The issue of pandemics is a concern to us all.<\/p>\n\n\n\n
The key to looking at pandemic preparation is surveillance. Surveillance has two purposes. The first is to track mutations of existing viral subtypes in order to adjust each year's vaccine preparation, and the second is to search for any new sign of any other mutation of the disease.<\/p>\n\n\n\n
Few countries in the world practice adequate surveillance. Public education, coordination among all levels of government, and enabling medical needs to take precedence over moral considerations are all important as well.<\/p>\n\n\n\n
It remains to be seen how the policy community, in the US and abroad, will handle this next wave of pandemics.<\/p>\n\n\n\n
According to the American Medical Association, nationwide, our hospitals are at 94-96% occupancy. If we were to have another flu epidemic, we would need 197% of our current hospital capacity.<\/p>\n\n\n\n
In preparing for a disaster, we need to take advantage of technology to deliver care outside the hospital and in the home to reduce the burden on the system and to reduce the points of contact between the sick and the healthy. How do healthcare institutions provide care where people don\u2019t have to come into the hospital and provide quality service at a reduced cost? It becomes essential to care for patients in a quarantine situation.<\/p>\n\n\n\n
Singapore used technology to manage the SARS pandemic with great success. With technology, we can provide care to populations in isolation and reduce the risk of contact between exposed and healthy populations.<\/p>\n\n\n\n
When people are in first responder mode, they do not try new things, they go by protocol. The protocol does not include using connected health technologies. So in advance, we need to set up protocols that work that incorporate technology to create order in an otherwise chaotic environment. It is crucial to educate first responders on the value of connected health technologies because when disasters strike, no one wants to think differently. That is not the time to try new technologies.<\/p>\n\n\n\n
Communication and planning are critical to reducing the toll a pandemic takes on a community.<\/p>\n\n\n\n
Planning: there are 116 tasks in the report signed by the President, including establishing and maintaining anti-viral vaccines and antibiotic stockpiles, medical material gap analysis, sharing scientific information, enhancing public health information and response, access to quick testing capabilities, communication materials, etc. The plan itself envisions a robust set of responsibilities and actions that must be taken at the local and state level to ensure stability and order.<\/p>\n\n\n\n
Surveillance: GEIS \u2013 a network of department of defense research laboratory facilities around the world to detect local respiratory outbreaks and new strains. ESSENCE \u2013 a syndromic-based system that includes 500 sites around the world. The Intelligence community also gathers data.<\/p>\n\n\n\n
Response: Make sure someone in a community has the authority to make decisions.<\/p>\n\n\n\n
Containment: Preventative measures to ward off an epidemic. Social distancing, such as the closure of schools and other public places, would have the most impact on the person-to-person transmission of the disease. Stockpiling of vaccines is also important.<\/p>\n\n\n\n
Communication: At the Department of Defense, communication materials that can be sent out on a moment's notice are already prepared and ready to go. A watch-board system that pulls in data and displays it so people can respond to an epidemic with good, accurate data.<\/p>\n\n\n\n
Human nature is somewhat predictable in a crisis, based on stress and the environment, and we can plan for these scenarios.<\/p>\n\n\n\n
Resiliency success factors in preparing for a pandemic:<\/p>\n\n\n\n
Stress is key in so many disasters. Don\u2019t under anticipate the level of stress in a major crisis. Prepare to teach the teacher classes in trauma counseling or even initiate television (or WebTV) programming to help people cope.<\/p>\n\n\n\n
Many government and NGO agencies will only work with free, open-source software solutions and systems, not proprietary technologies. Many companies, such as IBM and Microsoft, came together to develop open-source software to manage worldwide crisis events. SAHANA is an open-source software application and was used by the Philippines during the mudslides.<\/p>\n\n\n\n
Every tax dollar you spend on pre-disaster mitigation and preparedness has a benefit of $4.<\/p>\n\n\n\n
What can we do to mitigate the impact of an influenza pandemic before the vaccines arrive?<\/p>\n\n\n\n
