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Indeed, we are in a happy situation, because one of the
two companies that can guarantee this technique is
located in Austria.
Next, we explained our planning to all ministries and
large industries, requesting specific additions to the
health plan. The target was to secure public life and
security throughout the country, in the event of a flu
pandemic.
It is clear that all levels of society – public bodies,
private industry, and families – need to work together
to create an effective shield that will protect the popu-
lation. In a nationwide effort, we offered a common
purchasing of antivirals, and this was accepted by a
large part of the industry. In cooperation with our
defence ministry, we would be able to stockpile phar-
maceuticals and facemasks. Of course, efforts towards
such preparedness can never stop, and a constant
updating of all planning is necessary.
Preparedness across Europe
These issues and measures should extend beyond a
single country. A key requirement in preparing for future
pandemics is the coordination and synchronization of
preparedness measures Europe-wide. This was one of
the lessons learned under the first EU-wide pandemic
exercise.
From lessons learned, especially in Southeast Asia, it was clear
that there was a strong connection between the spread of avian flu
and a decrease in Gross National Product (GNP). Under the guide-
line ‘health in all policies’, we started our work primarily in the
public health field. However, an accompanying crossover with essen-
tial services and trade was also announced. Strong cooperation
between public health organizations at federal and regional levels
resulted in the structuring of a federal guideline and regional real-
ization plans.
From the beginning, all three medical universities were involved.
A special scientific advisory board was created under the chair of the
Director General of public health. We began working first to final-
ize a theoretical plan, and then to establish budgeting for it.
At the start, one important question was raised: what part of the
population should be protected – all of it, or only a part? Following
discussions with our acting minister it was decided that we want to
support and protect a maximum of the population.
The second development was our decision to use antivirals and
prophylactics, especially for all essential services. This had been
acknowledged before, but had not been a practical option until
recently.
Third, we wanted to ensure we had the best vaccine – that is, the
most recently produced vaccine using the pandemic strain. However,
the existing egg-based production techniques meant that these could
not be produced in time. Now, though, the cell-culture based vaccine
production technique gives us the opportunity to reach this target.
Van Swieten
Van Swieten was the first Austrian national exercise to evaluate
crisis management of a national emergency due to an infectious
disease.
2
In general, the EU exercise ‘Common Ground’ was taken
as a model for the national exercise concerning scenario, aims
and objective. Additionally, the results of the evaluation of
Common Ground were incorporated. The exercise took place in
November 2006 and lasted for two days.
The aim of the exercise was to evaluate the communication and
cooperation between national and regional levels during a
pandemic situation. The exercise centre was located on national
level. All public health officers on regional level were actively
involved, while the involvement of the district level was voluntary.
Furthermore, several hospitals asked for participation to test there
internal crisis plans.
The objectives of the exercise were the evaluation of:
• Communication between the Ministry of Health (MoH), the nine
regional health boards and the other involved ministries
• General preparedness for an influenza pandemic in Austria
• The interoperability of the regional plans.
Central elements of the exercise were therefore:
• Surveillance during a pandemic
• Counter measures such as use of antiviral medicinal products
and the pandemic vaccine
• Logistic issues
• Trans-border issues such as ‘health shopping’ and travel
restrictions.
The scenario of this two-day exercise was divided into three blocks
and covered six months in real time. Each block was played in
compressed time. In block one, players had to react according to
pandemic phase 5 when clusters of human infections with a new
influenza virus subtype appeared in Southeast Asia. In block two,
players had to manage pandemic phase 6 with no availability of
pandemic vaccine. In block three, the logistics for the use of the
pandemic vaccine during the second pandemic wave (phase 6)
had to be handled.
Van Swieten was evaluated by the same methods as used in the
evaluation of Common Ground.
3
In the evaluation process the
need for intensive work on several topics was disclosed:
• Continuous inter-ministerial cooperation concerning the issue
border control/closure of borders, closure of airports and ‘health
shopping’
• Concrete plans for business continuity
• Planning presumptions (definition of triggers for certain
situations).
However, one of the most important results was the need for
strengthening the public health sector. A well functioning public
health system is the backbone for successful crisis management
in the field of infectious diseases, and thus needs to be
supported concerning human and financial resources.
Furthermore, public health officers need to have continuous
access to training on high level. Therefore in 2006, the Austrian
MoH started a special initiative to send key personnel of the
regional health boards to international training seminars and
workshops.
4
A group of well-trained public health experts will be
established that can function as multipliers at regional level.
Additionally, the MoH organizes crisis management training
seminars at national level.
Another important element is the electronic reporting system for
infectious diseases (EMS), which was implemented in Austria
beginning in 2009.
5
The EMS allows for real-time surveillance and
thus for immediate crisis management when needed. The EMS will
be fully integrated in future exercises in order to optimize its
functionality.