An Investment in Preparation

UMMC pandemic ready

The now-dwindling call for alarm over a new flu strain that claimed nearly 50lives internationally leaves the state anticipating cases, and the University of Mississippi Medical Center ready to respond.

Call it H1N1, Swine Flu or North American Flu, the strain that first surfaced in Mexico and went on to dot the globe will spread farther, for sure. The question is, how quickly?

“This could be no more than the garden-variety flu we see annually. But we’ve planned and prepared for the worst and we’ll work from there,” said Dr. Rathel “Skip” Nolan, interim director of the Division of Infectious Diseases at the Medical Center.

“It could change, but there are few cases of secondary infection – people getting sick from casual transmission of the virus as might happen in a public place like a subway, movie theater or classroom.”

Taking the p-a-n-i-c out of pandemic

As scientists splice and replicate the virus through the months-long process of vaccine manufacturing, the World Health Organization, the U.S. Centers for Disease Control and Prevention and the media scaled down earlier warnings.

As such, the CDC early this month canceled its recommendation that schools consider closing to prevent spread of the disease. Instead, citing nearly 1,000 cases covering most U.S. states, the CDC said closings would be ineffective for virus control and recommended those who feel ill stay home.

“Most U.S. cases have not been severe and are comparable in severity to seasonal influenza. CDC, local and state health officials will continue to closely monitor the severity and spread of this novel H1N1 influenza outbreak,” a statement from the CDC read.

Prepped for response

Whatever the outcome, officials at the Medical Center stand ready. How so?

In terms of patient care, employees set up cough-etiquette stations in clinics, waiting rooms and public-gathering spots. Stations consist of boxes of tissues, disposable masks and hand sanitizer.

In the Emergency Department, where officials expect a good portion of flu-wary people could arrive, care providers received specific instruction.

“In our triage area, if somebody has symptoms suggestive of the flu, we put a mask on them and separate them early on. We fast-track them and get them to an area where they’re not going to infect other patients,” said Dr. James Kolb, medical director of the Emergency Department.

“Most of our patients are calm and rational about it. We haven’t had any confirmed cases of it in Mississippi. We’re in contact with the Mississippi Department of Health, we swab people who may have flu symptoms, both for our own samples and for the Health Department.”

The CDC released to states portions of its stockpiles of antiviral medications Tamiflu and Relenza as well as clinical supplies, such as disposable masks. Should infection rates spike, there’s layers of plans that could see treatment centers set up both on and off campus, with continued close contact with the Health Department and the CDC.

“If we had an overwhelming number of people coming in with this, a backup plan is to use a disaster trailer, to allow us more space to keep people separated and to treat them,” Kolb said.

Separation of suspected cases remains key because flu viruses are thought to spread mainly person-to-person through the coughing or sneezing of infected people.

Medical Center hospitals would put more care providers on flu duty by canceling elective surgeries and other non-essential procedures, said Nolan.

As the state’s only level-one trauma center, the Medical Center would have to keep more people on hand in the ED because it would still receive the day-to-day patients with major injuries and illness.

Medical Center emergency-operations planners run practice scenarios to sharpen skills. In fact, many spent the first week of May on the Mississippi  Gulf Coast for a drill.

Jonathan Wilson, UMMC clinical director of emergency services, said the National Disaster Medical System regional drill – “LIFESAVER 2009” – was the first joint exercise between federal and state emergency-response teams in Mississippi.

It gave the Medical Center an opportunity to show the depth of its emergency medical response capabilities in coordination with federal disaster medical-assistance teams.

The exercise involved about 27 hospitals from five states along the U.S Gulf Coast, more than 1,500 local, state and federal government personnel and first responders and more than 100 simulated patients recruited from Keesler Air Force Base students. Wilson described the drill as a “good dress rehearsal” for Mississippi Med-1, a mobile hospital scheduled to be available for activation starting June 1.

“We have to be ready, no matter the threat, whether it’s a nuclear, chemical or biological release,” he said. “We must have a contingency plan in place, no matter the situation.”

Provisions for students and employees

Dr. Rebecca Waterer, director of Student-Employee Health Services, laid out guidelines to Medical Center executives and hospital workers in an early-May meeting.

“If you have an employee who comes down with a confirmed, diagnosed case of H1N1, notify Infection Control (4-2188), have them stay home and notify Student-Employee Health (4-1185).”

Student-Employee Health Service fit-tests people with N-95 face masks, Waterer said. “Priority will be given to direct-patient-care workers who have never been fitted and direct-patient-care workers who have not been fitted in the last year as of June.”

Facial hair, even when closely groomed, prevents a mask from fitting tightly,so shave before coming in, she said.

And yes, pork remains safe to eat. Flu viruses don’t attach themselves to skeletal muscle or travel in the blood system, Waterer said. Rather, she said, they breed in the mucous glands, the reason why sneezing and nose-blowing remain contagious concerns.

Kolb said health-care workers are hearing the outbreak’s severity is declining.

“But there’s still going to be more cases reported,” he said.

Nolan said experts will keep a close watch.

“We’ve dealt with the flu every year. This is a novel strain of influenza out there, which the population doesn’t have much immunity to. It may burn itself out, it may hang around through the next flu season.”

Personal precaution

•   Cover sneezes with a tissue or sleeve

•   Stay home if you feel flu-like symptoms, limit contact with others and call your care provider

•   Wash hands thoroughly with soap andwarm water

•   Use alcohol-based hand sanitizer

•   Stay informed: the CDC Web site remains the national information source on H1N1

 

- Jack Mazurak

2009-05-11 00:00:00 18911