Proportional response

Response occurs at the onset of an emergency. The level of response is likely to vary during the pandemic. Initially, pandemic cases may be sporadic, whereas during a peak, general practices may be inundated with patients with pandemic influenza.

Practices should implement their response strategies just prior to and during the pandemic. The action(s) required will depend on the current pandemic stage as determined by the Australian Government. These four stages are aligned with the Department of Health’s AHMPPI:

Responding to a pandemic means activating the plans made in the preparedness phase – in a manner and to a degree appropriate for the severity and intensity of the outbreak.

The quality of planning will affect the ability to respond. Strategies for implementation of pandemic plans are considered effective if they:³

• are flexible
• include a range of pandemic preparedness approaches applicable to different situations
• include communication aspects and are transparent
• include advance stockpiling (eg for drugs and equipment).

In the early stages of a pandemic, information about the risks and severity will be minimal. The best source of upto-date and relevant information for general practices will be the Department of Health, the RACGP, and state and territory health departments. They will provide information about:

• what is known about the virus early in the pandemic – this is likely to include mode of transmission, broad incubation period, broad clinical presentation and case definition, and preventive measures to reduce transmission
• what is unknown early in the pandemic – this may include age and clinical groups most affected, age groups with most transmission, ‘severity’ and case-fatality rates, precise case definition, complicating conditions, effectiveness of antivirals and other medications, and safety of any pharmaceutical interventions
• what GPs should do early in the pandemic – as more information becomes available it will be easier to tailor your response according to the pandemic, your patients and your practice.

To continue to provide locally relevant information, health authorities will need to be informed about frontline pandemic situations, including patient feedback and effectiveness of any interventions.¹¹