Key Elements of the Canadian Pandemic Influenza Plan

Updated: September 2010

Canada is one of the few countries that had a pandemic plan in place well in advance of the H1N1 flu virus outbreak.

The overall goals of Canadian Pandemic Influenza Plan are to minimize serious illness and overall deaths, and to minimize societal disruption caused by the pandemic. The Government of Canada implementedthis plan to address theH1N1 flu virus outbreak.

The following is a summary of the key elements of the Canadian Pandemic Influenza Plan.

1. Surveillance and Laboratory Preparedness

Canadian surveillance systems are in place to ensure that all levels of government have the laboratory and surveillance capacity in place to identify and respond to outbreaks quickly and efficiently.

Since 1996, the Government of Canada has worked with provinces and territories to provide a detailed analysis of influenza viruses and how they are behaving through our FluWatch surveillance reports. During the H1N1 pandemic, FluWatch was ramped up to provide Canadians a detailed analysis of the community impact of the H1N1 flu virus.

In addition to these existing surveillance mechanisms, the Public Health Agency of Canada's National Microbiology Laboratory (NML) coordinated a national study of severe cases of H1N1 flu virus. The NML partnered with intensive care units across the country to answer questions about how and why severe illness affects some patients with H1N1 flu virus. Information from this study and from our weekly reports helped to inform all the other elements of our response.

Canada’s surveillance also has an international impact. The Government of Canada’s Global Public Health Intelligence Network was used to detect the first reports of severe respiratory illness that eventually were linked to the H1N1 flu virus. During the outbreak, Canada continued to liaise with the World Health Organization and international governments to better understand the global impact of the virus.  The Agency will continue to work with provinces, territories and international partners to monitor for the H1N1 influenza virus and will remain vigilant in preparing for any future influenza outbreak.

2. Pandemic Vaccine

Immunization is one of the strongest methods of protection against influenza and it has always been an important part of Canada’s Pandemic Influenza Plan. In 2001, the Public Health Agency of Canada (PHAC) signed a contract with GlaxoSmithKline to ensure that enough vaccine for all Canadians would be produced in the event of a pandemic.

PHAC placed an order for 50.4 million doses of pandemic vaccine, which was made available in October 2009 for all Canadians who needed or wanted it.  Since then approximately 45 percent of Canadians have received the vaccine.

3. Antivirals

Antivirals are drugs used to treat people infected with influenza to help lessen the length and severity of their symptoms.

Antivirals are not needed if someone is otherwise healthy and has only a mild illness. The Public Health Agency of Canada recommends that antivirals be used to treat people who have severe illness or who are at risk of complications of influenza.

Canada has a National Antiviral Stockpile which contains over 55 million doses of antivirals. The stockpile is stored in secure sites throughout the country, and is primarily made up of oseltamivir (Tamiflu). Antivirals have been distributed to each province and territory on a per capita basis, and have already been used to address outbreaks in rural and remote areas.

4. Public Health Measures

Some of the individual public health measures that the PHAC has been promoting are:

• Frequent hand washing with soap and water or hand sanitizer
• Coughing or sneezing into your elbow or a tissue instead of your hands
• Staying home when sick

During the outbreak, PHAC officials created guidance documents on public health measures and infection control practices for people working in schools and daycares and in public transportation, as well as for people caring for loved ones who were infected with the virus.

On a more global scale, PHAC’s Quarantine Officers and Canadian Border Services staff continue to screen travellers entering Canada for visible signs of any illness so that they can be directed to medical attention when necessary.

5. Health Services

During a pandemic, there are increased demands on the healthcare system. To help prepare healthcare workers, the Canadian Pandemic Influenza Plan makes recommendations for healthcare workers on issues like infection control and occupational health, resource management, clinical care, and the distribution of antivirals and vaccines.

Since the beginning of the outbreak in April 2009, the Public Health Agency has provided healthcare workers with guidance on addressing the outbreak, including case definitions, recommended infection control practices, and public health measures. These guidelines were distributed to healthcare workers through provincial and territorial health authorities and made available on the PHAC website.

While the delivery of healthcare is a provincial/territorial responsibility, PHAC has been working in close coordination with all levels of government to prepare and ensure there are systems in place to respond to this outbreak.

The Government of Canada is responsible for providing healthcare to First Nations and Inuit reserves. Health Canada and PHAC have worked closely with Aboriginal leaders to assist them in their pandemic planning, and Health Canada sent additional resources and staff to nursing stations to help manage outbreaks of the virus in these communities.

6. Communications

Communications to the Canadian public is a crucial part of Canada’s pandemic response. During a pandemic, the scale of its impact is, at least in part, determined by all of our individual responses – citizens, communities, businesses and governments alike. It’s important that everyone know the part they can play in helping to minimize the impact of the pandemic on our society.

To this end, throughout the outbreak, the Government of Canada shared information with Canadians, through press briefings, websites, and via partners in healthcare. Our federal/provincial/territorial website www.fightflu.ca (External link) offers Canadians a one-stop shop for the latest information on influenza.

Additionally, in May 2009, the Government of Canada launched the Citizen Readiness Marketing Campaign to help Canadians learn about steps they can take to reduce the risk of infection.  The campaign included ads that ran in major papers across the country and on public transit. A second installment of the campaign focused on preparedness for the flu season and throughout the course of the pandemic.

7. Emergency Preparedness and Coordination

The Government of Canada has an emergency management structure in place, with Public Safety Canada coordinating the response of all government partners. Public Safety coordinates collaboration between all federal departments and agencies during national emergencies.

PHAC is the lead department in managing Canada’s pandemic response. PHAC has strong networks in place with provincial/territorial governments, international governments and bodies like the World Health Organization to ensure a united response to this outbreak.

Federal public officials collaborated frequently with the provincial/territorial Chief Medical Officers of Health and other federal/provincial/territorial public health officials on decisions that involved all aspects of addressing the H1N1 flu virus outbreak.