection, avoiding
unnecessary personal contacts (educational material)
Infection control measures in health care settings
(educational material, supplies)
Infection control measures include immunization,
hand hygiene, barrier control (masks, gloves, gowns),
patient isolation/accommodation, restriction of visitors,
staff, cohorting, environmental cleaning, and
education for staff, patients and visitors.
Public Health advisories to reduce congregation :
schools, public gatherings… (MOH, Head Nurse, C &
C)
Self Care
Pandemic Flu Vaccine
 Challenge : mass immunization when vaccine
becomes available
 Likely to proceed by priority groups
 Canada self-sufficient and capacity well
maintained
 Vaccines can be mass-produced, distributed,
and administered
Use of Antivirals
 Treatment : documented effectiveness in
reducing complications, hospitalizations, and
mortality.
 Prophylaxis : may have protectective effect
against clinical disease or severe disease,
dose not prevent infection and antibody
development.
Business Continuity
 Pandemic influenza could create a
general state of emergency
 At least 33% absenteeism in workplaces
 Business continuity : identifying essential
services and contingency measures
 Governance continuity : who makes the
decisions (at all times) ?
 Issues with infrastructures, transportation,
food supply, communications, etc.
Health Services
 Medical supplies may be inadequate
 Hospitals and medical clinics may be
overwhelmed.
 Significant numbers of illness and death may
occur.
 Significant number of people may not have
anyone to take care of.
Health Services (2)
 Self Care Education
 Infection control measures
 Think about a place for Flu/Alternate Care
Centre
Communications
 Two key roles in communities (Health Care
Workers (HCW) and Chief and Council (C&C)
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HCW and C&C will receive information and
make decisions and will transmit information
to the public and local decision-makers
(school principal, other health professionals,
Northern store, etc.).
HCW and C&C will report back information to
the zone / regional / provincial / national level
Participate
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Surveillance activity
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Early detection / diagnosis period : ILI
surveillance in communities ;
identification of pandemic strain
Does your community participate in ILI
surveillance?
Participate
(School Curriculum)
 Public Education – Crucial to integrate ‘Infection
Control’ in school curriculum
 Goal – To form habits to control spread of infection.
 Teaching and Learning Strategies – must be theory
and practice base
 Hand hygiene
 Coughing precautions
 Germ education
 Self Care
 Environmental Cleanliness – control of spitting,
garbage, body hygiene, homes, school,
community
Prepare
 Believe that the preparation for an emergency is
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necessary
Disasters do happen where you live and work
Disasters do impact you, your family and your
community
You can significantly lessen the impact by being
prepared
Plan for all hazards
Consider infrastructure disruption (i.e., power outage,
water/sewer treatment, communication, etc.)
Prepare
 Community plans
 Community planning – addresses the 7
components of the Pandemic Influenza
Plan in each community.
The objectives Pandemic plan
1) to reduce the morbidity and mortality by
influenza
2) to minimize social disruption
Your Community Plan
Do you know what is in your
community plan?
Prepare
Personal responsibility:
 Create a family communication plan:
 Work/school/cell numbers, addresses and email
 Meeting place for your family if separated –
local/distant
 Personal information on all family members
 Gather emergency supplies
 Talk about emergency planning in your
community.
Prepare
Emergency Supplies
Water & food
Cash funds
Battery /crank radio
Maps
Spare batteries
Communication plan
Flash lights
Medical histories
ID and credentials
Infant needs
Medications
Pet needs
First aid kit
Copy of legal/financial papers
Etc………
Practice
 Self care measures (self isolation, taking
measures to self treat until medical
intervention is necessary)
 Infection control measures
 First aid
Are you ready?
 In an emergency the best way to
ensure the safety your family and
your community is to prepare
Websites
 The Ontario Pandemic Plan (hard to find on the
MOHLTC site)
 http://www.health.gov.on.ca/english/providers/pro
gram/emu/pan_flu/pan_flu_plan.html
 World Health Organization for an international
perspective
 www.who.int
 Centers for Disease Control (US, this is science)
 http://www.cdc.gov/flu/pandemic/
 FluWatch : influenza surveillance in Canada
 http://www.hc-sc.gc.ca/pphb-dgspsp/fluwatch
Thanks !