The Sunday Telegraph (UK) ran a piece on the Department of Health's planning framework for operations during a Mass Casualty Incident (MCI). An MCI is an incident where a large number of sick or injured occur due to a chemical, biological, radiological or nuclear incident. Pandemic Influenza would fall under this designation.
Security guards could be posted at hospitals to stop casualties gaining entry and contaminating other patients in the event of a "chemical" terrorist attack, government plans show.
Guidance published last week instructs every hospital to "retain control of access to its facilities" following a chemical, biological, radiological or nuclear incident.
The advice is part of the Department of Health's planning framework for dealing with "mass casualty incidents" - whether from terrorist attack or infectious diseases, such as a flu pandemic.
This planning framework is probably reasonably workable during a localized event but not during severe PanFlu (Pandemic Influenza).
Understanding that there are often differences in meaning and usage of words between English and American "English", I sit here wondering what the operative definition is of "security guard" as used in this piece. Does the term mean anyone functioning in that role, such as military or law enforcement personnel, or does it mean, literally, a privately employed security guard?
If it is the privately employed type I'm afraid their "framework" still needs "work". It will be a dangerous and difficult task to hold back a desperate and determined crowd, even a small one, which is determined to gain entry.
It is well understood that the health care system, in every country, will be rapidly over run in the event of a moderate to severe pandemic. Many more people will be in need of treatment than will be able to be handled. Hospital beds are a finite resource, as are the supportive equipment, staff, and medical supplies. When capacity is reached the others will have to be turned away. Those denied treatment, either for themselves or a loved one, will not be happy.
The most recent official prediction of the number of people who could die in a flu pandemic is 750,000; and the framework admits that the main problem would be finding "dignified and suitable" temporary storage for the dead within hospitals.
Although certainly a part of the PanFlu picture, …dignified and suitable temporary storage for the dead within hospitals…, is neither the main problem, nor should it be a hospital problem. This was also a bit of a surprise because the UK has made no secret of their intent to utilize mass graves if a sever pandemic were to happen and bodies overwhelm their mortuary capacity.
While the NHS would attempt to "provide the best care possible", normal medical protocols might have to be suspended, the document warns.
However, he warned that the current hospital system in the UK - with no designated "major trauma centres" to take charge in an emergency - would result in "chaos" in the event of a full-scale crisis.
Chaos. At least they know, and understand, that much.
What is never publicly addressed in any of these plans is the fact that should our health care systems become over run the "triage" plans will be immediately rendered nothing more than so many hollow words.
It will not be deciding who is a "better" candidate for treatment, a 27 year old mother of two, a 7 year old little girl, or a 77 year grandmother, it will be deciding which few of the 100's of 27 year old mothers, 100's of 7 year old little girls, and 100's of 77 year old grandmothers, along with 1,000's of others is the "better" or more "deserving" treatment candidate. In an average size small city of 100,000 residents it is reasonable to plan for 10% of the population being ill at the same time. That's 10,000 potential sick and dying vying for that finite health care resource at roughly the same time.
Yes, they are wise to consider security needs as person after person is told that their loved one will receive no care, even such as it will be reduced to during a severe pandemic. And, I certainly hope they plan on using personnel better trained and equipped than those who fall under the American concept of "security guard".