Canadian Pandemic Influenza Preparedness:

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Canadian Pandemic Influenza Preparedness: Planning Guidance for the Health Sector (CPIP) provides planning guidance to prepare for and respond to an influenza pandemic. Influenza pandemics (subsequently referred to as pandemics) are unpredictable but recurring events that occur when a novel influenza virus strain emerges, spreads widely and causes a worldwide epidemic. Unfortunately, it is not possible to predict the anticipated impact of the next pandemic or when it will occur.

Planning for a prolonged and widespread health emergency of unpredictable impact is challenging but essential. It requires a “whole of society” response and the coordinated efforts of all levels of government in collaboration with their stakeholders.

Pandemic planning activities within the health sector in Canada began in 1983. The first Canadian pandemic plan was completed in 1988 and was followed by several updates. In 2004, the Canadian Pandemic Influenza Plan for the Health Sector was published as the result of extensive collaboration among FPT and other stakeholders. Before this version, the last major update to the CPIP and its annexes occurred in 2006.

The 2009 influenza A (H1N1) pandemic (subsequently referred to as the 2009 pandemic) provided the first real test of Canada’s pandemic preparedness planning efforts. Collaboration among all levels of government and stakeholders was unprecedented compared with previous events like the Severe Acute Respiratory Syndrome (SARS) outbreak in 2003. The public health and health care systems were stressed but in most instances were able to cope. Antiviral stockpiles were deployed and pandemic vaccine was administered to millions of Canadians. There were, however, many challenges identified in this experience.

Canada’s pandemic planning continues to evolve on the basis of research, emerging evidence and the lessons learned from the 2009 pandemic. The value of building on seasonal influenza surveillance systems and control measures is well recognized. Making these systems and measures as robust as possible in the interpandemic period will help prepare for a strong pandemic response.

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Conversation based on: Canadian Pandemic Influenza Preparedness:

Canadian Pandemic Influenza Preparedness:

  • People may be sick with the virus for 1 to 14 days before developing symptoms. The most common symptoms of coronavirus disease (COVID-19) are fever, tiredness, and dry cough. Most people (about 80%) recover from the disease without needing special treatment. More rarely, the disease can be serious and even fatal. Older people, and people with other medical conditions (such as asthma, diabetes, or heart disease), may be more vulnerable to becoming severely ill. People may experience: cough fever tiredness difficulty breathing (severe cases)
  • AND SOME TIPS TO MAINTAIN YOUR HEALTH AND WELLNESS: Give your days some structure: Shower and put on jeans, says Lia Grainger. If you work from home, make a separate space for work. Try meditation. Don’t just binge Netflix; lift a little: Paul Landini suggests body-weight exercises, or skipping rope to get in some cardio. When you do need a break, try one of these 10 books that offer lessons from past pandemics or consult Barry Hertz’s guide to the best Canadian streaming options.
  • ADVICE FOR ENHANCED HYGIENE MEASURES FOR THOSE SELF-ISOLATING AT HOME INCLUDE: frequent hand-washing, avoid touching their faces; coughing and sneezing only into the bend of their arm; and disinfecting surfaces at least once daily. Those in self-isolation are advised to get lots of rest and eat a balanced diet. They are to monitor themselves for symptoms and immediately get in touch with their health-care provider or with public-health authorities if those symptoms worsen.
  • EXPECTATIONS FOR THOSE WHO ARE SELF-ISOLATING INCLUDE: Staying home from work and school; Avoiding public transportation; Arranging to have supplies, such as groceries, dropped off at their doors; Especially avoiding elderly people and anyone with compromised immune systems or chronic conditions; Keeping any unavoidable interactions with other people brief, maintaining at least two metres’ distance from them and wearing a mask. ADVICE FOR ENHANCED HYGIENE MEASURES FOR
  • What does self-isolation mean? Self-isolation requires you to stay at home, monitor for symptoms, and avoid contact with other people for 14 days, according to the Government of Canada website.
