Pandemic (H1N1) 2009 Influenza Outbreak in Australia: Impact on Emergency Departments

Abstract

Emergency Departments (EDs) and ambulance services are at the forefront of Australia’s health disaster response providing immediate patient care, system wide coordination, and retrieval and transfer of patients. The recent outbreak of Pandemic (H1N1) 2009 Influenza demonstrated the diversity of roles EDs play in disease containment and management. Public awareness of Pandemic (H1N1) 2009 Influenza and concern about the potential severity of the disease led to a large number of patients presenting to both EDs and primary health services, including General Practitioners (GPs) and ambulance services. However, the extent of the impact of Pandemic (H1N1) 2009 Influenza on EDs and their staff has not previously been documented in detail. The Pandemic (H1N1) 2009 Influenza outbreak had a significant impact on EDs with large numbers of patients presenting with influenza-like illness (ILI), which caused considerable demands on ED staff and further impeded the management and flow of ED patients1, 2. This occurred at a time when EDs in Australia are confronting continual problems of overcrowding associated with ‘access block’ and growing service demands. EDs had to respond to the additional demand caused by the Pandemic (H1N1) 2009 Influenza outbreak and to implement specific precautions to safely manage these patients, whilst also protecting staff members and non-affected patients and visitors from potential cross-contamination. The response by EDs to the Pandemic (H1N1) 2009 Influenza outbreak occurred during a period of evolving knowledge about the disease. Initial reports from Mexico raised serious concerns regarding the severity of the disease and the mortality rate. Although the severity was subsequently shown to be of less concern, the initial response was, and necessarily had to be, based on the information available at the time. The aim of this study was to identify the impact of Pandemic (H1N1) 2009 Influenza in Australia on ED operations and staff; to inform future planning, preparedness, and response management arrangements for pandemics; and to inform the management of infectious patients presenting to EDs in every day practice.