5.1 Pandemic Planning

The AHMPPI outlines a range of public health actions that may be implemented during the different phases of a pandemic. They include actions focusing on both individual and community levels. A key principle early in a pandemic is the identification, separation and management of potentially infectious people in order to reduce transmission of the virus, which involves voluntary home isolation and quarantine at individual level and a range of social distancing measures at community level.

During the DELAY phase, the emphasis is on the early detection of cases arriving in Australia through international borders, hence a range of complementary border health measures would be implemented to detect cases and identify contacts. During the CONTAIN phase, the emphasis is on containing the establishment of the pandemic virus in Australia and ensuring that the health system is able to cope. During the SUSTAIN phase, the public health response is continued (sustained) while awaiting the availability of a customised vaccine, the most effective countermeasure being an immune population.

The AHMPPI foreshadowed the potential for closure of schools and childcare centres to minimise transmission of a pandemic virus, recognising that children shed influenza virus more readily than adults, have poorer hygiene practices and may shed influenza virus without becoming obviously unwell. Other social distancing measures could be considered, such as cancellation of mass gatherings and changing of public transport arrangements to limit opportunities for the virus to spread. Implementation of such measures would be supported by appropriate public information campaigns encouraging Australians to maintain good hygiene practices, including cough etiquette and hand washing, at all times.

It was planned that jurisdictions would establish ‘flu clinics’ and influenza-specific services to help prevent the spread of infection by keeping potentially infectious patients separate from other patients being seen in general practices and hospitals. It was considered that the role of GPs would be to maintain essential primary healthcare services in the community, with assessment of suspected pandemic influenza patients to occur in specialised influenza clinics or in general practices that had declared themselves influenza-specific practices. Other benefits of these measures could include assisting in managing a larger patient load; providing an earlier triage before a hospital emergency department (ED); using staff familiar with infectious diseases; efficient use of limited PPE supplies; and providing sites for supply of antiviral medication and vaccine.

The AHMPPI described a flexible policy for the use of antiviral medication, recognising that this medication may be necessary for treatment of cases as well as for pre- and post-exposure prophylaxis. How it would be used would depend on a number of factors, such as the severity of the pandemic, the availability of vaccine and the effectiveness of the antiviral medication, including any evidence of resistance. It was planned to prioritise at-risk (front-line) healthcare workforce personnel with antiviral prophylaxis in recognition of the importance of maintaining a skilled healthcare workforce during a pandemic.