Yesterday, the World Health Organization (WHO) raised the worldwide pandemic alert level to Phase 5. A Phase 5 alert is a strong signal that a pandemic is imminent. According to WHO Director-General Margaret Chan, “The change to a higher phase of alert is a signal to governments, to ministries of health and other ministries, to the pharmaceutical industry and the business community that certain actions should now be undertaken with increased urgency, and at an accelerated pace.”
Today, the Centers for Disease Control and Prevention (CDC) reported 109 H1N1 swine flu cases in 11 states. South Carolina is the newest state with confirmed cases. For a complete listing of states and the number of cases, go to http://www.cdc.gov/swineflu/.
CDC also reported that the strategic national stockpile deployment includes approximately 11 million antiviral regiments, masks, N95 respirators, gowns, gloves and face shields. Deployment to the following has been completed: NYC, IN, NY, TX, KS, OH, IL NJ and DC. Other states will receive their supplies no later than May 3. AHCA expressed to federal officials the importance of long term care (LTC) facilities receiving some of these supplies. Federal officials have assured us that they will relay to states that it is essential that the supplies go not only to hospitals, but to the continuum of care.
CDC posted a number of new or revised interim guidances last night and today, including:
N-95 Respirators
CDC may be planning to issue interim guidance that recommends that long term care (LTC) facilities make arrangements to have a supply of N95 respirators, or other equivalent respiratory protection, available for staff use. AHCA is aware of the difficulties involved with using N95 respirators, i.e., the OSHA requirement for fit-testing and training, and we are communicating our concerns to the CDC and other federal officials. On a more positive note, such a recommendation could help LTC facilities to obtain N95 respirators, which may be in short supply, and to obtain, if needed, other influenza countermeasures.
AHCA was advised that facilities interested in stocking up on N95s may wish to contact their local or state public health department for assistance with N95 fit-testing and training. We also understand that the FDA may issue an Emergency Use Authorization to address the need for fit-testing during this emergency.
Treatment
According to the CDC, influenza antiviral drugs work best when started soon after illness onset (within 2 days), but treatment with antiviral drugs should still be considered after 48 hours of symptom onset, particularly for people at high risk of influenza-related complications. Currently, there appears to be enough antivirals to meet treatment needs. In addition, it appears that manufacturers can replenish stock fairly quickly.
School Closings
The National Infrastructure Coordinating Center today reported that 74 schools in 7 states (CA, NY, TX, OH, SC, IL and MN) were closed due to confirmed and probable cases of swine flu. The closures impact 47,590 students. An additional 30 schools in TX and CT closed for precautionary measures only.