Some health staff wouldn't work during a pandemic

Airmen work on a connecting hallway for a portable hospital in preparation for a national emergency like the feared bird flu pandemic in Topeka, Kansas, June 3, 2006. A survey of U.S. healthcare workers suggests that not all will be willing to be on the frontlines if there should be an outbreak of bird flu or other infectious disease. Some will opt to play it safe and stay home, according to the survey.

NEW YORK (Reuters Health) - A survey of U.S. healthcare workers suggests that not all will be willing to be on the frontlines if there should be an outbreak of bird flu or other infectious disease. Some will opt to play it safe and stay home, according to the survey.

"This survey tells us that the US government and the medical community may not be doing a very good job at educating our healthcare workers about what measures would be in place to keep them safe and how successful these measures would be," said Dr. Charlene Irvin of St. John Hospital and Medical Center, Detroit, Michigan.

"Open and honest discussion may turn out to be the most important feature" of a pandemic influenza plan, Irvin predicted. "No workers means no plan, so no matter what you have on paper, and stored in the closet (masks, gowns, gloves), the plan won't work if no workers show up."

Results are based on surveys completed by 169 nurses, doctors and other hospital workers regarding their willingness to report to work in the event of bird flu pandemic. The average age of those surveyed was 38 years and 32 percent were male.

About 50 percent of the hospital workers said "yes" they would report to work, while 42 percent said "maybe" and 8 percent said "no, even if I would lose my job."

Doctors (73 percent) were more likely than nurses (44 percent) or other hospital personnel (33 percent) to indicate that they would report to work in the event of bird flu pandemic.

"I was very surprised that only 44 percent of nurses said they would report to work as usual," Irvin admitted. "Additionally, that only 33 percent of the ancillary support (secretaries, transporters, environmental workers) -- that ironically have less exposure to infection than doctors or nurses -- were planning on reporting to work as usual."

Men were more likely than women to indicate that they would report to work (66 percent versus 42 percent). For the "maybe" responders, the factor making the biggest difference (83 percent) was their level of confidence that the hospital would protect them.

Eighteen percent said a financial incentive to come to work would make no difference, even up to triple pay.

"Clearly, we have work we need to do to educate healthcare personnel about the realistic risk given the infection control measures we would be using," Irvin said. "The SARS outbreak can be used as a close template for what to expect; once strict infection control measures were followed, the infection rate in healthcare personnel plummeted."

Getting "realistic" information out to the public about the risk of bird flu is also important, Irvin said, noting that "the 50 percent mortality risk reported (in the media) is likely an over-exaggeration. Experts predict the mortality risk will be closer to the influenza pandemic of 1918 at less than 5 percent."