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Source: http://www.calgaryherald.com/health/prepared+worst+hoping+best/1908024/story.html
'We're prepared for the worst, hoping for the best'
Calgary day cares, reserves and institutions eye strategy
By Jamie Komarnicki, with files from Michelle Lang and Jason van Rassel, Calgary HeraldAugust 19, 2009 7:04 AM
CALGARY - Reserves, day cares and group homes across Calgary and southern Alberta are escalating their pandemic planning this fall as those most vulnerable to H1N1 say they're concerned about the impacts they could face at the peak of flu season.
Several groups of people--including aboriginals, pregnant women, seniors and those with underlying health conditions--are believed to be particularly susceptible to H1N1 for various reasons.
Alberta health officials, who are warning the public to prepare for a possible second wave of the virus this fall, say they are developing a communications strategy for high-risk patients.
The strategy will, for example, tell pregnant women it's important to get vaccinated against H1N1 because they are at a greater risk of developing severe disease from the virus. High-risk groups will also be encouraged to seek early treatment from the medical system, under the strategy.
Some of those most at risk are troubled.
"There is a lot of concern, but in the process of concern we're doing the utmost to be prepared," said Patricia YellowHorn-Melton, community health co-ordinator for the Piikani reserve, about 200 kilometres south of Calgary.
The tribe's six-person health team is tacking up posters, handing out pamphlets and planning its annual seasonal flu immunization as a trial run for an upcoming H1N1 vaccination.
They're also fending off fears over how H1N1 could hit the reserve. Only two cases have been confirmed among southern Alberta's Treaty 7 nations, but leaders have sounded the alarm over cramped housing and unique health concerns that could put their band members at risk for exposure.
"Community members, I think a lot of them are starting to become aware of what's going on. They have questions, they call and ask," said YellowHorn-Melton, the nurse in charge of the small native reserve.
"I told the staff we need to start preparing for a pandemic because it's something that's going to occur sooner or later."
Natives aren't the only people taking special measures heading into flu season.
Medical experts are still learning more about the disease. But, for varying reasons, several population groups appear to be particularly at risk for the new strain of the flu.
Infants, women in mid-to-late pregnancy and people with underlying health conditions including asthma, heart disease and severe diabetes, seem to be hit with especially severe attacks once infected, said a University of Calgary flu expert.
While some seniors appear to be protected, possibly immune due to previous exposure to another type of the flu in the past, once they're infected, it's usually a serious case, said Dr. Jim Dickenson.
"Those people, if they get it, they may get it quite badly," said Dickenson.
The numbers are just a sliver of the total population, he added.
But after a slight lull during the summer months, the overall number of H1N1 cases is expected to pick up during the regular flu season. Further, experts are warning the virus could develop into a more severe strain.
Tanya Szarko said she feels an extra sense of responsibility for the 115 children and staff at her downtown day care, Bow Valley Child Care.
When the disease first hit this spring, workers put up hand sanitizer dispensers at the day care entrance and continued to regularly remind parents and kids to stay home if they were feeling ill, she said. So far, they haven't experienced any H1N1 cases.
But, with children considered super-spreaders of flu, Szarko says the day care will be heightening its efforts to fight off H1N1 come fall.
"More bleaching toys and tables and chairs and bleaching after the (children) leave the certain play areas . . . Do we have enough staff so we can allow our staff to go home if they have minor symptoms and how much is that going to cost us," said Szarko, who also represents the Daycare Society of Alberta.
"Those are critical things."
The Public Health Agency of Canada, the lead body on Canadian pandemic planning, recommends that schools and day cares stay open even if there is a confirmed H1N1 patient since the current cases are causing generally mild illness with symptoms similar to seasonal flu.
Closing the facilities would provide more of a disruption than the potential benefits, although the recommendations could change as the disease progresses.
The plan also recommends that ill students and staff stay at home.
Indeed, an outbreak would inevitably lead to higher absentee rates--a growing concern among the care providers who'd like to be first in line for a vaccine.
Federal Health Minister Leona Aglukkaq said she expects the H1N1 vaccine will be ready by November, but not all doses will be available at once. Federal health officials are creating a list of priority patients who should receive the shots first, which is expected to be complete by the fall.
Alberta Health Services has said it will base its vaccinations on the federal program. Determining who gets the initial doses is extremely complicated, said Dickinson.
"If we define it too widely, then we can't really provide the service. If we define it too narrowly, then we could miss people who need to be helped," he said. "We've got to use every bit of information we can find to make the right decisions."
Most agencies are focusing on simple health practices, such as meticulous hand washing, as the best way to stave off the spread.
" Our population is vulnerable and our job is to decrease their risk," said Jennifer McCue, vice-president and chief operating officer of Bethany Care Society, which provides long-term care to about 900 seniors and adults with disabilities.
"We do that by educating, informing and protecting them from the risk," McCue said.