  • The rules on social isolation are changing. André Picard has the answers to your latest questions Stated simply, social distancing means maintaining a distance between you and other people – one metre to two metres – and minimizing contact with people. In other words, assume everyone around you could be infected.
  • 5 Things You Should Know Canadians know that things are going to get worse and they are most concerned about our elders. However, 28% say that the health implications have been overblown. Canadians are ensuring they have their nest egg available and cutting back on expenses. However, 56% say that investors are over-reacting to the crisis. Canadians will go to grocery stores and retail stores, but airports and movie theaters are out of the question. One-third of working Canadians are working from home. Roughly 1-in-10 have experienced some sort of reduction of shifts or company shut down. Canadians report that they’ve been doing a lot more online in the last two weeks including video calls, like Skype (35%) or spending time binging on their streaming services (37%)
  • Vancouver School Board announcement: I wish to share updated information with you about impacts of the novel coronavirus (COVID-19) on our school communities. Today, we received the attached letter from the Ministry of Education following the provincial government’s announcement to suspend in-class learning in BC’s schools. Everyone at the District understands that the effects of this decision will vary family-to-family. We are committed to doing all that we can to maintain safety for your children. Like the Minister of Education indicated, the District will work to develop ways to ensure children’s learning continues. With schools out on spring break, we will take this time to initiate those plans. The District will provide more information as soon as details are determined. Please check our website for updates. Additionally, we are looking at how to continue to meet the needs of students who rely on enhanced supports at their schools such as nutrition/food programs. In addition to today’s announcement, the District also suspended community groups’ rentals in our facilities. At this time, daycare and the District’s Community School Teams’ programs are not impacted. We continue to work closely with the Ministry of Education, the Ministry of Health, the Office of the Provincial Health Officer and Vancouver Coastal Health on the COVID-19 response. Public institutions, such as our education system, have a responsibility to ensure every step is taken to address this pandemic in our communities. As I said before, these are extraordinary times. Yet, I know our school communities are places of deep connections and good will. I hope, like me, you find comfort in that sense of community amidst our current situation.
  • BREAKING NEWS: Canada’s big six banks say they will allow customers to defer mortgage payments for up to six months among other changes due to the COVID-19 pandemic. And BREAKING NEWS: Prime Minister Justin Trudeau has announced an additional $82-billion aid package to help Canadians and businesses, including income supports and wage subsidies and tax deferrals. The package includes $27 billion in direct supports and another $55 billion to help business liquidity through tax deferrals.
  • Introduction The Ministry of Health and Long-Term Care (MOHLTC) leads the development of the OHPIP to support the provincial health system to prepare for and respond to an influenza pandemic. Since the release of the first iteration of the plan in 2004, the OHPIP has been regularly updated to reflect new knowledge, information and best practices. This process is supported by the OHPIP Steering Committee – which consists of representatives from health associations, unions, regulatory bodies and government organizations – and a variety of workgroups (See Appendix A – OHPIP Steering Committee and workgroup members).The OHPIP supported the provincial health system’s response to the 2009 H1N1 influenza pandemic (pH1N1). Although a number of simulated scenarios have been held over the years to exercise components of the OHPIP, pH1N1 was the first opportunity to use the plan to guide the response to a pandemic. The 2013 version of the OHPIP was updated to incorporate the priority lessonslearned and best practices from pH1N1. More information about Ontario’s evaluation of the response to pH1N1 can be found in Pandemic (H1N1) 2009: A Review of Ontario’s Response and The H1N1 Pandemic – How Ontario Fared: A Repo rt by Ontario’s Chief Medical Officer of Health . Previous versions of the OHPIP have used World Health Organization (WHO) and Public Health Agency of Canada (PHAC) response plans as a conceptual foundation. These pandemic response plans are in the process of being revised based on the lessons learned and best practices from pH1N1. Some concepts that were previously incorporated in the OHPIP aren’t in the 2013 iteration as they haven’t yet beenupdated by the WHO and PHAC. For example, the WHO’s six-phase description of a pandemic featured in previous versions of the OHPIP and Canadian Pandemic Influenza Plan for the Health Sector (CPIP). An evaluation by an external review committee on the functioning of the International Health Regulations (2005) in relation to pH1N1 recommended that the WHO simplify the pandemic phase structure. As the WHO has not released an updated plan since the evaluation was released, the phase structure is not included in this version of the OHPIP. This is the final iteration of the OHPIP. The Ontario Influenza Response Plan (OIRP) will eventually replace it. Through this new plan, the provincial health system’s focus will shift from preparing for an influenza pandemic to creating and building effective seasonal influenza responses and escalating those measures during a pandemic. The OIRP will link to updated pandemic response plans from the WHO and PHAC, and it will also address the next steps documented in this version of the OHPIP and outstanding lessons learned and best practices from pH1N1. The OIRP will outline influenza responses for the entire health system, including government, primary health care, community care, hospitals and public health.
