Wednesday, February 28, 2007

Ethical issues in Pandemic Planning

South Carolina is buying enough medicine to cover at least a quarter of its 4.3 million people. The likelihood is high that more than a quarter of its population could get sick from the first wave alone.

So the question is; who should receive the vaccine first? The answer to this ethical question could decide who lives and who dies. South Carolina's state epidemiologist, Dr. Jerry Gibson points out some of the main ethical issues when planning for a pandemic:

1. Who gets to decide what is done, and how?
2. How do you make sure more good than harm is done?
3. How do you minimize the harm done, while trying to do good?

Some ways in deciding who gets the limited medicine may include:

People could be chosen randomly, but this wouldn't necessary treat the sickest or the most likely to survive. Those with occupations considered to be critical to public health, could receive the vaccination first. But who gets to decide what those are? Federal recommendations call for those who are hospitalized with the flu and front-line health care workers. Lower on the list are outpatients and workers in other critical areas. Civil liberties questions could arise too.

Some folks may be isolated or quarantined. Will this violate their individual rights? Who will take care of their medical, food and other needs?

Will people get a chance to say how they will be affected by restrictions or provisions, during the pre-planning stage? Last summer a pandemic in each county was held and included people from business, schools, ethnic minorities and other groups.

How will you provide folks with the opportunity to "speak up" on issues involving possible ethical dilemmas?

For additional information on Pandemic preparedness from a business continuity perspective, please feel free to contact Pitsel & Associates Ltd. Calgary, Alberta, (403) 245-0550. “The time to plan is when you have time to plan.”

Friday, February 23, 2007


Breakfast Workshop March 22 Register now!

Preparing for a Pandemic

Presenter: Dr. Pat Pitsel
When: Thursday March 22, 2007
Time: 7:30 - 9:00 a.m.
Location: Sheraton Eau Claire
Cost: $125 pp
includes continental breakfast, workshop & Pandemic Planning Guide

The Time to Plan is When You Have Time to Plan…

The Motivation!

Planning for a potentially catastrophic event that has never occurred in the lifetime of most of us… is particularly difficult.

It is especially challenging for businesses that may have a business continuity plan that covers physical disasters but who have no plans for a catastrophe that impacts the Human Capital in the organization.

Be Ready! Join us as renowned presenter, psychologist, educator and Human Resource professional Dr. Pat Pitsel leads us in an interactive workshop.

The Purpose!

Preparing for a Pandemic – The Time to Plan is When You Have Time to Plan…

…is designed to give senior executives and Human Resources Professionals an extensive, high- level overview of the issues they must be aware of in order to guide their pandemic planning team.

Three major business areas will be addressed, including the provision of critical questions that every President, CEO, COO, or CFO needs to ask.

- Key Human Resource policies that need to be considered
- Communication strategies – pre, during and post pandemic
- Critical supply chain issues to establish continuity of your business

The Expertise!

Dr. Patricia Pitsel is a psychologist, educator and Human Resource professional. A registered psychologist in the Province of Alberta, Pat received her M.Sc.Ed. in counselling from Fordham University in New York City, and her Ph.D. in counselling psychology from the University of Calgary.

Dr. Pitsel has worked with a wide range of organizations and companies in both private and public sector both in training and in a facilitation capacity. Her current work with clients is in the field of preparing for a possible Pandemic, her motto being: The time to plan is when you have time to plan.

Dr. Pitsel has served on a number of community Boards and Agencies including the Calgary Police Commission, The Duke of Edinburgh Young Canadian Challenge Award, the Federation of Calgary Communities and the Calgary Convention Centre. She was awarded the Outstanding Instructor Award from the Faculty of Continuing Education, University of Calgary, for four years in a row; she is enthusiastic, frequently amusing—and recognized as a Calgary leader in the area of Pandemic planning.

Decision makers are encouraged to attend. Human Resources, Purchasing and Executive leaders need to plan NOW for your organization’s business continuity in the event of a Pandemic.

Resources provided are valuable. Register today!

Register to: Myra Lever,%202007
(403) 269-6786 (tel)
(403) 237-9016 (fax)

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Our company is built on a commitment to quality, ethics, service leadership and innovation. By integrating these values into everything we do – and devoting ourselves to meeting the needs of our clients and candidates – we have earned the reputation for …Staffing and Building successful Companies for over 30 Years…

Please share this information with other business colleagues/organizations who may also value this important workshop content.

Friday, February 16, 2007

Single point of failure

Martin McKeay reminds us of the importance of 'single points of failure' in our organizations. He was watching Dr. Michael Osterholm talk on Oprah's show about the inevitability of a flu pandemic and how we can prepare for it.

Apparently many of the drugs we depend on today all come from one or two manufacturing plants in the whole world. Can you imagine how a disaster at one of the plants would affect the entire world's drug supply? Now think about some of the parrallels in your own network and business. How many single points of failure do you have and what is your plan in the case of a failure?

What if someone by accident takes out the cable up the street? Would your business survive until the phone company can get you back online? What about your back-up system for files? What will the impact on your business be?

Step away from the technology for a second and think about the people. Who knows how to get the critical jobs done? Are you reliant on a single person? What if anyone of us get hit by a bus or just get sick for a couple of days?

Dr. Osterholm said there is a lot to learn from Hurricane Katrina and New Orleans. If we look at it that way, then it's really not a question of if a disaster is going to strike, but when. By simply being prepared, we can minimize its impact. So, you may not need to prepare for a hurricane, but you do need to identify your single points of failure.

