Download files
Abstract
A severe influenza pandemic has the proven potential to cause high levels of mortality and morbidity. In all countries preparedness plans have been devised, intended to be used by stakeholders, to guide the health system which is expected to attend to a fast rising number of patients. This thesis explores the dimensions of pandemic preparedness planning from three perspectives: governmental plans and planning; stakeholder perspectives on critical infrastructure systems; and an analysis of mass media reporting on preparedness planning and infrastructure issues during the 2009 pandemic. The pandemic occurred shortly after this thesis had commenced, and afforded me a unique opportunity to conduct my research in the midst of it. The findings suggest that preparedness plans are not consistent, vary highly in quality, clarity and often neglect aspects of planning for critical infrastructure dependencies. They are also unclear about the intended target audience and do not cater for the differing needs of different stakeholders. The alignment of pandemic plans appears to be poor between different levels of governance. Key stakeholders make little use of planning information, are unaware of existing pandemic plans and have a lack of awareness of the high level of dependency on critical services. The media analysis showed fluctuating interest in the 2009 pandemic focused mainly on health issues, and did not reflect any major failures in critical infrastructure. Crisis communication, as propagated by plans, is traditionally centred on mass media, but could gradually benefit from the internet and social media. Hospitals operate on baseline staffing levels which, during a sustained emergency, would endanger their capacity to handle the impact of an outbreak. Hospitals and the health system are critically reliant on infrastructure systems. The thesis' findings can inform planners of the systemic vulnerabilities, potentially affecting health care, which could deteriorate in an outbreak, leading to cascading failures further exacerbating the impact. Planners need to consider this and the planning documents should be aligned with stakeholders from health and non-health organisations who are the end-users of the plans. It is suggested that established tools such as international standards and continuity planning be applied with stakeholder consultation. Fewer plans which target the intended end-user would be the result and would improve the usability and utility of these documents. This research shows that greater alignment of plans and closer communication between planners, stakeholders and the public, would enhance pandemic planning. In terms of communicating and documenting the societal impact of a pandemic, the mass media is a useful tool not just for communicating key messages in a disaster, but for monitoring impact on society. For this it should be complemented by the internet and social media.