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Influenza Pandemic Planning


Exercise Cumpston 06. 16 19 October. Victorian Pandemic Modelling ... Australian Government Department of Health and Ageing. ... – PowerPoint PPT presentation

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Title: Influenza Pandemic Planning

Influenza Pandemic Planning
  • Elizabeth Birbilis, Senior Policy and Planning
  • Communicable Disease Control Unit
  • Public Health

Presentation Outline
  • International/National/State Pandemic Planning
  • Victorian Influenza Pandemic Plan
  • The role of GPs
  • Future Directions

International/National Pandemic Planning
  • WHO Global Influenza Preparedness Plan March
  • Australian Management Plan for Pandemic Influenza
    May 2006
  • Australian Governance Plan for Pandemic Influenza
    August 2005
  • COAG National Action Plan July 2006
  • Interlocking arrangements
  • Communicable Diseases Network of Australia (CDNA)
  • National Influenza Pandemic Action Committee
  • Australian Health Protection Committee (AHPC)
  • Exercise Cumpston 06
  • 16 19 October

(No Transcript)
Victorian Pandemic Modelling
  • Upper limit estimates (30 attack rate)
  • 24,000 excess hospitalizations
  • 10,000 excess deaths
  • 710,000 excess outpatient visits
  • Figures based on 6-8 week period
  • Victorias current healthcare system would be
    under enormous stress

Victorian Influenza Pandemic Plan
  • Covers response activities including
  • Surveillance
  • Public health (contact tracing, isolation,
  • Clinical Care
  • Community support
  • Vaccine/antiviral policy and distribution
  • Recovery arrangements
  • Laboratory diagnostic testing
  • Business continuity
  • Communication

Preparedness Initiatives
  • The Federal government has established the NMS,
    to supplement existing state resources once a
    pandemic is declared. It contains items such as
    antivirals, and personal protective equipment
  • Victoria has a small stock of starter
    antivirals and PPE for urgent cases before access
    to the NMS can be made
  • Victorian Government recently provided additional
    funding to bolster state resources
  • Governments working with manufacturers to develop
    a vaccine
  • Likely to be 3-6 months before first doses
  • Priority administration based on
    exposure/morbidity risk

National Medical Stockpile (NMS)
  • Components of the NMS Influenza related
  • Antiviral/prophylactic treatments
  • N95/P2 and surgical masks (fit test kits)
  • Ventilators and negative pressure isolation units
  • Quarantine caches
  • Vaccination packs
  • Gloves
  • Personnel protective equipment for border workers
  • Formal arrangement for state/territory access to
    the stockpile currently being finalised (MOU).
    Access via Chief Health Officer request

Current Situation Overseas 3
  • Enhanced surveillance
  • raised awareness for health care workers
  • international, rumors, border
  • (Suspected) case definition clinical (Influenza
    Like Illness) epidemiological (travel poultry
  • Containment
  • isolation of rare suspected cases
  • rapid testing to exclude diagnosis
  • antivirals if case confirmed
  • contact tracing with isolation and antiviral
    prophylaxis if case confirmed

Next phases Overseas 4 5Human to human
transmission overseas
  • Strengthened border controls
  • discouragement of travel to affected areas
  • Strengthened communication
  • Strengthened surveillance
  • new case definition (no longer necessary to have
    poultry contact)
  • close monitoring of international situation
  • Intensive containment measures if any imported
    cases occur
  • quarantine measures

Next phases Aus 4 5Human to human
transmission in Australia
  • Strengthened surveillance
  • new case definition (no longer necessary to have
    overseas travel)
  • laboratory testing of all cases will continue
  • monitor epidemiology as evolves
  • Strengthened communication
  • opening of Health Services Support Centre
  • Containment
  • designated hospitals, stringent infection
    control, intensive contact tracing and
  • escalation of isolation and quarantine

Next phase Aus 6Pandemic in Australia
  • Containment no longer feasible, maintenance of
    services new strategy
  • Surveillance no longer confirm all cases,
    monitor morbidity, mortality, and health services
    utilisation, absenteeism
  • Designated hospitals, fever clinics to manage
  • Contact tracing no longer feasible
  • education, voluntary home isolation

Next phase Aus 6Pandemic in Australia
  • Strengthen prevention activities
  • social distancing
  • cough etiquette/handwashing
  • increased cleaning
  • pre-exposure prophylaxis for front line health
    care workers, switch to vaccine when available
  • Community support model and recovery

Designated Hospital Model
  • Patients will telephone or present to GPs or
    emergency departments
  • In the pandemic alert period, suspected cases
    will be transferred to the EDs with isolation
    roomsif required
  • During the pandemic period, confirmed cases will
    be transferred to EDs at designated hospitals
  • Hospitals will be designated based on
  • Location
  • Isolation facilities (e.g. negative pressure
  • Infectious diseases expertise

