Introduction
Many cases in the medical history show the importance of healthcare system units’ awareness of the outcomes of infectious disease epidemics such as influenza for both population and health workers. The case study analyzes the influenza epidemic planning developed at the London Health Science Centre (LHSC). The pandemic interventions implementation presents ethical issues including the risks medical workers face when contacting with ill patients, the limits of their responsibilities under the circumstances, and their right to influence the decision-making process. It is vital to utilize the insights of previously experienced cases around the world to develop a system of actions for the preparation for a possible influenza epidemic in hospitals preserving patients’ and healthcare workers’ safety.
The Predicted Outcomes of the Influenza Epidemic to the Canadian Population
The LHSC influenza epidemic planning process, as well as any other planning of such kind, imposes some critical issue for the manager to resolve. LHSC incorporates three main hospitals in the London region in Ontario and employs about 11,000 medical workers whose safety it is responsible for under the compliance with the Ontario Health and Safety Act (House & Grasby, 2008). However, the task of the planning was to predict the outcomes of the possible epidemic and develop the system of actions the units would be obligated to do in case of emergency.
The data retrieved from the previous influenza pandemics such as the 1997 influenza outbreak in China and the 2001 USA anthrax epidemic indicates numerous victims (Iskander, Strikas, Gensheimer, Cox & Redd, 2013). The evaluation of the health impact of these cases gives an opportunity to estimate the outcomes of possible influenza epidemic for the Canadian population. It would be comprised of 4 to 10 million clinically ill patients, from 2 to 5 million outpatients, from 34 to 138 thousand hospitalized people, and from 11 to 58 thousand deaths (House & Grasby, 2008, p. 9). Thus, the risks of adverse health outcomes for the population are high and need to be addressed with a proper strategy to ensure patients’ and workers’ safety.
The 2003 SARS Outbreak Insights and LHSC Precautions Evaluation
The effective planning is only possible when the previous experiences are analyzed. The 2009 H1N1 influenza case also imposes the need for close attention to the acute problem of dangers presented by influenza (Fineberg, 2014). The challenges experienced by healthcare during the 2003 SARS outbreak in Canada introduced some valuable lessons for the future planning strategy. In 2003, “several hundred health-care workers … were quarantined due to their exposure to SARS,” and 800 people (44 in Toronto) died in the world (House & Grasby, 2008, p. 5). In comparison to data of the SARS outbreak, the potential flu data imposes a significantly larger number of victims. This data influenced the planning and precautions development in LHSC.
Upon these events, the administrations of the medical institutions in Canada learned that it is essential to prioritize front-line workers in anti-viral medications prescriptions due to their direct contact with the patients. According to the multiple cases of workers’ refusal to go to work during the epidemic or falsely claiming to be ill, the organizational interventions must have been clarified beforehand. It might have been done within the articulation of the Ontario Health and Safety Act and the coverage procedure.
Also, the 2003 SARS outbreak showed the importance of post-epidemic psychological disorders among health staff, which was insufficiently addressed. There was no training developed to prepare the workers for the psychological challenges during and after the epidemic, which could have predicted some adverse outcomes for the personnel.
Ethical Challenges in the Influenza Epidemic Planning
The ethical challenges faced by health workers in the circumstances of an epidemic present the need to underline the public health values. The planning manager, Cathy Stark, succeeded in considering the explicit communication of the issues with the staff to ensure both her employees’ safety and the flawless course of the influenza epidemic interventions. Medical employees are committed to providing health care services by the available research because “only by understanding the social burden of disease … can public health impact the health of the entire population” (Barrett et al., 2016, p. 7).
Therefore, the medical workers should utilize the scientific approaches and provide high-quality services in the circumstances of epidemic even when their lives are at risk because they are the only specialists who can help in such a situation. Moreover, the Canadian Medical Association’s ethical code prioritizes the patient’s health over the worker’s health. The case being resolved by Cathy Starks has some parallels with the Ebola outbreak during which the medical workers took vaccines to decrease the chances of being infected (Gates, 2015).
In conclusion, exposure to danger presents a series of ethical issues related to personal health damage, choice, and an opportunity to have a say in planning. According to the physicians’ and nurses’ obligation to help people under any circumstances, it is irrelevant to reconsider the issue in the discussion. Thus, the methods of available data analysis and synthesis should be used by the team before the accurate discussion of the responsibilities and expectations in the case of a pandemic.
All the communication with the LHSC staff should be conducted within the framework of the documents and rules underlying the precautions implemented for the workers’ safety and the responsibilities they will have during an epidemic. The regulations in case of any violations of the documented rules should be explicitly addressed. At the same time, maximum efforts must be put to prevent infection’s spread among health workers, which should include anti-viral medication prescriptions, preparations, and awareness of the dangers. It is essential to utilize a multifaceted approach to prepare the health staff for a possible influenza epidemic.
References
Barrett, D. H., Ortmann, L. W., Dawson, A., Saenz, C., Reis, A., & Bolan, G. (Eds.). (2016). Public health ethics: Cases spanning the globe (Vol. 3). New York, NY: Springer.
Fineberg, H. V. (2014). Pandemic preparedness and response: Lessons from the H1N1 influenza of 2009. The New England Journal of Medicine, 370, 1335-1342. Web.
House, D., & Grasby, E. M. A. (2008). Influenza pandemic planning at LHSC. Richard Ivy School of Business, 1-9.
Iskander, J., Strikas, R. A., Gensheimer, K. F., Cox, N. J., & Redd, S. C. (2013). Pandemic influenza planning, United States, 1978–2008. Emerging Infectious Diseases, 19(6), 879-885.
Gates, B. (2015). The next epidemic – lessons from Ebola. The New England Journal of Medicine, 372(15), 1381-1384. Web.