Pandemic Planning and Influenza Management

The provided report focuses on the Australian Health Management Plan for Pandemic Influenza (AHMPPI), which aims to provide decision-makers with the best possible information to minimize the spread of diseases. The AHMPPI prioritizes planning, communication, and surveillance strategies to reduce the impact of influenza pandemics on the population. Additionally, the report touches upon the H1N1 vaccination program and the use of antiviral medicines as potential measures to mitigate the effects of influenza.

Australia’s response to pandemic
influenza in 2009 was guided by a
nationally agreed plan

TABLE OF CONTENTS
INTRODUCTION...........................................................................................................................1
Planning..................................................................................................................................1
Surveillance............................................................................................................................3
Communication......................................................................................................................4
Control strategies....................................................................................................................6
CONCLUSION ...............................................................................................................................7
REFERENCES ...............................................................................................................................8

INTRODUCTION
An influenza pandemic takes place in human due to emergence of new flu virus that
easily infect people and spread from one person to another. A large proportion of world
population is affected by this influenza. Australia’s response to this influenza was guided by a
national plan, Australian Health Management plan for Pandemic Influenza (AHMPPI). The plan
was designed in the year 2008 that outline nation’s measures so as to prevent the occurrence of
influenza pandemic (The Department of health, 2011). This report will examine four essential
components of the AHMPPI plan in order to reduce the impact of pandemic influenza in
Australia that are planning, surveillance, communication and control strategies. The report
targeted at analysing the planned strategies, actual occurrence and lesson learned for each of the
component along with commendable recommendations.
Planning
What was initially planned
A detailed planning has been undertaken by Australian government to react to an
influenza pandemic. There are various interconnected activity plan for pandemic control in
Australia. A guide to coordinate response to an influenza pandemic was provided by health and
entire government, political unit and jurisdictional, “Council of Australian Governments”
etc. The AHMPPI plan was designed in 2008. A menu of options was provided by the plans that
were made. A national health pandemic plan AHMPPI is reviewed regularly to include the latest
policy developments. As stated by Al-Tawfiq and Memish, (2014) The main objective of
pandemic planning was to provide the decision-making, public and professional of health with
best available information and to reduce the spread of pandemic virus. The AHMPPI worked
with alls aspect of government so as to educate the consequences of pandemic on social
functioning and the community. In order to responds to a severe pandemic, the plan that was
made have the capacity, flexibility. The response plan was made by each state and territory that
integrates with the national plan. According to Gray (2015), by the National Action Plan (NAP)
for Human Influenza Pandemic the AHMPPI is supported. At each level of government the roles
and responsibilities were outlined by NAP that will pay attention to address the broader socio-
economic effects of pandemic. For the purpose of response and pandemic planning purposes the
health sector structures of decision-making were detailed by AHMPPI. A series of committed
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such as decision-making committee, operational committee prepared and coordinated with the of
national health sector. In the AHMPPI the Australia's phasing system, determines whether the
rising infectious agent is in land or in Australia. For determining and implementing the phases of
pandemic change the steps were outlined in Australia by AHMPPI. Under International Health
Regulations (IHR) 2005 Australia has agreed to document incidents and hold out good
surveillance and outcome capacity to forbid the global outspread of disease, while neglecting
excess hinderance with global traffic and trade. Further, Being National Focal Point (NFP),
Australian Government Department of Health and Ageing’s National Incident Room were
accountable for informing and reporting public health events of global importance within 24
hours to the World Health Organization (WHO) .
