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Holed up in a ninth-floor boardroom at City Hall, a group of Calgary's top department officials convened an emergency meeting spurred by a troubling new virus gaining steam worldwide.
Armed with the city's 323-page infectious disease strategy, the team of about 20 people--including police, fire, EMS, transit and environmental protection members-- sat down early last week. It was the first of several gatherings to map the city's response to the new strain of H1N1, widely known as swine flu.
"One of the things I'm most confident about is our plan," said Tom Sampson, acting director of Calgary's Emergency Management Agency, who chairs the meetings.
As of Saturday, at least 15 Albertans-- including eight from Calgary --have contracted mild forms of the virus, which has also been identified in a central Alberta pig herd.
The outbreak has infected 700 people in 16 countries, swiftly tracking from Mexico, where it has killed about 100 people, across international borders. Cases outside of Mexico haven't been severe, but health authorities around the globe were put on alert as the World Health Organization increased its global pandemic alert to Level 5 on a six-stage scale, indicating a pandemic could be imminent.
Governments at all levels are dusting off their pandemic plans.
In Alberta, health officials placed the province's medical system on alert for the virus last Sunday, when the first Canadian cases were con-firmed in British Columbia and Nova Scotia.
Dr. Andre Corriveau, chief medical officer of health for Alberta, also activated a provincial pandemic operational centre last weekend.
"Our pandemic plan is already kicked in to some extent,"Corriveau told reporters last week.
"Our system is ready."
The Edmonton-based operations office--which is now open seven days a week -- is a 30-person command centre that allows Corriveau to communicate with regional health officials, federal officials and the public.
"The centre is operating 12 hours a day, seven days a week, and we'll increase that if necessary,"Health Minister Ron Liepert said Friday.
He added the centre's role is"making sure that all of the briefings are going to the right people."
In Calgary, the city's cross-departmental infectious disease management team has met every day since Tuesday and plans to come together twice a week as efforts to track the spread of the virus in Alberta continue, said Sampson.
The team liaises with Alberta Health, which is leading efforts in the province.
Early discussions centre mainly around communication and efforts to stymie the virus's spread by promoting simple healthy practices such as handwashing, Sampson said.
Though he stressed that a pandemic is far from the current reality in Alberta, he said the emergency team is poring over every scenario to deal with a full-blown outbreak.
Emergency teams are ready to snap into action to implement the city's infectious disease strategy, which closely mirrors the WHO's plan.
"From a stockpile perspective, from a training perspective, all sorts of things, we feel very confident that we're ready to go in the event we have a full-blown pandemic,"Sampson said.
He noted the city has a$1.5-million stockpile of gloves, gowns, masks and goggles purchased about two years ago that are "ready to go."
"We've been keeping that stock fresh. Now we look like geniuses, because, of course, it's very hard to find those things right now," he said.
Across the province, Alberta Health instructed all doctors last week to practise "enhanced surveillance" for flu-like illness, particularly when a patient has travelled to Mexico or the southern United States.
On Tuesday, when Alberta confirmed its first cases of swine flu in a Calgary man and a young boy from northern Alberta, Corriveau sent a letter to all doctors outlining how they should handle patients with flu-like symptoms.
"Your urgent attention to this matter is appreciated," said the letter.
The four-page document provides detailed instructions on how physicians should protect themselves, including asking the patient and doc-tor to both wear a mask during any assessment. It also asks physicians to alert the local medical officer of health of any suspect cases.
Some Calgary doctors'offices have implemented their own pandemic protocols.
By last Monday, one day after Canada's cases of swine flu hit headlines, Crowfoot Village Family Practice was ready. The receptionist at the front desk was instructed to move any patients with flu-like symptoms to an isolated room that had been set aside. The clinic posted a sign on the door telling patients to inform staff immediately if they thought they had the flu.
The clinic also has disposable gowns, goggles and a special kit with swabs to protect doctors who need to test any potential swine flu patients.
"We've thought this out," said Dr. Richard Ward, a physician at the northwest clinic who is also president of the Alberta College of Family Physicians. "We have a nurse who is in charge of our pandemic planning and we've started to implement some of the steps in the planning."
