Wave: Fall 2009 - Winnipeg Regional Health Authority

Gearing up for H1N1Region planners take steps toready health-care systemBy Joel SchlesingerIt’s a daunting task.Figure out a way to give influenza shotsto as many as 500,000 people. Twice.When it comes to preventing the spreadof the H1N1 influenza virus this fall andwinter, the job of organizing mass immunizationclinics is one of the more challengingones.It’s easy to see why. Not only do youhave to identify venues large enough tovaccinate hundreds or even thousands ofpeople at a time, you also have to makesure they are properly staffed and accessible.What about parking? What aboutsecurity? Is it on a major bus route?Then there is the little issue of havingto explain to people that the vaccine maybe administered in two doses to ensure effectiveness,although recent reports suggestone dose may be enough. And, of course,the H1N1 vaccine should not be confusedwith the vaccine for the seasonal influenza.That is an entirely different vaccine, onethat will be administered weeks before theH1N1 vaccine is available. That means,when all is said and done, health officialsexpect they will have administered morethan one million doses of vaccine this season.And that is unprecedented.The H1N1 immunization program isjust one example of how the WinnipegHealth Region is preparing for a possibleresurgence of H1N1 influenza this fall andwinter. Ever since the virus surfaced inManitoba last spring, hundreds of peopleworking on dozens of committees havebeen tackling issues ranging from how bestto immunize the public to staffing for IntensiveCare Units with two goals in mind: toprevent the spread of the virus and ensurethose who become ill get the best treatmentpossible. Now, with the flu season justaround the corner, all those hours of deliberationand planning are being put intoaction. The plan is about to be tested.Dr. Sande Harlos is the Medical Officerof Health for the Winnipeg Health Regionand one of the key players in the H1N1readiness effort. Although the planningprocess has been in high gear for severalmonths, Harlos says preparations for apossible influenza pandemic began manyyears ago.“One of the reasons we were able torespond as well as we did to the H1N1surge last spring was because we had plansin place,” says Harlos. “But with the workthat has gone on over the last few months, Iam confident that we are in an even betterposition to respond to whatever unfoldsthis fall and winter,” she says. “I can’t sayenough about Region leaders and staffmembers and the work they have done. Butit doesn’t stop there. Our people have beenworking with outside groups – the City ofWinnipeg, the province, physicians, schooldivisions, business leaders, volunteer agenciesand other community groups to try andmake sure all the bases are covered. It’stypical of Winnipeg – everyone just pullstogether to get things done.”Much of the broader thinking aboutpandemic preparedness involves high-levelplanning among governments around theworld, leaving organizations like the WinnipegHealth Region to focus on implementingprevention and treatment issues.As a result, the Region’s team of plannershas put every facet of health care underthe microscope to prepare for a possibleresurgence of H1N1.The H1N1 plan is based on severalscenarios that take into account demandson the system. “The first goal is prevention.We’ve tried to look at all the things we cando as a Region to help stop the spread. Insome cases, that means looking at immunizationclinics or ways to prevent patientswho may have H1N1 symptoms from cominginto contact with others who may not.In other cases, that means ramping up ourcommunications efforts to ensure peopleliving in our community know how to reducetheir risk or where to go if they needcare,” says Harlos. The second goal is treatment.“We have made every effort to shoreup our supplies and bring in additionalstaff, should the need arise. The planninghas been very detailed,” says Harlos.Trish Bergal, Director of Utilization forthe Winnipeg Health Region, is responsiblefor co-ordinating the activities of many ofthe groups that have been working on thecold medicines sold in storesthat do not require a doctor’sprescription. These includedecongestants, cough syrups,nasal drops and antihistamines.Over-the-countercough and cold medicinesshould not be given to childrenunder six years of ageunless prescribed by a doctor.Check with your doctoror pharmacist before takingor giving over-the-countermedicines to anyone. This isespecially important if theperson is under 12 years ofage, is taking other medicinesor has a chronic medicalcondition. Be sure to readlabel instructions carefullyand do not take more thanrecommended.Q: Should I be wearing a face mask?A: Manitoba Health and Healthy Living and the PublicHealth Agency of Canada do not recommendthat healthy people wear masks as they go abouttheir daily routines. There is no evidence that wearinga mask will prevent the spread of infection in thegeneral population. People who are in close contactwith someone who is sick with flu, like doctorsand nurses, may be asked to wear a face mask toprotect them from the virus. If a mask is to be used, itmust cover the mouth and nose, and hands must becleaned after removal of the mask.Fall 2009 29