Olga Michie, MA MEd

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EMERGENCY RESPONSE Public Health in Action 2009
alPHa Annual Conference , Timmins Ontario
Olga Michie, MA MEd Regional EPR Coordinator
Ontario and Nunavut Region June 15, 2009
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SRI Clusters in Mexico / Human Swine Flu Cases in
the U.S. ... Human Swine Flu ... H1N1 flu virus
(Human Swine Flu) ... H1N1 flu virus
April 17 PHAC becomes aware of an outbreak of SRI
clusters in Mexico and in the U.S. April 20 PHAC
Centre for Emergency Preparedness and Response
(CEPR) begins monitoring investigation of SRI
clusters in Mexico in the U.S. April 23 Health
Portfolio Emergency Operations Centre (HP EOC),
Ottawa activates to Level 3 (Partial
Activation), due to increase in numbers of
confirmed cases in the U.S. and to coordinate
and manage information April 24 National
Microbiology Lab and U.S. CDC Laboratories
confirm Mexico and U.S. SRI clusters are
identical virus Human Swine Flu PHAC
represents Canada on trilateral calls with USA
and Mexico April 26 Mexico requests lab EPI
support from Canada and USA PHAC EOC raises to
Level 4 (Full Activation) and deploys EPIs Lab
Technicians to Mexico the U.S. April 27 All
six (6) Regional Emergency Coordinating Centres
(RECC) raise their activation Levels to 3 (Full
Activation) WHO raises pandemic alert to level 4
(sustained human to human transmission)
containment no longer feasible focus now on
mitigation.
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PHAC Roles Responsibilities

• International Role
• PHAC is Canadian focal point for International
  Health Regulations (WHO)
• Part of international surveillance (GPHIN) WHO
  PAHO US CDC
• Domestic Role
• Prepare for and respond to public health
  emergencies in collaboration with federal
  departments, provinces, territories and municipal
  officials
• Federal Health Emergency Preparedness and
  Response
• Health Portfolio (Health Canada and PHAC)
• Centre for Emergency Preparedness and Response
• Provides national leadership and coordination
• Operates Health Portfolio Emergency Operations
  Centre (HP EOC)

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HP Emergency Roles

• PHAC

• Health Canada

• All public health emergencies as a result of any
  disaster, emergency, risk including infectious
  disease outbreaks
• Quarantine Eastern Regional
• office Pearson International
• Airport
• National Emergency Stockpile System (NESS)
• Laboratory of biosafety and biosecurity

• First Nations and Inuit
• Workplace Health and Public Safety
• Government-wide nuclear EPR
• Chemical and food events

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• RECC has 2 functions
• 1. Support Regional HP Activities
• 2. Situational Awareness
• PEOC
• MOHLTC EMU

HPEOC
GOC
NML
RECC (6)
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Federal Emergency Management Framework
Health Canada
National Microbiology Laboratory EOC
CEPR
PHAC
Other Departments
Canadian Food Inspection Agency
HP EOC
In a complex public health emergency,
coordination reverts to Public Safety Canada
while the Public Health Agency of Canada (PHAC)
responds to public health issues.
Public Safety Canada
Environment Canada
GOC
Department of National Defence
Department of Foreign Affairs and International
Trade
Transport Canada
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HP EOC Emergency Response Structure
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Regional HP ECC Emergency Response Structure
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HP EOC Briefing Business Cycle
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• Communications Call on H1N1 (May 01/2009)

• Press Conferences on H1N1 (May 01/2009)

• 89 Communication Update call (Regional
  National Comms)
• 93010 ECC Chiefs Meeting
• 1112 F/P/T Communication Committee call
• 12-1 Communication Update call
• 1-145 Regional EPR Committee
• 430-530 Communication Update call

• 830 New Brunswick
• 1100 WHO
• 1300 Alberta
• 1300 Nova Scotia
• 1315 CDC (U.S.)
• 1330 British Columbia CDC
• 1500 White House/ Homeland Security briefing
• 1500 Ontario
• 1530 Quebec
• 1530 Manitoba
• 1600 Government of Canada

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HPEOC in ACTION

• April 27, 2009 - WHO moves to Level 4
• - No containment, focus on mitigation
• - Implement Pandemic Plans
• - No recommendation to restrict travel or
  close borders
• Domestic Activity
• Developing policy on anti viral use and national
  surveillance strategy
• Working on case definitions
• Developing Lab confirmed case investigation
  Form
• Developed with Transport Canada joint Health
  Alert Notice for flights from Mexico Guidance
  Documents for Canada Border Security Agency
  Screening Officers to monitor infected travelers
• Issued Travel Advisory for non-essential travel
  to Mexico
• Other Governmental Departments
• Transport Canada
• Canadian Food Inspection Agency
• Canadian Border Service Agency
• Public Safety

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HPEOC in ACTION

• Provincial Activity
• Calls with P/T
• Nova Scotia British Columbia confirmed cases
• International Activity
• Work with WHO and US CDC to provide assistance to
  Mexico re infection control, field EPI, lab
  support, risk assessments
• NLM analyzing samples
• Communications
• Launch together with P/Ts www.fightflu.ca
• Media lines and Q and As distributed to federal,
  provincial/territorial, NGO and international
  partners. Public Information line established
• Common messaging with U.S. and Mexico has been
  developed around the use of antiviral medication,
  border management, and the designation of the
  next pandemic phase.

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HPEOC RECC Operations

• HP EOC
• GPHIN
• NESS
• Quarantine Program
• Environmental Health Officers
• Physical EPR Team
• Migration and Travel Health Program
• Risk Assessment Unit
• Epidemiology ERT

• RECC
• Workplace Health Safety
• Public Health Bureau
• Quarantine Services
• First Nation Inuit Health

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Health Alert Notices
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PHAC in ACTION
Today .
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THANK YOU
Olga Michie Regional EPR Public Health Agency of
Canada Ontario and Nunavut Olga_Michie_at_phac-aspc.
gc.ca