Pandemic Influenza: Is Your PSAP Prepared?

Excerpts taken from Emergency Number Professional Magazine/September 2009
Written by Anthony Oliver, MPH, Public Health Fellow in the Department of Transportation's Office of Emergency Medical Services (Washington, DC) and Richard Alcorta, MD, state EMS Medical Director for the Maryland Institute for Emergency Medical Services Systems and a Board Certified Emergency Medicine physician


9-1-1 facilitates single point access to Emergency Medical Services (EMS), law enforcement and fire services. Including 9-1-1 in planning and response efforts is essential to maintaining the Nation's health and safety during an influenza pandemic. A pandemic will likely cause 9-1-1 systems to experience increased demands for services while facing strains on resources (e.g. increased employee absenteeism, supply chain disruptions). The Federal government and others have developed resources to assist 9-1-1 communications centers prepare for a pandemic.

The public has been trained to call 9-1-1 when help is needed, whether the problem is small or large, urgent or not. The PSAP is a trusted source of information for the public and will be inundated with calls for help during a pandemic. Plans need to ensure that PSAPs have current, factual information regarding the events affecting their communities, that they have resources to update that information as changes arise and that they can effectively communicate that information to the public.

Influenza (also known as the flu) is a contagious illness which causes more than 200,000 hospitalizations and about 36,000 deaths annually. Influenza viruses can change into new and mutant viruses, against which no one has immunity, making the entire population susceptible, even if previously vaccinated or infected with other strains. Seasonal influenza outbreaks usually cause large increases in the need for medical care. An influenza pandemic occurs when a new strain develops which can easily be transmitted from person-to-person in a population with very little or no immunity. A pandemic is a worldwide disease outbreak, occurring in many different countries. If a pandemic occurs, there will be a surge in the demand for both hospital and prehospital resources. One way to reduce the flu's impact is the development of plans to lessen the demand for services on hospitals and prehospital systems.

History has shown that an influenza pandemic has the potential to seriously impact the Nation's health care system, economy and social structure. Recognizing the importance of 9-1-1 in accessing the nation's healthcare, and its potential to reduce the resource demand during a pandemic, the White House Homeland Security Council directed the creation of guidance to assist 9-1-1 call centers in preparing for pandemic influenza in May 2006. The National Strategy for Pandemic Influenza: Implementation Plan instructed the Department of Transportation and its Federal partners to develop model statewide protocols which address (1) the provision to information to the public, and (2) facilitation of caller screening and (3) assistance with priority dispatch of limited EMS resources. The Office of Emergency Medical Services and the National 9-1-1 Office worked with the National Association of State EMS Officials to develop and disseminate two documents: EMS Pandemic Influenza Guidelines for Statewide Adoption and Preparing for Pandemic Influenza: Recommendations for Protocol Development for 9-1-1 Personnel and Public Safety Answering Points (available at www.pandemicflu.gov and www.ems.gov) first made publicly available in May 2007. Additionally, more than 6,500 CD-ROM copies of both guidelines were disseminated to PSAPs nationwide in January 2008.

Is Your PSAP Prepared?

Scientists believe that an influenza pandemic is inevitable - a "when" not an "if" proposition. To provide adequate 9-1-1 services during a pandemic, it is necessary to prepare, just as 9-1-1 prepares for other mass casualty incidents. This preparation may be particularly important for a pandemic because once an entire region or state is affected, mutual aid may not be possible. It behooves each 9-1-1 service to prepare itself, and to become actively involved in its local and State pandemic planning process.

Implementing infection control practices along with influenza-like illness screening can also result in decreased PSAP absenteeisn. Anecdotal reports from PSAP directors in Washington State showed a 60 percent reduction in sick leave after infection control procedures were instituted. One manager commented that it was the first time staff had available sick leave going into summer, and that employees did not have to use vacation time in lieu of sick leave. Additionally, one manager noted that the cost of infection control supplies was recovered in a reduced need for overtime.

Preparing PSAPs for an influenza pandemic is a critical component in ensuring demand for healthcare services is met for the community. Planning and preparing for pandemic influenza can reduce absenteeism in the emergency services workforce, distribute resources effectively and decrease demand on 9-1-1, EMS and hospital resources. Is your PSAP prepared?