Monday, May 4, 2009

All Staff Message from the Director

The following is an all staff message sent today by William B. Walker, M.D., Director and Health Officer, Contra Costa Health Services.

As we begin a new week, I want to share some information related to the H1N1 influenza outbreak. (We are no longer referring to it as swine influenza at the request of the federal government.)

As of today, we do not have a major increase in the number of probable cases (there are now eight.) There will no doubt be more. There are now five schools closed and there may be more closures as more test results come back, based on evolving guidelines from the State and the Centers for Disease Control and Prevention. Symptoms for most cases in the United States have been relatively mild, and preliminary work in analyzing the virus itself shows it lacks the components that made the 1918 virus so deadly. (Updated information is on our website at including a list of the closed schools.)

Last Friday, our initial shipment of Tamiflu – the antiviral for treating the disease – arrived from the federal Strategic National Stockpile. Adequate amounts have been distributed to all our local hospitals to be used by medical staff according to guidelines we are providing.

While I am cautiously optimistic about the disease not becoming unmanageable, there have been influenza outbreaks in the past where a relatively mild wave has been followed by a much more severe one, so it is too soon to relax our vigilance. And school closures certainly cause considerable problems for children, parents and other caretakers so we want to proceed with investigation of the problem in this area very cautiously and in consultation with the school community.

We are continuing to monitor the number of new cases, and in the days and weeks ahead we should know more about the virus and the outbreak. Meanwhile, continue to be vigilant about hand washing and other methods of preventing the spread of the disease. Please stay home if you are sick. People have asked about the use of masks. In general, they are not effective except for health care workers working directly with patients with influenza symptoms. It is not necessary or effective for others to use masks.

As we move into our second full week of the emergency, one thing I feel very positive about is the progress we’ve made internally and with our partners in responding. CCHS staff has been outstanding in their professional and efficient actions. Public Health (assisted by others) has staffed our Department Operations Center, preparing comprehensive plans for our response, making home visits to test suspected cases, working with schools, providers and partners to get out accurate information, shifting through avalanches of information to cull out critical directives and coordinating with our regional counterparts. Our Public Health Lab is in high gear testing samples to comply with CDC’s request that local health
departments step up surveillance.

Contra Costa Regional Medical Center has been holding twice-daily briefings with their managers to share updates on the latest directives and deploy staff appropriately. The Emergency Department has expanded its space to serve residents who are concerned about the influenza outbreak. Our Health Centers are working to identify patients with symptoms and conduct appropriate tests. Our Health Plan Advice Nurse Unit has fielded hundreds of calls from concerned patients and community members and is working with their pharmacy local provider networks. Emergency Medical Services continues to survey local hospitals to monitor emergency room activity and emerging trends. Information Systems converted our internal Incident Response Information System to a web-based application available 24/7 so
our Emergency Management Team can monitor our ongoing response from anywhere.

Fed by all of those working on the response, our Community Education and Information Unit is continually posting information on our website, blast faxing alerts to our partners and using social media like Twitter to get out our messages. Amazing as it is, in the Google search process, our website is number 20 worldwide for the search “flu pandemic” and number 11 worldwide for "gripe pandemica.”

It has been an impressive example of how an integrated health department can work together.

William B. Walker, M.D., Director and Health Officer
Contra Costa Health Services

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