Planning for the next influenza pandemic: Using the science and art of logistics
DOI:
https://doi.org/10.5055/ajdm.2019.0342Keywords:
pandemic, influenza, logistics, bed space, oxygenAbstract
The complexities and challenges for healthcare providers and their efforts to provide fundamental basic items to meet the logistical demands of an influenza pandemic are discussed in this article. The supply chain, planning, and alternatives for inevitable shortages are some of the considerations associated with this emergency mass critical care situation. The planning process and support for such events are discussed in detail with several recommendations obtained from the literature and the experience from recent mass casualty incidents (MCIs). The first step in this planning process is the development of specific triage requirements during an influenza pandemic. The second step is identification of logistical resources required during such a pandemic, which are then analyzed within the proposed logistics science and art model for planning purposes. Resources highlighted within the model include allocation and use of work force, bed space, intensive care unit assets, ventilators, personal protective equipment, and oxygen. The third step is using the model to discuss in detail possible workarounds, suitable substitutes, and resource allocation. An examination is also made of the ethics surrounding palliative care within the construction of an MCI and the factors that will inevitably determine rationing and prioritizing of these critical assets to palliative care patients.References
Morens DM, Fauci AS: The 1918 influenza pandemic: Insights for the 21st century. J Infect Dis. 2007; 195: 1018-1028.
Johnson NP, Mueller J: Updating the account global mortality of the 1918-1920 “Spanish” influenza pandemic. Bull Hist Med. 2002; 76: 105-115.
Ferguson NM, Mallett S, Jackson H, et al.: A population-dynamic model for evaluating the potential spread of drug-resistant influenza virus infections during community-based use of antivirals. J Antimicrob Chemother. 2003; 51: 977-990.
Osterholm MT: Perspective: Preparing for the next pandemic. N Engl J Med. 2005; 18: 1839-1842.
Kim CS, Pile JA, Lozon MM, et al.: Role of hospitalists in an offsite
alternate care center (ACC) for pandemic flu. J Hosp Med. 2009; 4: 546-549.
Pandemic Flu Web site. Available at http://www.flu.gov/. Accessed November 15, 2010.
U.S. Department of Health and Human Services (HHS): HHS pandemic influenza plan; November 2005. Available at http://www.hhs.gov/pandemicflu/plan. Accessed November 15, 2010.
Jang H, Boltz D, Sturm-Ramirez K, et al.: Highly pathogenic H5N1 influenza virus can enter the central nervous system and induce neuroinflammation and neurodegeneration. Proc Natl Acad Sci USA. 2009; 106: 14063-14068.
Schnirring L: New studies show low household transmission of H1N1. Available at http://www.cidrap.umn.edu/cidrap/content/influenza/swineflu/news/jun2110household-br.html. Accessed November 15, 2010.
Donaldson LJ, Rutter PD, Eillis BM, et al.: Mortality from pandemic A/H1N1 2009 influenza in England: Public health surveillance study. Br Med J. 2009; 339: 1-8.
Mahoney EJ, Biffl WL, Cioffi WG: Mass-casualty incidents: How does an ICU prepare? J Intensive Care Med. 2008; 23: 219-235.
Devereaux A, Christian MD, Dichter JR, et al.: Summary of suggestions from the task force for mass critical care summit. Chest. 2008; 133: 1S-7S.
Toner R, Waldhorn R, Maldin B, et al.: Meeting report hospital preparedness for pandemic influenza. Biosecur Bioterror. 2006; 2(4): 207-217.
Christian MD, Devereaux AV, Dichter JR, et al.: Definitive care for the critically ill during a disaster: Current capabilities and limitations. Chest. 2008; 133: 8S-17S.
Radonovic LJ, Magalian PD, Hollingsworth MK, et al.: Stockpiling supplies for the next influenza pandemic. Emerg Infect Dis [online report]. 2009. Available at http://www.cdc.gov/eid/content/15/6/e1.htm. Accessed November 15, 2010.
Cinti SK, Wilkerson W, Homes JG, et al.: Pandemic influenza and acute care centers: Taking care of sick patients in a nonhospital setting. Biosecur Bioterror. 2008; 6: 335-344.
Bascetta CA: Emergency Preparedness: State Efforts to Plan for Medical Surge Could Benefit from Shared Guidance for Allocating Scare Medical Resources, GAO-10-381T. Danville, PA: United States Government Accountability Office, January 25, 2010.
Eyck RPT: Ability of regional hospitals to meet projected avian flu pandemic surge capacity requirements. Prehosp Disaster Med. 2008; 23: 103-112.
Klein GD, McCarthy ML: The science of surge. Acad Emerg Med. 2006; 13: 1089-1094.
Burkle FM: Population-based triage management in response to surge-capacity requirements during a large-scale bioevent disaster. Acad Emerg Med. 2006; 13: 1118-1129.
Matzo M,Wilkinson A, Lynn J, et al.: Palliative care considerations in mass casualty events with scare resources. Biosecur Bioterror. 2009; 7: 199-210.
