• How is the 2008 Ontario Health Plan for an Influenza Pandemic different from the version released in 2007?
• How was the 2008 Ontario Health Plan for an Influenza Pandemic developed and who was involved?
• Does the 2008 Ontario Health Plan for an Influenza Pandemic align with the Canadian Pandemic Influenza Plan?
• Is the Ontario government going to provide health workers with antivirals to prevent influenza during an influenza pandemic?
• As a health care worker, how can I learn more about pandemic planning?
• How can I get involved with pandemic planning?
• What is personal protective equipment?
• Who is responsible for purchasing stockpiles of personal protective equipment for use by health care workers during an influenza pandemic?

The Ontario Health Plan for an Influenza Pandemic (OHPIP) continues to evolve year after year. The 2008 OHPIP includes updates to existing chapters, as well as new chapters and tools designed to further guide and support pandemic planning across the health system.

Key enhancements of the 2008 OHPIP include :

• New details on surveillance and reporting systems to monitor a pandemic;
• Updated information on occupational health and safety and infection prevention and control measures;
• More details on the organization and delivery of influenza-related primary care services, including updated information on early assessment, treatment and referral strategies;
• Revisions to planning guidelines for laboratories, paediatric services, and long-term care homes;
• Planning guidelines for the provision of chronic kidney disease/ acute kidney injury services; and,
• Guidance to assist hospitals in planning for potential blood shortages.

These are just some highlights of the 2008 edition of the plan. To view or download the OHPIP, visit the Ontario Health Plan for an Influenza Pandemic section of the Ministry of Health and Long-Term Care web site.

The OHPIP was first developed in 2004 and it continues to be updated annually. As in previous years, the 2008 OHPIP was developed through consultation and input from experts representing a broad spectrum of health stakeholders, including all three levels of government; public health, infectious diseases, and infection control experts; clinicians; and labour unions, professional associations, and health sector regulatory bodies.

The 2008 version of the OHPIP aligns with the planning assumptions in the Canadian Pandemic Influenza Plan (CPIP).

However, with respect to the use of personal protective equipment, the OHPIP goes beyond current recommendations in the CPIP. The 2008 OHPIP is recommending that health workers entering a room or assessment area (e.g., emergency department) with patients who have influenza-like-illness wear an N95 respirator. Ontario's plan is advising a higher level of protection than the CPIP's recommendation, which states that surgical masks be used by health workers in close proximity to patients with influenza-like-illness and N95 respirators be used only when performing aerosol-generating procedures.

The 2008 OHPIP exceeds the minimal requirements set by the federal government's plan given the scientific uncertainty over the modes of influenza transmission. Therefore, health workers in Ontario shall wear N95 respirators as an extra precaution during an influenza pandemic.

The CPIP annex on infection control and occupational health and safety is currently under review and an updated version is anticipated to be released in fall 2008. Ontario will closely review the revised annex for updates to the federal recommendations on the use of personal protective equipment for health workers during an influenza pandemic.

Currently there is no evidence that putting large groups of otherwise healthy Canadians on antiviral drugs in order to prevent influenza (i.e., prophylaxis) will slow or stop the spread of a pandemic. However, prophylaxis with antiviral drugs may play a key role in maintaining critical services (i.e., preventing infection in and providing reassurance to people caring for individuals with influenza as well as workers in critical sectors such as energy, police services, etc.) until a vaccine becomes available.

Ontario will develop a provincial policy on the use of antivirals for prophylaxis after consideration of the national policy (currently under development) and in accordance with the OHPIP's ethical framework for decision-making. This will help ensure a consistent approach to using antivirals for prophylaxis across all provinces and territories, which will lead to stronger public confidence and morale.

To learn more about pandemic planning, visit the Information For Health Care Providers section of the Ministry of Health and Long-Term Care's web site. This section is updated regularly and includes important information about pandemic planning that healthcare workers should know.There are useful links to a variety of resources, such as pandemic fact sheets for health care workers and the Ministry of Health and Long-Term Care's monthly Pandemic Planner newsletter.

In addition, you can access the interactive, on-line Personal and Family Care Module for information and tools to help you look after yourself and the people you care about during an influenza pandemic.

You can become involved in preparedness activities at home and at work. To learn more, visit the Ministry of Health and Long-Term Care's influenza pandemic website and select from a number of links for valuable information on making emergency plans.

As employer, it is also important to have information on pandemic planning. For more information on how to develop a pandemic plan for the private sector, contact the Employers' Health Hotline at 1-866-331-0339 or e-mail emergencymanagement.MOH@ontario.ca.

You may also wish to visit the Information For Employers section on the Ministry of Health and Long-Term Care's web site. This site is updated regularly, and is designed specifically for help employers to plan effectively. This section contains a Guide to Developing a Workplace Health Plan for an Influenza Pandemic; business continuity in a pandemic checklist; and links to relevant resources.

Personal protective equipment is equipment that helps protect individuals from the transmission of disease and illness. It typically includes masks, gloves, gowns, eye protection, and masks.

All health care settings/providers are required to plan for and maintain a four-week stockpile of personal protective equipment and other critical supplies. It is expected that this stockpile will be used first.

The ministry is developing a four-week stockpile of personal protective equipment that health care providers will be able to access when/if their individual stockpiles are exhausted.

CritiCall Ontario provides a 24 hour call centre for hospitals to contact on-call specialists; arrange for appropriate hospital bed access and facilitate urgent triage for patients
1-800-668-4357

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