Pandemic Influenza Plan - Questar III

Section 3: Healthcare Planning and Emergency Response
Funeral firms must also develop a mass fatality plan that reinforces infection control (e.g.
vaccination, the proper use of PPE and terminal disinfection procedures) ; identifies
additional funeral services resources; and assesses additional equipment and supply
needs.
Every LHD must work with the county OEM and county Coroner/Medical Examiner to
assess current capacities and develop a plan for the care, transportation and disposition of
the dead (i.e., mass fatality/mortality) including storage and dispositions that are outside
of the current/standard means.
The NYSDOH must:
• Develop plans to modify the processing of death certificates.
• Clearly communicate mortality reporting requirements to hospitals.
• Require registrars, medical examiners and coroners to develop emergency staffing
plans to handle the anticipated surge in volume during a pandemic.
• Coordinate actions with New York City Vital Statistics.
D. Altered Standards of Care
Current health care standards are based on providing the best possible care for every
individual that interfaces with the health care system. These standards are based on the
unspoken precepts that the supply of service is essentially unlimited and that all patients,
with only a few exceptions, have the right to the best level of care that society can
provide, regardless of long term quality of life issues or prognosis.
The possibility of the occurrence of pandemic influenza as well as other man made mass
casualty situations is forcing society at all levels to re-examine these concepts. The health
care system in NYS is operating roughly at 80-95% of full capacity. NYS has roughly
242 hospitals with a total of approximately 62,800 staffed beds. Of these, perhaps 3,000-
12,000 are open for new admissions at any one time. If a severe influenza pandemic were
to occur, NYS, with a population of 20 million, could expect over 650,000
hospitalizations over a six week period according to numbers calculated by HHS. The
peak surge of the pandemic would likely have over 200,000 weekly hospitalizations
according to the same statistics. This assumes an attack rate of 35% with a 3.5%
hospitalization rate. It is probable that using current disaster planning models hospitals
could further expand their available bed counts by approximately 25-35%, thus making
available roughly a total of 18,000 to 33,000 beds for new admissions. It becomes
obvious that under these circumstances, our current health care system would be
overwhelmed and incapable of meeting demand under our current standards and precepts.
The New York State Department of Health will convene an expert panel to develop
guidance for hospitals and other healthcare facilities on altered standards of care. This
guidance will include discussion of the management of limited staff and material
resources, such as ventilators, in the event of a pandemic.
February 7, 2006 3-23