Sunnybrook prepares for a pandemic influenza
Toronto – Sunnybrook Health Sciences Centre has a plan in place to deal with an outbreak of pandemic influenza. The hospital is leading the way in Canada by developing strategies to deal with large numbers of ill patients with limited hospital resources.
“We now have a plan in place in the event of world-wide pandemic influenza,” says Dr. Mary Vearncombe, Medical Microbiologist and Medical Director, Infection Prevention and Control at Sunnybrook. “The plan outlines how Sunnybrook will care for patients who become very ill with influenza in addition to our patients who are traumatically injured, require cancer care, urgent surgery and medical attention.”
The plan clearly outlines strategies to: optimize beds and personnel; manage elective activity; prioritize access to ventilators; obtain access to hospital supplies; and distribute vaccination and antiviral medication. All elements of the plan take into consideration the ethical guidelines created by Clinical Ethics Centre at Sunnybrook in consultation the University of Toronto’s Joint Centre for Bioethics.
“We can not predict when the world will see the next pandemic, but statistically we are overdue. We haven’t had a pandemic in the last 36 years and there is a consensus among infectious disease experts that we are closer now to the next pandemic than we have ever been before," says Vearncombe. “Our plan is an evergreen document that will continue to evolve as we move into the future.”
If a pandemic should strike, it is natural that Sunnybrook would be among the first to respond. The hospital is a leader in disaster preparedness. During the SARS outbreak, the hospital was at the centre of the fight against the disease, treating more than 50 per cent of the city’s in-patients. It was the first to respond to the crisis. Within mere days of the first SARS cases, the hospital had created the first SARS screening and assessment clinic in downtown Toronto, increased the capacity of its negative pressure rooms from 22 to 48 and converted an entire nursing unit dedicated to treating SARS patients at the Sunnybrook Campus.
While the response to SARS focused on containing the virus, pandemic influenza planning focuses on maximizing capacity to manage the increased patient load at a time of depleted resources.
“There will have to be solidarity among the healthcare community as we work together to keep the public healthy” says Marilyn Reddick, Vice-President of Human Resources, Sunnybrook.
The hospital has examined ways to ensure the organization has sufficient staffing during the pandemic influenza outbreak, including approaching recent retirees, students that are in their final year of studies and volunteers. Amid these considerations are occupational health issues, such as determining when staff will be fit to return to work after being sick.
Healthcare professionals will be affected equally with the general population, as influenza is a community-spread organism and is highly contagious. Experts predict that 30 to 50 per cent of the healthcare population will become ill during the first wave.
“We have a duty to protect our staff and patients,” says Reddick. “Our plan outlines measures that will be put in place in order to protect the health and safety of our staff, and help them cope with the high stress throughout what could be an extended period of extraordinary demands.”
Sunnybrook is unique in that the hospital is home to 500 Veterans who call K and L Wing their home. In order the maintain their overall safety, the hospital will take considerable measures such as restricting non-essential access to the unit, implementing an interim visiting policy that is flexible and compassionate to meet the needs of the residents, and their families.
The hospital has been working closely with the Toronto Academic Health Sciences Network (TASHN), nine fully affiliated teaching hospitals, to coordinate and share resources and expertise. One of the key lesions learned from Toronto’s experience with the SARS outbreak is the need for a coordinated and consistent approach by hospitals and governments.
Dr. Mary Vearncombe is a driving force locally, provincially and nationally in preparing for a pandemic influenza. She is chair of the Health Canada Working Group on infection prevention and control and occupational health guidelines for pandemic influenza, a member of the Ontario Health Pandemic Influenza Plan Steering Committee, a member of the Toronto Pandemic Influenza Advisory Group.
As a result of her expertise, the hospital’s plan has been widely used as a model by academic centres, community hospitals, regional health authorities and long-term care facilities across the country.
