1. Pandemic Influenza Catherine Donovan, MD. MHSc. CIPHI, Newfoundland and Labrador, Oct 25, 2005 Eastern Region 2002-2005

2. PANDEMIC INFLUENZA ( A quick review ) Respiratory Illness with Significant Complications and Deaths Worldwide Outbreak Major Change in Existing Types of Viruses Prolonged Course with 2 or More Phases

3. WHY THE CONCERN History 11,000-58,000 Deaths in Canada Health Care Costs: $330M - $1.4B Societal Costs: $5B - $38B Scarce HealthCare Resources Social Disruption Avian Influenza (H5N1)

4. Eastern Process Establish Regional Planning Committee (2000) Community Presentation (2001) Draft Pandemic Influenza Plan Framework (2001) Identify Gaps/Unanswered Questions (2001) Organizational Action Plans(2001) Annual Review of Framework (2002-2004) Regional Communicable Disease Advisory Committee (2004) Communicable Disease Emergency Preparedness Framework (2004) Paper exercise??

5. Regional Committee Communicable Disease Control Infection Control Nursing Environmental Health Medical Officer of Health

6. Principles to Guide Planning Enhance Existing Plans to Address Unique Needs For Pandemic Influenza Evaluate Plans Within Context Of Provincial / National Plan Focus on Community or Areas Preparedness

7. INTERNATIONAL PLANS (2000) World Health Organization (WHO) 5 Part Plan:  Emergency Planning  Surveillance  Vaccines & Antivirals  Communications  Health Services

8. CANADIAN PLAN (2000) Aligned with WHO Plan: 5 Parts In 6 Phases 0. Interpandemic Preparedness 1. Onset of Pandemic 2. Regional & Multi-regional Epidemics 3. End of First Wave 4. Second & Later Waves 5. End of Pandemic

9. PROVINCIAL (2000) Aligned with WHO & Canadian Plan Uses 5 Part WHO Components With Canadian 6 Phases. IE 0. Interpandemic Period 1.Emergency Planning 2.Surveillance 3.Vaccines & Antivirals 4.Communications 5.Health services

10. KEY STRATEGIES IN PLANNING Focus on Prevention Preparation for Prolonged Event Preparation for Essential Workers Enhance Surveillance Enhance Accessibility of Vaccine/Antivirals Alter Vaccine Priority Communication

11. Community Workshop Agenda May 3, 2001 Welcome Introduction to Pandemic Influenza Influenza the Clinical Picture Influenza the Historical Perspective Disaster Planning in the Eastern Region Using the Media for Communication Small Group Discussion Feedback/Wrap-up

12. WORKSHOP DISCUSSION QUESTIONS Essential Services & Employees With Ill Employees How Would You Cope Role of Your Organization in an Outbreak and in Planning Participation in Immunization Campaign

13. Framework (July 2001) Followed National/Provincial Format ( 6 Phases, 5 Key areas Identified areas for action in each phase for Planning, Surveillance, Vaccines/Anti-virals, Communications Health Services Action would occur within existing organizational plans Identified issues that required provincial action

14. Issues Increased accessibility to publicly funded immunization program Liability issues, IE alternate care providers and spaces Minimum standards of service in the event of closure of services Payment for private provision of services/resources in emergency setting Stock piling of drugs and equipment Rapid licensing or exemptions (facilities, workers)

15. H&CS, Eastern Pandemic Influenza Action Plan Phase 0 Interpandemic Strategic Issue Action RequiredLeadComment Emergency Planning 1.Information session for regional Management 2.Information session for CHNs CD PH, FB complete

16. Annual Review Focus on Interpandemic Period Review Status of activity under each part: emergency planning, surveillance, etc. Identify outstanding issues Report to province

17. Regional Communicable Disease Advisory Committee Mandate: Facilitate prevention & control of communicable diseases in the Eastern Region through inter- organization collaboration Responsibilities: –Facilitate regional planning –Effective communication –Coordination of responses to outbreaks –Provide advice to partner organizations

18. Communicable Disease Emergency Response Framework Template similar to Pandemic Influenza 6 Phases, 5 Parts Includes Communicable Diseases Emergency Communications Plan Appended to Health & Community Services, Eastern Emergency Response Plan

19. 1.Outstanding Issues Status of provincial planning and response to regional questions Support for municipal planning Overall framework in which public health is an integral part Investment of time and resources into planning Provincial Communication Strategy

20. 2. Outstanding Issues Universal Immunization Program Electronic Transmission of Surveillance data Review of Acts to assess authority Management of fatalities and death certificates. Liability issues Compensation for Emergency Services

21. 3. Outstanding issues Refusal to work Working students (training) Emergency licensing (workers/facilities) Stock piling Gaps in resources (for planning & to address increased workload during pandemic). “ No surge capacity”

22. “The real epidemic is fear” MACLEAN’S, October 3,2005

23. THE END