11:19am Saturday 19 August 2017

Learning from the H1N1 flu outbreak

— In September, the UCLA School of Public Health’s Center for Public Health and Disasters brought together representatives from federal, state and local health agencies, hospitals, emergency medical services, and private industry for an intensive two-day workshop to assess the effectiveness of actions taken during the early months of the novel H1N1 influenza outbreak.
 
A new report on those proceedings — including recommendations for dealing with the continuing H1N1 pandemic and future national disease outbreaks — is now available in the current issue of the journal Prehospital and Disaster Medicine.  
 
Workshop participants looked at the actions taken as the H1N1 outbreak unfolded in four categories — epidemiology, public-health risk communication, local public health actions and provision of health care — and identified both effective strategies and processes that could have been handled differently.
 
Keynote presentations by officers from the U.S. Centers for Disease Control and Prevention and the U.S. Public Health Service provided an overview of the spring outbreak, as well as the CDC’s role and strategy in responding to the outbreak and the decisions that led to the federal declaration of a public health emergency in April.
 
Participants focused on the challenges of applying the broad guidance provided by the CDC and other agencies to specific situations, such as whether to close schools or cancel events and whether health care and emergency medical workers should use respirators. Discussions emphasized the need to make information on the outbreak — including its changing nature and the number of cases — consistent and easy for the public and the media to understand. Talks also addressed concerns about the sustained ability of hospitals to deal with a large increase in the number of patients with influenza in light of the decrease in hospital facilities in recent years.  
 
Local, state and federal health agencies have been planning and working together for several years to improve responses to a broad spectrum of mass-population emergencies, with specific planning for pandemic influenza beginning with the emergence of the H5N1 (avian) flu. These strategies were put into practice in a remarkably short time-frame last spring and improved the national response to a rapidly evolving communicable disease pandemic.
 
The UCLA workshop’s key recommendations for moving forward in combating the H1N1 influenza include:
 
Epidemiology
Ensure the uniformity of data collection processes with simple, clear and accessible presentations of case numbers and information on specific groups at increased risk; conduct increased surveillance in schools.
 
Providing health care
Develop uniform guidelines for antiviral medications and the prioritized use of vaccines for health care practitioners, with specific outreach efforts to those caring for pregnant women; ensure that recommended policies for the protection of health care workers have provisions for situations in which there are limited amounts of materials (e.g. high-filtration capability respirators).
 
Risk communication
Create uniform public information messages to avoid any ambiguity in interpretation; cultivate close working relationships with both print and broadcast editors to facilitate timely and accurate reporting of consistent messages through print, broadcast and electronic media.
 
Local public health actions
Utilize the standardized National Incident Management System (NIMS) to integrate the many resources necessary for a sustained pandemic response; integrate a broad spectrum of partners in a community-wide response, including schools, faith-based organizations and major employers.
 
Since the conclusion of the workshop, several recommendations have already been put in place, including the presentation of published CDC guidance and the merging of CDC and Occupational Safety and Health Administration recommendations.
 
To view the complete report, visit http://pdm.medicine.wisc.edu/.
 
The UCLA Center for Public Health and Disasters was established in 1997 to address the critical issues faced when disaster impacts a community. The center facilitates interaction between the fields of public health and medicine, engineering, physical and social sciences, and emergency management. The center collaborates with state and local public health agencies, community-based organizations, schools, hospitals and agencies in the public and private sector.
 
The UCLA School of Public Health is dedicated to enhancing the public’s health by conducting innovative research, training future leaders and health professionals, translating research into policy and practice, and serving local, national and international communities.

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