WHO Declares Pandemic

Dear Colleagues,

In recent weeks the stories about pandemic flu have decreased in the media but we are seeing an increase in number of patients with respiratory illnesses and an increase in the number of staff who are going to Occupational Health and Safety with flu. It is clear to me that the H1N1 influenza is widespread in the community and doesn't appear to be taking a 'summer vacation'. Today the World Health Organization moved to Level 6 on their 'flu alert' because we are now seeing flu outbreaks on more than two continents. What does this mean for everyone at UHN?

• Active screening of patients using the FRI tool is absolutely necessary and I'm concerned that every staff member who is evaluating new patients is not using this tool and protecting themselves as they should.
  
• In the near future we will be erecting plexiglass barriers at many first 'points of contact' between staff members and patients. This will help us keep staff as safe as possible until we can determine that the patient does not have an unknown respiratory illness. It also means that staff members won't have to spend their days in an N95 mask.
  
• Our pandemic planning committee continues to meet and has done much preparatory work so that we will be ready if we begin to see large numbers of staff becoming ill. We are also coordinating our work with other Toronto-area hospitals so that we will take decisions together and follow the same procedures in all hospitals.
  
• We are not using nasopharyngeal swabs to determine which flu a patient might have if they are not admitted to hospital. We assume that patients with flu have the H1N1 flu. We are continuing to swab staff members who come to Occupational Health with respiratory symptoms and any patients who are hospitalized with respiratory illness. The results of these swabs will give us a sense of whether the flu is increasing in the community and whether it is the cause of hospitalizations.
  

As you know, most of Canada's population does not have immunity to this flu and therefore large numbers of people are likely to get sick. This means that we'll spend some pretty miserable time in bed and will then recover. UHN has purchased enough Tamiflu to treat everyone for 8 weeks as a prophylaxis. We made this purchase because we believe that, in a situation where large numbers of people are ill, we will need to keep our workforce stable so that we can continue to care for all our patients – flu patients and all of the other individuals who need our care. We are not yet at the time when we will distribute the Tamiflu – and we may never reach that point. However, we are planning and we will have the ability to distribute large amounts of Tamiflu to our staff should we, in concert with other Toronto area hospitals, determine that this would be a wise thing to do.

If you have questions, I encourage you to attend one of the town halls that Infection Prevention and Control is hosting in the coming days. I know of no better way to face a pandemic than by ensuring that everyone at UHN has all the information they need about this flu and what we can do to limit its effects. Flu is community acquired, so we won't be able to stop it, but we can do a lot to prevent its spread and prevent illness from affecting the care we deliver.

Bob