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Gearing Up for H1N1 Region planners take steps to ready health-care system By Joel Schlesinger
It's a daunting task. Figure out a way to give influenza shots to as many as 500,000 people. Twice. When it comes to preventing the spread of the H1N1 influenza virus this fall and winter, the job of organizing mass immunization clinics is one of the more challenging ones. It's easy to see why. Not only do you have to identify venues large enough to vaccinate hundreds or even thousands of people at a time, you also have to make sure they are properly staffed and accessible. What about parking? What about security? Is it on a major bus route?
Then there is the little issue of having to explain to people that the vaccine may be administered in two doses to ensure effectiveness, although recent reports suggest one dose may be enough. And, of course, the H1N1 vaccine should not be confused with the vaccine for the seasonal influenza. That is an entirely different vaccine, one that will be administered weeks before the H1N1 vaccine is available. That means, when all is said and done, health officials expect they will have administered more than one million doses of vaccine this season. And that is unprecedented. The H1N1 immunization program is just one example of how the Winnipeg Health Region is preparing for a possible resurgence of H1N1 influenza this fall and winter. Ever since the virus surfaced in Manitoba last spring, hundreds of people working on dozens of committees have been tackling issues ranging from how best to immunize the public to staffing for Intensive Care Units with two goals in mind: to prevent the spread of the virus and ensure those who become ill get the best treatment possible. Now, with the flu season just around the corner, all those hours of deliberation and planning are being put into action. The plan is about to be tested. Dr. Sande Harlos is the Medical Officer of Health for the Winnipeg Health Region and one of the key players in the H1N1 readiness effort. Although the planning process has been in high gear for several months, Harlos says preparations for a possible influenza pandemic began many years ago. "One of the reasons we were able to respond as well as we did to the H1N1 surge last spring was because we had plans in place," says Harlos. "But with the work that has gone on over the last few months, I am confident that we are in an even better position to respond to whatever unfolds this fall and winter," she says. "I can't say enough about Region leaders and staff members and the work they have done. But it doesn't stop there. Our people have been working with outside groups - the City of Winnipeg, the province, physicians, school divisions, business leaders, volunteer agencies and other community groups to try and make sure all the bases are covered. It's typical of Winnipeg - everyone just pulls together to get things done." Much of the broader thinking about pandemic preparedness involves high-level planning among governments around the world, leaving organizations like the Winnipeg Health Region to focus on implementing prevention and treatment issues. As a result, the Region's team of planners has put every facet of health care under the microscope to prepare for a possible resurgence of H1N1. The H1N1 plan is based on several scenarios that take into account demands on the system. "The first goal is prevention. We've tried to look at all the things we can do as a Region to help stop the spread. In some cases, that means looking at immunization clinics or ways to prevent patients who may have H1N1 symptoms from coming into contact with others who may not. In other cases, that means ramping up our communications efforts to ensure people living in our community know how to reduce their risk or where to go if they need care," says Harlos. The second goal is treatment. "We have made every effort to shore up our supplies and bring in additional staff, should the need arise. The planning has been very detailed," says Harlos. Trish Bergal, Director of Utilization for the Winnipeg Health Region, is responsible for co-ordinating the activities of many of the groups that have been working on the H1N1 readiness project. She says the springtime H1N1 surge provided a good test of the Region's existing plans, and highlighted some areas for improvement. "You can always anticipate in your head what you might want to do if it (a pandemic) happens. But when you begin to see patients affected by H1N1, then your plan is actually being tested. That's where the real-life experience comes into play," she says. One of the key areas of the plan involves supplies. Peggy Maitland, Director of Logistics Services for the Region, says hospitals had enough respirators, gloves, gowns and other protective gear during the first wave of H1N1. But the experience did provide some insight into how to better equip hospitals in a larger emergency. As a result, the basic necessities have been addressed for the fall: purchase orders for masks, syringes, hand sanitizer and other supplies have been placed, and large orders for the N95 respirator masks have arrived. During the spring and summer, the Region consumed what would have been a two-year supply of N95 respirators. Should the H1N1 threat fail to materialize, the four million N95 respirators ordered would amount to a 20-year supply under normal conditions. The Region has also acquired about 20 new ventilators, a potential trouble spot identified before the outbreak occurred, Maitland says.
Wave is published six times a year by the Winnipeg Regional Health Authority in cooperation with the Winnipeg Free Press. It is available at newsstands, hospitals and clinics throughout Winnipeg, as well as McNally Robinson Books.
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