ARCHIVED - A Tool for the Potential Fall 2009 Wave of Pandemic H1N1 to Guide Public Health Decision-Making: An Overview of the Public Health Agency of Canada’s Planning Considerations, September 2009

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Figure 1

This figure is a pictorial description of the potential factors which may have impacted the Public Health Agency of Canada’s human and financial resources heading into the potential 2009 fall wave of pandemic H1N1 influenza virus.  The factors are grouped into four broad categories: the nature of the disease, population vulnerability, capacity to respond, and the environment.

Factors related to the nature of the disease included clinical characteristics, epidemiological characteristics, and virological characteristics of the disease.  Clinical characteristics included the signs and symptoms, clinical features of severe cases, hospitalizations, and predisposing risk factors to severe illness.  Epidemiological characteristics included the number of cases and deaths by age and sex, the distribution of cases and deaths by health status and risk factors, the clinical attack rates, the case-fatality rate, and the transmission characteristics (e.g. reproductive number).  Virological charateristics included molecular markers, virulence transmissibility, antiviral resistance, and antigenicity.

Factors related to population vulnerability included vaccine availability, vaccine uptake, access to antivirals, history of immunizations, co-morbidities, access to care, self-efficacy, geography, socio-economic status, psychological factors, and communications strategy.

Factors related to the capacity of public health to respond included communication factors, including PHAC/Government standards and guidelines, and communication with the public; public health workforce absenteeism; clinical workforce factors, including absenteeism and quality of care; public health measures, including the interventions and compliance, responsiveness to health system needs, capacity, and syndemic environments; health care resources, including active research; social mobilization, including population responsiveness and action.

Factors related to the environment included social factors, including vaccination compliance, dependence on media, and social voices; economic factors, including workforce absenteeism, and community mitigation measures; political factors, including the continuity of governments, the 2010 Olympics, and liaising with multiple jurisdictions; regulatory factors, including data sharing agreements; technology factors, including real-time information dissemination, and event tracking and monitoring of disease spread.

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