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Health Protection perspective on Winter Planning Guidance & Communications Norovirus & Flu 2010-11 Drs Jim McMenamin & Evonne Curran Consultant Epidemiologist &

Health Protection perspective on Winter Planning Guidance & Communications Norovirus & Flu 2010-11 Drs Jim McMenamin & Evonne Curran Consultant Epidemiologist

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Page 1: Health Protection perspective on Winter Planning Guidance & Communications Norovirus & Flu 2010-11 Drs Jim McMenamin & Evonne Curran Consultant Epidemiologist

Health Protection perspective on Winter Planning Guidance &

Communications

Norovirus & Flu2010-11

Drs Jim McMenamin & Evonne Curran

Consultant Epidemiologist & CNIC

Page 2: Health Protection perspective on Winter Planning Guidance & Communications Norovirus & Flu 2010-11 Drs Jim McMenamin & Evonne Curran Consultant Epidemiologist

Winter planning – an infection perspective

• Clairvoyance helpful since its not an exact science!– Early alerts re norovirus

& flu• has it started in UK,

Scotland, my board)– Trend surveillance

• How bad is it compared with last years/years)

Page 3: Health Protection perspective on Winter Planning Guidance & Communications Norovirus & Flu 2010-11 Drs Jim McMenamin & Evonne Curran Consultant Epidemiologist

Norovirus

Page 4: Health Protection perspective on Winter Planning Guidance & Communications Norovirus & Flu 2010-11 Drs Jim McMenamin & Evonne Curran Consultant Epidemiologist

2010/11 Norovirus season – A Blue Peter Badge for

• Being better prepared in general

• Working together better to prepare for the season

• Developing escalation plans

• Better epidemiology of local situation

• Working better together during outbreaks

Page 5: Health Protection perspective on Winter Planning Guidance & Communications Norovirus & Flu 2010-11 Drs Jim McMenamin & Evonne Curran Consultant Epidemiologist

NHS Scotland Norovirus Ward Closures NHS board 1 week 29 (2009) - week 28 (2010) n = 85

0

10

20

30

40

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60

Wk 29

Wk 30

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Wk 1

Wk 2

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Wk 28

Weeks 2009-10

NH

S S

co

tla

nd

Wa

rd C

los

ure

s

0

2

4

6

8

10

12

Scotland

Board 1

NHS Scotland Norovirus Ward Closures Board 8Week 29 (2009) - Week 28 (2010) n = 48

0

10

20

30

40

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60

Weeks 2009 - 10

NH

S S

co

tla

nd

Wa

rd C

los

ure

s

0

2

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Scotland

Board 8

2009-2010 season =‘Worst ever’?

Lots of points where there was a sudden peak – loss of control

Page 6: Health Protection perspective on Winter Planning Guidance & Communications Norovirus & Flu 2010-11 Drs Jim McMenamin & Evonne Curran Consultant Epidemiologist

2010-11 season =

‘Best ever’?

Few points where there was a sudden peak and control was lost

NHS Scotland Norovirus Ward Closures & NHS Board 4Week 29 (2010) - Week 19 (2011) n = 14 Week 29 (2009) - Week 19 (2010) n = 52

0

5

10

15

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25

30

Wk 29

Wk 30

Wk 31

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Wk 1

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Wk 19

Weeks 2010 - 2011

NH

S S

cotl

and

War

d C

losu

res

0

2

4

6

8

10

12

NH

S B

oar

d 4

War

d C

losu

res

Scotland

Board 4

NHS Scotland Norovirus Ward Closures & NHS Board 10Week 29 (2010) - Week 19 (2011) n = 28 Week 29 (2009) - Week 19 (2010) n = 28

0

5

10

15

20

25

30W

k 29W

k 30W

k 31W

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k 12W

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k 18W

k 19

Weeks 2010 - 2011

NH

S S

cotl

and

War

d C

losu

res

0

1

2

3

4

5

6

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8

9

10

11

12

Scotland Board 10

Page 7: Health Protection perspective on Winter Planning Guidance & Communications Norovirus & Flu 2010-11 Drs Jim McMenamin & Evonne Curran Consultant Epidemiologist

Why was it so much better

• Good year usually follows a bad year• The weather was so cold no one went

out at peak transmission times• Different circulating virus• We were better prepared• We reacted better

Page 8: Health Protection perspective on Winter Planning Guidance & Communications Norovirus & Flu 2010-11 Drs Jim McMenamin & Evonne Curran Consultant Epidemiologist

Good Practice Identified from the Evaluation

• Lots of reports of new planning and response• Radio Broadcasts – in English and Gaelic• Engagement with managers • Agreement on escalation• Education and training in clinical huddles• Something can be done attitude• Working with A&E

Page 9: Health Protection perspective on Winter Planning Guidance & Communications Norovirus & Flu 2010-11 Drs Jim McMenamin & Evonne Curran Consultant Epidemiologist

