Surveillance of novel H1N1 Influenza A

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					Health Emergency Management at the Provincial Level – the H1N1 Example
ONTARIO AGENCY FOR HEALTH PROTECTION AND PROMOTION
2009 aLPHA Conference
Dr. Brian Schwartz Director, Emergency Management Support Ontario Agency for Health Protection and Promotion Scientific Advisor, Emergency Management Branch Ontario Ministry of Health and Long-Term Care

Role of the OAHPP in Emergency Situations
• Agency Implementation Task Force Ministry/Agency MOU – Agency Mandate: Support role to government in emergency and exigent circumstances Scientific and technical advice, risk assessments, research

Role of the OAHPP in Emergency Situations
• Scientific Response Team (SRT) focal point for Agency’s role in emergency/exigent circumstances  Structured enough to allow for expedited scientific advice  Flexible enough to adapt to different events, advice to different settings • Applied to infectious disease related emergencies but other events as well (e.g. CBRN, medical isotopes, etc)

OAHPP Incident Management System

Command

Operations

Planning

Logistics

Finance / Administration

Doers

Thinkers

Getters

Payers

OAHPP Response to H1N1
Command - Liaison with Chief Medical Officer of Health, Ministry, EEMC - Public communication, overall leadership Operations - Public Health Laboratories - Scientific Response Team Planning - Non-science medium and long-term outlook, scenarios Logistics - Focused on lab equipment and lab processes, Business continuity Finance & Admin - Documentation and cost recovery

Incident Command (Director, EMU) Liaison Officer (PEOC Operations)

Safety Officer

MOHLTC Incident Management System
Operations Lead

Information Officer (CIB Representative)

Planning Lead

Logistics Lead

Finance and Administration Lead

Pre-Hospital Group (EHSB Representative) Public Health Group (PHD Representative) Other Health Care Group (LLB Representative) OHIP Group (RCB Representative) Call Centre Group
(TeleHealth, INFOLine, OPA)

Incident Action Planning Officer

Procurement Group (EMU, CRMB, SFSB) Stockpile Distribution Group (EMU, SFSB) Teleconference Management Officer Continuity of Operations Coordination Officer (EMU) Technical Support Officer (HS I&IT Representative) MEOC Supplies and Equipment Officer Volunteer Coordination Officer (HRB Representative)

MEOC Human Resources Officer (HRB Representative) Incident Documentation Officer

Incident Status/ Data Officer

Demobilization and Recovery Officer

Cost Tracking and Compensation Officer

Technical Advice (Scientific Advisor)

Emergency Financial Stewardship Committee Financial Coordination (CRMB, CFBPB, FMB, SFSB, CCO)

Health Human Resources (HHRSD Representative) Leg. and Regs Group (HSSD, CCO, Legal) Emergency Medical Assistance Team (Ornge)

Scientific Response Team

Research Officer (PHD Librarian)

Medical Writer (Contracted with EMU)

President and CEO
Continuity of Operations Team

EEMC MOHLTC

EMO

Incident Manager
EMU MOHLTC PEOC

Communications
Spokesperson

Safety
Media Relations

Liaison

Operations

Planning

Science

Logistics

Fin/ Admin

Laboratories

Scenario Development Internal Planning

Surveillance & Epidemiology Modelling Research Clinical Guidelines Infection Control PH Measures Psycho-Social

Continuity of Operations Coordination Exec & CEO Support Information Technology Teleconference Management Facilities

Documentation

Legal

Lab Communications Lab Safety Liaison

Internal Communications Internal Safety
Internal Emergency Medical Response

Radiation Environmental Medical Writer Response to MEOC Requests

Internal Em. Mngmt: Best Practices

Internal Supplies

Finance HR

Lab Operations

Lab Medical

Lab Logistics

Lab Finance

What’s wrong with this picture?

Plans are nothing…Planning is everything
Dwight D. Eisenhower

OAHPP Response to H1N1: Structures & Processes
• Scientific Response Team • Liaison with MOHLTC • Support to and from Public Health Laboratory

What we expected
• • • • Started in Southeast Asia Time to prepare High morbidity & mortality Predilection for risk groups (including elderly and young) • High societal disruption

What we got
• Started in North America • No time to prepare • Low morbidity and mortality (so far) • Predilection for young risk groups • High media profile

OAHPP Emergency Operations Centre

2. Where are we now?

What do we know?
H1N1 acting like seasonal ‘flu: • R0 likely < 1.5 • Thus far low severity of illness • May recede with warmer weather

What do we know?
Protective effects: • Age: born prior to 1957 • ?seasonal influenza vaccine

Questions
• Will H1N1 go away and come back? • Will it mutate into a more virulent strain? • Can a (safe and effective) vaccine be developed? – 1976 swine ‘flu • If so, to whom do we give it? • Do we sacrifice seasonal vaccine?


				
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