Roehl_JC
Moderator
An already underfunded and over-extended public health system, currently bearing the brunt of the H1N1 pandemic, needs major reinforcement so it has the same kind of "surge capacity" that is built into hospital settings, according to the Canadian Public Health Association.
The system is coping as best it can with the pandemic but the redeployment of staff and resources to deal with it comes at the cost of other public health activities, the chair of the association told Canwest News Service in an interview.
It shouldn't be that way, says Dr. Cordell Neudorf.
"If we are going to prepare for crises, public health needs to have a bit of surge capacity, like the rest of the system," said Neudorf. "Without investing in that surge capacity, what you end up with is a workforce that is under-resourced even between crises, and then during crises, having all that prevention and promotion activity completely stopping. That's part of the issue we are trying to draw attention to."
Surge capacity refers to the ability to respond to a sudden increase in demand for services. The term is often heard in the context of hospital care.
While hospitals, doctor's offices and other primary-care facilities are certainly on the front lines of a pandemic, the burden likely falls heaviest on the public health sector of the health-care system.
For the past week, public health professionals jabbed needles into arms as fast as they could, answered queries from a worried public and were on the receiving end of the frustration of people who waited hours in line to see them.
This is what they have been preparing for since April, when the novel human H1N1 influenza virus first appeared and quickly swept the globe.
The public health community has been working non-stop since then, across the whole spectrum of pandemic planning. Their duties are numerous - detecting and monitoring the spread of the disease and managing the supply of resources are among them - but the biggest task of all is delivering the most extensive immunization program in Canada's history.
"Idon't think people really appreciate that public health hasn't had to immunize this volume of people for decades," said Neudorf, who is also Saskatoon's chief medical officer.
"The planning to deliver this type of campaign in a short time period has been a huge planning issue that has taken a large volume of staff, and many hours to pull together." Added to the logistical challenges was the unknown variable of when the H1N1 vaccine would be ready to roll out, he added.
Locations to administer the vaccine had to be secured, supplies were needed, staff had to be trained and staff had to be found - some public health nurses were brought out of retirement to help while other health professionals, such as paramedics, received training on how to give the shot.
Neudorf said the staff involved in this pandemic are going above and beyond the call of duty and that efforts are being made so they don't burn out. Schedules are being carefully designed at immunization clinics, for example, and it has even been determined how many shots one person should give in a day so they don't get a repetitive strain injury. The number will vary depending on how the clinic is set up, but generally most staff should be giving a maximum of 110 injections a day.
With public health workers across the country largely deployed to the H1N1 campaign, some of their usual activities have been postponed or cancelled.
Those activities can include home visits with new mothers, breastfeeding-support programs, sexually transmitted disease clinics, school visits and delivering other immunization programs.
Which programs are sacrificed will vary from one jurisdiction to another, said Neudorf, and the impact of putting them off should not be underestimated because there are health risks to doing so.
Reduced services could mean, for example, that a child doesn't get a shot that they should or misses a screening clinic where a health problem could get caught.
The system's inability to stretch very far was highlighted during the SARS health emergency in 2003 and the public health community is trying to draw attention to the lack of surge capacity, said Neudorf.
In a pre-budget consultation in August with the House of Commons finance committee, the association warned that public health units are already strained to respond to routine demands and that additional demands resulting from a pandemic could result in "the collapse" of the health system. It recommended the federal government increase funding for public health agencies at the community level and for the Public Health Agency of Canada.
Dr. David Butler-Jones, head of Public Health Agency of Canada, said public health is likely the most cost-effective area in health-care and does need to be expanded.
"In Canada, over the last five years we've been building increasing capacity in public health,"he told Canwest News Service. "There's certainly a lot more we can do."
Butler-Jones praised public health workers for how they've "pulled together" during the H1N1 pandemic.
"I think we're fortunate those people are willing to put in their time to assist us and there is always more to be done and more we can do and we continue to build capacity," he said.
http://www.nationalpost.com/news/story.html?id=2168452
The system is coping as best it can with the pandemic but the redeployment of staff and resources to deal with it comes at the cost of other public health activities, the chair of the association told Canwest News Service in an interview.
It shouldn't be that way, says Dr. Cordell Neudorf.
"If we are going to prepare for crises, public health needs to have a bit of surge capacity, like the rest of the system," said Neudorf. "Without investing in that surge capacity, what you end up with is a workforce that is under-resourced even between crises, and then during crises, having all that prevention and promotion activity completely stopping. That's part of the issue we are trying to draw attention to."
Surge capacity refers to the ability to respond to a sudden increase in demand for services. The term is often heard in the context of hospital care.
While hospitals, doctor's offices and other primary-care facilities are certainly on the front lines of a pandemic, the burden likely falls heaviest on the public health sector of the health-care system.
For the past week, public health professionals jabbed needles into arms as fast as they could, answered queries from a worried public and were on the receiving end of the frustration of people who waited hours in line to see them.
This is what they have been preparing for since April, when the novel human H1N1 influenza virus first appeared and quickly swept the globe.
The public health community has been working non-stop since then, across the whole spectrum of pandemic planning. Their duties are numerous - detecting and monitoring the spread of the disease and managing the supply of resources are among them - but the biggest task of all is delivering the most extensive immunization program in Canada's history.
"Idon't think people really appreciate that public health hasn't had to immunize this volume of people for decades," said Neudorf, who is also Saskatoon's chief medical officer.
"The planning to deliver this type of campaign in a short time period has been a huge planning issue that has taken a large volume of staff, and many hours to pull together." Added to the logistical challenges was the unknown variable of when the H1N1 vaccine would be ready to roll out, he added.
Locations to administer the vaccine had to be secured, supplies were needed, staff had to be trained and staff had to be found - some public health nurses were brought out of retirement to help while other health professionals, such as paramedics, received training on how to give the shot.
Neudorf said the staff involved in this pandemic are going above and beyond the call of duty and that efforts are being made so they don't burn out. Schedules are being carefully designed at immunization clinics, for example, and it has even been determined how many shots one person should give in a day so they don't get a repetitive strain injury. The number will vary depending on how the clinic is set up, but generally most staff should be giving a maximum of 110 injections a day.
With public health workers across the country largely deployed to the H1N1 campaign, some of their usual activities have been postponed or cancelled.
Those activities can include home visits with new mothers, breastfeeding-support programs, sexually transmitted disease clinics, school visits and delivering other immunization programs.
Which programs are sacrificed will vary from one jurisdiction to another, said Neudorf, and the impact of putting them off should not be underestimated because there are health risks to doing so.
Reduced services could mean, for example, that a child doesn't get a shot that they should or misses a screening clinic where a health problem could get caught.
The system's inability to stretch very far was highlighted during the SARS health emergency in 2003 and the public health community is trying to draw attention to the lack of surge capacity, said Neudorf.
In a pre-budget consultation in August with the House of Commons finance committee, the association warned that public health units are already strained to respond to routine demands and that additional demands resulting from a pandemic could result in "the collapse" of the health system. It recommended the federal government increase funding for public health agencies at the community level and for the Public Health Agency of Canada.
Dr. David Butler-Jones, head of Public Health Agency of Canada, said public health is likely the most cost-effective area in health-care and does need to be expanded.
"In Canada, over the last five years we've been building increasing capacity in public health,"he told Canwest News Service. "There's certainly a lot more we can do."
Butler-Jones praised public health workers for how they've "pulled together" during the H1N1 pandemic.
"I think we're fortunate those people are willing to put in their time to assist us and there is always more to be done and more we can do and we continue to build capacity," he said.
http://www.nationalpost.com/news/story.html?id=2168452