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New Developments in Alberta Pandemic Influenza Planning

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March 2000 Plan begins. September 2002 Alberta Pandemic. Influenza ... Three levels of care: acute, triage and community. Treatment and immunization supplies ... – PowerPoint PPT presentation

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Title: New Developments in Alberta Pandemic Influenza Planning


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 2002 Alberta Pandemic
  • Influenza Contingency Plan
  • September 2002 Stakeholder Meeting
  • September 2003 Three Subcommittees Reports
    (Infection control., antivirals, clinical
    guidelines)

3
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 natl 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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