Hick JL, Rubinson L, O’Laughlin DT, et al.: Clinical review: Allocating ventilators during large-scale disasters--Problems, planning and process. Crit Care. 2007; 11(3): 217.
Domres B, Kich M, Manger A, et al.: Ethics and triage. Prehosp Disaster Med. 2001; 16: 53-58.
Talmor D, Jones AE, Rubinson L, et al.: Simple triage scoring system predicting death and the need for critical care resources for use during epidemics. Crit Care Med. 2007; 35: 1251-1256.
Christian MD, Hawryluck L, Wax RS, et al.: Development of a triage protocol for critical care during an influenza pandemic. Can Med Assoc J. 2006; 175: 1377-1381.
Rubins L, O’Toole T: Critical care during epidemics. Crit Care. 2005; 9: 311-313.
Hick JL, Barbera JA, Lelen GD: Refining surge capacity: Conventional, contingency, and crisis capacity. Disaster Med Public Health Prep. 2009; 3 (Suppl 1): S59-S67.
Christian MD, Hamielec C, Lazar NM, et al.: A retrospective cohort pilot study to evaluate a triage tool for use in a pandemic. Crit Care. 2009; 13: 1-9.
Qureshi K, Gershon RRM, Sherman MF, et al.: Health care workers’ ability and willingness to report to duty during catastrophic disasters. J Urban Health. 2005; 82: 378-388.
Irvin CB, Cindrich L, Patterson W, et al. Survey of hospital healthcare personnel response during a potential avian influenza pandemic: Will they come to work? Prehosp Disaster Med. 2008; 23(4): 328-325.
Levin D, Cadigan RO, Biddigner PD, et al.: Altered standards of care during an influenza pandemic: Identifying ethical, legal, and practical principles to guide decision making. Disaster Med Public Health Prep. 2009; 3 (Suppl): S132-S140.
Kotalik J: Preparing for an influenza pandemic: Ethical issues. Bioethics. 2005; 19(4): 422-431.
Courtney E, Toner E,Waldhorn R, et al.: Healthcare coalitions: The new foundation for national healthcare preparedness and response for catastrophic health emergencies. Biosecur Bioterror. 2009; 7: 153-163.
Franco C,Toner E,Waldhorn R, et al.: Systemic collapse: Medical care in the aftermath of hurricane Katrina. Biosecur Bioterror. 2006; 4: 135-146.
Rubinson L, Branson RD, Pesik N, et al.: Positive-pressure ventilation equipment for mass casualty respiratory failure. Biosecur Bioterror. 2006; 4: 183-194.
Rello J, Rodriquez A, Ibanez P, et al.: Intensive care adult patients with severe respiratory failure caused by influenza A (H1N1)v in Spain. Crit Care. 2009; 13: R148.
Lynn M, Garr D, Memo A, et al.: Management of conventional mass casualty incidents: Ten commandments for hospital planning. J Burn Care Res. 2006; 27: 649-658.
Hotchkin DL, Rubinson L: Modified critical care and treatment space considerations for mass casualty critical illness and injury. Respir Care. 2008; 53(1): 67-74.
Ritz R, Previtera JE: Oxygen supplies during a mass casualty situation. Respir Care. 2008; 53: 215-225.
Hick JL, O'Laughlin DT: Concept of operatives for triage of mechanical ventilation in an epidemic. Acad Emerg Med. 2006; 13: 223-229.
Hasikura M, Kizu J: Stockpile of personal protective equipment in hospital settings: Preparedness for influenza pandemic. Am J Infect Control. 2009; 37(9): 703-707.
Matheny J,Toner E,Waldhorn R: Financial effects of an influenza pandemic on U.S. hospitals. J Health Care Finance. 2007; 34: 58-63.
Fiscal Policy Institute: The Fiscal Impact of the World Trade Center Attack on New York Hospitals. New York: Greater New York Hospital Association, 2001.
Schulta CH, Koenig KL: State of research in high-consequence hospital surge capacity. Acad Emerg Med. 2006; 13: 1153-1156.
Toner E,Waldhorn R: What hospitals should do to prepare for an influenza pandemic? Biosecur Bioterror. 2006; 4: 397-402.
Itzwerth RL, MacIntyre CR, Shah S, et al.: Pandemic influenza and critical infrastructure dependencies: Possible impact on hospitals. Med J Aust. 2006; 185: S70-S72.
Kr„mer M, Bongaerts J, Bovenberg R, et al.: Metabolic engineering for microbial production of shikimic acid. Metab Eng. 2003; 5: 277-283.
Fleming DM, Elliot AJ, Meijer A, et al.: Influenza virus resistance to oseltamivir: What are the implications? Eur J Public Health. 2009; 19(3): 238-239.
Lynn M, Garr D, Memo A, et al: Management of conventional mass casualty incidents:Ten Commandments for hospital planning. J Burn Care Res. 2006; 27: 649-658.
Lapinsky SE: H1N1 novel influenza A in pregnant and immunocompromised patients. Crit Care Med. 2010; 38(4): S52-S57.
Published
How to Cite
Issue
Section
License
Copyright 2007-2023, Weston Medical Publishing, LLC
All Rights Reserved