The clinic has not yet seen anyone who had symptoms of the new virus, but Ward said many patients were worried about the disease.
Alberta Health officials have said the province's pandemic planning was partly based on a SARS scenario, noting "we learned from SARS and have incorporated those lessons into our plans."But the current outbreak is so different from the 2003 SARS epidemic, which killed 44 people in Toronto, that provincial officials have been tweaking the plan.
One of the early changes to how health officials in Canada and Alberta have been approaching swine flu is how they are using the antiviral drug Tamiflu to treat influenza.
Corriveau said Alberta's plans originally called for the use of Tamiflu as a preventive measure for close contacts of infected patients, such as family members.
In Nova Scotia, where some of the first cases of swine flu appeared last week, some students at a private school were given Tamiflu after four of their classmates fell ill.
But Alberta has not treated family and contacts of infected patients with the drug because the virus is causing such mild illness. In fact, overuse of a drug like Tamiflu can lead the virus to become resistant to the medication, say experts.
"The general practice is moving toward not providing any Tamiflu unless there are very high risk factors," said Corriveau.
Alberta has a stockpile of about 6.7 million doses of Tamiflu on hand.
If the outbreak were to become far more serious and authorities declared a pandemic, the province's approach to dealing with the virus would likely change drastically.
Alberta Health's pandemic plan calls for the province to work with the Public Health Agency of Canada, the lead federal agency in a pandemic, but also kick-start its own emergency plan.
Public health measures would likely include restricting public gatherings and distancing those who are ill from others.
In a pandemic, authorities would also look at scaling back non-essential health-care services to make sure critical care was available for those affected by the virus, Sampson said.
Once the first batches of vaccine were ready, the federal pandemic plan has guidelines to dole it out on a priority basis, with the first groups including essential service providers such as health workers, police and firefighters, as well as elected officials.
Flu patients would also need some-where to go if hospitals are full, so non-traditional health-care sites would likely be set up in schools, churches and day-care centres; temporary morgues would also likely be created if necessary.
The Alberta Emergency Management Agency, which deals with all large-scale emergencies including fires and flooding, would work closely with health authorities and local officials in the more than 360 communities in the province.
"If there is a major emergency of that sort, our job is to look at the support communities would need: if people are sick, that we know about it and know the effects that would have in government and across communities so that essential services can (continue)," said Colin Lloyd, the agency's executive director of operations.
The province has a sophisticated response system that can be rolled out in less than two hours.
"We've got to be co-ordinated, we've got to be linked," Lloyd said.
More than anything, though, authorities are urging calm.
In Canada, particularly, the lessons learned from SARS have served the system well, said Dr.Glen Armstrong, head of the department of microbiology and infectious diseases in the University of Calgary's faculty of medicine.
All levels of government have pandemic preparedness protocols in place that were tightened following the SARS outbreak, he noted.
A huge responsibility rests with the general public, Armstrong added.
Handwashing, coughing into a sleeve and staying home when feeling ill are left to the sick person to self-enforce, he said.
"Following the various guidelines and taking the advice they're given --that's really the best thing people can do to protect themselves."
One week after the first Canadian cases of the new flu were discovered, it's not yet clear whether the outbreak will become a pandemic.
Cases of the disease outside Mexico have not been serious, but experts say there can be a second "wave" of a flu outbreak where a virus mutates, acquires additional traits and becomes more virulent.
Canada's chief public health officer expressed optimism Friday the outbreak may turn out to be relatively mild.
Dr. David Butler-Jones said the virus could die down over summer, buying time to develop a vaccine before the fall flu season.
Corriveau agreed, saying if the virus returns unchanged this fall and there is a vaccine, there will be little to worry about.
If that occurs, Alberta's top doctor argues the province will be more prepared than ever to deal with a future pandemic.
