EPIDEMIC ORGANISATION

Evening Star, Issue 16992, 14 March 1919, Page 7

EPIDEMIC ORGANISATION

SHOULD INFLUENZA RECUR

PROPOSED SCHEME DISCUSSED

For the purpose of providing organisation to oope with any future epidemic that might afflict the City, the chairman of the Hospital and Charitable Aid Board Mr W. E. S. Knight) called a meeting last evening of the St. John Ambulance Association, the Medical Association, and others, to consider this important and vital question. There were present Messrs A. F. Quelch and J. Gumming (members of the board). Dr Falconer (medical superintendent of the Hospital), Dr Bowie (assistant medical superintendent), Dr Lmdo Ferguson (dean of the medical faculty). Dr Gowland (president of the British Medical Association), Messrs J. E. Bone, C. B. Smith, E. C. Haggitt, and C. Speight (St. John Ambulance Association), Dr Barnett (chairman of the hon. medical staff). Dr Faris (Public Health Officer), and Dr Williams. ~ , The Chairman explained that he called the meeting to consider the question of organisation in case there should be a recrudescence of the influenza epidemic. They all knew that during the recent trouble everything had to be done on the spur of the moment, and they wanted to be organised properly should a similar epidemic come along again. Their greatest difficulty last time was to provide hospital j accommodation immediately. Excellent j work, thev all realised, was done through- | out the district. He thought they would i agree with him that if it were possible it would be advisable to keep infectious cases out of the Hospital. The principal thing was to keep together the voluntary staff of workers. They did remarkably well during the recent epidemic; but, unfortunately, there was no time to train them, | and he noticed that it had been suggested ; in Christchurch that the St. John Ambu- j lance Association should undertake to keep j a list of voluntary workers up to date, and • to give them lectures by trained nurses or medical men. They had been warned of a possible recurrence of the epidemic, and it was necessary that every precaution should be taken. The Health" Department ■ and the board were absolutely satisfied with the work that bad been done by those in charge of the central bureau. They did not propose to take the work out of the hands of the committee that was formed in connection with that bureau, but they felt that _ closer co-opera-tion was required, and with that end in view the meeting had been called. He did not think it would be necessary to discuss hospital accommodation. That could be gone into with the hon. medical staff. Mr Smith explained that the Rev. V. G. Bryan King was at present , out of town. One thing that his association had done was to go over the old Post Office Building to see what improvements could be made there if they were called on again. The Public Works engineer had been very good over the matter, and had showed them how the building could be improved for a medical dispensary' for V.A.D.s and for transport woik. He had drafted a letter to the Rev. Mr King, and he had asked him if he approved of its contents, and he had expressed himself as, satisfied. The letter was as follows: “In view of the meeting which is to be held, I think it well to let you know how things have progressed with St. John Association during your absence. Major Fleming, Messrs C. Speight, E. Hazlett, and F. J. Carter have been elected to St. John Committee. I have been to some trouble to explain to St. John Committee how I think we could strengthen our organisation, and I feel sure that when you again occupy the chair there will be no great difficulty in arranging matters on the following lines. . The General Committee to elect a small executive committee, which would in emergency take control of the whole organisation, consisting of St. John Ambulance Association, the Ambulance Brigades. Red Cross Association, Nursing Division, and V.A.D.s. The path has been prepared for this arrangement. You will find St. John Committee quite prepared. The ladies of the Red Cross will welcome such an arrangement. Major Fleming has expressed himself as being quite willing to help to bring the Brigades and nursing divisions into line, and himself to work on the executive, or merely as a member of the -General Committee. It is intended that lady representatives from the Red Cross Association and the nursing divisions, also representatives from ! the brigades, shall be asked to confer with ( St. John Association at an early date. The outcome of such a conference will probably be that the members of the various ! branches, including V.A.D.s, will be graded somewhat as follows:—Red Cross and private V.A.D.s—(a) certificated nurses, (b) holding St. John certificates, ' (c) willing to work under direction. Nursing divisions and brigades—(a) willing to accept service, (b) willing to accept service provided they can be freed from business, (o) unable to accept service. Assuming that St. John Association could organise somewhat on the lines indicated, the Minister of Public Health would probably select the Executive Committee to act with the Hospital Board, the local Public Health Officer, and the representative of the British Medical Association for relief work, should occasion arise at any time.” Mr Speight said there should be no difficulty so far as transport work was concerned. A weakness they found during the epidemic was the want of a light ambulance. Without the van belonging to Herbert, Haynes on the last occasion they could not have handled all the work, and they thought another ambulance should be secured for the City. A light motor ambulanca would bo of "more general use than the present one, Mr Hazlett also considered that it was necessary to have a motor ambulance much lighter than The present one. The Chairman said the board had in view the question of purchasing another one. They realised that a light one could make quicker journeys. Mr Hazlett said they could put ore into practical use in a very short time. It was necessary to have one. The- Chairman said that outside the epidemic cases they were able to cope with the class of patients brought to, the Hospital by their ambulance. It was possible in case of emergency to convert vans running in the City into temporary ambulance*. Dr Barnett said they had to consider first of all the measures to be taken to keep the epidemic away. That was a matter for the Health Department. Then if it came here they had to minimise its ill effects. If it came, then there would be the question of influenza masks. Apparently in Australia and America influenza masks had done some good, and they ought to have masks of an"improved pattern made here at the earliest possible moment. The Red Cross people could help in that connection, after the pattern nad been devised by the Health Department, and masks could be made by the thousand. He believed that everybody going about their daily duties would be compelled to wear a mask. He did not know himself about the value of inhalation chambers. He had his own doubts about them; but he thought that sprays might be provided in the streets Tor the people. He thought that that would be better than shutting people up in an inhalation chamber. Then there was the question of hospital accommodation. It did not 1 matter very much whether half of the Hospital was used for the influenza cases and "the other half for ordinary cases, or wdiether they used adjacent buildings, so long as something was prepared. They knew from the last epidemic what serious cases many of them were, and how much attention they required, and how necessary it was to have them close to a d'sEensary. He believed that patients would ave a bettor chance of life in the Hospital than in any of the annexes, and he thought it- would be worth considering the reserving of part of the Hospital for serious pneumonic cases of influenza. He was glad to hear from Mr Smith that they had come to some arrangement fur organising the bureau and for equipping it better for the work it might be called upon to perform. Then there was the question ol arranging for suitable drugs to be on hand. Arrangements ought certainly to be made, so that they could be procured) at short notice. They had a pretty good idea now from the last epidemic what were the requirements. He

