Influenza Pandemic Preparedness and Response in Madrid
Phase 1 of Initiation: Building the Public Issue and Incorporation into the Agenda
Before starting the determination of the problem that concerns us in this analysis, we must state the type of culture and power of organizations from which to translate the issues of this work. After careful analysis of all of them, we decided to stand with “Athena,” characterized as a goddess of wisdom. Organizational power and culture “type Athena” is characterized by leadership based on participation, organizational objectives based on meeting changing market needs, and few rules that are not detailed and continually changing, a shared responsibility for coordination based in both formal and informal meetings, a very easy growth taking into account the role, a network structure, a mainly unstable environment with ups and downs, a factor of change based on stabilization, and finally a large size. All these characteristics result in organizations based on high-technology companies. The organizational culture model “Athene” is associated with an ideology or values related to technology and environmental changes.
Having explained the model chosen, we turn to the issue of job analysis. First, we proceed to identify problems and social tensions that could result if appropriate measures are taken to curb the pandemic. The public agenda is the plural composition of public initiatives and proposals to decide the use of social resources in solving social problems (M. Murphy). For the construction of the agenda, we will analyze it from a prescriptive point of view, which is the practical definition of public problems, answering questions like: How is the problem? What are its dimensions? What are the causes of the problem? Who is affected and to what extent? And how does the problem evolve if we do not act on it?
First, we make an overall assessment of the pandemic as an overview: we start with the date of the outbreak, scientific identification, and a general assessment of the severity level presented in the population (for example, “Most cases have mild symptoms and are younger than 30 years, with a limited presentation of the virus in over 64”). We consider the recommendations of the health institutes to pool efforts for better performance of specialists and limit the action of the virus with antiviral drugs, reserving them for those patients with advanced and severe disease. We determine the balance of detention cases to promote a situation of total control to prevent panic in the population and the need for evaluation to determine whether increases in cases of infection are temporary or are increasing.
Identifying different measures to the usual seasonal flu: clinical management and surveillance cases, communication and professional training for specific clinical management of each handling suspected cases, confirmed case patient health, and hygiene advice for patients. Public information, population groups at high risk, monitoring phase, monitoring strategies, mitigation strategies.
Now we proceed to identify precisely the definition of a public issue that puts on the agenda of institutions and public authorities the need to adopt this plan and put it underway. We could define a public problem as “a substantial discrepancy between what is and what it should be.” We can qualify under the definition of what would be a public issue the kinds of problems that can be found in this case, could include in those involving a bus and/or those that create an undesirable situation not acceptable. It is very complex to establish the exact definition of a public issue, and we must take into account the perspectives of the person who will decide on the issue, the players involved, and the solutions available.
The public issue has been identified (the implementation of the National Plan for Preparedness and Response to a Flu Epidemic) and now requires definition. “This can be done in terms of subjective or an “objective” analysis. Often what is defined as “a problem” is actually a combination of problems that need to be separated and identified. When possible, problems should be measured while identified, as there are several advantages in quantification. However, the identification of a problem does not mean that it exists; we must try to explain how it emerged and what combination of causes and effects act.”
In our opinion, and based on the analysis of the foregoing, the public issue would simply be not implementing the Plan. The guidelines are required to increase the urgency and magnitude of the problem and the need to convert the conflict actors of pandemic flu into a problem that can be exhausted. In this case, the problem of the spread of the epidemic would be offset and probably eradicated with the application of the National Preparedness and Response to the pandemic.
Phase 2 Development: Development of Alternatives
The National Preparedness Plan and Response to an influenza pandemic set specific targets. These targets are set taking into account the guidelines of the World Health Organization (WHO) and the European Union, since the flu pandemic is something that affects the world and not just Spain. The basis of these objectives is to harmonize the response and to guide possible plans launched by the Autonomous Communities.
We differentiate two types of objectives: general and specific. Among the general objectives are: to reduce the impact of the pandemic on the health of the population, limit the spread of the virus, and ensure that measures are established by WHO.
The specific objectives can be summarized into four closely interrelated objectives. The first is to keep the population informed as best as possible, the second is to avoid getting sick, the third objective is to maintain social order and avoid panic, and the fourth and final objective is to apply the proper treatment and necessary measures to prevent the spread after an infection has occurred.
Strategies Defined in the Preparedness and Response Plan
Among the strategies defined in the Preparedness and Response Plan for Pandemic Influenza in Madrid, we will focus on the analysis set out in that plan last: External Communication to the Public and Health Education. An information protocol was developed to fulfill the information needs of the population, providing appropriate messages according to the real situation of risk and providing all information necessary for the adoption of preventive measures and promoting the efficient use of human resources. So that your message meets the objectives for which it emerges, it is necessary that the different institutions involved in the implementation of the plan maintain contact information with one another. In this way, the message, as well as being suitable according to the pandemic phase where we are, should be a cohesive message and consensus among all involved. It is necessary for the designation of official spokesmen to centralize all the information before transmitting it.
