Sally Furniss
Well-known member
Presentations made to Civil Defence teams in Canterbury area
First Presentation.
Began presentation with this line The take home message is a pandemic is imminent
The plan makes extensive use of the historical 1918 information
-Lower mortality is associated with easier transmission (WHO).
-2% CFR
-Attack rate 40%
-CFR of pregnant woman 23-71% -Summary of 13 studies.
-Lancet paper mentioned. 140 deaths with 40% mortality in Nov 1916 ( http://www.flutrackers.com/forum/showthread.php?t=8602)
Disadvantages to this.
-viral pneumonia
-Government dependence
-Anti viral resistance
-Loss of neighbourhood support (due to fast moving population)
Implications for New Zealand.
-40% attack rate, 2% mortality = 32,000 deaths. (NZ pop is 4 million).
Implications for Canterbury
-Peak for Canterbury will be in week 5 (based on seasonal flu figures).
-Will last 2-3 months
-Essential services are not expected to be affected. Exception is the internet where congestion is expected, mostly due to people down loading movies.
-Hospital beds 500
-Population 400,000
Health Service Workers
-Mainly woman
-Working population will be affected. Over 40's relatively ok
Graph
New infections against time for St. Louie (1918), Australia (1918).
St. Louie implemented early NPI
Australia closed borders and kept flu out for quite some time.
Principle Pandemic Responses
-6 cases is all services can handle
-Believed main working population will be vulnerable (theory is that in this age group the ability to respire is greatest and so virus goes deeper)
-Benefit of doubt will not be given at airport. Whole plane load will be quarantined.
-Hotels have been identified for quarantine.
-Temperature checking was used to screen for SARS. Will not be used in a pandemic.
-Migrating birds are not considered a major risk to NZ.
-What happens to patients who can't get in the hospital (he went quiet for a moment). Special hotels are being identified, still working on this.
Break for light supper
Viewed the pandemic road show. http://www.flutrackers.com/forum/showthread.php?t=24448
Second Presentation.
Mission: To avoid the worst by flattening the curve.
-Planning has to happen before the event
-In SARS more people died because of lack of access to healthcare than of SARS
-Compared Canada with Singapore regarding SARS
-For most cases surgical masks recommended due to risk of contamination from persons own mask (surgical mask is easier to take off). (Singapore SARS experience mentioned)
CBAC Community Based Assessment Centres
(the plan is to keep flu patients separate from regular patients)
Levels:
-self triage (at home)
-phone triage
-CBAC triage and treatment (in car park if possible or at door). People will be given their tamiflu and sent home.
-CBAC assessment. Doctor will only see those with complications e.g. viral pneumonia
Health Staff Availability
30% unavailable: ill, unwilling to work, at home with children.
20% in green stream
10% in management
20% waiting for peak, manning the phones
20% in red stream
Plan is to flatten curve from 60,000 cases to 30,000 cases. Less than 1% in hospital, 20% in holding, 80% home
Admission criteria
Staff availability is biggest criteria
Group1. Those who are too sick will be sent home
Group 2. Those who are sick enough will get in to hospital (or held in holding area)
Group 3. Those who are not sick enough will be sent home
At the peak of the pandemic the majority of people will be in group 1 and 3. Where do they go? They go home.
CBAC Community Based Assessment Centres
The first one to open will be near hospital.
The first one open will also be the last one closed.
Total of 7 CBABC planned. 6 in a ring around the city.
Geographical location has greater importance than available facilities at the centre.
Decentralised local response.
Police expect domestic violence to be biggest problem. That and bored teenagers (joke made about handing out movies and condoms)
Supermarkets are not going to run out of food. They are involved and have designed food parcels.
The dying will be more of a problem than the dead
Rural areas
Centralise medical resources
Community Treatment Centre (CTC)
Give tamiflu and send home
Holding area is for locals only.
What Do You Need To Do
Engage the community
Connect with community leaders. (Information available to help with this.)
