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Preparing intensive care for the next pandemic influenza

tetano

Editor, Senior Moderator
Crit Care. 2019 Oct 30;23(1):337. doi: 10.1186/s13054-019-2616-1. [h=1]Preparing intensive care for the next pandemic influenza.[/h]
Kain T[SUP]1[/SUP], Fowler R[SUP]2,[/SUP][SUP]3[/SUP].
[h=3]Author information[/h] 1 Department of Critical Care, University of Toronto, Toronto, ON, Canada. 2 Department of Critical Care, University of Toronto, Toronto, ON, Canada. rob.fowler@sunnybrook.ca. 3 Sunnybrook Health Sciences Centre, Room D478, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada. rob.fowler@sunnybrook.ca.

[h=3]Abstract[/h] Few viruses have shaped the course of human history more than influenza viruses. A century since the 1918-1919 Spanish influenza pandemic-the largest and deadliest influenza pandemic in recorded history-we have learned much about pandemic influenza and the origins of antigenic drift among influenza A viruses. Despite this knowledge, we remain largely underprepared for when the next major pandemic occurs.While emergency departments are likely to care for the first cases of pandemic influenza, intensive care units (ICUs) will certainly see the sickest and will likely have the most complex issues regarding resource allocation. Intensivists must therefore be prepared for the next pandemic influenza virus. Preparation requires multiple steps, including careful surveillance for new pandemics, a scalable response system to respond to surge capacity, vaccine production mechanisms, coordinated communication strategies, and stream-lined research plans for timely initiation during a pandemic. Conservative models of a large-scale influenza pandemic predict more than 170% utilization of ICU-level resources. When faced with pandemic influenza, ICUs must have a strategy for resource allocation as strain increases on the system.There are several current threats, including avian influenza A(H5N1) and A(H7N9) viruses. As humans continue to live in closer proximity to each other, travel more extensively, and interact with greater numbers of birds and livestock, the risk of emergence of the next pandemic influenza virus mounts. Now is the time to prepare and coordinate local, national, and global efforts.


[h=4]KEYWORDS:[/h] Health care worker safety; Highly pathogenic avian influenza; Human; Influenza; Intensive care; Pandemic; Preparation; Research; Resource allocation; Triage

PMID: 31665057 DOI: 10.1186/s13054-019-2616-1
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