Increasing patient numbers
  • Admit patients to isolation rooms
  • Cohort influenza patients in influenza wards
  • Identify specific hospital/s that can be closed
    and used solely for influenza patients
  • Consider use of non hospital facilities

Patients Presenting to Hospitals
  • Patients will (typically) present to EDs
  • Hospitals will need protocols for rapid id of
    patients with suspected PI including
  • Separating patients from non flu patients
  • Signage
  • Patient infection control measures
  • Triage

Patients Presenting to Hospitals
  • Influenza clinics will assess and triage
  • Home
  • Hospital (isolation room or ward)
  • To another facility (when hospital-level care not
    required but patient is unfit to return home)
  • Provide medication or other treatment and advice
    as appropriate

Proposed Hospital Care Model
Possible Community Support Model
Municipal Coordination Centre
  • Proposed roles and responsibilities for community
  • Provide support to individuals/communities
    quarantined/isolated in homes/institutions
  • Provision and/or coordination of health
    staff/volunteer helpers for general
    medical/essential service support for those in
  • Provision of personal support services, eg
    counselling, advocacy
  • Provision and staffing of recovery/information
  • Convening of municipal/community recovery
    committees as necessary
  • Provision of mass vaccination (if/once
    available) LGA specific

Staffing of Centre
  • Proposed groups represented
  • LGA response, recovery, communication, senior
  • Division/s of GPs
  • Volunteer agency rep eg. Red Cross, SES
  • Health agencies rep eg. RDNS, HACC Co-ordinator,
    hospital liaison, DHS regional liaison
  • Others eg. Police, MAS/RAV

Business Continuity
  • What is business continuity?
  • Maintaining critical business activities
  • Why should organisations undertake planning?
  • To minimise the impact of an influenza pandemic
    on your organisation
  • To protect your business and ensure business
  • To protect staff

Business Continuity Guide
  • The Australian Government Department of Industry,
    Tourism and Resources has developed Being
    prepared for a Human Influenza A Business
    Continuity Guide for Australian Businesses, it is
    a practical guide outlining
  • What government is doing in preparation for a
    potential pandemic
  • The likely impacts on businesses
  • How businesses can minimise those impacts
  • How to help protect staff from getting sick
  • Useful internet reference sources for more
  • A pandemic planning checklist and
  • A series of health posters for the workplace

What can organisations be doing now?
  • Start business continuity planning for pandemic
  • Education
  • Provision of accurate up to date information
  • OHS
  • Infection control cough etiquette, handwashing,
    cleaning surfaces, PPE, antivirals
  • Seasonal influenza vaccine

What can GPs be doing now?
  • Check DHS website for Health Alerts
  • Contact DHS if you suspect avian influenza
  • Have access to appropriate PPE
  • Promote seasonal vaccination
  • Immunisation with pneumococcal vaccine will
    prevent a major complication ie pneumococcal
  • Important to attain high inter-pandemic coverage
    with conjugate vaccine (for children) and
    polysaccharide vaccine (for older persons and
    those at medical risk)

What can individuals be doing now?
  • Understand pandemic influenza and current
    developments of avian influenza overseas by
    checking reliable websites
  • WHO, DoHA, DHS
  • Practice prevention activities
  • cough etiquette/handwashing
  • travel safe
  • stay home if unwell
  • Immunisation (seasonal influenza and

  • Vic research
  • Community
  • 600 CATI survey Vic adults aged 18 years over
    (400 metro, 200 rural)
  • 6 focus groups young mums, low income men,
    working women, men aged 65, low income women,
    working men
  • Business
  • 200 small/medium/large online survey
  • Health providers
  • 60 online surveys nurses pharmacists
  • Local government
  • 25 in depth interviews with CEO or equivalent

Research Results
  • In the event of a pandemic, most Victorians
    expect to receive critical advice and information
    from the Government (42), while 22 will expect
    this information from their GP
  • When asked where people would go to for further
    information about a serious health issue such as
    a pandemic, 50 said their GP
  • When businesses were asked who they would expect
    to provide their employers with critical advice
    and information in the event of a pandemic 61
    said their GP

Available resources
  • Material for business
  • Australian Government Department of Industry,
    Tourism and Resources
  • Materials for the general public
  • Materials for health professionals
  • Australian Government Department of Health and
  • Victorian Department of Human Services
  • http//

Further Information?
  • Communicable Diseases Section
  • ?(03) 9096 5220
  • email
  • Web
  • (Victorian Pandemic Plan at this address)

Where to from here?
  • General Practitioner package
  • Local Government preparedness
  • Plans modified as new evidence/information is
  • Communication strategy (Commonwealth and State)
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