Planning for a pandemic: Are you ready?

Federal experts offer a checklist to help physicians take steps to prepare their practices.

Posted April 24, 2006.

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This question is increasingly being asked of physicians as the reach of the avian flu broadens and transforms what many used to consider an abstract threat -- that of another pandemic influenza -- into a more likely possibility.

There has been considerable high-level attention about pandemic preparedness. Activity is under way among federal, state and local governments, as well as within public health departments and hospitals. It is also becoming more and more clear that doctors, too, have to begin thinking about arrangements for their medical offices and clinics before a crisis occurs.

Think of the issues that could be in play in the event of this type of catastrophic infectious disease outbreak. How would a practice handle a surge of patients if not all physicians and support staff can make it into the office? How should a practice address the needs of those who get sick at work? At what point, in practices large and small, would it be necessary to close the office or recruit temporary personnel? What about maintaining supplies?

The Dept. of Health and Human Services, along with the Centers for Disease Control and Prevention, has created an online checklist to help physicians prepare their practices by encouraging them to think through these complex matters. The goal is to maximize physicians' ability to confront the unique challenges a pandemic would present. HHS' efforts to provide a tool to ease this process should be applauded as an important step in enhancing physicians' abilities to handle emergencies of all types -- whether it be a pandemic, a natural disaster or even a terrorist attack.

The HHS checklist highlights the central elements of a pandemic preparedness plan, including how to implement surveillance and detection mechanisms as well as communication strategies. It also helps practices determine necessary education and training for staff and offers frameworks for patient triage and management. In addition, the checklist lays out guidance for developing infection control, vaccine and antiviral use, and occupational health blueprints.

With detailed responses in place, if the dreaded influenza emerges, physicians will be better equipped to care for patients while also protecting themselves and staff members.

It's important to note that the concerns highlighted in the HHS document dovetail with ongoing efforts by the AMA to encourage physician preparedness.

The Association plans to distribute information in June on this very topic to nearly 250,000 doctors through its publication, AMA Voice. The AMA also participated in the HHS checklist's development by providing expert comment.

Meanwhile, the AMA continues its work in disaster education through its Center for Public Health Preparedness and Disaster Response.

Ultimately, though, in the event of this specific type of catastrophe, the responsibility for being ready will fall to individual physicians, because they will be the first responders. Primary care physicians, especially, can expect to diagnose the index cases, report them to local and state public health officials and deal with patients in need.

And this reality is why planning before a crisis is so important.

Some steps will be straightforward. Reliance on sound infection control practices will be integral, especially because vaccines and antivirals might not be immediately available in all areas. Also, government officials increasingly warn that, especially early on, federal agencies could not be relied upon to send help to everyone.

Thus, preparation and self-sufficiency are becoming the buzzwords. It's a message that should resonate with physicians and trigger action before it's too late.

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External links

Pandemic and avian flu information from the federal government, including links to health care planning checklists (link)

The AMA's Center for Public Health Preparedness and Disaster Response (link)

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