Presentation to Building Continuity conference. 5 May Steve Brazier Director of Emergency Management

Transcription

1 SWINE FLU Presentation to Building Continuity conference 5 May 2010 Steve Brazier Director of Emergency Management

2 Swine flu Background Risks Risk management of apandemic Health response What was done Key indicators The weapons used Looking forward Where to from here

3 Pandemic flu in New Zealand: Risks and management

4 Influenza Flu is a serious debilitating disease that for many people can be mild, but for some people fatal. The virus mutates rapidly and has adapted itself to co-exist with several species, including ours. It spreads easily and we have no resistance to new strains. The new wave, now in the US, has already killed over We will have a second wave.

5 The risks Deaths in today s society the 1918 pandemic would have produced 33,000 deaths. Disruption over 1,600,000 people would become very ill. GDP would drop by between 5% and 15%. All world markets would be affected. Many businesses would not survive. Recovery would take years. No guarantees that 1918 could not re-occur.

6 Auckland Airport: introduction Situated in New Zealand s largest urban area (1.4 million residents, 31% of NZ population) In 12 months to September 09: 3.3 million international passenger arrivals (~72% NZ total) 41,385 international flight arrivals

7 Flight origins/destinations China: 5% Japan: 3% United States: 7% Singapore: 6% Pacific Island Countries: 10% Australia: 58%

8 Risk management High consequence certain likelihood Mitigation or reduction very difficult Management techniques required rapid decisions without much information No managers had previous experience wth pandemics Even success was ill defined at the start

9 Health response: NZ Pandemic Action Plan Completed in 2006 aimed at bird flu, but generic An all-of government plan based on the 4 Rs.Readiness, Reduction, Response Recovery A pandemic is the only event other than a war that would engage the whole country. There are at least 3 every century.

10 What was done Activated 2.30pm, Saturday April 25 - by April 27 were in the configuration one large room with 34 workstations, three meeting rooms, video and audio links. All DHBs, all Public Health Units, many primary care organisations activated. Only 3 regions formed into Emergency Operations Centres. The spread was uneven, and some unexplained anomalies. At its peak about 1000 involved in the response, as wellas many doctors and nurses.

11 The response

12 The response

13 Structure for border response National Health Coordination Centre National agencies with border responsibility: Health, Customs, Biosecurity, Immigration, Police, Aviation Security, Defence, Tourism, Statistics, Justice Incident controller Planning/intelligence Logistics Operations Hospitals, Isolation facility, primary care Medical Officer of Health Border health team Border agencies: Airport Company Police Airlines Customs Immigration Aviation Security Ambulance service

14 Border management process Pre-arrival announcement on plane by aircrew: Flu information, request for those with symptoms to present for assessment Passengers complete Passenger Locator Forms Flight arrives Arriving passengers walk past border health team Ill passengers self-present Pre-identified sick passengers met at airbridge PLFs collected by Customs Clinical assessment on-site airside Passengers depart airport Cases meeting definition swabbed, treated, sent to hospital, home or facility

15 Medical assessment room Airside health screening point

16 Focus of response Focus of response came down to single issues: Communications Public health messages Keeping safe Keeping away from GPs

17 Some of the key indicators Absenteeism Healthline calls GP consultations Hospitalisations ICU admissions

18 Our weapons Border management School closures Quarantine Tamiflu Antibiotics Vaccines

19 Absenteeism (Sick & Domestic) Sector Absenteeism /01/2009 1/02/2009 1/03/2009 1/04/2009 1/05/2009 1/06/2009 1/07/2009 1/08/2009 1/09/2009 1/10/2009 1/11/2009 1/12/2009

20 Healthline calls - ILI symptomatic Healthline - Daily Number of Answered Calls ILI Symptomatic

21 GP consultations - rate of ILI consultations per 100,000 registered population 160 Weekly rate of ILI per 100,000 registered population All ages, Rate per 100,000 registered patients January April July October Data source: From responding sentinel HealthStat GP practices of the panel of 81 GP practices Week

22 19/8/ /8/ H1N1 hospitalisations - ICU and non-icu All NZ - Reported (and weekend assessed) Daily Occupancy of Hospitalisations & ICU Care - H1N1 H1N1 ICU Beds H1N1 Non ICU Beds 16/6/ /6/ /6/ /6/2009 2/7/2009 6/7/ /7/ /7/ /7/ /7/ /7/ /7/2009 3/8/2009 7/8/ /8/ /8/ /6/2009 8/6/2009 No.

23 H1N1 hospitalisations - ICU and non-icu Smoothed 5 Day Moving Average Reported Total H1N1 Bed Occupancy H1N1 Non ICU Beds H1N1 ICU Beds 22/6/ /6/2009 6/7/ /7/ /7/ /7/2009 3/8/ /8/ /8/ /8/ /8/2009 7/9/ /6/2009 8/6/2009

24 Health system burden Influenza pandemic: health system burden /6/ /6/ /6/2009 3/7/ /7/ /7/ /7/ /7/2009 7/8/ /8/ /8/2009 Week ending GP consultation for ILI - rate per 100,000 registered patients Hospital bed use - rate per 100,000 population GP consultations for influenza-like illness (ILI) - daily rate per 100,000 registered patients (7 day moving average) Hospital bed use: H1N1 non ICU - daily rate per 100,000 population (5 day moving average) Hospital bed use: H1N1 ICU - daily rate per 100,000 population (5 day moving average)

25 Aims of community reduction of influenza transmission mitigation Delay and flatten epidemic peak. Reduce peak burden on healthcare system and threat. Somewhat reduce total number of cases. Buy a little time. No intervention Daily cases With interventions Days since first case Based on an original graph developed by the US CDC, Atlanta Animated slide: Press key

26 The way forward?

27 Where we were at April 24

28 Where to now? NZ Influenza Pandemic Plan completed in new version Work programme urgent, short, medium timeframes mainly completed 50+ projects The next wave is here ( but more like a ripple)