# 643
A sobering, and unfortunately, probably realistic appraisal of some of the challenges hospitals would face in a pandemic or other MCI (Mass Casualty Incident).
This from the Sunday Telegraph.
Hospitals would be guarded in wake of attack
By Laura Donnelly, Sunday TelegraphLast Updated: 11:56pm BST 07/04/2007
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.
Medical students and retired doctors could also be drafted in to staff overloaded services, while hotels and schools may have to be used to care for patients.
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.
While the NHS would attempt to "provide the best care possible", normal medical protocols might have to be suspended, the document warns.
It also states that hospitals "may require enhanced security measures to ensure access can be restricted to a single point of entry".
Mike Walsh, from the Royal London Hospital, which took the majority of casualties from the bombings of July 7, 2005, said that his surgical team had instigated a system of "damage control" which meant doing the "absolute minimum required to save life and limb - and no more".
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.
Although this report focused on terrorist attacks with `contaminated' individuals seeking access to medical care, it isn't much of a stretch to include infectious flu patients in a pandemic. The concerns would be the same.
Hospital security, and ensuring the safety of medical personnel, will be a major issue in a pandemic. Crowd control, and triage stations outside of the facilities, along with counselors, will be a priority.
As hospitals fill up, and become overloaded, new patients may be turned away. Some may not be happy with that turn of events, and may become unruly, or even violent. Among health care workers planning to work during a pandemic, violence directed towards them is a real concern.
Hospitals, clinics, doctor's offices, pharmacies, and EMS services are likely to become `hot spots' during a pandemic, and provisions need to be put in place to protect them. This won't be a short term problem, and such protection could be needed for the duration of a pandemic.
This task will become even more daunting when you factor in that 40% of LEO's (Law Enforcement Officers) and security personnel are likely to be directly impacted by the illness.
While it is fairly easy to point out the problems. The solutions are much harder to come by.