"Even if nothing happens, it will help us to improve planning and structures,"he said. "It's a real-time exercise, not a hypothetical one."
jkomarniCki@tHeHerald.Canwest.Com
http://www.calgaryherald.com/Health/Officials+dust+pandemic+plans/1558490/story.html
Armed with the city's 323-page infectious disease strategy, the team of about 20 people--including police, fire, EMS, transit and environmental protection members-- sat down early last week. It was the first of several gatherings to map the city's response to the new strain of H1N1, widely known as swine flu.
"One of the things I'm most confident about is our plan," said Tom Sampson, acting director of Calgary's Emergency Management Agency, who chairs the meetings.
As of Saturday, at least 15 Albertans-- including eight from Calgary --have contracted mild forms of the virus, which has also been identified in a central Alberta pig herd.
The outbreak has infected 700 people in 16 countries, swiftly tracking from Mexico, where it has killed about 100 people, across international borders. Cases outside of Mexico haven't been severe, but health authorities around the globe were put on alert as the World Health Organization increased its global pandemic alert to Level 5 on a six-stage scale, indicating a pandemic could be imminent.
Governments at all levels are dusting off their pandemic plans.
In Alberta, health officials placed the province's medical system on alert for the virus last Sunday, when the first Canadian cases were con-firmed in British Columbia and Nova Scotia.
Dr. Andre Corriveau, chief medical officer of health for Alberta, also activated a provincial pandemic operational centre last weekend.
"Our pandemic plan is already kicked in to some extent,"Corriveau told reporters last week.
"Our system is ready."
The Edmonton-based operations office--which is now open seven days a week -- is a 30-person command centre that allows Corriveau to communicate with regional health officials, federal officials and the public.
"The centre is operating 12 hours a day, seven days a week, and we'll increase that if necessary,"Health Minister Ron Liepert said Friday.
He added the centre's role is"making sure that all of the briefings are going to the right people."
In Calgary, the city's cross-departmental infectious disease management team has met every day since Tuesday and plans to come together twice a week as efforts to track the spread of the virus in Alberta continue, said Sampson.
The team liaises with Alberta Health, which is leading efforts in the province.
Early discussions centre mainly around communication and efforts to stymie the virus's spread by promoting simple healthy practices such as handwashing, Sampson said.
Though he stressed that a pandemic is far from the current reality in Alberta, he said the emergency team is poring over every scenario to deal with a full-blown outbreak.
Emergency teams are ready to snap into action to implement the city's infectious disease strategy, which closely mirrors the WHO's plan.
"From a stockpile perspective, from a training perspective, all sorts of things, we feel very confident that we're ready to go in the event we have a full-blown pandemic,"Sampson said.
He noted the city has a$1.5-million stockpile of gloves, gowns, masks and goggles purchased about two years ago that are "ready to go."
"We've been keeping that stock fresh. Now we look like geniuses, because, of course, it's very hard to find those things right now," he said.
Across the province, Alberta Health instructed all doctors last week to practise "enhanced surveillance" for flu-like illness, particularly when a patient has travelled to Mexico or the southern United States.
On Tuesday, when Alberta confirmed its first cases of swine flu in a Calgary man and a young boy from northern Alberta, Corriveau sent a letter to all doctors outlining how they should handle patients with flu-like symptoms.
"Your urgent attention to this matter is appreciated," said the letter.
The four-page document provides detailed instructions on how physicians should protect themselves, including asking the patient and doc-tor to both wear a mask during any assessment. It also asks physicians to alert the local medical officer of health of any suspect cases.
Some Calgary doctors'offices have implemented their own pandemic protocols.
By last Monday, one day after Canada's cases of swine flu hit headlines, Crowfoot Village Family Practice was ready. The receptionist at the front desk was instructed to move any patients with flu-like symptoms to an isolated room that had been set aside. The clinic posted a sign on the door telling patients to inform staff immediately if they thought they had the flu.
The clinic also has disposable gowns, goggles and a special kit with swabs to protect doctors who need to test any potential swine flu patients.
"We've thought this out," said Dr. Richard Ward, a physician at the northwest clinic who is also president of the Alberta College of Family Physicians. "We have a nurse who is in charge of our pandemic planning and we've started to implement some of the steps in the planning."
