12 October 2005
HBDHB Pandemic Influenza Plans Gear Up a Notch
Hawke’s Bay District Health Board chief operating officer, Ray Lind, updated Board members at today’s Board meeting, on
the international, national and local planning for a potential influenza pandemic.
Mr Lind is a member of New Zealand’s Pandemic Influenza Reference Committee.
Ray Lind said a pandemic (worldwide) influenza outbreak would have serious effects on the Hawke’s Bay community. “This
wouldn’t be a problem just for health services…it would be a community problem and everyone in Hawke’s Bay would have to
change their day-to-day activities to help stop the spread of influenza, contain and control the outbreak, and
eventually return to ‘business as usual’.
He said over a six to eight week period, a possible scenario is that between 25% and 50% of Hawke’s Bay people would
have severe influenza. 53,000 people would be sick; 25,000 would visit the doctor; 600 would be seriously ill and
admitted to hospital and 150 people would die.
“As this would be a novel (new) virus, no one would have immunity and even fit, healthy people could die. In the 1918
Spanish flu pandemic, otherwise fit and healthy young soldiers made up a high number of the casualties.
“During an influenza pandemic schools would be closed, businesses and industry would temporarily close. There would be
no public gatherings, and of course all health services would be under extreme pressure. GPs would be treating more
complex cases, with only the sickest people being admitted to hospital. Families would become caregivers for their loved
ones at home.
“Everyone would have to play their part in a community response. Hawke’s Bay District Health Board and the Ministry of
Health would provide health education and information to the public.
“It would take time for a vaccine to be developed, so in the interim it would be a case of treating symptoms and
complications of influenza. Current vaccines don’t provide protection against Asian bird flu H5N1,” he said.
Mr Lind said it wasn’t all doom and gloom. “There are some simple, practical things people can do to protect themselves
and their families…hand washing is still the single most important measure to reduce the risks of transmitting influenza
from person to person. Because influenza virus is easily spread by droplets from sneezing or coughing hand washing with
soap and water and thoroughly drying (preferably on disposable towels) will reduce the spread of the virus.
People with flu or cold-like respiratory symptoms should:
- avoid close contact (less than 1 metre) with other people
- cover their nose and mouth when coughing or sneezing
- use disposable tissues
- immediately dispose of used tissues
- immediately wash and dry hands after sneezing
- use a disposable mask to help prevent exposing others to their respiratory secretions
Mr Lind said a briefing had been held earlier today on ‘Operation Flubuggers’ an interagency desktop exercise designed
to test the community’s capability for managing an Influenza Pandemic.
“The exercise involves representatives from across the health sector and government agencies. Various scenarios will be
played out over three weeks in November, and each participating agency will be given 48 hours to come up with their
response to the various phases of the pandemic.
“The purpose of the exercise is to test our plans as they stand, and in the process, identify any gaps and devise
strategies to ensure we are as well prepared as possible,” Ray Lind said.
Detailed information on Pandemic Influenza is available on the Ministry of Health website
www.moh.govt.nz This includes very specific information for health professionals.
ENDS
Background information
Interim guidelines for personal protection during an influenza pandemic
(Edited from Ministry of Health Information issued 15 September 2005)
Concern for personal protection is greater during a pandemic influenza as it is caused by a virus that is markedly
different from recently circulating strains such as found in a seasonal influenza, which is a familiar infection,
especially during winter. A pandemic influenza causes illness in a large number of the people infected; it spreads
widely and quickly because the population will have no immunity.
How is pandemic influenza transmitted?
Primarily, human influenza is transmitted from person to person via virus-laden large droplets (particles >5 µm in
diameter), which are generated when an infected person coughs or sneezes. These large droplets can then be directly
deposited onto the mucosal surfaces of the upper respiratory tract of susceptible people who are near the infected
person (ie, within 1 metre). Transmission may also occur through direct contact with infectious (wet) respiratory
secretions, such as by touching door handles, taps, lift buttons, stairwell railings, keyboards, etc that have deposits
of the infected secretions on their surfaces, and then hand-to-face contact.