What actually happened, and why
As per Hanschke, Wolf and Hensel, (2014), The outbreak of novel influenza was notified to
NIR by WHO. The other Australian government were informed by the NIR. The activating their
pandemic plans need to be considered by the state and territory public health agencies. The
vaccination program for pandemic was implemented. The teleconferences were held by the
health ministers to pay attention on national Pandemic Vaccination Program (H1N1). In order to
make inform decision-making throughout the response a range of skilled people met, precious
proposal was given by them. The two-way communication forum was provided by General
Practice Round table (GPRT) between the government of Australia and peak bodies. In parallel
with GPRT a medical intensivist skilled group was constituted. The new phase of PROTECT
was developed on 17th June 2009 in identification that H1N1 2009 virus was mild in most, severs
in few and average overall. The government of Australia worked with epidemiologists and
scientists during the response to evaluates a number of difficult questions regarding
hospitalization rates, distribution of vaccines etc. In June 2009, guidance was given to clinicians
on how to manage patients with confirmed infection with pandemic.
Lessons learned and recommendations
In response to the emergent threat of pandemic 2009, the exercised pandemic plan that
was made by Australia was in good positions to implement rapid actions. The AHMPPI guide
was used efficiently by the AHPC in order to adapt the understanding of the illness involved.
The development of new PROTECT phase represents that the bendable public health response
system is there in Australia. In order to enable the responses adaptable to severity of disease the
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ways should be consider incorporating greater flexibility in pandemic influenza planning. The
purpose of Australian phases needs to be reviewed and national consistency on the issues is
required. A decision support document need to be developed. This will include the recognition of
all the measures of public health control are acquirable in pandemic, the goals of all measure
and the benefits of risk and the requirement of resources. The number and the compositions of
health advisory group on pandemic influenza need to be reviewed. A research plan need to be
developed to make sure that investigation meets the wants of a public health response to an
influenza pandemic.
Surveillance
During the public health emergencies surveillance has a fundamental role to give correct
and necessary information to assist in making decisions.
What was initially planned
When the pandemic emergence a draft surveillance annex to the AHMPPI was advised
by advisory Group of the scientific influenza. The acknowledgement was given by AHMPPI
that the planning assumptions need to be reassess when a growth of pandemic takes place. More
information is need in comparison with routine surveillance systems can give. For disease
outbreaks an internet-based reporting system has been developed. In 2009 prior to the
pandemic , NetEpi was formed to give more information during an outbreak, By means of data
collection forms the information will be recorded in NetEpi. The disease severity indication was
included by few of the routine surveillance systems. To overcome the labour-intensive double
data entry between NetEpi and jurisdictional system the progressive implementation of an
interface take place at distinct phase throughout the pandemic. By network of clinicians’ critical
information also has been provided. A collection system was developed with the help of
networks so as to identify unforeseen demand for Extra-Corporeal Membrane Oxygenation
(ECMO) was recognized. With the help of media reporters, official health websites the global
pandemic situation was monitored. Three times per day the latest surveillance data were passed
from Australia. By Weekly Australian Influenza Surveillance reports a elaborate investigation of
the Australian situation was given. In order to meet the surge capability in all area of public
surveillance, analysis and reporting the guidance to DoHA was given by additional staff.
What actually happened, and why
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By Communicable Disease Network Australia (CDNA) the response of surveillance was
overseen. The change to testing protocols, case, definitions and requirements of reporting was
discussed by SDNA. The implementation of surveillance activities was guided by draft
surveillance annex. In order to monitor trends in influenza such as illness in Australia, the
existing sentinel and syndromic surveillance systems were use. The cases of influenza was
reported nationally with the help of NetEpi. From the sentinel laboratories the laboratory data
were collected. By the WHO collaborating centre for reference and research on influenza in
Melbourne the priceless information on the subtypes of the virus was given. In order to
understand the burden diseases in community extra capacity of laboratory to test and study on
patients presenting to GPS with ILI was enforced. The phase changes were used to inform the
laboratory-conformed case data. By state and territory health department the case data and data
on hospitalization were collected during early months of the pandemic. The new sources of data
such as ICU admission data from Australian and New Zealand intensive care society were used.
The enables effective collection of analysis was provided by the NetEpi outbreak management
system. More than 37,000 cases were analysed with the help of this system.
