Many Health Care Workers Won't Show Up in Flu Pandemic

Poll results a 'wake-up call' for better preparedness training, experts say

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By Steven Reinberg
HealthDay Reporter

TUESDAY, April 18, 2006 (HealthDay News) -- With many Americans worried about their safety should a flu pandemic occur, there's little reassurance from a survey that finds that close to half of U.S. public health-care workers would not show up for work if such a pandemic occurred.

In fact, two-thirds of the 308 employees polled said their work would put them at risk of contracting the potentially deadly flu should an outbreak come to pass.

"Forty-two percent of the health care workers surveyed said they would not respond in the event of a flu pandemic," said study co-author Dr. Daniel J. Barnett, an instructor at the Johns Hopkins University Center for Public Health Preparedness in Baltimore.

"The most important factor, in terms of showing up for work, was how much the individual employee perceived his or her role [to be] in the agency's response," he added. The less important an employee thought his or her role was, the less likely they were to report for work, Barrett said.

Just 40 percent of the employees felt that they would be asked to show up should a pandemic become a reality.

In addition, only 33 percent thought they were knowledgeable about the health impact of pandemic flu, Barnett said.

The survey was conducted between March 2005-July 2005 and involved employees of three Maryland county health departments. The findings appear in the April issue of the journal BMC Public Health.

The willingness to report for work was lowest among technical and support staff, Barnett said. These include computer data entry staff, clerical workers and receptionists. "In many cases, these are some of the people who will be on the frontline interfacing with the public," he noted.

The implication of these findings is that more training of health care workers is needed. "We need to do a better job of training the public health workforce," Barnett said. "Not just in ability to respond, but in willingness to respond," he added.

"We need to focus on giving each worker a better sense of the pandemic scenario and the importance of his or her personal role in responding to it as a health department employee," Barnett said. "In addition, we need to give workers confidence that the agencies will give them adequate personal protective equipment."

Barnett assumes that these findings would be the same throughout the United States. "The health departments we surveyed are consistent with a vast majority of health departments in the country," he said.

The public should be concerned with these findings, Barnett said, since the system can't function during a pandemic if many of the key health care workers don't show up. "This is a wake-up call of preparedness training to address willingness to respond," he said.

One expert is not surprised by these findings.

"Reluctance to report to work in a variety of settings will probably be an issue during a pandemic," said Dr. John Treanor, a professor of medicine, microbiology and immunology at the University of Rochester, N.Y. "It makes sense that if someone does not believe that they play an important role in whatever organization they work for, they are less likely to brave risks and hardship to go to work."

Education will be an important component of pandemic planning, Treanor said. "I would be interested to know the extent to which this would be impacted if the employees believed that they would receive an effective preventative, whether that was a drug or vaccine or something else, that would reduce or eliminate their personal risk," he said.

Another expert doesn't think these findings can predict the actual response during an actual crisis.

"The findings are potentially misleading because anticipating one's response to a genuine crisis is difficult," said Dr. David L. Katz, an associate professor of public health and director of the Prevention Research Center at Yale University School of Medicine.

"Completing a survey about hypothetical scenarios evokes none of the emotional intensity of a true crisis," he said. "Stating you might resist the call to duty in the advent of such a crisis does not induce the conflict or cognitive dissonance of actually doing so," he said.

However, he said, the findings should not be ignored.

"The findings are worrisome, though, because they suggest that the legions of public health workers around the country do not feel sufficiently informed about the threat of pandemic avian flu to respond to its arrival with confidence," Katz said. "Health departments can and should develop clear and coordinated response plans, and raise the prevailing level of flu knowledge among staff."

More information

For more on avian flu, head to the U.S. Center for Disease Control and Prevention.

SOURCES: Daniel J. Barnett, M.D., M.P.H., instructor, Johns Hopkins Center for Public Health Preparedness, Johns Hopkins Bloomberg School of Public Health, Baltimore; John Treanor, M.D., professor, medicine, microbiology and immunology, University of Rochester, N.Y.; David L. Katz, M.D., M.P.H., associate professor, public health, and director, Prevention Research Center, Yale University School of Medicine, New Haven, Conn.; April 2006, BMC Public Health

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