General and specific infection prevention and control measures
Organisational respiratory disease policies
Organisations of all kinds should have effective policies and processes in place to ensure people with symptoms of
respiratory disease do not place others at risk of infection. For workplaces, such policies can include sending ill
people home and enabling staff to work in more isolated settings, such as from home, during times of influenza outbreak.
Ventilation of internal spaces
There is scientific and medical evidence that influenza can spread in inadequately ventilated internal spaces. All
internal spaces should be well ventilated, preferably with fresh air, by opening windows, or with properly designed and
maintained air-conditioning systems. See www.moh.govt.nz/pandemicinfluenza for specific Ministry of Health advice on air
conditioning and influenza.
Hand hygiene
Hand washing is still the single most important measure to reduce the risks of transmitting infectious organisms from
one person to another.
Hands should be washed regularly with soap and water, an alcohol-based hand rub or an antiseptic hand wash and then
thoroughly dried, preferably using disposable tissues or towels.
Hands should always be washed and dried after contact with respiratory secretions or after touching surfaces that have
been contaminated with respiratory secretions. Health care workers dealing with respiratory secretions should be wearing
gloves as per the Standard Precautions. See Standard Precautions: www.cdc.gov/ncidod/hip/ISOLAT/std_prec_excerpt.htm
Hand-to-face contact, which occurs during such activities as eating, normal grooming or smoking, presents significant
risks because of the potential for transmitting influenza from surfaces contaminated with respiratory secretions, and
for this reason, hands should always be washed and dried before any activity that involves hand-to-face contact.
Respiratory hygiene/cough etiquette
People with respiratory infection symptoms should practise the following cough/sneeze etiquette whenever they are in the
presence of another person.
All symptomatic people should:
- avoid close contact (less than 1 metre) with other people
- cover their nose and mouth when coughing or sneezing
- use disposable tissues to contain respiratory secretions
- immediately dispose of used tissues in the nearest waste receptacle
- immediately wash and dry their hands.
-
Social distancing
Crowded places and large gatherings of people should be avoided at times of an influenza pandemic, whether such
gatherings are in internal or external spaces.
A distance of at least 1 metre should be maintained between persons wherever possible. Greater distances are more
effective.
Any form of contact with people who are unwell with pandemic influenza, including visiting, should be avoided wherever
practicable.
Protective barriers
Protective barriers in the form of perspex or glass may provide useful protection for people such as front-counter
staff, supermarket operators or public transport drivers, whose duties require them to have frequent face-to-face
contact with members of the public where social distancing is either not possible or not practical.
Using masks
People with respiratory infection symptoms should consider using a disposable surgical mask to help prevent exposing
others to their respiratory secretions.
Any mask must be disposed of as soon as it becomes moist or after any cough or sneeze, in an appropriate waste
receptacle, and hands must be thoroughly washed and dried after the used mask has been discarded.
Patients with respiratory infection symptoms in health care institutions should be masked to contain respiratory
secretions at any time they present a potential risk to unprotected people.
Recommendations for Personal Protective Equipment use
Personal protection equipment (PPE) includes masks, goggles, eye/face shields, gloves, gowns and aprons. Varying levels
and types of PPE are required, depending on the level of exposure and the risk of transmission.
Whatever the level of PPE to be used, education and training is necessary to ensure the equipment is used and disposed
of correctly, to maintain the equipment’s effectiveness.
Summary of protection measures
Protection measure Where applicable
Hand hygiene, cough etiquette, ventilation Everyone, all the time
Organisational policies Every organisation, all the time
Social distancing Everyone, whenever practical
Protective barriers In situations where regular work practice requires unavoidable, relatively close contact with
the public
Disposable surgical mask Workers in any community or health care setting who are caring for the sick (this
includes first responders) Also as a possible adjunct to protective barriers
Disposable particulate respirator mask, eye protection, gloves, gown/apron Health care workers participating
directly in close contact patient care when there is a high risk of contact with respiratory secretions, particularly
via aerosols (mostly inpatient settings).