also thou glit that they should have a more suitable ambulance. There should be no difficulty about that. , , Hr Paris said that if the board and the St. John Ambulance Association cooperated with regard to making masks he thought he could submit a model typo ox mask. He considered that a large reserve stock of masks should be kept. The Health Department was in favor of them being worn. He had arranged for inhalation chambers at the main railway ’■rations, and also at the wharves. He was sure that any suggestions for alterations and improvements to the central bureau would be sympathetically received by ms department. He thought that the old Post Office, being in a central position, was the most suitable place for a central bureau. He would like to hear what the president of the British Medical Association had to say about the block system. He agreed with Dr Barnett that serious influenza cases should be treated in a, wing at the main Hospital. With regard to the steps being taken to keep tlie influenza out in the event of a suspected case, tne patient was immediately isolated and contacts quarantined for a period of 4 hoturfi. , - Dr Ferguson considered the auostion or iho mamifaclvre of masks beforehand a capital one. The obtaining of another amInlanco ought to bo put in hand at once. Dr. Barnett’s sueprestion of sprays, m tae streets was distinctly a good one. .bo tar as the question of drugs was concerned. iirraop;emeTiis should bo made beforehan Ito have a slock of mixtures prepared ttc i considered it desirable to organise subsidi- ] orv bureaux at the beginning. As to the ! old Post Office ns a place tor a central bureau, he did not consider it sanitary. If there were to be inhalation chambers people should not have to wait in a crowd and infect one another before they went in. If the epidemic occurred again and it took a serious turn it tuts the duty of the board to take the patients into the ! Hospital. Ordinary patients could be I dealt with in a makeshift hospital. In answer to the chairman, Dr Barnett ! staid the block system, did not work so badly as to bo condemned. It could be improved upon. Dr Gowland said he was not in practice, and he felt diffident in expressing an opinion. In regard to the matter of ori can is at ion, speaking as an individual, wnat he felt had been really lacking was the presence of a medical man in command to act with the management committee m running the bureau. He believed himself that the thing could be run perfectly well from a central bureau with subsidiary bureaux in about half the time, and with about half the trouble experienced last time He believed that the medical men would go in for the block system again. They realised that it was the oniy way of dealing with the situation. He thought it would b© fatal to start again without same more preliminary organisation than they had before. Dr Williams favored the block It ought to be an understood/ thing that lodge practice should cease automatically, and drop into the block system, Mr Hazlett said the medical men were evidently of one opinion about the block system, and a-sked if they would draw up some, scheme covering any epidemic that might break out. Dr Falconer said if there were several pneumonic cases it would only be fair to give patients the benefit of the Hospital. •He advocated the use of subsidiary bureaux in conjunction with a central bureau, and thought the blocks ought to be less m number than they had been. In answer to the chairman, Dr Ferguson said that the Medical Association would furnish, a report on the block system. The Chairman then moved—“ln preparation for a possible recrudescence of an influenza epidemic, I propose that the St. John Ambulance Association be asked to formulate a scheme for the provision of transport, V.A.D. workers, and Bed Cross relief ; and that the chairman of the Medical Association, the District Health Officer and the chairman of the board should be associated with the St. John Ambulance to correlate the medical relief.” Dr Barnett seconded the motion, which was carried. As an outcome of the , conference Ur Bowie has. consented to give a lecture to nurses and others on ‘Lessons from the Late Epidemic ’ on a date to be fixed.