Initial Response of Healthcare Institutions to Emergence of H1N1 Influenza: Experiences, Obstacles, and Perceived Future Needs

Study Summary—Of 323 healthcare epidemiology professionals surveyed during the H1N1 crisis, 30.7% reported shortages of antiviral medication and 39.0% reported stockpiling of antiviral medications. Vaccine development, healthcare worker education, revisions of pandemic plans, and mandatory influenza vaccination were identified as important future initiatives. Background—The emergence of H1N1 influenza is cause for great concern. Although one of the most important components of the response to the H1N1 crisis is the work of healthcare epidemiology professionals, the beliefs and experiences of this community are unknown and the optimal approach to managing H1N1 in the future has not been delineated. Methods—To assess attitudes and responses of healthcare epidemiology professionals to the H1N1 influenza crisis, we conducted a cross-sectional survey of members of the Society for Healthcare Epidemiology of America. We assessed beliefs regarding: 1) importance of H1N1; 2) institutional preparedness; 3) time spent on the H1N1 crisis; and 4) the institution’s response to H1N1. Results—Of 323 respondents, 195 (60.4%) reported their hospitals were well prepared for a pandemic. Furthermore, the majority reported that senior administrators provided adequate political support and resources (85.1% and 80.2%, respectively) to respond to H1N1. However, 163 (50.9%) respondents reported other important infection prevention activities were neglected during the H1N1 crisis. Shortages of antiviral medication were reported by 99 (30.7%) respondents. Furthermore, 126 (39.0%) reported that personal stockpiling of antiviral medications occurred at their institution and 166 (51.4%) reported institutional actions were initiated to prevent personal stockpiling. Also, 294 (91.0%) respondents believed H1N1 influenza would reappear later this year. Vaccine development, healthcare worker education, and revisions of pandemic influenza plans were identified as the most important future initiatives. Finally, 251 (77.7%) respondents felt healthcare workers should be mandated to receive influenza vaccine. Conclusions—While generally well-prepared for the H1N1 crisis, substantial revisions of pandemic preparedness plans appear necessary. Future efforts to optimize the response to H1N1 should include curtailing personal stockpiling of antivirals and vaccine development with consideration of mandatory vaccination of healthcare workers.