Further preparation may be necessary to combat ongoing H1N1 outbreaks

More than 60% of health care workers surveyed reported that their hospital was prepared for an influenza A (H1N1) pandemic, according to results of a recent study.

Ebbing Lautenbach, MD, MPH, MSCE, of the University of Pennsylvania School of Medicine, and colleagues conducted a cross-sectional survey of members of the Society of Healthcare Epidemiology of America. The survey included questions about the importance of influenza A (H1N1), the preparedness of their institution, the time spent on the crisis and the response of their institution to the crisis.

Lautenbach discussed the potential impact of the study with Infectious Diseases in Children. “In a broad sense, this study is important because it gives us real-time data regarding the assessment and response to an ongoing outbreak,” he said. “These sorts of data are invaluable in helping hospitals, public health professionals and public officials determine how best to modify and improve future efforts.”

Lautenbach also said that the results provide insight into what healthcare epidemiologists believe has worked well and what has not worked well in the response to the pandemic. “It is affirming to know that, in general, respondents felt they were well prepared for this crisis,” he said. “That said, there are clearly areas where we need to improve, including an emphasis on vaccine development and healthcare worker education.”

Results

There were 323 respondents, 60.4% of whom reported that their hospitals were prepared for a pandemic. Lautenbach said that although this 60% is encouraging, it also indicates that a “substantial minority (about 40%) did not feel this way.”

Regarding hospital administration support, 85.1% of respondents reported that senior hospital administrators provided adequate political support, and 80.2% of respondents reported that adequate resources had been distributed.

Responses to the crisis may have caused hospitals to neglect other important infection prevention activities, according to 50.9% of respondents. “This neglect suggests that further resources may need to be mobilized to account for the large expansion of time and effort required to address this crisis,” Lautenbach said.

Antiviral medication shortages were reported by 30.7% of respondents. Though 39.0% of respondents reported that personal stockpiling of antiviral medications occurred at their institution, 51.4% of respondents reported that institutional actions were initiated to prevent personal stockpiling.

Lautenbach highlighted the fact that that about a third of respondents reported a shortage of antiviral medication during the crisis, and that this shortage was likely due to personal stockpiling. “Stockpiling of antiviral medications was reported often, suggesting that physicians could play a key role in helping to curb this practice,” Lautenbach said. “This includes both reassuring patients who might request unnecessary antivirals, and dealing with other healthcare professionals who might prescribe these medications outside of accepted indications.”

Influenza vaccine should be mandatory for health care workers, according to 77.7% of respondents. “The importance of vaccination against influenza was highlighted often,” Lautenbach said. “Indeed, over three quarters of respondents felt healthcare workers should be mandated to receive influenza vaccine or risk losing their jobs.”

Almost all respondents (91.0%) believed that an H1N1 would reappear later in the year.

“The main message is that while healthcare epidemiologists felt reasonably well prepared for the H1N1 crisis, much work remains to be done,” Lautenbach said. – by Rob Volansky

Lautenbach E et al. Clin Infect Dis. 2010;50:523-527.

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