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Role of Health Unit Rolling out Vaccines and Anti-Virals


... out Vaccines and Anti-Virals. Kathy Jovanovic (Peel Health) ... supporting role in the pandemic planning process for the City of Toronto & Region of Peel: ... – PowerPoint PPT presentation

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Title: Role of Health Unit Rolling out Vaccines and Anti-Virals

Role of Health UnitRolling out Vaccines and
  • Kathy Jovanovic (Peel Health)
  • Claudine DSouza (Toronto Public Health)
  • OAML Pandemic Planning Education Day
  • Toronto
  • June 16, 2005

Pandemic Influenza Planning
  • Public Health has a leading/
  • supporting role in the pandemic planning process
    for the City of Toronto Region of Peel
  • Key stakeholder model
  • Linkages with hospitals and the health care
  • Linkages with business, volunteer sectors, etc.
  • Adhering to Federal and Provincial plans

Routine Public Health Measures
  • Disease surveillance and reporting
  • Case investigation and management
  • Identification and follow-up of close contacts
  • Health risk assessment and communications
  • Liaison with hospitals and other agencies
  • Community-based disease control strategies
  • Vaccine (e.g. UIIP, Hep. B, Men.C.) distribution
    and administration

Routine Disease Surveillance and Reporting
  • Communicable disease reporting
  • Dissemination of institutional outbreak list
  • Daily monitoring of CD activity
  • Weekly flu bulletin
  • Monitor Federal and global CD activity

Ongoing Influenza Surveillance
  • Sentinel physician system
  • Monitoring outbreaks in hospitals and
  • long-term care facilities
  • Network with local labs
  • Enhanced surveillance program and
  • syndromic surveillance (FRI)
  • iPHIS roll-out (2005)

PH Surveillance/Management During a Pandemic
  • Data collection and reporting for Mass
    Prophylaxis of priority groups for
    vaccine/antiviral agents
  • Efficacy of vaccine/antiviral for priority groups
  • Track unusual or adverse events related to
    prophylaxis treatment
  • Liaise and report to MOHLTC
  • Initially Aggressive individual investigation
  • Move to broader community messaging re self-care

Case Investigation and Management
  • FRI/SRI investigations will continue into the WHO
    Pandemic Alert Phases
  • Management will change throughout the pandemic
  • Isolation of all cases at home or in hospital
  • Antiviral treatment to be considered

Close Contacts Identification and Follow-up
  • Contact tracing and quarantine/active
    surveillance will be used early in the pandemic
    alert phases
  • With widespread community transmission
  • Quarantine/active surveillance no longer
    effective --gt broad-based community messaging

Workplace Preparedness
  • Employers should
  • Identify essential services that must be
    maintained as part of good Business Continuity
  • plan to have sufficient supplies for at least one
    month (stockpile as required)
  • Identify alternate supply sources/chains
  • Expect high rates of staff absenteeism
  • Consider cross training of employees to maintain
    essential services
  • Employers will participate in enumerative process
    for vaccine/antiviral roll-out with local health
  • Consider role for education by Occupational
    Health services re Influenza Pandemic and UIIP

Expect These Types of Absenteeism
  • Absenteeism Related to pandemic
  • Absenteeism Normal
  • Absenteeism Related to sick family members
  • Absenteeism Scared, worried well

What Health Care Employers Can Do to Enhance
  • Absenteeism
  • Monitor general rates
  • Establish baseline each season, prepandemic
  • During Pandemic Alert
  • Enhance surveillance and request reporting of
    respiratory symptoms
  • Review work place policies-stay home if you are
    sick and report respiratory illness

Infection Prevention Controlfor Workplaces
  • General Hygienic Practices
  • Hand hygiene (soap water or alcohol-based
  • Respiratory etiquette (cover your cough sneeze)
  • Healthy workplace (stay home when ill)
  • Health Care Measures
  • Consistent use of Routine Practices in all work
  • Additional Precautions (droplet and contact) for
    management of patients with respiratory illnesses

Infection Prevention Controlfor Workplaces
  • Droplet Precautions
  • Surgical mask, eye protection for all activities
    that may generate coughing or when within one
    metre of the patient
  • Contact Precautions
  • Gown and gloves for activities that may result in
    soiling of uniform with blood, body fluids

Hand Hygiene Essential Items
  • Handwashing
  • Sink with hot and cold running water
  • Taps Electronic or manual?
  • Soap dispenser amount dispensed?
  • Paper towel or air dryer?
  • Waterless hand rinses
  • Pump style and location?
  • Amount Quarter size, sufficient to cover all
  • Procedure Squirt, swirl, switch, swirl, scrub

Vaccine/Antiviral Distribution
  • Assumptions
  • Vaccine not be available for 4-6 months after the
    identification of a novel strain
  • Anti-viral distribution for priority groups
  • Vaccine and anti-viral rolled out over time
  • Cross-jurisdictional planning between public
    health units
  • Enumeration of priority groups
  • Maintain Federal and Provincial priority groups
    at local level

Vaccine/Antiviral Distribution and Administration
  • Public Health to
  • Adopt the Federal and Provincial priority groups
  • Play role in the distribution of vaccine and
    antiviral medication to priority groups
    (co-ordination between provincial and local
  • Conduct mass vaccination/anti-viral clinics

Planning for Vaccine/Anti-viral Administration
  • Enumerate Health care/essential service workers
    according to priority groups
  • Clinic set-up and administration consideration
    On and off sites (depending on the size of a
  • Authentication For each person in priority
    group (e.g. Pay stub, photo/employee ID)
  • Reporting to MOHLTC doses provided, efficacy,

Our Enumeration Process
  • Use of newly developed planning tool for
  • Obtaining staff numbers to be vaccinated/ receive
  • Clinic planning Who? What? How? Where?
  • Determining total staff numbers for reporting to

Considerations for OAML
  • Staff identification e.g. photo ID, pay stub
  • Communication What is your process?
  • Alpha list Need to identify staff and provide
    list at time of clinic
  • Screening On arrival to clinic (i.e. ill/well)
  • Informed consent issue Verbal/written
  • Security Consider for on-site

Next Steps
  • Is there a centralized role for the OAML in the
    enumeration process?
  • Is there a centralized role for the OAML for
    co-ordinating clinics with local HUs?
  • Do you have occupational health support? If so,
    are they able to assist in these processes? If
    not, then who?
  • What are options for implementing planning tool
    with labs?

Influenza Pandemic Planning
  • PLAN

For More Information
  • Health Line Peel
  • (905) 799- 7700
  • Toronto Public Health
  • (416) 338- 7600