Preparing for the Unexpected - May 12, 2016

Infectious disease disasters have plagued mankind throughout the course of human history. Millions have suffered and died from pandemics such as influenza, Ebloa, rotaviruses, coronaviruses such as SARS, and many more. Yet, according to Infection Control Today (ICT), "unfortunately, experts believe occurrence of another pandemic is not so much a question of 'if' as a question of 'when.'" Research proposes that pandemics occur every 40 years and most likely will occur next in Asia or Africa, potentially killing an estimated 350 million people. This will disrupt millions of individual lives in addition to healthcare systems, society and the world’s economy.

In a recent article from ICT, "Year-Round Readiness Can Help Conquer the Unexpected", experts agree that preparedness plans in hospitals, healthcare facilities, and the community can be successful tools for increasing the likelihood of rapid, efficient and successful responses to outbreaks. By doing so, it will "reduce human suffering and negative effects on the community and society." Hospitals are at the center of infection outbreaks, providing direct medical care to infected individuals in the community. Preparing before an outbreak of a pandemic allows for hospitals to cope with the chaos and challenges of an emergency disaster and allows for a strategic framework for prioritizing actions.

However, hospitals are still struggling to create preparedness plans. This is mainly because of limited resources and high costs of planning. With every day present needs, the worth of planning and cost of future preparations becomes complicated. But the "inability to stockpile resources is a particularly problematic aspect of preparedness plans that often results in shortage during disasters. Typically, pre-disaster stockpiling efforts are stymied by limited availability, inadequate manufacturing capacity and high cost of equipment and supplies. In 2005, only 105,000 mechanical ventilators existed in the United States; of these, 75,000 to 80,000 ventilators were in use at any given time for everyday medical care; but during a typical influenza season more than 100,000 ventilators would be required, leaving most patients without access to ventilation."

In 2005 WHO released a checklist for influenza pandemic planning. Although preparedness primarily concerns pharmacological interventions such as vaccines, antiviral agents, and antibiotics, there is a need for non pharmacological interventions. These include: hand hygiene, additional infection control tools and processes, healthcare worker training on infection control practices, and community awareness in case of an outbreak. 

Michael Osterholm, PhD, MPH, wrote in the New England Journal of Medicine (2005): “Planning for a pandemic must be on the agenda of every public health agency, school board, manufacturing plant, investment firm, mortuary, state legislature and food distributor. Health professionals must become much more proficient in ‘risk communication,’ so that they can effectively provide the facts — and acknowledge the unknowns — to a frightened population. … [Infectious disease disaster planning] depends on how everyone, from world leaders to local elected officials, decides to respond. We need bold and timely leadership at the highest levels of the governments in the developed world; these governments must recognize the economic, security and health threats posed by the next influenza pandemic and invest accordingly. The resources needed must be considered in the light of the eventual costs of failing to invest in such an effort. The loss of human life even in a mild pandemic will be devastating and the cost of a world economy in shambles for several years can only be imagined.”