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NFPA Impact: Pandemic preparations and the fire service

If your
department has not already done so, it is time that you made your
preparations for the anticipated pandemic. Most experts agree that we
are overdue. It would stretch the existing social fabric to its
capacity. Essential services such as fire and medical response would be
greatly challenged with increased calls, expanded roles, and greater
personal risk. It is therefore essential that emergency services
personnel take the necessary precautions now so as to mitigate the
impact on their communities.

Why should you be concerned?
Pandemics have occurred in our past and have had devastating impacts on
generation of Canadians. The Spanish Influenza of 1918 is reported to
have killed between 20 and 50 million people worldwide.

Additional
pandemics have occurred in 1957, 1968, and 1977. The most probable
culprit would be a form of the H1N5 virus referred to as the avian
influenza.

The World Health Organization has reported 261
human cases of avian influenza since 2003, resulting in 157 fatalities.
Avian influenza has to this point been confined to birds and to humans
who have been in close contact with infected birds. There is no
indication of human-to-human spread. The great concern is that, should
this virus mutate by combining with an existing flu virus, the result
would be a highly contagious influenza with moderate to severe fatality
rates. The pandemic would strike with very little warning, quickly
spread worldwide, and vaccinations, if developed, would only be
available in nine to 10 months. Health Canada's website estimates that
if a moderately severe pandemic were to occur there may be between
11,000 and 58,000 deaths across Canada. (In my opinion these figures at
two per cent morbidity rate for infected people are optimistic.) This
says nothing of the numbers of individuals incapacitated for extended
periods of time and the demand on an already overtaxed health-care
system.

What will be the immediate impact on the fire service?
The major impact will be high absenteeism for extended periods of time
as members are either infected or remaining home to care for infected
family members. The outbreak would strike quickly, with most fatalities
occurring in the first 90 to 120 days. There would be a number of waves
of outbreaks, with the potential for 30 to 50 per cent of the
population to be infected at some point in time. Current estimates of
absenteeism within the service community may be as high as 30 per cent,
with the duration of the pandemic lasting up to 18 months. This has
obvious impacts on the availability of career and volunteer members for
normal emergency response and is complicated in that the remainder of
the emergency response community will be equally stressed. Volunteer
departments might be more adversely affected as the available pool of
volunteers willing to risk exposure to themselves and their families
may be further reduced. Medical supplies – especially personal
protection items not stockpiled – will become rapidly consumed and in
short supply. The best way to safeguard against these concerns is for
departments of any size to have their in-house protocols reviewed, and
preparations and training completed.

Fire departments need to
prepare now. Some provinces have provided general information, but
little appears pertinent to the fire service. There are some excellent
international resources currently available for the fire service
community. These include: The USFA website as of December 2006 has a
draft Pandemic Influenza: Planning and Preparation Best Practices Model
available at: www.usfa.dhs.gov . The IAFC website also has information
and recommendations for departments. These can be found at www.iafc.org
under their hot topics button. The IAFF has an excellent downloadable
Powerpoint presentation at www.iaff.org . This could easily be delivered
as an in-house training program.

My recommendation is that any
department, regardless of size or composition, prepare for its major
role in a pandemic. Municipalities should support departments in
carrying out these preparations. The threat has been identified and
they have a duty of care to their career or volunteer department
personnel.

By being adequately prepared they can mitigate
against the potential adverse impacts on their personnel and their
communities. To that end I have summarized some of the major
recommendations from the above resources:

• Have
  your department's role clearly defined within your community's
  emergency response plan for a pandemic. Know what is expected of your
  personnel and then begin training to this role.
• Have
  the necessary supplies, such as masks, gloves and disinfectant,
  stockpiled now as they would be in short supply during the initial
  stages of an outbreak. NFPA 1999 describes appropriate items.
• Review
  your medical call protocols with your regional medical director
  specifically looking at how you handle medical calls during a potential
  pandemic.
• If not already practising safe hygiene in the
  workplace, begin encouraging this behaviour now. Safe hygiene can
  reduce the potential spread. Have an infection control program that
  meets the minimum requirements of NFPA 1581 Standard on Fire Department
  Infection Control Program. All personnel should receive an annual flu
  vaccine.
• Review your staffing plans and organization
  chart. Look at critical positions from a perspective of possibly losing
  up to 30 per cent of your personnel for several weeks on end.
• Have
  plans for your own family in place. Experience has shown that only when
  the immediate family needs are covered can first responders be free to
  act on their responsibilities.

During
the upcoming pandemic fire service personnel will become overstretched.
As essential services within the community they may likely become the
first point of contact with infected people. It is, therefore,
essential that every department review its protocols and be prepared
now. Awaiting the first signs of an outbreak would be too late.

Sean Tracey, P.Eng., is the Canadian regional manager of NFPA
International and formerly the Canadian Armed Forces Fire Marshal. He
may be reached at 613-830-9102, e-mail stracey@nfpa.org .