Lessons Learned from H1N1Are We Ready For Another Pandemic OBJECTIVES At the end of this session the learner will be able to Understand and explain the public health implications of pandemic influenza ID: 581077
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Slide1
Preparing for Future Pandemic Influenza:
Lessons Learned from H1N1….Are We Ready For Another Pandemic?Slide2
OBJECTIVES
At the end of this session, the learner will be able to:Understand and explain the public health implications of pandemic influenzaIdentify antiviral agents and understand what is in the Strategic National StockpileDescribe mass prophylaxis
Describe
future preparedness plans for Pandemic InfluenzaSlide3
OVERVIEWSeasonal vs. Pandemic InfluenzaPandemic is a global disease outbreak
Infectious diseases pose a public health threat because they can be highly contagious and cause morbidity and mortality and also be utilized as an act of terrorismSlide4
20TH CENTURY FLU PANDEMICS
1918
–
Spanish
Flu
1957-1958 –
Asian Flu
1968-1969 –
Hong Kong Flu2009-2010 – H1N1 Flu Slide5
IMPLICATIONSMain challenge is that health officials do not have the know when and where future pandemics will occurManagement of pandemics require large stocks of antivirals, access to effective vaccines, resources and multidisciplinary and
multisectoral approach Slide6
LA Stats2238 lab confirmed cases>275,000 estimated casesHospitalized: 641Deaths: 48
PANDEMIC IN LOUISIANA (H1N1)Slide7
DISASTER MANAGEMENT CONTINUUM
Tener Goodwin Veenema
, 2009Slide8
EMERGENCY SUPPORT FUNCTION 8Louisiana Department of Health and Hospitals (DHH)/Office of Public Health (OPH)-Emergency Support Function 8 is the lead agency in any pandemic influenza response within the state
The Secretary of DHH under the advice of the State Health Officer has overall responsibility for the coordination, administration, implementation, receipt, distribution, and dispensing of assets Slide9
PUBLIC HEALTHInfectious Disease Epidemiology- disease surveillance and epidemiological investigationLaboratory- testing samples from hospitals, physician’s offices and conduct
syndromic surveillanceBureau of Emergency Medical Services- provides transport/care, ensure consistent communication among EMS organizations, may assist in strike teams if needed for vaccination Slide10
PUBLIC HEALTHImmunizations-provide vaccines, immunization protocols and technical assistancePharmacy- provide guidance on antivirals
Bureau Of Media and Communications-provides media campaign for the general public; timely and accurate informationHealth Alert Network- network of communication systems used to distribute messages to federal, state, local agencies and community partners Slide11
PANDEMIC INFLUENZA PLANNINGVaccine of a new pandemic strain of influenza will not be available at the onsetIf the pandemic is more widespread and severe, individuals with severe acute respiratory failure will exhaust the available mechanical ventilator supply
Antiviral medications that work may be in short supplySlide12
PUBLIC HEALTH EMERGENCYSevere Pandemic InfluenzaEthical Issues
Crisis Standards of CareHealth professionals/non health professionals may be called upon to temporarily perform tasks that are not routine and competence is limitedQuarantine and isolation
Mass Care-Triage-Population focused care
Routine operations of sickest first in ER could result in use of resources on those who may be too sick to survive Slide13
VULNERABLE POPULATIONSUnsure who will be most vulnerable in a pandemic.Children are identified as part of the vulnerable population group
Provisions for underinsured/uninsuredPlanning is underway with community outreach and other State agenciesSlide14
BEHAVIORAL HEALTH IMPLICATIONSPreparing families in the event the school may be closed
Consideration for children with special needsEncourage and support your coworkersStaffing absencesChildren in response to public health threat/terrorist attack (Post Traumatic Stress Disorder, depression, anxiety disorders)Death of a student, teacher or family memberSlide15
Social disruptionEconomic lossOverwhelmed healthcare systemStaff or family members ill lead to cause in absentismContigency plansSlide16
PREVENTING THE SPREAD OF INFLUENZACommunity MitigationHand washing
Respiratory hygiene and cough etiquetteStay at home when illPPESlide17
ANTIVIRAL AGENTS AND PANDEMIC FLUAntiviral Medications
are prescription medicines used to treat/prevent influenza virusescan make your illness milder and make you feel better faster if taken within first 48 hours of illness
extremely limited supply
would be prioritized for high risk groups
May not work or be indicated in most groups
Antiviral Medications
Oseltamivir
(
Tamiflu)SuspensionCapsule
Zanamivir
(
Relenza
)
Powder via inhalerSlide18
ANTIVIRAL AGENTS AND PANDEMIC INFLUENZAState Antiviral Cache consist of medications purchased by Louisiana for pandemic preparedness
Strategic National Stockpile added antivirals in 2006. Amount is apportioned by population of the stateSlide19
STRATEGIC NATIONAL STOCKPILEManaged InventoryVaccines
Antivirals CHEMPACKFederal Medical StationsSlide20
EMERGENCY USE AUTHORIZATION (EUA)Used for medical and public health communities and is applicable for both civilian and military use.
