NEW YORK NURSE: June 2009
As this issue of New York Nurse went to press, the A-H1N1 influenza (swine flu) outbreak was still expanding.
As of the end of May, most of the cases were centered in New York City, and the city Department of Health noted that a high percentage of cases were among school-aged children, with 70% of the 57 hospitalized patients under the age of 18. NYSNA is posting regular health alerts and updates from the NYCDOH at nysna.org.
Regardless of its severity, the novel H1N1 virus already has revealed how prepared we are for a pandemic.
Union surveys done in May indicated that healthcare workers were not being trained in identifying A-H1N1 cases, proper precautions, or how to handle suspected cases. A large percentage of those surveyed said they had not been medically cleared or fit-tested for N95 respirators. Some facilities were proposing to use surgical masks, which do not provide protection against viruses. At one point, even the New York State Department of Health advised that surgical masks could be used, but later retracted that statement.
“Considering that there are several reported cases of healthcare workers getting infected by A-H1N1 after taking care of patients in a hospital setting, we should double check our own facilities and make sure they are ready,” said Thomas Lowe, NYSNA Occupational Safety and Health Representative. “The lack of preparedness is unacceptable!”
According to the Occupational Safety and Health Administration (OSHA), healthcare facilities with isolation rooms should use them for known or suspected pandemic flu patients. It also recommends that physical barriers, such as plastic sneeze guards, be installed in reception or intake areas. Housekeeping should be stepped up to keep common areas clean – the A-H1N1 virus can live on surfaces for up to three days.
The seasonal flu vaccine, which was in production at the time the A-H1N1 virus appeared, will not provide immunity to the new strain. But it will prevent illness and death from the seasonal flu. Worldwide, seasonal flu causes about 3 million severe cases of illness each year with a death toll of more than 250,000. Plus, if more people are vaccinated against the seasonal flu, the H1N1 virus will have less opportunity to re-sort its genetic material with that of the seasonal flu to produce a super flu bug.
Despite this concern, only 42% of healthcare workers get flu shots each year, according to the Centers for Disease Control and Prevention. Currently there are no OSHA or Public Employee Safety and Health Bureau standards that require employers to provide flu shots or employees to get them.
As news of the A-H1N1 flu spread, public reaction was predictable but raised concerns. Emergency department staff reported a sharp increase in the “worried well” who wanted to be tested for the virus. The Emergency Nurses Association released a statement asking people not to come to the ED unless they had flu symptoms.
There also were reports of individuals stocking up on doses of Tamiflu and other antivirus medications, a practice that could make them unavailable to patients who really need them. Finally, experts felt obliged to recommend against people intentionally exposing themselves to the A-H1N1 flu (similar to the “pox parties” held by parents) to build their immunity. Too risky, they said.
If you are concerned about the level of infection protection being provided to workers at your facility, contact your nursing representative or call Lowe at 888-551-3112, ext. 200.