The clinic has not yet seen anyone who had symptoms of the new virus, but Ward said many patients were worried about the disease.
Alberta Health officials have said the province's pandemic planning was partly based on a SARS scenario, noting "we learned from SARS and have incorporated those lessons into our plans."But the current outbreak is so different from the 2003 SARS epidemic, which killed 44 people in Toronto, that provincial officials have been tweaking the plan.
One of the early changes to how health officials in Canada and Alberta have been approaching swine flu is how they are using the antiviral drug Tamiflu to treat influenza.
Corriveau said Alberta's plans originally called for the use of Tamiflu as a preventive measure for close contacts of infected patients, such as family members.
In Nova Scotia, where some of the first cases of swine flu appeared last week, some students at a private school were given Tamiflu after four of their classmates fell ill.
But Alberta has not treated family and contacts of infected patients with the drug because the virus is causing such mild illness. In fact, overuse of a drug like Tamiflu can lead the virus to become resistant to the medication, say experts.
"The general practice is moving toward not providing any Tamiflu unless there are very high risk factors," said Corriveau.
Alberta has a stockpile of about 6.7 million doses of Tamiflu on hand.
If the outbreak were to become far more serious and authorities declared a pandemic, the province's approach to dealing with the virus would likely change drastically.
Alberta Health's pandemic plan calls for the province to work with the Public Health Agency of Canada, the lead federal agency in a pandemic, but also kick-start its own emergency plan.
Public health measures would likely include restricting public gatherings and distancing those who are ill from others.
In a pandemic, authorities would also look at scaling back non-essential health-care services to make sure critical care was available for those affected by the virus, Sampson said.
Once the first batches of vaccine were ready, the federal pandemic plan has guidelines to dole it out on a priority basis, with the first groups including essential service providers such as health workers, police and firefighters, as well as elected officials.
Flu patients would also need some-where to go if hospitals are full, so non-traditional health-care sites would likely be set up in schools, churches and day-care centres; temporary morgues would also likely be created if necessary.
The Alberta Emergency Management Agency, which deals with all large-scale emergencies including fires and flooding, would work closely with health authorities and local officials in the more than 360 communities in the province.
"If there is a major emergency of that sort, our job is to look at the support communities would need: if people are sick, that we know about it and know the effects that would have in government and across communities so that essential services can (continue)," said Colin Lloyd, the agency's executive director of operations.
The province has a sophisticated response system that can be rolled out in less than two hours.
"We've got to be co-ordinated, we've got to be linked," Lloyd said.
More than anything, though, authorities are urging calm.
In Canada, particularly, the lessons learned from SARS have served the system well, said Dr.Glen Armstrong, head of the department of microbiology and infectious diseases in the University of Calgary's faculty of medicine.
All levels of government have pandemic preparedness protocols in place that were tightened following the SARS outbreak, he noted.
A huge responsibility rests with the general public, Armstrong added.
Handwashing, coughing into a sleeve and staying home when feeling ill are left to the sick person to self-enforce, he said.
"Following the various guidelines and taking the advice they're given --that's really the best thing people can do to protect themselves."
One week after the first Canadian cases of the new flu were discovered, it's not yet clear whether the outbreak will become a pandemic.
Cases of the disease outside Mexico have not been serious, but experts say there can be a second "wave" of a flu outbreak where a virus mutates, acquires additional traits and becomes more virulent.
Canada's chief public health officer expressed optimism Friday the outbreak may turn out to be relatively mild.
Dr. David Butler-Jones said the virus could die down over summer, buying time to develop a vaccine before the fall flu season.
Corriveau agreed, saying if the virus returns unchanged this fall and there is a vaccine, there will be little to worry about.
If that occurs, Alberta's top doctor argues the province will be more prepared than ever to deal with a future pandemic.
"Even if nothing happens, it will help us to improve planning and structures,"he said. "It's a real-time exercise, not a hypothetical one."
jkomarniCki@tHeHerald.Canwest.Com
http://www.calgaryherald.com/Health/Officials+dust+pandemic+plans/1558490/story.html