Lessons learned and recommendations
As per Bennett and Carney (2017), In order to understand the nature of the disease the accurate
and rapidly available pandemic data of surveillance is of great importance. In order to agree on
expectation regarding the level and sustainability of data collection from the response of
pandemic more work is needed. The tension between public information wants or interest need
to be balanced. The importance of early analysis needs to be emphasized by planning and the
skilled workforce and detailed data is needed to support the work. The evidence for decision-
making on transmission of disease is a provided by analysed data. The enormous effort is
required to maintain NetEpi due to increase in number of cases. In order to collect, analyse and
report data at national level the surveillance plan need to be completed.
Communication
The communication activities were adopted for the community of Australia in order to
make them understand the importance of hygiene in reducing the influenza transmission. The
future responses can be enhanced by improving communication strategies.
What was initially planned
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The importance of timely communication was highlighted by AHMPPI 2008 In order to
make available the best available information to decision-making. In May 2006, the Australian
Health Pandemic Influenza communication strategy was established . This approach was made to
inform or advice the key stakeholders or businesses during a pandemic. In order to reflect change
in AHMPPI 2008 when there was a declaration of pandemic there was updation in this
communications strategy. In order to complement the health’s sector strategy for public
communication the whole government public communication strategy was made by the Council
of Australian Governments (COAG). To manage public communications an overarching
framework was provided by the National Influenza Pandemic Public Communication Guidelines
for responding to and recovering from pandemic influenza. By the Australian department of
health the National Health Emergency Media Response Network(NHEMRN) was coordinated.
During health emergencies this network task is to keep the public informed by giving accordant
media and public responses. A tender process was taken by the Australian Government in 2006
to engage agencies of communication in order to give specialist services in case of pandemic.
For potential viral (H5N1) templates, information and advertising material were developed. The
two pandemic related websites were established by the Australian Government prior to
pandemic. The secure whole of government websites such as PannComm was developed. The
website that was launched for pandemic influenza provides information about the preparation of
pandemic.
What actually happened, and why
During the 2009 the government of Australia developed a national public communication
campaign that were based on four main drivers. They are as follows-:
 In order to reduce the spread of diseases the adoption of good hygienic practices and
keeping spacing form people are the most efficient methods.
 The H1N1 vaccines need to be advised to the Australians. The availability of this
vaccination and the importance of being vaccinated need to be explained to the
population of Australia.
 The parents need to be advised that vaccination can be given to children regarding this
disease form age group of 6-10 years. The motivations and encouragement should be
given to parents to vaccinate themselves and their child for this pandemic disease.
 The myths or perceptions need to be challenges that have restricted intake of the vaccine.
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The strong communication campaigns were run by states and territories in order to
encourage good personal hygienic practices. In order to response to public health emergency the
health emergency website was activated. The two-million users were allowed per day and ten-
million hits were allowed. The number of registered users for this site was in millions. The
content of this website was reviewed daily and updates as per requirements. All the information
regarding influenza protection, prevention and treatment was given in the website. The telephone
hotlines were established. The main goals of this hotline was to answer all the question of the
people regarding the pandemic. About the vaccination program (H1N1) all scripted information
was given to the callers.
Lessons learned and recommendations
According to Cork, Geales and Hall, (2015), during the pandemic the communication
strategy developed was prospering in transferring correct and punctual information of both
public and health professions. In order to incorporate key lessons identified during 2009
pandemic it is important to finalize a revised national pandemic combination strategy. A health
emergency website is a new website so it is not known by the general public and there were
delays to make this website fully functional. There was confusion between Health Emergency
and Pandemic Influenza websites. In order to support coordinated national and jurisdictional
media responses the national health emergency media responses network was not valuable
enough. In order to recognize Commonwealth and jurisdiction functions and responsibility there
is a need to develop principles for pandemic communication plan. The communication forum
needs to be considered similar to NHEMRN. For the pandemic influenza, a media-specific plan
need to be developed that will include the principle and protocols of media engagement.
