Becker's Hospital Review

61 FINANCE CMO / CARE DELIVERY 4 flu preparedness lessons from the 1918 pandemic By Mackenzie Bean T he 1918 flu pandemic offers several les- sons on infection control and outbreak response efforts for health officials today, according to a study published Oct. 8 in Fron- tiers in Cellular and Infection Microbiology. For the study, researchers analyzed numerous flu studies to identify the human, viral and societal factors that fueled the flu pandemic of 1918, in which 50 million people died. "Like the 1918 pandemic, the severity of any future outbreak will result from a com- plex interplay between viral, host and so- cietal factors," study author Carolien van de Sandt, PhD, a researcher at the Peter Doherty Institute for Infection and Immuni- ty in Melbourne, Australia, told Science Dai- ly. "Understanding these factors is vital for influenza pandemic preparedness." Here are four lessons from the 1918 flu pan- demic, as outlined by the researchers: 1. Conduct regular viral surveil- lance. e viral strain responsible for the 1918 pandemic could infect tissues outside of the respiratory tract and contained mutations that made it more easily spread between humans. Today, scientists can analyze new viral strains for pandemic potential, a practice that proves more important than ever amid climate change, according to the researchers. "Climate changes affect animal reservoirs of influenza viruses and bird migration patterns. is could spread viruses to new locations and across a wider range of bird species," Dr. van de Sandt told Science Daily. 2. Address public health issues. A centu- ry ago, malnourished individuals or those with underlying health issues were more likely to die from the flu. Current public health issues, such as obesity, could pose an issue for future pan- demics and cause a higher death toll. 3. Consider population demograph- ics. e 1918 pandemic had an outsized effect on young adults, not the elderly. Re- searchers suggested the older population had a greater immunity to the 1918 flu strain due to past virus exposure. "Providing emergency vaccines during fu- ture pandemics should take into account different age groups, viral and host factors," Katherine Kedzierska, PhD, a study author and researcher at the Doherty Institute, told Science Daily. 4. Be proactive with infection con- trol methods. Infection control measures such as prohibiting public gatherings and promoting hand-washing helped lower in- fection levels and death during the 1918 pandemic. However, the measures only proved successful if the interventions were implemented early and used throughout the entire pandemic. "Until a broadly-protective vaccine is avail- able, governments must inform the public on what to expect and how to act during a pan- demic," Dr. van de Sandt told Science Daily. "An important lesson from the 1918 influen- za pandemic is that a well-prepared public response can save many lives." n Most physicians burned out, overworked + 8 other survey findings By Kelly Gooch U .S. physicians continue to struggle with burnout and job satisfaction, according to a survey from the national nonprofit Physicians Foundation. The survey of 8,774 physicians was conducted by the foun- dation, with help from Merritt Hawkins, from early April through early June. Here are 10 findings: 1. Thirty-one percent of respondents said they identified as independent practice owners or partners. That's down from 33 percent in 2016 and 48.5 percent in 2012. 2. Nearly 16 percent of respondents said they work 61 to 70 hours per week, on average, on clinical and nonclinical duties, down from 16.5 percent in 2016. Additionally, 4.7 percent of respondents work 81 or more hours per week, on average, compared to 6 percent in 2016. 3. On average, 27.6 percent of respondents see 21-30 pa- tients per day, including office and hospital encounters, down from 28.1 percent in 2016. Additionally, 8.6 percent of respondents see an average of 31-40 patients per day compared to 8.8 percent in 2016. 4. Most respondents (80 percent) said they are at full ca- pacity or overextended and overworked. 5. Most respondents (61.6 percent) said they are very or some- what pessimistic about the future of the medical profession. Only 38.4 percent said they are very or somewhat optimistic. 6. Sixty-nine percent of respondents reported prescribing fewer pain medications amid the nation's opioid crisis. 7. Seventy-eight percent of respondents said they some- times, often or always feel burned out. 8. Respondents spend an average of 11.37 hours per week on nonclinical paperwork. That's an increase from 11.29 hours in 2016 and 10.58 hours in 2014. 9. Nearly half of respondents (46 percent) plan to change career paths, and 17 percent plan to retire in the next one to three years. 10. Respondents cited EHR design and interoperability challenges as the top reasons for professional dissatisfac- tion, and physician-patient relationships as the top reason for professional satisfaction. n

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