1

David Durrheim, Chris Kewley, Nadine White & Meredith Caelli

Preparing for the next influenza pandemic?

2

Preparing for the next pandemic

• Not if but when!

• What will the consequences be?

• Hunter New England Health Planning and Your Role

3

What is required for a pandemic?

• Emergence of new Influenza A subtype

• Must cause disease in humans

• Must have ability to spread easily from person

to person

4

Not if but when!BIOLOGY

• Mutates - Annual “drift”

• Mutates and reassorts (mixes) “shift”

• Transmission:

Respiratory droplets

Surfaces/hands

5

History!

• What makes our generation so special that what has always

happened through history, will not affect us?

6

Human H5N1 – severe!

7

Preparation essential

• “Only two mutations are necessary to make avian influenza easily transmissible amongst humans.

• Prepare as if it will happen tomorrow”

• David Nabarro, WHO

8

CONSEQUENCES

9

Effect of a pandemic in NSW - clinical capacity(assumes three month pandemic and 35 per cent attack rate)

Expected hospitalisationsExpected patients requiring

mech. ventilation

Inter-pandemic period 325 000 6 500

Mild pandemic

(Hong Kong pandemic)

352 000 (8%) 9 800 (50%)

Severe pandemic (Spanish

influenza pandemic)549 000 (70%) 34 400 (430%)

10

Pandemic response• Surveillance

• Containment

Quarantine Act, 1908 Border control Social distancing Quarantine (contacts) and

isolation (cases) Infection control Antivirals Immunisation

• Maintenance of health services

11

Effect of containment strategies on an influenza pandemic(assume 25% attack rate)

0

50000

100000

150000

200000

250000

300000

350000

400000

0 2 4 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35

Weeks

Nu

mb

er

of

cases

Uncontrolled pandemic Effect of containment

Vaccination program

Start Finish

Why contain?

12

Preparedness to date

• Area Pandemic Planning Executive

- Coordination of plans for all areas and facilities (2007)

• Workforce Planning

- Modelling the impact

- The challenge of surge and business continuity

Critical service identification

Workforce profile & competencies

Secondary workforce mapping to competencies

Workshop 3 April 2008

- Health care worker perception survey

13

Sequencing Workforce to Demand

14

CorporatePublic

healthOC&L

Mental

HealthMWDU

Nursing &

Midwifery.

Allied

HealthBioComms

Clinical

OperationsHR

PI Workforce Taskforce

Comms

Working

Group

Bio

Nursing &

Midwifery

Working Group

Allied

Health

Working

Group

MWDU

Working

Group

Corporate PI

Exec Mgt

Comm.

Clinical

Operations PI

Exec Mgt Comm.

Mental Health

Working

Group

OC&L

Working

Group

Public

health

Working

Group

HR

WG

HNEH Pandemic Executive

Workforce Planning & Development Unit Support

PI Workforce Taskforce Structure

15

Preparedness to date

• Pandemic exercises

Exercise Ring O’ Rosies (March 2008)

Exercise Forest Gump (Sept 2008) – each ED/MPS, public health surveillance surge, community enquiries