June 11, 2009
WHO Upgrades Flu Outbreak to Phase 6
For the first time in forty years the World Health Organization (WHO) has declared an influenza pandemic based on the continued spread of the Influenza H1N1 virus. As of today, nearly 30,000 cases have been reported in 74 countries. The virus is contagious and spreading easily from person to person, and country to country
Dr Margaret Chan, Director General of WHO conferred with leading influenza experts, virologists and public health offices and on the basis of available evidence determined that the scientific criteria for an influenza pandemic has been met.
The virus continues to target young healthy and middle-aged people. One third to half of the severe and fatal infections have occurred in that target group. Pregnant women, individuals with chronic diseases and/or immunosuppression related to malignancy, HIV infection or other diseases are at an increased risk for complications.
In a June 11, 2009 press statement Dr. Chan states, “Globally, we have good reason to believe that this pandemic, at least in its early days, will be of a moderate severity. As we know from experience severity can vary, depending on many factors, from one country to another”. She goes on to say “The virus writes the rules and this one, like all influenza viruses, can change the rules, without rhyme or reason, at any time”
Although the pandemic appears to be moderately severe the picture could get worse as the virus spreads to areas of limited resources, poor health care and high prevalence of underlying medical problems.
WHO anticipates that a vaccine will be readily available sometime in September 2009. There will be a limited supply available within the next several weeks that will be distributed to targeted population groups.
The organization is also supporting the development of a generic form of Tamaflu and Roche pharmaceutical has donated 10.6 million does, which have been distributed to affected countries.
Northern Manitoba Community is hit with severe form of H1N1
Over the last few weeks, the number of cases of H1N1 virus has increased in the northern Manitoba First Nations communities of Theresa Point and Garden. As of June 9, 2009, twenty seven (27) Theresa Point residents had been hospitalized with suspected cases of influenza H1N1. Twenty seven (27) people with severe symptoms have been admitted into Winnipeg intensive care units.
St. Teresa Point Chief David McDougall sites the lack of basic medical resources and personnel to deal with the situation as a contributing factor in the spread of the influenza virus.
Public Health Agency of Canada - June 11, 2009 Press Conference
The Public Health Agency of Canada (PHAC) held a press conference today to discuss the impact of the declaration of a phase 6 pandemic. Officials representing the agency stated that the WHO announcement was based on the fact that the virus is easily transmitted and is global. They stressed that this was a “technical decision” and not based on severity but agreed that it was “well considered and the right decision”.
In addition, they felt that Canada was well prepared for this latest decision and it would not change their approach to dealing with outbreak or any previous guidance.
The officials then addressed the emerging situation in northern Manitoba aboriginal communities. They stated that they have sent personal protective equipment, and hand sanitizers to these communities. Additional nurses and two physicians to assist the medical staff providing care to the population.
Despite repeated questions from the media they continued to skirt the issue of the number of severe cases in these communities although at one point stated that it was a small minority of the total cases. They reported that severe symptoms have occurred in 5% of the cases in Canada.
At one point one of the officials stated that nurses in the two northern Manitoba communities were wearing N95 masks when dealing with individuals. David Butler Jones, Chief Public Health Officer for Canada, who stated that surgical masks were sufficient, quickly corrected him. To date the specific mode of transmission of this virus has not been confirmed.
David Butler Jones said that PHAC would continue to monitor the spread based on the severity not on the spread of the disease and will tailor their response to the needs of Canadians. Alberta Health has advised physicians to stop testing for the H1N1 virus unless the individual is exhibiting severe symptoms or is at high risk of complications.
Recommended precautions for health workers remain
It is the position of United Nurses of Alberta that until such time as there is scientific certainty regarding the mode of transmission of Swine Influenza A (H1N1) all Employees covered by the Multi-Employer/UNA Collective Agreement that are required to provide patient care for suspected or confirmed swine influenza A cases must be provided with an appropriate supply of fit-tested N95 respirators and mandatory education regarding the care of procedures for donning and doffing N95 respirators.
Along with respiratory protection until the manner of causation is known, in addition to routine practices, infection control measures for suspected and confirmed cases of the swine influenza should include contact precautions, respiratory hygiene, accommodation, eye protection, surveillance and reporting.
What You Need to Know:
Get Fit Tested! - The Multi-Employer/UNA Joint Committee has reached an agreement regarding N95 Respirator Provision and Fit Testing, which requires the employer to provide N95 respirator fit-testing to all employees covered by the Multi-Employer/UNA Collective Agreement. Fit-Testing is mandatory as per Article 35.02 (a)
Ensure you have enough N95 respirators - The Joint Committee agreement obligates the Employer to ensure that an appropriate supply of N95 respirators is available.
You may be temporarily transferred - In the event of an emergency Article 44: Mobility (44.05 (e)) allows the Employer to reassign Employees from any site to perform work at any other site in emergency circumstances. An emergency is defined as “an unforeseen combination of circumstances or the resulting state that calls for immediate action”. Contact you Local representative or Labour Relations Office for additional information regarding emergency transfers.
Do not report to work if you are sick - Nurses should not be reporting to work if they have influenza like illness (fever and respiratory symptoms). Nurses who do report to work are putting patients and their co-workers at risk of infection and illness. The Alberta Government is asking that individuals with flu like symptoms stay home from work and avoid public places when ill.
You do not have to put your health at risk - The agreement between the parties states that employees who have not been fit-tested for an N95 respirator or are unable to achieve an effective facial seal shall not be expected to enter or provide services in an area where a suspected or confirmed case of swine influenza A has been identified. These Employees may be deployed to another area.
You need to assess whether you believe that you need to provided with N95 respirators (fit-tested), gown and eye protection. If your employer refuses then ask to be reassigned.
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