The Burntwood Regional Health Authority (BRHA) recently released its regional pandemic preparedness health services plan to city council.
The plan includes a message from CEO Gloria King, Dr. Lisa Richards, the BRHA's medical officer of health, the plan itself, a description of pandemic phases, information about the activities and resources supporting the pandemic plan and plans with community partners.
The plan is classified as a "living document", which means it will be updated and revised on a regular basis, with chapters being added ad they are created.
"We are on the other side of wave one of the 2009 H1N1 pandemic," King says in her message within the pandemic plan package. "There are many lessons learned which have been incorporated into this plan." King said the collaboration between the provincial government's Incident Command Centre, lead by Manitoba Health and Healthy Living, and the BRHA has "helped to minimize the impact" of the pandemic and has helped to provide mass immunizations and treatments on a timely basis.
In Richards' message, which was written in November of last year, she says that the BRHA has developed a "detailed and flexible" pandemic influenza response plan that partners with provincial, federal and international organizations and aims to minimize serious illness or death while avoiding disruption to community services in the North.
The BRHA's plan states that an influenza pandemic is an "inevitable event", but the timing of the next wave is unpredictable, leading to the organization to plan based on several assumptions.
One of these assumptions is that the next pandemic virus will be present nationwide three months after it occurs in another part of the world, but could happen sooner due to global air travel. Another assumption is that the first peak of illness in Canada will happen two to three months after the virus arrives in the country, with the first peak in mortality expected to be one month after the peak in illness.
The pandemic plan looks at the estimated impact in the Burntwood region. It states that during normal influenza epidemics that happen almost every winter in North America, an average of 10 to 25 per cent of the population will fall ill and some will be hospitalized and will die, with the highest rates of infection and clinical illness in children but serious complications and death occurring mainly in the elderly.
The plan suggests that the majority of the region's population, over 70 per cent, will be infected during the pandemic, but only 15 to 35 per cent of the population will become clinically ill. The majority of cases will happen during the first wave, while if the overall clinical attack rate is 35 per cent, one third of the population will become critically ill in the first wave. During a severe pandemic, in the absence of any intervention, up to 10 per cent of the critically ill may be hospitalized and two per cent may die.
In the event of such a pandemic, the BRHA is planning for a total workplace absenteeism of between 20 per cent and 25 per cent during the peak two-week period. As well, the plan suggests that there will likely not be a vaccine available at the start of a pandemic but may be available for a second wave. Mass immunization campaigns will occur when "sufficient quantities" of new vaccines are available. The use of antivirals to decrease the risk of transmission will be considered by the BRHA as a strategy to contain or slow the spread of novel viruses that have "pandemic potential" and will be limited to cases identified early in the Pandemic Alert Period in Canada. The BRHA is working in collaboration with Manitoba Health and Healthy Living to manage the pandemic vaccine supply when a vaccine is available and also the supply and distribution of antiviral drugs contained within the National Antiviral Stockpile.
The plan outlines that the BRHA is responsible for co-ordinating its regional health response to the influenza pandemic, including maintaining a local surveillance system, reporting and investigating outbreaks; creating plans to provide mass immunization and distribute vaccines, antivirals and medical supplies; liaising with local partners such as emergency responders, hospitals, community services, mortuary services, schools and workplaces; assessing the capacity of the organization's health services, including human resources, and identifying additional or alternative resources; defining responsibilities for communication during a pandemic; delivering mass vaccinations; and developing program specific pandemic activities.
When it comes to the legal considerations of pandemic planning, the plan states that the BRHA is working with Manitoba Health to work within a legal framework to balance the rights of individuals, such as privacy and equity, with the response to protect the public form harm and the right to workers to work in a safe environment. The BRHA will look to legislation that exists, including the Emergency Measures Act, the Public Health Act, the Regional Health Authority Act and the Freedom of Information and Protection of Privacy Act to help guide the organization's response to a pandemic.
When a pandemic occurs, the BRHA has in place a pandemic response, including containment (surveillance, public health measures and infection control) and management (antivirals, other clinical management). All BRHA leadership is responsible, according to material in the plan, to understand the system-wide process.
