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Health Protection perspective on Winter Planning Guidance & Communications. Norovirus & Flu 2010-11. Drs Jim McMenamin & Evonne Curran Consultant Epidemiologist & CNIC. Winter planning – an infection perspective. Clairvoyance helpful since its not an exact science!
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Health Protection perspective on Winter Planning Guidance & Communications Norovirus & Flu2010-11 Drs Jim McMenamin & Evonne Curran Consultant Epidemiologist & CNIC
Winter planning – an infection perspective • Clairvoyance helpful since its not an exact science! • Early alerts re norovirus & flu • has it started in UK, Scotland, my board) • Trend surveillance • How bad is it compared with last years/years)
2010/11 Norovirus season – A Blue Peter Badge for • Being better prepared in general • Working together better to prepare for the season • Developing escalation plans • Better epidemiology of local situation • Working better together during outbreaks
2009-2010 season =‘Worst ever’? Lots of points where there was a sudden peak – loss of control
2010-11 season = ‘Best ever’? Few points where there was a sudden peak and control was lost
Why was it so much better • Good year usually follows a bad year • The weather was so cold no one went out at peak transmission times • Different circulating virus • We were better prepared • We reacted better
Good Practice Identified from the Evaluation • Lots of reports of new planning and response • Radio Broadcasts – in English and Gaelic • Engagement with managers • Agreement on escalation • Education and training in clinical huddles • Something can be done attitude • Working with A&E
Care Homes - Norovirus • Most commonly reported outbreak in Scotland is norovirus in care homes (HPS Weekly report) • Data (not Scottish) • 3.1% of cases in Care Homes are admitted to hospital • 8% of care homes had at least 1 noro outbreak per year • Persons acquiring noro in the community (including care homes) and admitted to hospital are more likely to suffer more than those who acquire noro in hospital • Outbreaks in care homes when reported have been ongoing for 3.7 days • Theory: reduction in care home outbreaks will reduce admission of cases to hospital and reduce possible subsequent norovirus outbreaks in hospitals
New this year • Norovirus guidance in care homes pre season • Sharing preparedness with HPTs, e.g. key publicity messages, don’t visit hospitals or care homes if….. • Ensuring optimal communications with HPTs re care home admissions / outbreaks
New This Year – not confirmed (yet…) • Making official – a bay closure as alternative to full ward closure, if • Approved by IPCT (risk assessment) • Outbreak arises in a single bay or manageable area • Sufficient resources • Ongoing assessment that the policy does not just prolong outbreaks but reduce them. • Updated guidance is being consulted on - confirmation by October
Influenza • Enough vaccine @ the right time? • 1.16 million doses ordered (& contingency stockpile + additional supply) ☺ • Vaccine supply on target – mid Sept ☺ • 50% HCW target (Frontline) – CMO(2011)08 ☺ • Vaccine matched to circulating wild types? ☺ • Flu strains sensitive to antivirals? ☺ • Impact? ☺ • GP consultations • NHS 24 calls • ITU cases of confirmed flu etc
Warning • A bad year follows a good year • Being prepared for last season wont make you prepared for next season • Get prepared again