Many of the groups seemingly prone to H1N1 are also susceptible to seasonal flu strains and already have practices in place to deal with issues such as educating patients and setting up annual immunization clinics.
"A lot of what we're doing is very similar to what we're doing every year for seasonal flu," said McCue.
At her downtown day care, Szarko says she plans to meet with staff next week to come up with an enhanced H1N1 plan.
She doesn't want to overreact. But with the potential severity of the disease -- and children's role in spreading the virus--every case of the sniffles will warrant a closer look, she said.
The day care society is also developing a plan to network with other care centres across the city to support each other during a crisis.
"I don't think we can overreact and panic," said Szarko. "But the most important thing is the health and safety of children in our facility."
Other facilities simply don't have the option of shutting down during a pandemic.
There are currently no H1N1 cases in the federal prison system, but the Correctional Service of Canada said it is planning a voluntary immunization program this fall for the estimated 14,000 inmates in custody.
Preparations taking place in the six men's and one women's institutions in Alberta are similar to those taking place across the country, corrections spokesman Jeff Campbell said.
"We've been in consultation with the appropriate public health authorities for the past few months," he said.
Plans for dealing with H1N1 cases inside the prisons range from placing individual patients in medical isolation beds already in use for other contagious conditions, to quarantining entire institutions if necessary. In between, there are several other measures officials can take, such as restricting inmates' movements.
The correctional service has also distributed a list of frequently asked questions and answers to inmates, and institutions have several signs reminding people to wash their hands, Campbell said.
Similarly, the service has circulated information to staff and stockpiled protective equipment and garb for employees, he added.
Unlike other facilities, prisons can't shut down, so the correctional service has had to devise a contingency plan to ensure they're staffed even if large numbers of employees become ill.
"It's to ensure the business of the institutions can continue," Campbell said.
As a national organization, the correctional service can draw staff from other regions and many administrative staff also have prior experience working in institutions and would be able to fill in, added Campbell.
In Alberta, the solicitor general's department has had to make similar arrangements for provincial jails, which house inmates serving sentences of less than two years.
"It's not an option in corrections, to have people not coming into work," spokeswoman Michelle Davio said.
Like the federal prison system, provincial jails have stocked up on protective equipment and the solicitor general has made provisions for temporarily hiring retirees and giving casual staff additional hours if a high rate of correctional workers gets sick.
Officials in Alberta have tailored their response for three scenarios: mild, moderate and severe, the latter based on an infection rate of 35 per cent or higher, said Davio.
"We're prepared for the worst, hoping for the best," Davio said.
jkomarnicki@theherald.canwest.comThe Flu
'We're prepared for the worst, hoping for the best'
Calgary day cares, reserves and institutions eye strategy
By Jamie Komarnicki, with files from Michelle Lang and Jason van Rassel, Calgary HeraldAugust 19, 2009 7:04 AM
CALGARY - Reserves, day cares and group homes across Calgary and southern Alberta are escalating their pandemic planning this fall as those most vulnerable to H1N1 say they're concerned about the impacts they could face at the peak of flu season.
Several groups of people--including aboriginals, pregnant women, seniors and those with underlying health conditions--are believed to be particularly susceptible to H1N1 for various reasons.
Alberta health officials, who are warning the public to prepare for a possible second wave of the virus this fall, say they are developing a communications strategy for high-risk patients.
The strategy will, for example, tell pregnant women it's important to get vaccinated against H1N1 because they are at a greater risk of developing severe disease from the virus. High-risk groups will also be encouraged to seek early treatment from the medical system, under the strategy.
Some of those most at risk are troubled.
"There is a lot of concern, but in the process of concern we're doing the utmost to be prepared," said Patricia YellowHorn-Melton, community health co-ordinator for the Piikani reserve, about 200 kilometres south of Calgary.
The tribe's six-person health team is tacking up posters, handing out pamphlets and planning its annual seasonal flu immunization as a trial run for an upcoming H1N1 vaccination.
They're also fending off fears over how H1N1 could hit the reserve. Only two cases have been confirmed among southern Alberta's Treaty 7 nations, but leaders have sounded the alarm over cramped housing and unique health concerns that could put their band members at risk for exposure.
"Community members, I think a lot of them are starting to become aware of what's going on. They have questions, they call and ask," said YellowHorn-Melton, the nurse in charge of the small native reserve.
"I told the staff we need to start preparing for a pandemic because it's something that's going to occur sooner or later."
Natives aren't the only people taking special measures heading into flu season.
Medical experts are still learning more about the disease. But, for varying reasons, several population groups appear to be particularly at risk for the new strain of the flu.
Infants, women in mid-to-late pregnancy and people with underlying health conditions including asthma, heart disease and severe diabetes, seem to be hit with especially severe attacks once infected, said a University of Calgary flu expert.
While some seniors appear to be protected, possibly immune due to previous exposure to another type of the flu in the past, once they're infected, it's usually a serious case, said Dr. Jim Dickenson.
"Those people, if they get it, they may get it quite badly," said Dickenson.
