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Forward Thinking for Flu

 It's that time of year again. Time to be forward thinking for flu.

As we approach another flu season it remains unclear what, if any, role H1N1 Swine Flu will play. Will there be another Type A influenza strain that will impact us? Will we see Swine Flu back as a seasonal visitor? Or, will we simply continue to have the various seasonal flu wax and wain throughout the season? I'm safe to say I don't know, nor will predict. Equally safe is the bet that nobody knows for sure.

Despite the less-than-glamorous remarks I get from some planners and responders, I continue to hold the position that flu; seasonal or novel strain, is a naturally occurring biological event. Look at the situation in that frame for just a second or two...If you knew there was going to be a biological event occurring in your community in the next few months, would you begin preparing for it now? I certainly hope so.

We know that seasonal influenza kills 30-35 thousand people in the United States every year. And we also know (now) that vaccine production and distribution in the event of a novel (or, perhaps intentional) biological event will be slow and sparse. So why wait until flu season (with or with a novel strain or variant) to begin preparing to meet the demands this naturally occurring event will place on your public and your service? I'd like to offer my list of things to consider when reviewing/planning for the 2010 flu season:

First, start or renew your infection control practices now. Get in (or back in) the habit of disinfecting your apparatus at the beginning of each tour, after each patient, and at the end of each tour. This includes wiping down all surfaces in the patient care compartment of ambulances, equipment that comes in contact with patients, and the cab of the vehicle. Don't neglect the place were you ride! Wipe down or disinfect the cab...with special attention to door handles, radio microphones, and the steering wheel.

 Second, although vaccination is still a great way to protect yourself from getting the flu, non pharmacutical interventions go a long way in stopping the spread of any disease. Remember to follow good hand hygiene practices by washing your hands as often as possible and using waterless sanitizers when soap and water are not available. Practice respiratory ettiquette - cover your cough and sneeze. Do so by coughing or sneezing into your elbow reduces the spray of material that comes out of you and into society. Also, wear a mask and don't be afraid to put a mask on your patient. The Centers for Disease Prevention and Control has recently dropped their requierment for N95 masks in the setting of flu in favor of surgical masks (See my previous Mitigation Journal post CDC Drops N95 Requirement) Also, consider appropriate social distancing...that is, stay home if you're sick. Many employers don't like to hear about this one. It is irresponsible to go to work (especially if you have contact with the public) if you are ill. Those involved in planning must account for the possibility that the workforce will be decreased, perhaps significantly, by members not reporting due to illness. You must also consider the absentee rate to increase due to employees remaining home to care for significant others who are ill or children when schools/daycare centers are closed. 

I encourage everyone to review the Mitigation Journal posting Bio-Event Ready or Die! 3 Thing to do, Today. originally posted August, 2009, for more on this topic.

For a summary of Mitigation Journal blog postings and podcast episodes on flu and flu-related topics, click here

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