Bird flu planning looks for security and safety

Security at field hospitals could become an issue in an influenza pandemic, say emergency planners.

Managers from Auckland's three district health boards explained some of their planning to the Herald yesterday, although their draft Auckland-Northland regional plan will not go to the Ministry of Health until March.

The boards have previously turned down the Herald's Official Information Act request for pandemic planning documents. The managers yesterday said they wanted to get their plans right before making them public, to avoid causing panic.

While a flu pandemic is expected, no one can predict when, or how severe it might be. With the spread of H5N1 bird flu from parts of Asia into Eastern Europe, fears have grown it could mutate to spread easily between humans, which it cannot do yet.

New Zealand health authorities acknowledge the health system would not cope at the height of a severe pandemic, which, if similar to the 1918 Spanish flu, could make 1.6 million New Zealanders sick and kill 33,000. In the worst week, 3500 could die in Greater Auckland alone.

Mick Hubbard, the Counties Manukau health board's emergency response planner, said the public did not act rationally during disasters.

"What's commonly been seen overseas is riot situations where anything medical is concerned. We have to take that into consideration."

Other key points include:

* Elective surgery would be cancelled.

* Some 30 to 40 per cent of hospital staff may be home sick or looking after sick family or well children from closed schools.

* Greater Auckland has about 2500 public hospital beds, of which 536 could be devoted to flu patients.

* Health workers like physiotherapists may be asked to care for flu patients after on-the-job training.

* Extra protective gear including masks has been stocked up or ordered. as well as the $6 million stockpile held by all 21 DHBs for the Government.

* The Auckland DHBs will not buy extra Tamiflu on top of their "small" stock and the Government's 855,000-course national stockpile.

* The boards have consulted police and security experts on maintaining control at the field hospitals, called community-based assessment centres.

These are likely to be set up in public buildings, possibly town halls and gymnasiums at closed high schools, according to the Northland draft plan.

Mr Hubbard said people would come to these centres with medical conditions other than flu and would become disgruntled if turned away.

That had to be planned for.

The chairwoman of the Auckland boards' pandemic planning executive group, Jocelyn Peach, said another security issue was "having things locked down. Supplies like masks have legs and can disappear."

The health boards hope that non-medical, non-nursing staff will volunteer to help care for flu patients, but issues like their legal scopes of practice and whether they can be ordered to do this work are being analysed nationally by health authorities.

The role and staffing of the community centres has not been finalised, but the ministry has said they may be used to administer Tamiflu and the Auckland planners do not want public volunteers involved.

Dr Peach said the ministry had indicated Waitemata would need 16 centres, but this was too many.

"There's no way we could run 16 centres and continue some level of business-as-usual. There will just not be the staffing."