Is aged care ready for swine flu pandemic?
While debate rages in the Australian media about the likelihood and extent of the spread of swine influenza into Australia, what will this mean for aged care?
First, the word from risk management experts is that “Control of the flu is now not an option. Mitigation is.”
The swine flu is susceptible to four drugs licensed in the United States. For the 2009 outbreak it is recommended it be treated with the use of Tamiflu (oseltamivir) or Relenza (zanamivir) for the treatment and/or prevention of infection.
The viruses that have been tested from the United States and Mexico are however resistant to two other types of drugs on market.
If an individual gets sick, antiviral drugs can make the illness milder and make the individual feel in a better state more quickly. They may also prevent serious flu complications.
Although the swine flu overseas has mainly struck adults up to the age of 40 so far, its infectious nature means it will spread easily in confined, institutional surroundings such as schools, hospitals and aged care, unless stringent precautions and controls are taken.
The Department of Health and Ageing’s Influ-info: Influenza Kit for Aged Care, identifies influenza as a notifiable disease, and says those at greatest risk are:
- Those aged 65 years of age and over
- Those with chronic debilitating disease/s
- Aboriginal and Torres Strait Islanders 50 years of age and over
- Residents of long-term care establishments such as residential aged care homes
Facilities should, if they have not done so already, download the kit to see what the Department requires for influenza control planning at http://www.health.gov.au/
Influ-info Influenza Kit for Aged Care advises on how to:
- Identify and minimise potential infection risks;
- Identify suitable isolation areas;
- Communicate with staff, residents and visitors;
- Liaise with GPs, state/territory Public Health Unit and local hospitals;
- Maintain and document vaccination schedules;
- Identify and document possible infection outbreaks;
- Initiate precautions; and
- Coordinate protective measures.
The good news is that most aged care facilities will already have plans in place and will be able to implement their established infection control procedures. They have had warning of the likelihood of the swine influenza outbreak, and should have taken additional preventitive measures already, for example ensuring 100% flu vaccination of residents and staff, publicising and insisting on hand hygiene precautions for staff and visitors, and ensuring visitors do not enter a facility if they have flu like symptoms.
The consequences and costs of an influenza epidemic are substantial for age care. A document prepared by Aged and Community Services Australia (ACSA) for its members states that facilities must plan for 20-60% of staff to be absent with influenza for two to three weeks at the height of the outbreak.
Facilities must look at what actions and care can be provided, discontinued or referred to other service providers (including family care, and hospitals). New or re-admissions may not be possible .
Facilities will need to plan and budget for the increased staff costs, and likely lower bed day subsidies if residents are not present. They will also need to remember that mortality rates could increase as a result of the outbreak.
There are around 2,500 deaths annually in a normal year from influenza, it is the 12th highest cause of death. Around 1,000 of these deaths occur in aged care.
