White Alert: planning for a possible pandemic

• Follow regular updates on the MoH, WHO and CDC websites [these web addresses have been posted on the SLH website].
• Remind staff (clinical and non-clinical) to maintain awareness and hold a path between undue anxiety and reasonable precaution.
• Hold sufficient PPE for front-line staff - a first wave of pandemic disease might last 8-12 weeks. Further waves might follow.
• Advance prescriptions of anti-viral medication are not advised.
• Emphasise preventive measures (staff and patients) ? PPE, hand-washing and surface cleansing, immediate isolation of possible cases and safe disposal of tissues and other contaminated materials.
• Distinguish between seasonal flu and avian flu by seeking a history of travel from a recognised risk zone followed (within 2 days) by respiratory tract symptoms and rapidly progressive systemic illness. Refer to www.moh.govt.nz/pandemicinfluenza for case definition.
• Think about how you would manage general practice in the event of an emergent pandemic. Be prepared to use PPE and assess patients in their homes and, as far as possible, in isolation from others. Advise patients not to arrive in your waiting room but to describe their situations by telephone. Some practices may have suitably isolated space available for triage.
• Discuss contingency plans with neighbouring practices.
• Advise patients to hold sufficient regular medication, food and water to sustain personal needs as far as possible.
• In the event of an emergent pandemic, strongly advise avoidance of public places.
• Advise having a telephone and a radio/TV available for receiving public advisories.

• Move to a high level of awareness and apply strict precautions to reception and management of people with flu-like illness.
• Inform your DHB/Public Health Office about any suspect cases.
• Local diagnostic and further-care facilities are to be advised.

• Use PPE and apply isolation as far as possible
• Report all suspect cases to your DHB/Public Health Office
• Apply supportive care and request antiviral treatment for patients who meet the case definition. Plans for community-based assessment centres are being developed.
• In the event of a full-blown pandemic, services could be overwhelmed; staff will be depleted and practitioners will need to manage personal and patient needs as best they can.