Disasters

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Disasters Emergencies

• How Infectious Diseases Cause Emergencies
• Nancy Blackmore,
• Coordinator Preparedness, Planning Equipment
  Resource, EHS,

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Outline

• Infectious diseases by category
• Bioterrorism
• New emerging
• Pandemic influenza
• Impact planning considerations

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Infectious Communicable Diseases

• Endemic
• Normal expected level of disease
• Epidemic
• An outbreak with unusual high numbers
• Pandemic
• A world wide outbreak

• Bioterrorism
• 3 categories
• E.g. anthrax
• Newly emerging
• West Nile virus,
• SARS, etc.
• Naturally occurring
• E.g pandemics of influenza

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Definition

• Bioterrorism is the use of biological agents to
  intentionally produce disease or intoxication in
  susceptible populations to meet the aims of
  terrorists.
• In addition to the potential medical consequences
  is the likelihood of human panic a worthwhile
  goal in itself for the terrorist group.

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Public Reaction

• Cannot see, touch or feel it
• People cant get to a safe place, but sit and
  wait
• Panic!
• Increased psychosomatic illnesses
• Increased visits to an already overtaxed
  emergency department
• Health workers themselves may be fearful and
  stressed
• Hoarding of medical supplies and resources

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The Threat

• The Good News - low probability
• The Bad News - huge impact

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Organisms Diseases of New Concern to Us

• West Nile Virus
• Lyme disease
• Hantavirus
• Human Granulocytic Ehrlichiosis
• Son of SARS???

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What is Pandemic Influenza?

• A new influenza virus arising from a major
  genetic change antigenic shift or adaptive
  mutation
• The population will be very susceptible with
  little or no immunity
• The virus will transmit efficiently from person
  to person
• The virus will be virulent with the capacity to
  cause serious illness and death

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Each Pandemic is Different
Credit US National Museum of Health and Medicine
1918 Spanish Flu
1957 Asian Flu
1968 Hong Kong Flu
40-50 million deaths
2-4 million deaths
1 million deaths
H1N1
H2N2
H3N2
Source WHO
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Estimating the Impact for Nova Scotia

• 75 of people will be infected
• 15 38 will be clinically ill
• 6.8 17 will require outpatient care
• 0.1 0.3 will require hospitalization
• 0.03 0.1 will die
• Based on a flu aid formula developed by
  Meltzer colleagues, CDC Atlanta
  http//www.cdc.gov/ncidod/eid/vol5no5/meltzer.htm

• 681,005 will be infected
• 136,201 345,042 will be clinically ill
• 61,744 154,361 will require out-patient care
• 908 2724 will require hospitalization
• 272 908 will die
• Based on population numbers from 2001 census

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Pandemics are Unpredictable

• Direct impact of influenza
• Attack rate 15gt35
• Affected age groups unknown until it begins
• Virulence of the strain and rates of adverse
  outcomes/complications mild, moderate or
  severe?
• Speed of spread from country to country and
  within a country 1-3 months to arrive? 2-3
  waves? 12-18 months duration?

• Effectiveness of the response
• Vaccines not available for 1st wave
• antivirals in stockpile now for treatment
• non-pharmaceutical interventions public health
  measures
• Psychologically induced impacts/public behaviour

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Potential Challenges

• Must maintain mandatory business BCM
• Reduce elective or optional services
• Cope with simultaneous emergencies e.g.
  hurricanes, storms, etc.
• Prepare for economic consequences
• Increased demand for health social services
• Increased demand for volunteers
• Cope with loss of employees permanent or temp

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Consequences of Absenteeism

• All sectors impacted e.g. manufacturer,
  transportation, municipal services, etc.
• Possible shortages e.g. food, fuel, cash in bank
  machines
• Issues for workers ill themselves need
  self-care info may have elder or child care
  needs fear may be asked to work outside of
  usual environment, etc.

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Questions?

• The hardest part of responding to an emergency is
  explaining why we didnt prepare