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Infectious disease experts believe it's not a question of "if" a global pandemic will hit. Rather, it's a question of "when" and its severity. For the past 11 months, members of the Toronto Academic Health Science Network (TAHSN), representing Toronto's nine teaching hospitals have been working together to coordinate planning for an influenza pandemic. Co-chaired by Dr. Michael Gardam, Director of Infection Prevention and Control and John King, Executive Vice President of St. Michael's Hospital, this Task Force has been tackling many complex operational, ethical and psycho-social issues. Toronto Public Health, the Ministry of Health and Long-Term Care and two community hospitals (St. Joseph's Health Centre and Toronto East General Hospital) joined the Task Force as observers to share their unique perspectives and ensure linkages.
By sharing our expertise and developing common approaches, our goal is to mitigate the pandemic's impact on staff and patients and to keep hospitals running. In a few months, TAHSN will release a pandemic manual so staff, patients and the public can learn how we plan to respond.
You can imagine how difficult it is to plan for something extraordinary and unknown at this time; however, as hospitals we can't sit back and let it happen. Our best strategy is to prepare for the worst and frankly, hope for the best.
First, a few assumptions. We can expect that hospitals will come under extraordinary strain caring for influenza patients in addition to other patients. At the same time, we can also expect segments of the population - including health care workers - to become ill or absent from work so they can care for sick loved ones.
With these assumptions in mind, TAHSN's pandemic approach includes the use of anti-virals as an important tool in our preparedness strategy. Research has shown that anti-virals are very effective when used for prevention (referred to as prophylaxis). After much thoughtful discussion, TAHSN hospitals have ordered a supply of anti-virals so we can protect staff from getting sick in the first place and affecting patients and others. As hospitals, it's also our obligation to keep the health care system running so we can care for patients.
Prophylaxis is key; however, the use of this supply of anti-virals may change from our original plans when the pandemic occurs and we have new information about its epidemiology. For example, should it turn out that the pandemic predominantly affects young children (which is what happened in 1977), we may be asked to share our stockpile with facilities treating children.
The TAHSN planning work will help guide and further refine our own UHN planning which is currently being developed by our planning task force. To find out more about UHN's pandemic planning, visit our new pandemic intranet site under Emergency Preparedness.