  • How is coronavirus transmitted? Coronavirus is spread from an infected person through Respiratory droplets spread when a person coughs or sneezes Close personal contact such as touching or shaking hands Touching an object or surface with the virus on it, then touching your mouth, nose or eyes before washing your hands It is important to keep about a 2-metre distance away from a person who is sick, to reduce breathing in droplets when they cough or sneeze. What are the symptoms? Common symptoms for COVID-19 include Fever Cough Difficulty breathing Sore throat Sneezing The incubation period is the time from when a person is first exposed until symptoms appear. Symptoms may take up to 14 days to appear after exposure to COVID-19. This is the longest known infectious period for this disease. If you are unsure about your symptoms or have questions or concerns, contact HealthLinkBC (8-1-1) at any time. If you do need to see a health care provider, call them ahead of time so they can arrange for you to be assessed safely. Wear a mask to protect others. When seeing a health care provider, please tell them Your symptoms Where you have been travelling or living If you had direct contact with animals (for example, if you visited a live animal market) If you had close contact with a sick person, especially if they had a fever, cough or difficulty breathing How can I prevent getting infected? The most important thing you can do to prevent infection is to wash your hands regularly and avoid touching your face, eyes, nose or mouth. You can also practice respiratory etiquette and social distancing. To help reduce your risk of infection Wash your hands often with soap and water for at least 20 seconds. Using soap and water is the single most effective way of reducing the spread of infection If a sink is not available, alcohol based hand rubs (ABHR) can be used to clean your hands as long as they are not visibly soiled. If they are visibly soiled, use a wipe and then ABHR to effectively clean them Do not touch your face, eyes, nose or mouth with unwashed hands Follow good respiratory etiquette by covering your mouth and nose with a disposable tissue or the crease of your elbow when you sneeze or cough Regularly clean and disinfect frequently touched surfaces Do not share food, drinks, utensils, etc. Avoid crowded public spaces and places. Examples include mass gatherings, such as concerts and sporting events. Examples do not include hospitals (for healthcare workers) and schools Maintain social distancing by keeping at least a 2-metre distance between yourself and others Avoid shaking hands For more information on proper hand washing see: Hand Washing: Help Stop the Spread of Germs (HealthLinkBC File #85) Public Health Agency of Canada: Reduce the spread of COVID-19: Wash your hands (PDF 298KB) Should I wear a mask? Only wear a mask if you are ill with COVID-19 symptoms (especially coughing) or looking after someone who may have COVID-19 A disposable face mask can only be used once It may be less effective to wear a mask if you are not sick How is the test done for COVID-19? The BCCDC Public Health Laboratory (PHL) has developed laboratory guidance for COVID-19 diagnostic testing. If your health care provider thinks you may have COVID-19, they will arrange for testing. Testing may be available for those with symptoms (e.g. fever, cough, or difficulty breathing) and history of travel or for those who have had close physical and prolonged contact with a confirmed or probable case of COVID-19. The test for COVID-19 is done by Nasopharyngeal (NP) swabs or throat swabs. Is there a treatment for COVID-19? There is no specific treatment for COVID-19. Many of the symptoms can be managed with home treatment such as drinking plenty of fluids, rest and using a humidifier or hot shower to ease a cough or sore throat. Most people recover from coronaviruses on their own. For people who develop a more serious illness, supportive care in or out of hospital may be needed. For more information on what you can do if you have symptoms, see: Colds Fever or Chills, Age 12 and Older Fever or Chills, Age 11 & Younger Respiratory Problems, Age 11 and Younger Respiratory Problems, Age 12 and Older Is there a vaccine for a COVID-19? When a disease is new such as COVID-19, there is no vaccine until one is developed. Possible vaccines are under investigation. It