The numbers are just a sliver of the total population, he added.
But after a slight lull during the summer months, the overall number of H1N1 cases is expected to pick up during the regular flu season. Further, experts are warning the virus could develop into a more severe strain.
Tanya Szarko said she feels an extra sense of responsibility for the 115 children and staff at her downtown day care, Bow Valley Child Care.
When the disease first hit this spring, workers put up hand sanitizer dispensers at the day care entrance and continued to regularly remind parents and kids to stay home if they were feeling ill, she said. So far, they haven't experienced any H1N1 cases.
But, with children considered super-spreaders of flu, Szarko says the day care will be heightening its efforts to fight off H1N1 come fall.
"More bleaching toys and tables and chairs and bleaching after the (children) leave the certain play areas . . . Do we have enough staff so we can allow our staff to go home if they have minor symptoms and how much is that going to cost us," said Szarko, who also represents the Daycare Society of Alberta.
"Those are critical things."
The Public Health Agency of Canada, the lead body on Canadian pandemic planning, recommends that schools and day cares stay open even if there is a confirmed H1N1 patient since the current cases are causing generally mild illness with symptoms similar to seasonal flu.
Closing the facilities would provide more of a disruption than the potential benefits, although the recommendations could change as the disease progresses.
The plan also recommends that ill students and staff stay at home.
Indeed, an outbreak would inevitably lead to higher absentee rates--a growing concern among the care providers who'd like to be first in line for a vaccine.
Federal Health Minister Leona Aglukkaq said she expects the H1N1 vaccine will be ready by November, but not all doses will be available at once. Federal health officials are creating a list of priority patients who should receive the shots first, which is expected to be complete by the fall.
Alberta Health Services has said it will base its vaccinations on the federal program. Determining who gets the initial doses is extremely complicated, said Dickinson.
"If we define it too widely, then we can't really provide the service. If we define it too narrowly, then we could miss people who need to be helped," he said. "We've got to use every bit of information we can find to make the right decisions."
Most agencies are focusing on simple health practices, such as meticulous hand washing, as the best way to stave off the spread.
" Our population is vulnerable and our job is to decrease their risk," said Jennifer McCue, vice-president and chief operating officer of Bethany Care Society, which provides long-term care to about 900 seniors and adults with disabilities.
"We do that by educating, informing and protecting them from the risk," McCue said.
Many of the groups seemingly prone to H1N1 are also susceptible to seasonal flu strains and already have practices in place to deal with issues such as educating patients and setting up annual immunization clinics.
"A lot of what we're doing is very similar to what we're doing every year for seasonal flu," said McCue.
At her downtown day care, Szarko says she plans to meet with staff next week to come up with an enhanced H1N1 plan.
She doesn't want to overreact. But with the potential severity of the disease -- and children's role in spreading the virus--every case of the sniffles will warrant a closer look, she said.
The day care society is also developing a plan to network with other care centres across the city to support each other during a crisis.
"I don't think we can overreact and panic," said Szarko. "But the most important thing is the health and safety of children in our facility."
Other facilities simply don't have the option of shutting down during a pandemic.
There are currently no H1N1 cases in the federal prison system, but the Correctional Service of Canada said it is planning a voluntary immunization program this fall for the estimated 14,000 inmates in custody.
Preparations taking place in the six men's and one women's institutions in Alberta are similar to those taking place across the country, corrections spokesman Jeff Campbell said.
"We've been in consultation with the appropriate public health authorities for the past few months," he said.
Plans for dealing with H1N1 cases inside the prisons range from placing individual patients in medical isolation beds already in use for other contagious conditions, to quarantining entire institutions if necessary. In between, there are several other measures officials can take, such as restricting inmates' movements.
The correctional service has also distributed a list of frequently asked questions and answers to inmates, and institutions have several signs reminding people to wash their hands, Campbell said.
Similarly, the service has circulated information to staff and stockpiled protective equipment and garb for employees, he added.
Unlike other facilities, prisons can't shut down, so the correctional service has had to devise a contingency plan to ensure they're staffed even if large numbers of employees become ill.
"It's to ensure the business of the institutions can continue," Campbell said.
As a national organization, the correctional service can draw staff from other regions and many administrative staff also have prior experience working in institutions and would be able to fill in, added Campbell.
In Alberta, the solicitor general's department has had to make similar arrangements for provincial jails, which house inmates serving sentences of less than two years.
"It's not an option in corrections, to have people not coming into work," spokeswoman Michelle Davio said.
Like the federal prison system, provincial jails have stocked up on protective equipment and the solicitor general has made provisions for temporarily hiring retirees and giving casual staff additional hours if a high rate of correctional workers gets sick.
Officials in Alberta have tailored their response for three scenarios: mild, moderate and severe, the latter based on an infection rate of 35 per cent or higher, said Davio.
"We're prepared for the worst, hoping for the best," Davio said.
jkomarnicki@theherald.canwest.comThe Flu