Influenza H1N1 2009 in Canterbury: a case study in pandemic response co-ordination.

BACKGROUND AND CONTEXT: Reviews of overseas pandemic responses have suggested that stronger links between primary care and other parts of the health sector are required. The influenza A (H1N1) 2009 ('H1N1 09') pandemic was the first real test of New Zealand's pandemic preparedness. ASSESSMENT OF PROBLEM: In the six months from May to October 2009, there were 595 confirmed cases of H1N1 09 in Canterbury, with 187 hospitalisations and three deaths. This paper describes the way a range of Canterbury agencies worked together in a co-ordinated health-led response aimed at minimising the impact of H1N1 09 in the community and maintaining effective health care services for both influenza and non-influenza patients. STRATEGIES FOR IMPROVEMENT: Key strategies included sector-wide response co-ordination, intelligence and communications, a combined public health/primary care response during the 'containment' phase, and universal red/green streaming supported by dedicated 'flu centres and an 0800 call centre during the 'manage it' phase. LESSONS: Despite the considerable impact of the H1N1 09 virus in Canterbury, health care services were not overwhelmed. The key lesson learned from the Canterbury H1N1 09 response has been the importance of preparing and working together across the sector.