can take time to develop a new vaccine. What is self-monitoring and self-isolation? Self-monitoring Self-monitoring is monitoring for symptoms such as fever, cough and difficulty breathing for 14 days. During this time, monitor your own health and the health of your children and close contacts that are older or chronically ill. Individuals who are self-monitoring are allowed to attend work and school and participate in regular activities. You can actively self-monitor by taking your temperature twice a day, in the morning and at nighttime, using a digital thermometer by mouth (oral). If you take fever-reducing medications such as acetaminophen (e.g. Tylenol®) and ibuprofen (e.g. Advil®) the temperature should be recorded at least 4 hours after the last dose. If you start having symptoms of COVID-19, you need to begin self-isolation: Isolate yourself from others as quickly as possible Call your health care professional or contact HealthLinkBC (8-1-1) Describe your symptoms and travel history. They will provide advice on what you should do Self-Isolation Self-isolation means staying home and limiting your contact with others for 14 days. This helps to lower the chance of spreading the disease because symptoms may take up to 14 days to appear after exposure to COVID-19. During this 14 day incubation period, there is a small chance you can spread germs even though you don’t feel sick. This is why it is important for people at risk of having been exposed to the illness are asked to self-isolate. To limit contact with others, you should Stay home Avoid those who have chronic conditions, compromised immune systems and older adults Avoid having visitors to your home Wash your hands often with soap and warm water for 20 seconds Cover your mouth and nose with your arm when coughing or sneezing For more information on self-isolation see: Public Health Agency of Canada: Coronavirus disease (COVID-19): How to isolate at home when you have COVID-19 (PDF 344KB) Plan ahead and prepare for what you will do if you or a family member becomes sick and needs care. For more information on being prepared see: Public Health Agency of Canada: Be prepared (COVID-19) (PDF 344KB) For more useful resources see: Public Health Agency of Canada: About coronavirus disease (COVID-19) (PDF 575KB) Public Health Agency of Canada: Public Health Agency of Canada: How to care for a person with COVID-19 at home: Advice for caregivers (PDF 345KB) Public Health Agency of Canada: Vulnerable populations and COVID-19 (PDF 335KB) Common Questions about COVID-19 For more answers to some of the most common questions about coronavirus see: BC Cancer Agency: COVID-19 and Cancer Treatments - Information for Patients BCCDC: Frequently Asked Questions on New Coronavirus (COVID-19) for Children and Students (PDF 570KB) BCCDC: Novel coronavirus (COVID-19) Fraser Health Authority: Coronavirus Questions - General Public Government of Canada: Coronavirus disease (COVID-19)Frequently Asked Questions (FAQ) Vancouver Coastal Health Authority: Information on Coronavirus Disease (COVID-19) World Health Organization: Q&A on Coronaviruses (COVID-19) Useful Websites BC Centre for Disease Control BCCDC provides health promotion and prevention services, and diagnostic and treatment services to reduce communicable and chronic disease, preventable injury and environmental health risks. BCCDC also provides analytical and policy support to government and health authorities. BCCDC: 2019 Novel Coronavirus (COVID 19 ) B.C. public health guidance for schools and childcare programs (PDF 494KB) BCCDC: Recommendations to Post Secondary Institutions Regarding 2019 Novel Coronavirus (COVID 19) (PDF 260KB) General Public: Novel coronavirus (COVID-19) Health Professionals: Novel coronavirus (COVID-19) News and Updates: Latest case counts on novel coronavirus The Public Health Agency of Canada (PHAC) The Public Health Agency of Canada promotes health, prevents and controls chronic diseases and injuries and infectious diseases. The PHAC responds to public health emergencies. For more information about COVID-19, including travel advisories, see Government of Canada: Coronavirus disease (COVID-19): Outbreak update Government of Canada: Coronavirus disease (COVID-19): Travel advice Government of Canada: Travel health notices World Health Organization (WHO) The World Health Organization provides leadership on global health matters. The WHO monitors and assesses health issues such as COVID-19, provides technical support to countries and sets health standards. For more information about 2019-nCoV, see: WHO: Coronavirus disease (COVID-19) outbreak WHO: Getting your workplace ready for COVID-19 If you have concerns or questions about your health contact HealthLinkBC (8-1-1) at any time or speak with your health care provider. Last updated: March 13, 2020
