health system response to pandemic influenza: a clinician's perspective
DESCRIPTION
Health System Response to Pandemic Influenza: A Clinician's Perspective. Mary M. Klote, MD Walter Reed Army Medical Center. Disclosures. Financial: None - PowerPoint PPT PresentationTRANSCRIPT
![Page 1: Health System Response to Pandemic Influenza: A Clinician's Perspective](https://reader036.vdocuments.us/reader036/viewer/2022081811/568147c0550346895db503bc/html5/thumbnails/1.jpg)
Health System Response to Pandemic Influenza:
A Clinician's Perspective
Mary M. Klote, MD
Walter Reed Army Medical Center
![Page 2: Health System Response to Pandemic Influenza: A Clinician's Perspective](https://reader036.vdocuments.us/reader036/viewer/2022081811/568147c0550346895db503bc/html5/thumbnails/2.jpg)
Disclosures
• Financial: None
• The views expressed in this presentation are those of the author and do not reflect the official policy of the Department of the Army, Department of Defense, or US Government.
![Page 3: Health System Response to Pandemic Influenza: A Clinician's Perspective](https://reader036.vdocuments.us/reader036/viewer/2022081811/568147c0550346895db503bc/html5/thumbnails/3.jpg)
WHO 2005 Plan
• Revised from 1999 – Redefined the phases to more clearly
aid in coordination of containment of the disease
– Potentially allow for increased lead time for vaccine development
WHO/CDS/CSR/GIP/2005.5
![Page 4: Health System Response to Pandemic Influenza: A Clinician's Perspective](https://reader036.vdocuments.us/reader036/viewer/2022081811/568147c0550346895db503bc/html5/thumbnails/4.jpg)
WHO PhasesInterpandemic Period• Phase 1 - Animal infection - low risk to humans• Phase 2 - Animal infection - risk to humans
--------------------------------------------------------
Pandemic Alert Period • Phase 3 - Close contact human transmission• Phase 4 - Increased transmission• Phase 5 - Virus adapting and spreading
--------------------------------------------------------
Pandemic Period• Phase 6 - Generalized transmission
![Page 5: Health System Response to Pandemic Influenza: A Clinician's Perspective](https://reader036.vdocuments.us/reader036/viewer/2022081811/568147c0550346895db503bc/html5/thumbnails/5.jpg)
Phase Subcategories
• Planning and Coordination (PC)
• Situation Monitoring and Assessment (MA)
• Prevention and Containment (PreCon)
• Health System Response (HSR)
WHO/CDS/CSR/GIP/2005.5
![Page 6: Health System Response to Pandemic Influenza: A Clinician's Perspective](https://reader036.vdocuments.us/reader036/viewer/2022081811/568147c0550346895db503bc/html5/thumbnails/6.jpg)
Phase 1 WHO Goal
To promote contingency planning by health-care systems for response to an
influenza pandemic.
WHO/CDS/CSR/GIP/2005.5
![Page 7: Health System Response to Pandemic Influenza: A Clinician's Perspective](https://reader036.vdocuments.us/reader036/viewer/2022081811/568147c0550346895db503bc/html5/thumbnails/7.jpg)
Who to Vaccinate
• Tiered vaccine structure?– 1st responders
• Their families?
– Healthcare workers– Other Hospital/clinic employees– City/County Service Workers
• Waste removal• Electrical• Water
![Page 8: Health System Response to Pandemic Influenza: A Clinician's Perspective](https://reader036.vdocuments.us/reader036/viewer/2022081811/568147c0550346895db503bc/html5/thumbnails/8.jpg)
Contingencies to Consider
• Delivery of Quality Immunizations: – Immunization techniques
– Record keeping
– Adverse event tracking
– Legal Regulations
MMWR Mar 2000 – Report of NVAC
![Page 9: Health System Response to Pandemic Influenza: A Clinician's Perspective](https://reader036.vdocuments.us/reader036/viewer/2022081811/568147c0550346895db503bc/html5/thumbnails/9.jpg)
Contingencies to Consider
• Delivery Teams:– Right combination of skills
• Administrative• Technical
– Right place– Right time– Right equipment
![Page 10: Health System Response to Pandemic Influenza: A Clinician's Perspective](https://reader036.vdocuments.us/reader036/viewer/2022081811/568147c0550346895db503bc/html5/thumbnails/10.jpg)
Contingencies to Consider
• Method of Delivery:– “Push Out”
• Send teams to communities– Security– Vaccine storage
– “Pull In”• Centralized locations
– Security– Staffing– Transport of vaccinees
![Page 11: Health System Response to Pandemic Influenza: A Clinician's Perspective](https://reader036.vdocuments.us/reader036/viewer/2022081811/568147c0550346895db503bc/html5/thumbnails/11.jpg)
Contingencies to Consider
• Hospital Manning– Who will come to work?– How much of your staff works at another
hospital part-time?– Will you allow anyone to go home?– Where will you house them?– How will you feed them?
![Page 12: Health System Response to Pandemic Influenza: A Clinician's Perspective](https://reader036.vdocuments.us/reader036/viewer/2022081811/568147c0550346895db503bc/html5/thumbnails/12.jpg)
Contingencies to Consider
• Surge capacity– How many patients can your hospital hold?– How many ventilators?
• Are you prepared for family members to “bag” patients?
– How many in your morgue?– Scrubs?– Linen?– Cleaning supplies?– Regulated Medical Waste Bags?
• Sharps containers?
![Page 13: Health System Response to Pandemic Influenza: A Clinician's Perspective](https://reader036.vdocuments.us/reader036/viewer/2022081811/568147c0550346895db503bc/html5/thumbnails/13.jpg)
Contingencies to Consider
• Security– Access to Hospital
• Staff• Patients• Visitors
– “Quarantine” Wards– Triage outside of hospital
![Page 14: Health System Response to Pandemic Influenza: A Clinician's Perspective](https://reader036.vdocuments.us/reader036/viewer/2022081811/568147c0550346895db503bc/html5/thumbnails/14.jpg)
Managing the Unexpected
• Adverse Events– Swine Flu experience– Myopericarditis with Smallpox Vaccine
![Page 15: Health System Response to Pandemic Influenza: A Clinician's Perspective](https://reader036.vdocuments.us/reader036/viewer/2022081811/568147c0550346895db503bc/html5/thumbnails/15.jpg)
Questions?