In the event of a flu pandemic, the vocabulary of health care will change. "Self-reliance," "rationing of services" and "changing priorities" will guide public health policy, according to members of the Governor's Task Force for Pandemic Influenza Preparation.
The group is charged with recommending policies to help government, health experts and the general public cope in the event of a pandemic which, while difficult to predict, is expected to occur at some point. The next pandemic, whenever it happens, will be the first for which officials and citizens have tried to prepare. And task force members hope their planning will be valuable in the event of any large-scale disaster, not just a pandemic.
On Wednesday, the panel, which will meet monthly through February, focused on whether hospitals have enough "surge capacity" to handle a pandemic and what should be done to protect already-vulnerable populations like the elderly or people who rely on food banks or who have disabilities.
"We need to create an environment of realistic expectations," said Dr. David Sundwall, director of the state health department and the task force's co-chairman.
There's no question health delivery would be different in a pandemic. Most of those who get sick would have to remain in their homes, likely isolated or even quarantined.
A 2006 Utah Hospital Association survey found that Utah's 45 acute-care hospitals have 4,915 licensed beds, but only 3,949 of those beds are staffed because of a "chronic shortage" of physicians, nurses, pharmacists and respiratory therapists. And many hospitals run at 90 percent capacity or higher on a daily basis, so few beds would be available to those stricken by pandemic flu.
In planning for a pandemic, said Colleen Connelly, University of Utah bioterrorism-response coordinator, officials assume one-third or more of the population would get sick, and about half of those people would seek outpatient medical care. Officials also estimate that absenteeism from flu would approach 40 percent of health-care workers during peak flu activity.
A typical outbreak, Connelly said, would likely last about six to eight weeks, but a pandemic might have several waves of illness.
Supplies that would be needed are not readily available in adequate quantity, either, she said. Most hospitals have a "just-in-time" inventory and lack resources to stockpile.
While the No. 1 rule of medical care during disaster is to do "the greatest good for the greatest number," the panel agreed to the need for legal protection for those health-care workers who may have to make decisions about rationing care. They agreed that the standard of care that could be expected would be altered and health-care workers should not be liable for that. The public needs to understand that the care patients receive during a pandemic would be very different from that to which most are accustomed, the panel warned.
As for self-reliance, people need to do much of their own preparations, because government workers will not be able to take care of everyone and may not even show up for several days in a severe crisis.
Task-force members also consigned several issues to the "parking lot," for later consideration, including essential services like water supply, food and fuel during a pandemic.Recommendations and other task-force information can be found online at www.pandemicflu.utah.gov.