Care Homes - Norovirus

• Most commonly reported outbreak in Scotland is norovirus in care homes (HPS Weekly report)

• Data (not Scottish)– 3.1% of cases in Care Homes are admitted to hospital– 8% of care homes had at least 1 noro outbreak per

year– Persons acquiring noro in the community (including

care homes) and admitted to hospital are more likely to suffer more than those who acquire noro in hospital

– Outbreaks in care homes when reported have been ongoing for 3.7 days

• Theory: reduction in care home outbreaks will reduce admission of cases to hospital and reduce possible subsequent norovirus outbreaks in hospitals

Page 10: Health Protection perspective on Winter Planning Guidance & Communications Norovirus & Flu 2010-11 Drs Jim McMenamin & Evonne Curran Consultant Epidemiologist

New this year

• Norovirus guidance in care homes pre season

• Sharing preparedness with HPTs, e.g. key publicity messages, don’t visit hospitals or care homes if…..

• Ensuring optimal communications with HPTs re care home admissions / outbreaks

Page 11: Health Protection perspective on Winter Planning Guidance & Communications Norovirus & Flu 2010-11 Drs Jim McMenamin & Evonne Curran Consultant Epidemiologist

New This Year – not confirmed (yet…)

• Making official – a bay closure as alternative to full ward closure, if– Approved by IPCT (risk assessment)– Outbreak arises in a single bay or

manageable area– Sufficient resources– Ongoing assessment that the policy does

not just prolong outbreaks but reduce them.• Updated guidance is being consulted

on - confirmation by October

Page 12: Health Protection perspective on Winter Planning Guidance & Communications Norovirus & Flu 2010-11 Drs Jim McMenamin & Evonne Curran Consultant Epidemiologist

Influenza

Page 13: Health Protection perspective on Winter Planning Guidance & Communications Norovirus & Flu 2010-11 Drs Jim McMenamin & Evonne Curran Consultant Epidemiologist

Influenza• Enough vaccine @ the right time?

– 1.16 million doses ordered (& contingency stockpile + additional supply) ☺

– Vaccine supply on target – mid Sept ☺– 50% HCW target (Frontline) – CMO(2011)08 ☺

• Vaccine matched to circulating wild types? ☺• Flu strains sensitive to antivirals? ☺• Impact? ☺

– GP consultations– NHS 24 calls– ITU cases of confirmed flu etc

Page 14: Health Protection perspective on Winter Planning Guidance & Communications Norovirus & Flu 2010-11 Drs Jim McMenamin & Evonne Curran Consultant Epidemiologist

What to look out for? – Source = HPS

Page 15: Health Protection perspective on Winter Planning Guidance & Communications Norovirus & Flu 2010-11 Drs Jim McMenamin & Evonne Curran Consultant Epidemiologist

What to look out for? – Source = ISD

Page 16: Health Protection perspective on Winter Planning Guidance & Communications Norovirus & Flu 2010-11 Drs Jim McMenamin & Evonne Curran Consultant Epidemiologist

Date Issues / Activity / Theme Details / Venue / Target Audience

Lead Contact / Organisation Notes

8 Sept 11 Publication of 2nd HPS National Norovirus Evaluation Report

NHS Boards Health Protection [email protected]

This report describes innovative practices to prepare for and manage norovirus.

9 Sept 11 Publication of Norovirus Guidelines for Care Homes

Care Homes Health Protection [email protected]

Provides guidance on HPS norovirus control measures for care home settings.

9 Sept 11 HPS Norovirus Guidance sent out for consultation with a view to final completion and publication by the end of September 2011.

Health Protection [email protected]

Late Sept 11

Publication of HPS Norovirus Guidance

NHS Boards Health Protection [email protected]

3 October Flu Launch – Cabinet Secretary General Public SG Communications Healthier [email protected], Vaccination, Screening & Infectious Diseases [email protected]

Marks the start of a flu awareness week. Adverts on TV, radio and online, + local media will encourage people with health conditions to get the vaccine through local flu vaccination clinics. Launch will also focus on pregnant women, who will also be encouraged to come forward for vaccination this season. UK emphasis on HCW uptake – CMO England

Nov/Dec 11 (Exact Date TBC)

CMO/CNO Joint Press Release on Norovirus and what visitors can do to stop it spreading in hospitals and care homes.

SG Healthcare Associated Infection [email protected]

Last year this was issued on 16 Dec but was ready to go from Nov.

Health Protection Contribution to Get Ready for Winter Week

Page 17: Health Protection perspective on Winter Planning Guidance & Communications Norovirus & Flu 2010-11 Drs Jim McMenamin & Evonne Curran Consultant Epidemiologist

Warning

• A bad year follows a good year• Being prepared for last season wont

make you prepared for next season• Get prepared again