What ever fear you have, get over it now
First Presentation.
Began presentation with this line The take home message is a pandemic is imminent
The plan makes extensive use of the historical 1918 information
-Lower mortality is associated with easier transmission (WHO).
-2% CFR
-Attack rate 40%
-CFR of pregnant woman 23-71% -Summary of 13 studies.
-Lancet paper mentioned. 140 deaths with 40% mortality in Nov 1916 ( http://www.flutrackers.com/forum/showthread.php?t=8602)
Disadvantages to this.
-viral pneumonia
-Government dependence
-Anti viral resistance
-Loss of neighbourhood support (due to fast moving population)
Implications for New Zealand.
-40% attack rate, 2% mortality = 32,000 deaths. (NZ pop is 4 million).
Implications for Canterbury
-Peak for Canterbury will be in week 5 (based on seasonal flu figures).
-Will last 2-3 months
-Essential services are not expected to be affected. Exception is the internet where congestion is expected, mostly due to people down loading movies.
-Hospital beds 500
-Population 400,000
Health Service Workers
-Mainly woman
-Working population will be affected. Over 40's relatively ok
Graph
New infections against time for St. Louie (1918), Australia (1918).
St. Louie implemented early NPI
Australia closed borders and kept flu out for quite some time.
Principle Pandemic Responses
-6 cases is all services can handle
-Believed main working population will be vulnerable (theory is that in this age group the ability to respire is greatest and so virus goes deeper)
-Benefit of doubt will not be given at airport. Whole plane load will be quarantined.
-Hotels have been identified for quarantine.
-Temperature checking was used to screen for SARS. Will not be used in a pandemic.
-Migrating birds are not considered a major risk to NZ.
-What happens to patients who can't get in the hospital (he went quiet for a moment). Special hotels are being identified, still working on this.
Break for light supper
Viewed the pandemic road show. http://www.flutrackers.com/forum/showthread.php?t=24448
Second Presentation.
Mission: To avoid the worst by flattening the curve.
-Planning has to happen before the event
-In SARS more people died because of lack of access to healthcare than of SARS
-Compared Canada with Singapore regarding SARS
-For most cases surgical masks recommended due to risk of contamination from persons own mask (surgical mask is easier to take off). (Singapore SARS experience mentioned)
CBAC Community Based Assessment Centres
(the plan is to keep flu patients separate from regular patients)
Levels:
-self triage (at home)
-phone triage
-CBAC triage and treatment (in car park if possible or at door). People will be given their tamiflu and sent home.
-CBAC assessment. Doctor will only see those with complications e.g. viral pneumonia
Health Staff Availability
30% unavailable: ill, unwilling to work, at home with children.
20% in green stream
10% in management
20% waiting for peak, manning the phones
20% in red stream
Plan is to flatten curve from 60,000 cases to 30,000 cases. Less than 1% in hospital, 20% in holding, 80% home
Admission criteria
Staff availability is biggest criteria
Group1. Those who are too sick will be sent home
Group 2. Those who are sick enough will get in to hospital (or held in holding area)
Group 3. Those who are not sick enough will be sent home
At the peak of the pandemic the majority of people will be in group 1 and 3. Where do they go? They go home.
CBAC Community Based Assessment Centres
The first one to open will be near hospital.
The first one open will also be the last one closed.
Total of 7 CBABC planned. 6 in a ring around the city.
Geographical location has greater importance than available facilities at the centre.
Decentralised local response.
Police expect domestic violence to be biggest problem. That and bored teenagers (joke made about handing out movies and condoms)
Supermarkets are not going to run out of food. They are involved and have designed food parcels.
The dying will be more of a problem than the dead
Rural areas
Centralise medical resources
Community Treatment Centre (CTC)
Give tamiflu and send home
Holding area is for locals only.
What Do You Need To Do
Engage the community
Connect with community leaders. (Information available to help with this.)
What ever fear you have, get over it now