Dr. Hill asks doctor input in pandemic flu planning
■ The AMA immediate past president says it's critical to keep physicians in the loop to ensure timely detection and efficient management of an outbreak.
By Victoria Stagg Elliott — Posted Sept. 4, 2006
Local public health departments need to take steps to make sure that physicians and other first responders in the health care system know what to do when pandemic influenza hits to detect the earliest cases and manage the outbreak as it spreads, says AMA Immediate Past President J. Edward Hill, MD.
He was speaking at the National Assn. of Counties annual conference in Chicago last month.
"The majority of America's doctors want to provide medical help in the event of a disaster but don't feel prepared to do so," he said.
Dr. Hill called for public health departments to build surge capacity into laboratory systems, create links to local medical societies and have strategies for communicating about infection control -- particularly early in a pandemic, when vaccines most likely will not yet be available. In addition, he warned that plans need to be in place to prepare for surges in the number of patients who need care and isolation at a time when the health care work force could be affected by high rates of illness.
"Sick nurses, doctors and health professionals won't be able to come to work, and hospitals and surge centers may be relying on a skeleton staff," Dr. Hill said.
The AMA immediate past president said he expects physicians and the public health system to handle any impending pandemic far better than the 1918 Spanish flu outbreak. Improvements in technology mean that viruses can be genetically sequenced quickly, and antiviral medications exist that can mediate their impact. The availability of antibiotics also means that those who do contract the pandemic strain of flu will be less likely to die of secondary bacterial infections.
"We have much better tools for combating flu today than we did in 1918," he said.
But while Dr. Hill said there was reason for optimism, he noted that public health is far from well-prepared and that more efforts are needed to ensure that this technology gets to where it needs to go.
"We must continue to prepare, and to remember that we already have -- or are capable of producing -- the tools we need to combat a flu pandemic," he said.
And municipalities need plans that are not too reliant on federal resources, which may be spread thin in a pandemic, he added -- a view shared by many regarding this issue.
For instance, in August, the National Assn. of County and City Health Officials published the "Local Health Department Guide to Pandemic Influenza Planning" to help local health departments take on this challenge.