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Preparing for H1N1 fall resurgence
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(PART 2 OF 4)
Following is part of the transcripts from the first COS Roundtable on Emergency Preparedness, held on August 12 at the Centre for Health and Safety Innovation in Mississauga, Ont. COS editor Mari-Len De Guzman moderated the discussion.

Panelists:
John Hollands, corporate account manager, Ontario Service Safety Alliance
John Parish, chief, provincial fire sector, Municipal Health and Safety Association
Andrew Harkness, senior strategy advisor, healthy workplaces, IAPA
Ralph Dunham, board member, Canadian Centre for Emergency Preparedness
Doug Morton, director, life sciences and business management, CSA Standards
Jason Lakhan, Gowlings
John Saunders, provincial director, disaster management and international response, Canadian Red Cross – Ontario

Moderator: The H1N1 pandemic we saw last spring is potentially going to resurface this fall flu season. How are organizations preparing for a potentially larger and more widespread comeback of this virus?

Dunham: The organizations that I have talked to or dealt with are all focusing on being better prepared for the fall. A lot of them are looking at what they need to do as a minimum in order to be consistent with their industry and with their equivalence in the public sector and private sector. And they certainly are trying to become more prepared.
 
I think that the challenge that they keep raising is: ‘What is the level of preparedness that we should be at? How far do we go?' And in a lot of cases they look to what are the legislative requirements, and there’s not a lot there from a business perspective. They look to their industry associations, and maybe they will have some guidelines and maybe they won’t. They look to their competitors and the medical officers of health outside of their organization and say, ‘What are the best practices or where should we be?’
 
And in a lot of cases it’s not open discussions. There’s a confidentiality factor and a lot of organizations just won’t release what their pandemic plans are going to entail.

So there is a lack of consistency because this is a relatively new situation. It’s not like a fire. It’s not like a building falling down, it’s not like an earthquake where we have experience upon which we can draw. Now, they did learn a lot through the herald wave at the beginning of this year, in the springtime. And learned things like how effective WHO (World Health Organization) phases are versus severity impacts. So they’re updating those programs and everything else. But again, it is so driven by how much attention it is being paid by the media: If it’s front and centre on the nightly news, then the next day there’ll be a lot of work done. If there’s nothing in the nightly news, the next day there wont be any work done on it.
 
I think the whole topic - and this is a very interesting approach to emergency preparedness because it’s almost defining the roles and responsibilities - there’s this assumption by business that governments will look after these things. And there’s an assumption by the government that 85 per cent of the critical infrastructures are in the private hands, therefore they will look after things. And there’s never been this meeting of the minds as to what are you going to do and what am I going to do and there’s a lot of, ‘Well you tell me first.’
 
So until we break down that communication barrier – whether it’s with H1N1 or whether it’s what to do with the large regional evacuations – until we understand the private-public sector interlocks and where they do miss and where there are gaps, we’re going to have a lot of difficulty, I think, in having that consistent emergency preparedness capability.
 
Parish: Part of the discussions a while back I think when they started talking about worst case scenarios and one of the things in the municipalities that came up was, if in the worst case scenario we had all these deaths and all these things taking place, what were they going to do with the bodies. And understanding that the undertakers and the funeral homes and so on can only handle so much. So the thing came up: ‘Well that’s no problem, we’ll just fire up the arenas and put them all in the arenas and stockpile them,' and things like that. And when everything fixes itself again and the world went back to normal, whenever that was going to be, then we’ll deal with these situations after.
 
I think, we just saw Toronto go through the garbage strike and they filled the arenas and the rinks full of garbage and now people are starting to say, we probably don’t want to go back there again. And we probably don’t want to be there because of contamination and so on and all those issues.
 
So in the municipality side, being the local government they will be looked at as trying to fill in some of these gaps and deal with some of these situations. So now after you fill an arena full of bodies and again as part of the discussion that came up was, ‘ well what if the refrigeration system quits?’ So we always look at the ‘what ifs’. It ended that there wasn’t any answers and we kept going through, which we always do in these types of things, looking at the worst-case scenarios. And they came to a situation in saying, 'well I guess the only thing we would do then is to take them out and dig a whole and burn them and bury them' and stuff like that.
 
So there’s a lot of unknown answers in the municipal sector as to how they would deal with some of these things if it went to the worst-case scenarios. If it didn’t, then it probably wouldn’t be too bad, they will be able to do things. So we really don’t know what’s going to happen and I think municipalities are having a really hard time – being the local government – trying to figure out how they would deal with things if they go to the worst case.
 
So it was just a discussion that ended up going nowhere because it came to a point where nobody had an answer and I think this happens quite often, and maybe this garbage strike, putting everything in the rinks, there may be some answers after that. But who knows what contamination has been leashed out in the soils and all other stuff from a situation like that that we normally don’t ever have to deal with.
 
Saunders: I think that’s another example – from Ralph’s comment – by way of communication breakdowns. A lot of that type of situation has been addressed by the provincial pandemic steering committee by way of planning, by way of the discussions surrounding rinks. Unmarked refrigerator trailers was the recommended option by way of, should there be short term or longer term necessity for overflow while coroners and funeral homes are trying to keep up with, trying to maintain dignity as much as possible. And there was a decision made eventually that there would never be mass graves in Ontario, that is not a viable option within the province or an acceptable option.
 
If that is not being communicated well from the province and the feds to municipalities, it’s another example of where the communication aspect by way of all the partners involved needs to be improved. So that corporations have a good idea what the province and the municipalities are doing – does an individual corporation know what their municipal plans are? Is that conversation happening?
 
I don’t want to redirect the conversation too much in this regard, but for the most part larger industries are doing a good job in emergency management. They are devoting some good resources toward safety, towards emergency planning. Where the biggest gap is in the small and medium sized businesses who just don’t have the resources – material or human – to invest in a large way in business continuity planning.
 
Public Safety Canada recognized that. They have brought the Canadian Red Cross and other members of the voluntary sector together. One area that we were looking at is, for example organizations that provide support to people in their homes. So that they can age at home as opposed to going into an old age facility or hospital. So there are all these different community associations, sometimes they’re 10-people shops. How do they invest in business continuity planning? But yet during a pandemic, their role is going to be vital so that we don’t have a further wave of people needing to be introduced into the hospital setting.
 
So how do we keep those organizations running? Public Safety Canada funded the volunteer sector to put together a website, it’s called Readyforcrisis.ca. It was designed primarily as a not-for-profit to do home support but it gets into the concepts of business continuity, it gets into some templates and the basic planning that’s needed. So that at least it gives them the tools to move forward so that they can start pecking at it.
 
Just being realistic, again, it’s a 10-person operation, it’s a not-for-profit. Where do they come up with the money to hire a consultant to develop a business continuity plan for them? So initiatives like that are happening but we need to start sharing that information. And again, really want to emphasize the point that companies need to talk with their municipalities, municipalities and provinces need to talk better. And provinces and the feds need to start communicating better by way of – what discussions have already happened? What decisions have already been put into place that would have business impacts so that we aren’t duplicating efforts, we are working together. Because that really is the other evolution of emergency management is the partnerships – doing it alone just doesn’t work.

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