An influenza pandemic comes in a wave. It spreads rapidly in human populations. From the initial onset in a community to the peak of the disease is a matter of weeks. The rapid taking out of people who become sick and die is enormously incapacitating to the function of communities.<\/p>\n\n\n\n
We need to develop strategies to diminish the impact of a pandemic:<\/p>\n\n\n\n
Doing simple things, such as closing schools and implementing social distancing policies, and doing them early can diminish the impact of a pandemic on a community. People don\u2019t need to lock themselves in their homes but should judiciously decrease their contact with others.<\/p>\n\n\n\n
Ill individuals should voluntarily stay at home for 7-10 days. They are much less likely to transmit disease.<\/p>\n\n\n\n
We can target anti-viral treatment for individuals who are ill at home and prophylactic treatment for those who are healthy but staying home with the sick.<\/p>\n\n\n\n
By implementing these strategies, we can reduce a 40% attack rate to a virtually negligible attack rate. Strategies have to be implemented at a local level.<\/p>\n\n\n\n
85% of the population lives in urban centers. Travel is faster than ever. It takes 1.5 days to go around the world. Mass transportation is ubiquitous in urban centers. A contagious disease has everything working in its favor, which is why many of the ideas outlined above are so important to minimize the impact of a pandemic<\/p>\n\n\n\n
The Great Influenza by John Barry is a fascinating book.<\/p>\n\n\n\n
Moderator<\/strong> Panelists<\/strong><\/p>\n\n\n\n Toby Merlin, MD, Director, Division of Partnerships and Strategic Alliances, National Center for Health Marketing, Centers for Disease Control and Prevention;<\/p>\n\n\n\n Brent Woodworth, Global Operations Manager, Crisis Response Team, IBM;<\/p>\n\n\n\n Joxel Garcia, MD, Senior Vice President, Maximus, Former Deputy Director, Pan American Health Organization (PAHO);<\/p>\n\n\n\n Joseph Kvedar, MD, Director, Partners Telemedicine, Partners, HealthCare;<\/p>\n\n\n\n William Winkenwerder, MD, Assistant Secretary of Defense, Health Affairs, Department of Defense;<\/p>\n\n\n\n Pandemics happen when a disease spreads across a large area, like a whole country or even the world. When this happens, it's important to respond quickly and effectively to try to stop the disease from spreading and to help people who are sick. To respond to a pandemic, governments, organizations and healthcare workers work together to:<\/p>\n\n\n\n As for preparedness, different countries have different plans and resources in place to deal with pandemics. Some countries have well-developed healthcare systems and emergency response teams that are trained to handle outbreaks, while others may not have as many resources. It's crucial for countries to continually update and improve their pandemic response plans and to have resources like medicine and protective equipment readily available.<\/p>\n","protected":false},"excerpt":{"rendered":" The issue of pandemics is a concern to us all. The key to looking at pandemic preparation is surveillance. Surveillance has two purposes. The first is to track mutations of existing viral subtypes in order to adjust each year’s vaccine preparation, and the second is to search for any new sign of any other mutation of the disease. Few countries in the world practice adequate surveillance. Public education, coordination among all levels of government, and enabling medical needs to take precedence over moral considerations are all important as well. It remains to be seen how the policy community, in the <\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[25],"tags":[],"_links":{"self":[{"href":"https:\/\/www.scribemedia.org\/wp-json\/wp\/v2\/posts\/2121"}],"collection":[{"href":"https:\/\/www.scribemedia.org\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.scribemedia.org\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.scribemedia.org\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.scribemedia.org\/wp-json\/wp\/v2\/comments?post=2121"}],"version-history":[{"count":4,"href":"https:\/\/www.scribemedia.org\/wp-json\/wp\/v2\/posts\/2121\/revisions"}],"predecessor-version":[{"id":2126,"href":"https:\/\/www.scribemedia.org\/wp-json\/wp\/v2\/posts\/2121\/revisions\/2126"}],"wp:attachment":[{"href":"https:\/\/www.scribemedia.org\/wp-json\/wp\/v2\/media?parent=2121"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.scribemedia.org\/wp-json\/wp\/v2\/categories?post=2121"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.scribemedia.org\/wp-json\/wp\/v2\/tags?post=2121"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
Bernard Kershner, Chairman, AAHC Institute for Quality Improvement<\/p>\n\n\n\n\n