Swine Flu Outbreak Underscores Role of Homecare

The swine flu outbreak, which reportedly has spread from Mexico to several states in the U.S., is a vivid reminder of the key role of homecare in responding to a pandemic flu and importance of disaster planning for the home medical community. Health experts believe that a serious, pandemic flu outbreak is a question of “when” not “if.” On Sunday, President Obama declared a public health emergency, a step that puts federal resources in motion to deal with the outbreak of the swine influenza A (H1N1) virus.

Federal health officials in the United States place homecare at the center of a planned response to pandemic flu. In a pandemic event, hospitals will quickly be overwhelmed by a surge in patients and the vast majority of infected people will remain in their homes. Pandemic flu is defined as a virulent human flu that causes a global (pandemic) outbreak of serious illness. Because there is little natural immunity, the disease can spread easily from person to person.

“The nation’s infrastructure of home medical equipment providers represents a critical piece of any front-line response to pandemic flu,” said Tyler Wilson, AAHomecare president. The Association has also argued that home medical providers must be given first-responder status during emergencies when it is critically important to reach patients in their homes.

Two years ago, the American Association for Homecare participated, with the Centers for Disease Control and other federal agencies and with home health associations, in a two-day expert panel to advise the federal government about the role of homecare in a pandemic flu. The chief result of that panel is the publication, “Home Health Care during an Influenza Pandemic: Issues and Resources,” prepared by the Agency for Healthcare Research and Quality, which contains useful links to resources and detailed discussion of key issues related to planning, patient care, community and business response, legal questions, and workforce challenges. View the text at http://www.pandemicflu.gov/plan/healthcare/homehealth.html. The report summarizes what homecare workers can expect during a pandemic:

“What to Expect During a Pandemic. In the event of an influenza pandemic, because of anticipated shortages of health care professionals and widespread implementation of social distancing techniques, it is expected that the large majority of individuals infected with the influenza virus will be cared for in the home by family members, friends, and other members of the community - not by trained health care professionals. Given these circumstances, home health care workers can expect to be called on to provide care for two main populations of patients:
• Those medical and surgical patients, not hospitalized because of the pandemic, who are well enough to be discharged early from hospitals to free up hospital beds for more severely ill patients.
• Patients who become or already are dependent on home health care services (predominantly elderly persons with chronic disease) and will continue to need in-home care during the influenza pandemic whether or not they become infected with the influenza virus.
• The demand for home health care services during a pandemic influenza outbreak is likely to exceed the home health care industry's current capacity to respond. Indeed, the overall surge capacity and preparedness levels of the home health care sector that will be necessary to respond effectively to a public health emergency such as pandemic influenza are significant unknowns.”

Also the main pandemic flu website is a good resource as well: www.pandemicflu.gov. Guidance for clinicians and public health officials can be found at: http://www.cdc.gov/swineflu/guidance/.