GNYHA participated in an Executive Level Workshop last week that explored the early impact on New York City and its health care delivery system if a worldwide pandemic avian flu outbreak were to occur. Co-hosted by NYC Health + Hospital’s (H + H) Emergency Management Special Pathogens Program and the Johns Hopkins Center for Health Security, the workshop was conducted at NYC H+H/Woodhull and included representatives from hospitals and health systems across the New York region as observers.

The first module examined how the health system would react to initial reports of a disease in China, followed by the first waves of patients. The module was acted out by players representing H + H acute, ambulatory, and post-acute service lines, as well as key departments such as legal, supply chain, and communications. Discussions focused on actions H + H could take to maximize and preserve resources to accommodate patient surge, changes to routine clinical and operational practices, and coordination with external governmental and non-governmental agencies.

The second module—which involved representatives from the New York City and New York State departments of health, New York City Emergency Management, the Fire Department of the City of New York, the Centers for Disease Control and Prevention, the Assistant Secretary for Preparedness and Response, and GNYHA—focused on actions that would likely be taken by public health authorities to limit transmission, mitigate illness severity, and develop a vaccine. The inherent challenges of evolving clinical guidance related to patient management and health care workforce protection, as well as managing patients in an environment of diminishing resources, were also highlighted. All players agreed on the importance of strong public messaging to discourage those with mild illness from going to hospitals for treatment, and the need to rethink how various parts of the health care ecosystem could be used to meet demand. As the pandemic would not be expected to peak for several weeks, the need for strong forward planning was emphasized.

Federal partners and researchers presented on current and prospective technologies that could aid in pandemic preparedness and response and provided a comparison of the 1918 worldwide flu pandemic to the conditions we see today. The workshop highlighted how quickly such an outbreak might overwhelm the City’s health care delivery system. Cohesive, deliberative planning now will increase preparedness for a pandemic, but more importantly for seasonal flu and other special pathogens such as Zika, MERS, and Ebola, which continue to pose threats.