  • Know the flu facts The flu can be serious. The flu is very contagious and can spread quickly and easily. Before you even know you are sick, you can pass the flu on to others. In Canada, an average of 12,200 hospitalizations and 3,500 deaths related to the flu occur each year *. The flu can affect anyone. Even healthy people can get the flu, and it can be serious. People at higher risk of serious complications* are: adults aged 65 and over those living with one or more chronic health conditions those residing in nursing homes or other facilities young children pregnant women Indigenous peoples You need to get vaccinated every year. Flu viruses change each year. Experts create a new vaccine to protect you each flu season. You can't get the flu from the flu shot. The viruses in the flu shot are either killed or weakened and cannot give you the flu. The flu shot is safe. The flu shot has benefited millions of Canadians since 1946. Most people don't have reactions to the flu shot; those who do may have soreness, redness or swelling at the injection site. Severe reactions to the vaccine are extremely rare. Everybody wins when you get vaccinated. If you do get the flu, the flu shot may reduce the severity of your symptoms. By getting the flu shot, you protect yourself and others because you are less likely to spread the flu. It's a simple action that can prevent complications and save lives.
  • Flu symptoms Some people only get mildly ill. Others get very sick. Flu symptoms appear 1 to 4 days after exposure to the virus. Usually they include the sudden appearance of: fever cough muscle aches and pain Other common symptoms may include: headache chills fatigue (tiredness) loss of appetite sore throat runny or stuffy nose Some people (especially children) may also have: diarrhea nausea and vomiting Additional symptoms to watch for in children As a parent, you know your child best. Talk to your healthcare provider right away if you notice any of these symptoms: not drinking or eating as usual not waking up or interacting with others irritable (not wanting to play or be held) Contagious period People infected with the flu virus can spread it to others: starting 1 day before the first symptoms until approximately 5 days after the first symptoms If you get the flu If you do get sick, stay home. Avoid close contact with other people until you feel well enough to get back to your usual day-to-day activities. This will help prevent the spread of the flu. Most people recover from the flu in 7 to 10 days. If you are a person at high risk of flu-related complications and develop flu symptoms, contact your healthcare provider. Tell them about your flu symptoms over the phone before your appointment. That way, they can arrange to see you without exposing other people. When to seek immediate attention Visit your nearest hospital if you develop any of these serious symptoms: shortness of breath, rapid breathing or difficulty breathing chest pain bluish or grey skin colour bloody or coloured mucus/spit sudden dizziness or confusion severe or persistent vomiting high fever lasting more than three days low blood pressure Possible complications of the flu pneumonia and respiratory failure worsening of chronic health conditions Other severe outcomes of the flu hospitalization death How the flu is diagnosed The flu is usually diagnosed by your healthcare provider based on: symptoms laboratory tests Flu treatment Flu symptoms can be treated with: rest fluids, like water medication to reduce any fever or aches In some cases your healthcare provider may prescribe medication, especially if you are: at high risk for flu-related complications very sick with severe symptoms Over-the-counter cough and flu medicine should not be given to children younger than 6 years old. It is only safe to do so if you are advised to by your healthcare provider.
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