Fills the need for timely and practical medical treatment under emergency conditions and authorizes use of the best product available for treatment or prevention Used when a drug has not already been approved or it is not indicated for the specific useSlide21
INVESTIGATIONAL NEW DRUG (IND)
Investigational New Drug (IND)The FDA can permit treatment use of an investigational drug during an investigational period when the drug is intended as therapy for a serious or immediately life-threatening condition and when no comparable or satisfactory alternative drug or therapy is availableSlide22
MASS PROPHYLAXISCapability to protect the health of the population through administration of critical interventions in response to a public health emergency in order to prevent the development of disease among those who are exposed or potentially exposed to public health threatsDispensing of antibiotics and/or vaccines to the community to prevent the development of disease in exposed individualsSlide23
MASS PROPHYLAXISPublic Health emergencies may require the dispensing of vaccines or medicine to the entire populationPoints Of Dispensing (PODs) are needed to reach populations in shorter time periods“Push” vs. “Pull”Slide24
Point of Dispensing (POD) sites
Location where medications/vaccines are provided to the public to prevent disease during an emergencyRange from small clinics to very large facilities (school auditoriums, civic centers, churches or large businesses)Slide25
FEDERAL LAWSPublic Readiness and Emergency Preparedness (PREP) Act
authorizes the Secretary of HHS to issue a declaration that provides immunity from tort liability except for willful misconduct for claims of loss regarding administration or use of countermeasures against chemical, biological, radiological and nuclear agents of terrorism, epidemics, and pandemics.Slide26
FEDERAL LAWSIsolation And Quarantine
Title 42 US Code Section 264 gives the Secretary of Health and Human Services responsibility for preventing the introduction, transmission, and spread of communicable diseases from foreign countries into the US and within the US and its territories/possessionsSlide27
LOUISIANA STATE LAWLouisiana Revise Statutes and the Louisiana Administrative Code, June 2004, Public Health Code (5), Part 2:
The Control of Disease provides the Louisiana State Health Officer with the authority to take actions to control diseasesSlide28
LOUISIANA STATE LAWLouisiana Emergency Powers Act 2003 grants the Louisiana State Health Officer, Department of Health and Hospitals, and the Office of Public Health jurisdiction, control and authority to isolate or quarantine in order to prevent the spread of disease.Slide29
Reinforce/initiate infection prevention and control measures Encourage flu vaccination Share best practicesHand washing signs in restroomsCleaning and disinfecting daily or when there is visibly soiled areas (flu.gov)Slide30
Review and revise existing pandemic plans Recognizing the signs/symptoms of influenzaAlcohol based hand sanitizer when water is not availableSlide31
USING ALTERNATIVE METHODSShortage of medical suppliesOverwhelmed healthcare system
Decreased personnelLimited number of ventilatorsShelter in place/Social distancingSlide32
LESSONS LEARNEDSchool CampaignProtocol needed for school nurses administering vaccines
Expansion of vaccinators (Pharmacists)Vaccine Rollout versus the H1N1 outbreakVaccine types led to confusionRumors about vaccine/Media frenzyNeedle supplies received were appropriate for pediatricsSlide33
LESSONS LEARNEDH1N1 After Action Plan revealed some school nurses were not comfortable administering vaccines
H1N1 affected different age groups from seasonal most severe cases occurring in older children and adults <65 years of age Slide34
SKILLS Breakout session/Review of Medication techniquesArm injections
Intranasal Slide35
AVAILABLE PRINTED MEDIA RESOURCES
“How You Can Be Prepared
for a Flu Pandemic
”
Individual and Family Guide
Spanish, English, Vietnamese
versions available
Audio version available through
the State Library SystemBraille version - Summer 2008 through the State Library SystemSlide36
AVAILABLE PRINTED MEDIA RESOURCESFamily Readiness Guides
(also online)Get Ready, Stay Healthy! Pan Flu Brochure
Counter Cards
(two-sided; card stock)
“How You Can Be Prepared
for a Flu Pandemic”
Online Fact Sheets: www.fighttheflula.com
(click pandemic flu information)
Pandemic Flu: The FactsPandemics in the United States Slide37
REFERENCESCenters for Disease Control and Prevention-www.cdc.gov
www.flu.govUS Department of Health and Human Services (www.hhs.gov)Louisiana Emergency Operations PlanLouisiana DHH/OPH Pandemic Influenza GuidanceLouisiana Office of Behavioral HealthSubstance Abuse and Mental Health Services Administration (SAMHSA)Slide38
REFERENCESAfrica Influenza Preparedness Pandemic Plan, www.doh.gov.zaSlide39
RESOURCESNational Association of School NursesNational Commission on Children and DisastersUS Department of Education
American Academy of PediatricsFederal Emergency Management Agency (FEMA)Slide40
FightthefluLA.comSlide41
“Doing the greatest good for the greatest number with least amount of harm”Slide42
CONTACT INFORMATIONSherhonda Harper, MHA, RN, PHN 7Statewide Nurse Consultant,Emergency Preparedness and Response
DHH/OPH(225) 763-5740-OFFICE(225) 763-5727-FAXSlide43
QUESTIONS