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University Hospital develops pandemic flu plan

To Anne Ryan, it's not a matter of if, but when, which is why she is leading University Hospital's effort to develop a comprehensive pandemic flu plan that will address every imaginable issue from patient care to employee and public safeguards.

"One of the essentials in emergency planning is being prepared," said Ryan, who serves as an emergency preparedness coordinator for University Hospital. "It's having a plan of action in place for everything that might occur, from hurricanes, to chemical weapons to a flu pandemic."

A flu pandemic is a global outbreak of disease that occurs when a new influenza A virus appears in the human population and spreads easily from person to person. The Hong Kong flu pandemic in 1968-69 caused 34,000 deaths in the United States and some health experts believe the time is right for another pandemic to stretch across the globe. Of most concern is the possibility of a widespread outbreak of the highly pathogenic avian H5N1 virus, also referred to as avian or bird flu. Since 2003, health organizations have been tracking human cases of the H5N1 virus. Most of these cases are believed to have been caused by exposure to infected poultry. There have been no sustained cases of human-to-human transmission, but there is great concern that this will occur, especially if the virus mutates to a form more easily transmissible. There is currently no vaccine available for the avian flu.

"We need to be ready with a healthcare strategy when the first report of such a human case hits close to home," Ryan said. To that end, Ryan convened a 24-member Pandemic Flu Planning Committee that represents nearly every facet of hospital operations. The group began meeting in late spring to develop a specific plan detailing how University Hospital would operate during a pandemic. All hospitals across the state must have a pandemic flu plan filed with the state Department of Health by the end of September. Planning on the campus side of operations is under way and will incorporate many of the hospital's employee health screening protocols.

The committee has produced a 35-page Pandemic Flu Response Plan, currently in draft form, that outlines the hospital's response to a various levels of pandemic flu activity, as determined by the state health department. The implementation of various aspects of the plan will be determined by the hospital's incident command team.

Phases one through three of the plan outline hospital responses in the "inter-pandemic period," where no new influenza virus subtypes have been detected in humans. Phases four and five refer to reports of human-to-human contact, but no reports of the virus in North America. Phase six contains various levels, starting with level one in which increased and sustained transmission in the general population is documented, but still no reported cases in North America. Levels two through six detail various levels of the flu outbreak in North America and its movement to Onondaga County. Phase seven refers to the postpandemic period.

Currently the hospital is operating under the plans it has established the inter-pandemic period. During this phase, the hospital is assessing the availability of equipment and supplies, educating staff and revising plans on medical care for patients with infectious diseases. A key aspect of the plan is to increase the number of SUNY Upstate employees who are vaccinated against the seasonal flu. Vaccinations for members of the SUNY Upstate community are expected to be available in October.

"Flu vaccine is very important for those at greatest risk and for those that care for these persons, especially health care providers, and this year it may be of greater importance " said K. Bruce Simmons, M.D., director of Student/Employee Health, who expects the supply of seasonal flu vaccine to meet the anticipated increased demand. "Although the available flu vaccine will not protect against avian influenza, it will protect against the seasonal flu and therefore, avoid the possibility of severe illness from two different types of flu at the same time in the event of an avian flu pandemic."

The health of employees during a pandemic will be key to the hospital's ability to provide all its services. Experts say that the percentage of employees who could be absent from work because of illness or are needed at home to care for a sick family member during a pandemic could reach 40 percent.

"How affected the workforce will be as a result of a flu pandemic is a significant concern for all hospitals and healthcare organizations," said Wendy Merritt, RN, nursing director for emergency services, who serves as co-chair with Ryan of the hospital's Pandemic Flu Planning Committee. "The plan we developed places the utmost importance on protecting our staff members and patients from the flu pandemic."

Under the plan, Student/Employee Health will screen employees, students and volunteers who develop a new cough as well those who report pneumonia or respiratory infection. Those who exhibit symptoms or influenza will be asked to report to Employee/Student Health for a health assessment. Employees, students or volunteers who travel to geographic areas where pandemic influenza has occurred must register with Employee/Student Health upon and report any symptoms of fever and cough.

As the flu activity is identified in Onondaga County, the hospital will increase precautions such as placing health screening stations at hospital entrances to review symptoms and check temperatures of staff members and others entering the hospital and limiting the number of visitors to patients.

Increased communications with staff members regarding the flu pandemic planning and status is also part of the plan. E-mail reports and a special website are being developed to keep staff members updated on the situation.

Throughout all phases of the plan and even today, the hospital monitors the flu pandemic through contacts with the state and local health departments, the Centers for Disease Control and the World Health Organization.

Ryan said the hospital's Pandemic Flu Response Plan will be submitted to the state for review and approval.

Members of the Pandemic Flu Planning Committee are, in addition to co-chairs Anne Ryan and Wendy Merritt, Rob Andrus (Environmental Health and Safety); Darryl Geddes (Public and Media Relations), Jennifer Gilhooley (Human Resources); Sue Hockenberry (Nursing); John Keller, (University Police); Richard Kilburg (Ambulatory Services); Sharon Kitchie (Nursing); Karla Lauenstein (Clinical Pathology); Sandra Lazzaro (Employee/Student Health); Ray Long (Infection Control); Joyce Mackessy (Patient Support); Regina McGraw (Legal Counsel); Sondra Mott (Ambulatory Services); Melanie Rich (Marketing and University Communications); Scott Riddell (Clinical Pathology); Barb Riggall (Human Resources); Fred Rose, M.D., (Infection Control); Kathy Same (Emergency Preparedness) K. Bruce Simmons, M.D., (Employee/Student Health); Frank Tees (University Police); Gary Kittell (Physical Plant); Shelley White (Healthcare Teleservices); Terry Woodfork (Materials Management); and Russ Yandon (Pharmacy).

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