In the spring of 2009, a novel strain of influenza virus was identified in Mexico and soon began spreading across continents. That event was the beginning of what became known as the 2009 H1N1 Pandemic Influenza. This document is a summary of Saskatchewan's response and mitigation of the H1N1 influenza in this province.

In September, 2009 the Ministry of Health released the Saskatchewan Pandemic Influenza Plan for the Health Care System to guide the pandemic health response. The document aligns closely with the Public Health Agency of Canada's Pandemic Plan.

 What Worked Well

Overall, Saskatchewan's health response to the H1N1 pandemic was very successful with ultimately 50% of the province's population immunized through the mass vaccination campaign delivered through the health regions. By January 2010, H1N1 confirmed cases dwindled to nearly zero, and all influenza viruses disappeared by late winter; a highly unusual occurrence in a normal seasonal influenza cycle, and a testament to the effectiveness of the H1N1 vaccine.

 Some Highlights

The Health Emergency Operations Centre was established in April 2009 to coordinate the activities of the Ministry of Health and its partners. The Population Health Branch was the lead for the initial response with support from other ministry branches. The structure worked very well in managing the response. Some successful items to note:

• Strong and effective links with regional emergency operations centres;
• Strong communications and collaboration with the Medical Officers of Health from all the health regions;
• Strong public communications through regular media updates with provincial medical health officers;
• Effective structures and relationships with First Nations partners such as First Nations and Inuit Health, Occupational Health and Safety and affected provincial government ministries;
• Early pre-positioning and use of antivirals, especially in remote and isolated communities is believed to have played a key role in mitigating unnecessary medical evacuations, ICU admissions and deaths;
• A similar approach to early vaccinations of vulnerable remote and isolated populations is credited with significant reduction of disease, hospital admissions and death;
• As the primary laboratory for surveillance, detection and type of influenza, the Saskatchewan Disease Control Laboratory adapted well to pandemic needs, at peak periods processing as many as 1,349 specimens a week;
• Saskatchewan was recognized for its effective approach in the sequencing and prioritization of vaccinations allowing for limitations of vaccine availability, epidemiology, and community preferences;
• Public health measures focused on infection prevention were widely disseminated throughout the province through other ministries, health regions, business organizations and federal government.

 Areas for Improvement

While the response overall worked very well, there are always areas, upon reflection, where adjustments could be made to benefit future potential responses.

• While Population Health initially led the pandemic response, the entire health system would benefit from earlier engagement of all sectors responsible for planning and operations;
• In any response that involves a large number of players across multiple jurisdictions and levels of government - clarity of roles and responsibilities is critical to effective and timely management of the response;
• An initial world-wide shortage of some personal protective equipment identified a need for policy around ongoing pandemic supply and inventory management;
• Rapidly evolving changes due to new information and epidemiology created challenges for maintaining up-to-date information on infection prevention and control. A clearer mechanism is needed for alerting stakeholders to new information.

Ultimately, the 2009 pandemic response in Saskatchewan resulted in very low levels of disease and death and minimal disruption to the people of the province.

In the videos below, Chief Medical Health Officer Dr. Moira McKinnon talks about Saskatchewan's Pandemic response.