These two characteristics of the message, cohesion and consensus, are of great importance. It is necessary that the various means that are responsible for informing the public do so in the same direction. For it, all administrations or institutions involved in the information strategy must interact. Otherwise, ambiguous or contradictory messages can be transmitted, causing confusion, distrust, and alarm in the population.
The message serves two purposes: first, it informs the population of the state of the pandemic at all times to avoid mistrust and fear-mongering, and second, it transmits to the population the health education plan developed by the institutions to know the methods and how to minimize the spread and transmission of disease. The message should be direct without hiding information. Although it should not be alarmist, not to provoke the average population, it should not ease the situation because this could lead to overconfidence that favored the spread by not taking the citizens every precaution in their power.
Therefore, in the pamphlets, there are reports on how the disease is transmitted through contact with infected persons and the period of infection, so people who have been in contact with infected may take the necessary measures if they believe they can be infected.
Among the measures introduced to prevent the spread of the virus, we can distinguish two types: those relating to eliminating the virus from surfaces and materials relating to preventing the spread between people. Regarding the former, it is necessary to disinfect water at 70ยบ and use alcohol disinfectant on surfaces that are touched by people, such as door handles and lights, especially in public places. With respect to human transmission, it is necessary to prevent the adoption of certain habits of easy implementation: covering your cough with tissues, disposing of those tissues in the trash, avoiding direct contact with other people (that is, avoiding shaking hands, kissing), and continually washing hands a certain way.
Phase 3: Implementation and Enforcement of Public Policy
Then, in the development of Phase 3, we proceed to discuss public policy we developed across all the work, focusing on the identification of organizational structures and coordination that resulted in the development of the management of influenza A, as well as their composition, functions, and activities.
First, the Preparedness and Response Plan Pandemic Flu Community Madrid outlines the basis of that plan, supported by recommendations from:
- The World Health Organization. WHO Global Plan to prepare for an influenza pandemic.
- The European Union, concerning planning and preparation for the same flu pandemic.
- Statewide, the Ministry of Health and Social Policy, as well as various other committees for prevention, control, and epidemiological monitoring of influenza viruses.
Therefore, we can see in principle for the implementation of the Plan for Preparedness and Response to an influenza pandemic in the Community of Madrid, from now on Plan and develop public policy and to give a possible solution to the problem addressed, the Plan is based on three distinct levels: an international level, based on the recommendations of the World Health Organization; another community could be defined as, i.e., relying on the schedules of the European Union and its various recommendations and decisions coordinated through its committees; and another latter being the state, supported by the Ministry of Health and Social Policy in this case. In addition, we can also point out, and in a more secondary way, the Plan also follows the recommendations of scientific societies at the regional level, as well as programs and plans of other countries, in order to provide the public policy of unity, efficiency, and effectiveness.
As noted earlier, many organisms for which the Plan is based, therefore it is essential to the coordination of data with the aim of public policy that will come out efficiently. To allow for proper coordination, create ad hoc Committee on Prevention, Control, and Evolution Epidemiological Monitoring of Influenza Virus by Decree 89/2005 of 22 September and now the Committee, in this You decree also includes the creation of the Scientific Commission to study and advise on Influenza A (H1N1) of the Community of Madrid. The Plan reflected the composition of the Committee, chaired by the head of the Ministry of secondment or person to whom it delegates. Also the members of this Committee, with the presence of the Health Ministry and other Ministries of the Community. Also other members outside the structure of the Regional Government, highlighting a representative of the Government Delegation in Madrid, the President of the Federation of Municipalities of Madrid, or a representative of the City of Madrid with the rank of Alderman.
In addition to the composition of the also contains the functions that it must do to conduct a proper public policy and to give a solution to the problem we are considering, and, among the various functions of the Committee highlights: Propose actions to be taken on prevention of pandemic influenza in the Community of Madrid, or the coordination of all activities with the Central Government or other public authorities with competence in the field.
We can say then that the Committee is the body set of greatest importance to the implementation of public policies. In addition, there is also the aforementioned Commission, which, like the Committee, the decree states the composition of the same, and the functions that it is attributes, among which are: evaluation of potential situations risk in relation to avian influenza, analysis and proposals concerning measures adopted by other authorities or proposal of preventive measures about bird flu. We can say that the Commission has authority to second order in the Committee, but also has importance for the effectiveness of public policy developed.
Finally, we note the equally important coordination group, hereafter the Group-tsp main function is to initiate, planning, and coordinating the technical activities necessary to prepare the response plan for pandemic influenza in C. We note that this group has several subcommittees, as could be:
- Subcommittee on Oversight.
- Subcommittee on vaccines and antivirals.
- Subcommittee on response to health services.
- Communications Subcommittee.
The subcommittees will serve to finalize technical aspects of each of the points Key Response Plan. Therefore, the development of public policies for responding to pandemic influenza A in the Madrid Plan creates a certain, which states that based on these bodies mentioned, from organizations such as WHO, up to the regional level. On this basis, establishing the Plan, in order to carry out coordination of the different structures involved in public policy making, creating, in hierarchical order, a Committee, a committee, and finally a Coordination Group, each with its composition and functions clearly defined to ensure an appropriate response and give a prompt solution to the problem that raises the implementation of specific public policy.