Click on this link to see the video clip

For additional information on Pandemic preparedness from a business continuity perspective, please feel free to contact Pitsel & Associates Ltd. Calgary, Alberta, (403) 245-0550. “The time to plan is when you have time to plan.”

Monday, February 12, 2007

If bird flu grips the nation, doctors will need guns!

The National Health Service (NHS) in the UK will be unable to handle a pandemic, says Dr Andrew Lawson.

"Towards the end of the film Dr Strangelove, Peter Sellers discusses who will go into the mines to survive. A surreal echo came for myself and colleagues recently when we were in discussions about planning for a bird flu pandemic in the UK as part of an ethics committee.

If a true pandemic of bird flu hits these shores then our notions of what we can expect from the National Health Service will have to change. Some people will have to be denied potentially life-saving treatment: there simply will not be enough beds.

Managing such a pandemic is unimaginable. While it is possible to work out what will happen if a bomb goes off in central London — we can empty intensive care units, mobilise extra staff and stop elective work — what we cannot plan for is 200,000 extra patients who need a life support machine.

Arnie Schwarzenegger, the governor of California, says his state will buy thousands more machines, but who will man them? A gut reaction is to blame the government for underresourcing. It is true that we have a chronic underinvestment in intensive care compared with the United States, Australia or other European countries. In any normal situation such a criticism would be valid, but in a pandemic it becomes a statistical irrelevancy.

Who will decide, and on what criteria, those getting the chance of survival? If you and a friend get bird flu and you both end up in hospital, the estimates are that within 48 hours one of you will need life support. At conservative estimates the need for intensive care will be about two-and-a-half times more than we can provide.

Allocation of such resources will have to be either on a first come first served basis or on an explicitly utilitarian basis of capacity to benefit. This shift from an egalitarian free access to a limited one based on expected outcome represents a profound shift in how we deliver healthcare.

Exclusion criteria have already been drawn up in Canada and the United States and include such contentious issues as restriction based on age or on preexisting disease such as cystic fibrosis or metastatic cancer. Saying “no” to a desperately ill child with cystic fibrosis or to a previously fit 85-year-old is not something we are morally or emotionally prepared for. By an ethical analysis it may be the correct thing to do, but will patients or their relatives be prepared to accept it?

Such arguments may, of course, be purely academic. Assumptions as to what we can do are based on the doctors and nurses, porters and technicians turning up to work. But if we do not have enough masks to protect staff dealing with infected patients, then do the staff have a moral duty to turn up for work and get infected themselves? It may be that they go to work but only once — who will want to return home and potentially infect their own family?

In Victoria, Australia, it was suggested that patients would not go to the GP but to a “flu centre”. The idea that patients would go to where flu is concentrated displays an astounding lack of comprehension of human nature. Similarly, staff will be reluctant to put themselves at risk. HSBC, the banking group, was accused of scaremongering when it announced that perhaps 40% of its staff would not turn up for work in the event of a pandemic, but the NHS may suffer just as badly.

It is not only the risk of infection that may stop staff turning up to work. With such limited access to intensive care, it would be expected that hospitals might not be safe places at all. If I decide not to ventilate someone, his or her relatives might not be too happy. Threats to staff are all too common and many are worried about personal security. Consequently it has been suggested that the decision as to who gets the intensive care bed should be taken away from frontline staff in order to protect them.

At a discussion over how we would react to a biological emergency, where casualties would be decontaminated before we resuscitated them, it was asked who would protect the staff. The answer given was hospital security. Pleasant and helpful as they are, these guys are hardly equipped to deal with an angry mob. One doctor said that the most useful thing staff could be given in such an event was a gun.

Another concern is the legal position of staff who refuse treatment. In the absence of any measures put in place to protect them, one can imagine a raft of legal actions being taken out against them.

If attempting to allocate resources on the basis of capacity to benefit is the right thing to do, then those making the decisions need to be protected, otherwise people will not make the decisions required. Perhaps the only equitable and fair way is to shut the intensive care units and limit treatment to the best we can achieve without artificial ventilation".

Dr Andrew Lawson lectures in medical ethics at Imperial College, London, UK.


TIMESONLINE (2007). If bird flu grips the nation, doctors will need guns (Electronic version). Retrieved February 12, 2007

For additional information on Pandemic preparedness from a business continuity perspective, please feel free to contact Pitsel & Associates Ltd. Calgary, Alberta, (403) 245-0550. “The time to plan is when you have time to plan.”

Tuesday, February 6, 2007

More recent outbreaks in Japan, UK.

BBC News world has confirmed the recent outbreak of bird flu in Japan. Samples taken from 3 000 dead chickens revealed that all had been infected with the H5N1 virus. There have been a number of H5N1 outbreaks in Japan since early 2004, but there have been no reported human deaths from the virus. However, Japan is one of the five countries who have put an immediate ban on the importation of poultry from the UK.

Health officials across Asia are on alert as a growing number of countries have reported cases in both birds and humans in recent weeks.

This past weekend saw the official bird flu outbreak in Suffolk, England. According to the Health Protection Agency, a vet who attended the outbreak is in hospital suffering from a mild respiratory ilness. The vet is undergoing tests at Nottinham hospital and his condition "is causing no immediate concern".

The H5N1 strain which has caused dozens of human deaths in Asia, was found in Suffolk. The H5N1 virus does not pose a large-scale threat to humans because it can't easily be transferred from human to human. However, experts fear the virus could mutate at some point in the future and trigger a bird flu pandemic.

For additional information on Pandemic preparedness from a business continuity perspective, please feel free to contact Pitsel & Associates Ltd. Calgary, Alberta, (403) 245-0550. “The time to plan is when you have time to plan.”