Publication related to RSI or an RSI staff member
National assessment of Canadian pandemic preparedness: Employing InFluNet to identify high-risk areas for inter-wave vaccine distribution.
BACKGROUND: Influenza pandemics emerge at irregular and unpredictable intervals to cause substantial health, economic and social burdens. Optimizing health-system response is vital to mitigating the consequences of future pandemics. METHODS: We developed a mathematical model to assess the preparedness of Canadian health systems to accommodate pandemic-related increases in patient demand. We identify vulnerable areas, assess the potential of inter-wave vaccination to mitigate impacts and evaluate the association between demographic and health-system characteristics in order to identify predictors of pandemic consequences. RESULTS: Modelled average attack rates were 23.7-37.2% with no intervention and 2.5-6.4% with pre-vaccination. Peak acute-care demand was 7.5-19.5% of capacity with no intervention and 0.6-2.6% with pre-vaccination. The peak ICU demand was 39.3-101.8% with no intervention and 2.9-13.3% with pre-vaccination. Total mortality was 2258-7944 with no intervention and 88-472 with pre-vaccination. Regions of Southern Ontario were identified as most vulnerable to surges in patient demand. The strongest predictors of peak acute-care demand and ICU demand were acute-care bed capacity (R = -0.8697; r(2) = 0.7564) and ICU bed capacity (R = -0.8151; r(2) = 0.6644), respectively. Demographic characteristics had mild associations with predicted pandemic consequences. CONCLUSION: Inter-wave vaccination provided adequate acute-care resource protection under all scenarios; ICU resource adequacy was protected under mild disease assumptions, but moderate and severe diseases caused demand to exceed expected availability in 21% and 49% of study areas, respectively. Our study informs priority vaccine distribution strategies for pandemic planning, emphasizing the need for targeted early vaccine distribution to high-risk individuals and areas.
Authors
- Saunders-Hastings, Patrick, Saunders-Hastings P, University of Ottawa, McLaughlin Centre for Population Health Risk Assessment, 850 Peter Morand Crescent, Ottawa, Ontario, K1G 5Z3, Canada.; University of Ottawa, School of Epidemiology, Public Health, and Preventive Medicine, Faculty of Medicine, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada.
- Hayes, Bryson Quinn, Hayes BQ, University of Ottawa, Department of Mathematics, 585 King Edward Avenue, Ottawa, ON, K1N 6N5, Canada.
- Smith, Robert, Smith R, University of Ottawa, School of Epidemiology, Public Health, and Preventive Medicine, Faculty of Medicine, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada.; University of Ottawa, Department of Mathematics, 585 King Edward Avenue, Ottawa, ON, K1N 6N5, Canada.
- Krewski, Daniel, Krewski D, University of Ottawa, McLaughlin Centre for Population Health Risk Assessment, 850 Peter Morand Crescent, Ottawa, Ontario, K1G 5Z3, Canada.; University of Ottawa, School of Epidemiology, Public Health, and Preventive Medicine, Faculty of Medicine, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada.; Risk Sciences International, 55 Metcalfe Street, Suite 700, Ottawa, ON, K1P 6L5, Canada.
BACKGROUND: Influenza pandemics emerge at irregular and unpredictable intervals to cause substantial health, economic and social burdens. Optimizing health-system response is vital to mitigating the consequences of future pandemics. METHODS: We developed a mathematical model to assess the preparedness of Canadian health systems to accommodate pandemic-related increases in patient demand. We identify vulnerable areas, assess the potential of inter-wave vaccination to mitigate impacts and evaluate the association between demographic and health-system characteristics in order to identify predictors of pandemic consequences. RESULTS: Modelled average attack rates were 23.7-37.2% with no intervention and 2.5-6.4% with pre-vaccination. Peak acute-care demand was 7.5-19.5% of capacity with no intervention and 0.6-2.6% with pre-vaccination. The peak ICU demand was 39.3-101.8% with no intervention and 2.9-13.3% with pre-vaccination. Total mortality was 2258-7944 with no intervention and 88-472 with pre-vaccination. Regions of Southern Ontario were identified as most vulnerable to surges in patient demand. The strongest predictors of peak acute-care demand and ICU demand were acute-care bed capacity (R = -0.8697; r(2) = 0.7564) and ICU bed capacity (R = -0.8151; r(2) = 0.6644), respectively. Demographic characteristics had mild associations with predicted pandemic consequences. CONCLUSION: Inter-wave vaccination provided adequate acute-care resource protection under all scenarios; ICU resource adequacy was protected under mild disease assumptions, but moderate and severe diseases caused demand to exceed expected availability in 21% and 49% of study areas, respectively. Our study informs priority vaccine distribution strategies for pandemic planning, emphasizing the need for targeted early vaccine distribution to high-risk individuals and areas.
