Thank you, Madam Chair.
The College of Family Physicians of Canada is pleased to be invited to present again to the Standing Committee on Health about H1N1 pandemic preparations. Having spoken to you on August 12, we'll provide an update on the progress made to address the issues identified at that time.
Specifically to your question about whether the situation has improved and whether family physicians feel more confident now than they did eight weeks ago, our short answer is that much work has been done, but much more remains.
There have been improvements. The Public Health Agency of Canada has invited the College of Family Physicians of Canada to several tables, including those where vaccine sequencing and antiviral therapies have been discussed. During our recent visit to the agency, Dr. Butler-Jones and agency staff demonstrated their continued openness and transparency in listening to our concerns. As a result, we are currently working with the agency and other key stakeholders to develop information resources that will hopefully be more accessible, easier to read, and focused on information of practical value to family physicians and other providers in busy office settings.
Nevertheless, what keeps us awake at night is that all of these good intentions, hard work, and multiple resources will be of minimal benefit to front-line providers unless they are translated for their realities and pushed to them through the channels of communication with which they are most familiar. This must happen at the local level, not solely at national or even provincial or territorial levels of our health care system, for while some regions have been blessed with too much information through a variety of channels, thereby raising the risk of mixed messages, others have not had enough, producing a patchwork of resources for family physicians and other providers across the country.
If you overlay this mix with the clinical controversies—about the interaction between seasonal and H1N1 flu vaccines, post-influenza viral spread, who should be prescribed antivirals pre- or post-exposure, and what defines populations in Canada with the greatest potential to be most affected by this pandemic—then we may have the right components for a health system storm.
We respect that protocols and advice will necessarily change as new information comes to light. However, related to vaccine sequencing, we must also not be afraid to answer broader questions such as these. When will the vaccine be available? Why sequenced groups if everyone can get the vaccine? And if there are priority groups, where do people over 65 years of age fit in?
Infection control is a high priority in family practice. SARS and H1N1 have brought greater attention to the way family physicians manage patients with infectious diseases in their offices. Most family practices have not been designed to handle a deluge of pandemic patients, and practical advice is needed to consider patient flow and spacing issues. Family physicians and other members of the health care team also need expedited access to resources for infection control—for example, fitted N95 masks and other personal protection equipment. They need to know where and what the right resources are.
As stated on August 12, it's the unknown potential of an advancing pandemic outbreak that should cause governments and public health authorities to strive for optimal conditions that will provide family physicians and other health care providers with the information resources they require to manage patients who will present first with H1N1 flu symptoms to their family doctor and primary care providers.
To summarize, the CFPC recommends the following. Timely, consistent, easy-to-access, and user-friendly pandemic information must be provided to all family physicians and health care providers included in front-line services. Information must come to family physicians and other providers from public health at the local level. It is imperative that we work together to translate pandemic information into the practical realities that front-line providers experience. And finally, public health resources must be clearly defined and readily available for patients, family physicians, and other health care providers involved in first-contact services.
In closing, the CFPC and family doctors believe that we can respond collaboratively to the H1N1 pandemic outbreak. We are grateful for the significant efforts that have been made and welcome opportunities to address the ongoing challenges.
Once again, thank you very much, Madam Chair.