Control strategies
In order to control the formation and execution of strategic plans the control strategies are
made by the organizations.
What was initially planned
As per Rubin, Dunham and Sleeman, (2014), a range of public health actions were
outlined by the AHMPPI that need to be implemented during different phases of pandemic. The
both individual and community levels need be focused. In order to reduce the transmission of
virus the key principle early in pandemic is to recognize and manage the potential infectious
people. The early detection of cases arriving in Australia is made by Delay phase. In order to
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detect cases and identify contact a various of additive border health measures would be
enforced. The emphasis of CONTAIN phase is to make sure that system of health is able to cope
with the establishment of pandemic virus in Australia. The public heath response is continued
during SUSTAIN phase.
What actually happened, and why
As a response to the nature of the pandemic to include a new phase PROTECT. In order
the phasing system was amended to reduce the transmission of this disease in community the
CMO's VAG recommended vaccinations. However as per McVernon and Lewin (2017). The
Australia's pandemic phase was assessed by the expert advisory and recommended modification
from PROTECT to ALERT. The considerable fears were made during the DELAY and
CONTAIN phases to recognize cases and their contracts. The assessment of people meeting the
suspected case took place and notification was sent to public health units (PHU). For the
treatment antiviral medicines were provided. The main focus of PROTECT phase was to focus
on complication of influenza rather identifying and managing every case.
Lessons learned and recommendations
According to Buccieri and Gaetz, (2013), the roles and responsibility about the case need
to be communicated to the workforce in more efficient ways. The policy to access and use
antiviral medicines need to be reviewed. The risk that is possess with the vaccination program
need to be identified and recognized. There is a risk for using unregistered vaccine.
CONCLUSION
Thus, summing up the above report it can be concluded that the overwhelm nation's
health system is under the burden of influenza pandemic. The economic and societal disruption
can be caused by the influenza pandemic. The goals of pandemic planning are to provide the
decision-making with the best possible information and to minimize the spread of this disease.
The AHMPPI focuses on planning, communication, and surveillance and control strategies in
order to reduce the impact of the disease on the population of Australia. The H1N1 vaccination
program can reduce the cause of this disease. The use of antiviral medicines can also reduce its
effect on people.
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REFERENCES
Books and journals
Al-Tawfiq, J.A. and Memish, Z.A., 2014. Surveillance for emerging respiratory viruses. The
Lancet Infectious Diseases. 14(10). pp.992-1000.
Bennett, B. and Carney, T., 2017. Public health emergencies of international concern: global,
regional, and local responses to risk. Medical law review, p. fwx004.
Buccieri, K. and Gaetz, S., 2013. Ethical vaccine distribution planning for pandemic influenza:
Prioritizing homeless and hard-to-reach populations. Public Health Ethics. 6(2). pp.185-
196.
Cork, S.C., Geale, D.W. and Hall, D.C., 2015. 25 One Health in Policy Development: An
Integrated Approach to Translating Science into Policy. One Health: The Theory and
Practice of Integrated Health Approaches, p.304.
Gray, B., 2015. 23. A case study of complexity and health policy: planning for a
pandemic. Handbook on Complexity and Public Policy, p.384.
Hanschke, K., Wolf, L.E. and Hensel, W.F., 2014. The Impact of Disability: A Comparative
Approach to Medical Resource Allocation in Public Health Emergencies. Louis UJ
Health L. & Pol'y. 8. p.259.
McVernon, J. and Lewin, S.R., 2017. Is Australia prepared for the next pandemic?. The Medical
Journal of Australia. 206(7). pp.284-286.
Rubin, C., Dunham, B. and Sleeman, J., 2014. Making one health a reality—crossing
bureaucratic boundaries. One Health: People, Animals, and the Environment, p.269.
Online
The Department of health. 2011. [Online]. Available
through:<http://www.health.gov.au/internet/main/publishing.nsf/content/ohp-pandemic-
influenza.html/>. [Accessed On: 9th October 2017].
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