Abstract
BackgroundOntario’s 36 Public Health Units (PHUs) were responsible for implementing the H1N1 Pandemic Influenza Plans (PIPs) to address the first pandemic influenza virus in over 40 years. It was the first under conditions which permitted mass immunization. This is therefore the first opportunity to learn and document what worked well, and did not work well, in Ontario’s response to pH1N1, and to make recommendations based on experience.MethodsOur objectives were to: describe the PIP models, obtain perceptions on outcomes, lessons learned and to solicit policy suggestions for improvement. We conducted a 3-phase comparative analysis study comprised of semi-structured key informant interviews with local Medical Officers of Health (n = 29 of 36), and Primary Care Physicians (n = 20) and in Phase 3 with provincial Chief-Medical Officers of Health (n = 6) and a provincial Medical Organization. Phase 2 data came from a Pan-Ontario symposium (n = 44) comprised leaders representing: Public Health, Primary Care, Provincial and Federal Government.ResultsPIPs varied resulting in diverse experiences and lessons learned. This was in part due to different PHU characteristics that included: degree of planning, PHU and Primary Care capacity, population, geographic and relationships with Primary Care. Main lessons learned were: 1) Planning should be more comprehensive and operationalized at all levels. 2) Improve national and provincial communication strategies and eliminate contradictory messages from different sources. 3) An integrated community-wide response may be the best approach to decrease the impact of a pandemic. 4) The best Mass Immunization models can be quickly implemented and have high immunization rates. They should be flexible and allow for incremental responses that are based upon: i) pandemic severity, ii) local health system, population and geographic characteristics, iii) immunization objectives, and iv) vaccine supply.Conclusion“We were very lucky that pH1N1 was not more severe.” Consensus existed for more detailed planning and the inclusion of multiple health system and community stakeholders. PIPs should be flexible, allow for incremental responses and have important decisions (E.g., under which conditions Public Health, Primary Care, Pharmacists or others act as vaccine delivery agents.) made prior to a crisis.
Highlights
Ontario’s 36 Public Health Units (PHUs) were responsible for implementing the H1N1 Pandemic Influenza Plans (PIPs) to address the first pandemic influenza virus in over 40 years
Some were enhanced versions of the seasonal Flu model with a high degree of dependency upon Primary Care; whereas, other models were PHU administered high volume clinics with no or little reliance on Primary Care. We found that these differences were in part due to expectations or uncertainty regarding vaccine supply (E.g., when available and how much) and different local health system characteristics that included: a) PHU size, capacity and planning; b) population make-up, size, density and location; c) historical relationships between the PHU and Primary Care/ Family physicians and other providers; and d) seasonal influenza programs
We found that the majority of the Medical Officers of Health described their PIPs as being closer to a ‘Strategic’ document (65%) and that in those PHUs the Medical Officers of Health were more likely to indicate that their PIP addressed fewer of the total issues and challenges that arose during H1N1
Summary
Ontario’s 36 Public Health Units (PHUs) were responsible for implementing the H1N1 Pandemic Influenza Plans (PIPs) to address the first pandemic influenza virus in over 40 years. It was the first under conditions which permitted mass immunization. Its role is primarily in the realm of developing national standards, co-ordinating responses across jurisdictions and providing financial support through defined arrangements with the provinces and territories that deliver mandated services. It has a direct role only for specific populations such as Aboriginal peoples and the military. As responsibility for delivery of infectious disease prevention and control programs, including those for vaccine preventable diseases such as influenza falls to local PHUs, each local PHU was required to both develop and implement its own Pandemic Influenza Plan (PIP) [1]
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
