1. Health Protection perspective on Winter Planning Guidance & Communications Norovirus & Flu 2010-11 Drs Jim McMenamin & Evonne Curran Consultant Epidemiologist & CNIC

2. Winter planning – an infection perspective Clairvoyance helpful since its not an exact science! –Early alerts re norovirus & flu has it started in UK, Scotland, my board) –Trend surveillance How bad is it compared with last years/years)

3. Norovirus

4. 2010/11 Norovirus season – A Blue Peter Badge for Being better prepared in general Working together better to prepare for the season Developing escalation plans Better epidemiology of local situation Working better together during outbreaks

5. 2009-2010 season =Worst ever? Lots of points where there was a sudden peak – loss of control

6. 2010-11 season = Best ever? Few points where there was a sudden peak and control was lost

7. Why was it so much better Good year usually follows a bad year The weather was so cold no one went out at peak transmission times Different circulating virus We were better prepared We reacted better

8. Good Practice Identified from the Evaluation Lots of reports of new planning and response Radio Broadcasts – in English and Gaelic Engagement with managers Agreement on escalation Education and training in clinical huddles Something can be done attitude Working with A&E

9. Care Homes - Norovirus Most commonly reported outbreak in Scotland is norovirus in care homes (HPS Weekly report) Data (not Scottish) –3.1% of cases in Care Homes are admitted to hospital –8% of care homes had at least 1 noro outbreak per year –Persons acquiring noro in the community (including care homes) and admitted to hospital are more likely to suffer more than those who acquire noro in hospital –Outbreaks in care homes when reported have been ongoing for 3.7 days Theory: reduction in care home outbreaks will reduce admission of cases to hospital and reduce possible subsequent norovirus outbreaks in hospitals

10. New this year Norovirus guidance in care homes pre season Sharing preparedness with HPTs, e.g. key publicity messages, dont visit hospitals or care homes if….. Ensuring optimal communications with HPTs re care home admissions / outbreaks

11. New This Year – not confirmed (yet…) Making official – a bay closure as alternative to full ward closure, if –Approved by IPCT (risk assessment) –Outbreak arises in a single bay or manageable area –Sufficient resources –Ongoing assessment that the policy does not just prolong outbreaks but reduce them. Updated guidance is being consulted on - confirmation by October

12. Influenza

13. Enough vaccine @ the right time? –1.16 million doses ordered (& contingency stockpile + additional supply) –Vaccine supply on target – mid Sept –50% HCW target (Frontline) – CMO(2011)08 Vaccine matched to circulating wild types? Flu strains sensitive to antivirals? Impact? –GP consultations –NHS 24 calls –ITU cases of confirmed flu etc

14. What to look out for? – Source = HPS

15. What to look out for? – Source = ISD

16. DateIssues / Activity / ThemeDetails / Venue / Target Audience Lead Contact / OrganisationNotes 8 Sept 11Publication of 2 nd HPS National Norovirus Evaluation Report NHS BoardsHealth Protection Scotland evonne.curran@nhs.net This report describes innovative practices to prepare for and manage norovirus. 9 Sept 11Publication of Norovirus Guidelines for Care Homes Care HomesHealth Protection Scotland evonne.curran@nhs.net Provides guidance on HPS norovirus control measures for care home settings. 9 Sept 11HPS Norovirus Guidance sent out for consultation with a view to final completion and publication by the end of September 2011. Health Protection Scotland evonne.curran@nhs.net Late Sept 11 Publication of HPS Norovirus Guidance NHS BoardsHealth Protection Scotland evonne.curran@nhs.net 3 OctoberFlu Launch – Cabinet SecretaryGeneral PublicSG Communications Healthier Team Emma.Davis@scotland.gsi.gov.uk SG, Vaccination, Screening & Infectious Diseases Team Rona.Watters@scotland.gsi.gov.uk Marks the start of a flu awareness week. Adverts on TV, radio and online, + local media will encourage people with health conditions to get the vaccine through local flu vaccination clinics. Launch will also focus on pregnant women, who will also be encouraged to come forward for vaccination this season. UK emphasis on HCW uptake – CMO England Nov/Dec 11 (Exact Date TBC) CMO/CNO Joint Press Release on Norovirus and what visitors can do to stop it spreading in hospitals and care homes. SG Healthcare Associated Infection Unit Lorna.Willocks@scotland.gsi.gov.uk Last year this was issued on 16 Dec but was ready to go from Nov. Health Protection Contribution to Get Ready for Winter Week

17. Warning A bad year follows a good year Being prepared for last season wont make you prepared for next season Get prepared again