From:
Richard W. Freeman, MD, FACP, Chief Medical Officer &
SVP Medical Affairs, Spectrum Health Medical Group
David J. Dobbie, MD, Infectious disease, Spectrum Health Medical Group
October 23, 2009
To keep our associates informed regarding H1N1 influenza, we are launching a weekly staff alert to provide
information specific to SHMG and mmpc.
Novel H1N1 Influenza Update
Our community, including Spectrum Health, has experienced a significant increase in patients presenting with
influenza-like illness and confirmed H1N1 cases. Some seasonal influenza cases are also occurring. Our influenza
planning teams continue to review strategies for areas that have been impacted by this increase.
Public Information Hotline
A new information line for the public has been set up through Spectrum Health at 391-H1N1 (391-4161).
H1N1 Vaccine Supply and Distribution Update
At the request of the Kent County Health Department (KCHD), we have prioritized the vaccination needs of our
SHMG and mmpc offices in Kent County. Vaccinations have already begun for associates who have direct patient
contact, as well as associates considered to be at a higher risk for complications from H1N1 infection. We expect to
receive additional quantities of the H1N1 vaccine later this month and will be able to increase our vaccination
efforts at that time. We will also continue to coordinate efforts with the Spectrum Health Hospital Group, KCHD and
for our sites in Ottawa County, the Ottawa County Health Department. Additional information will follow as soon as
it is available.
Staff Recommendations for Care of Patients
Staff should place an isolation or surgical mask on patients who present with clinical symptoms consistent with
influenza-like illness upon registration. If N95 masks are available, staff should wear an N95 mask when in close
contact with an unmasked patient. To conserve N95 masks, staff members can follow extended use guidelines,
where staff can wear the same mask for multiple patient encounters during a single work shift. If the mask
becomes soiled or out of shape, it should be replaced. If N95 are not avail, staff should use surgical or isolation
masks.
Use of Antiviral Medications
 Treatment with Tamiflu should be reserved for patients who are hospitalized, have severe clinical illness, or
are identified as high risk.
 Widespread use of chemoprophylaxis is not recommended. Emphasis should be placed on early treatment
if/when symptoms develop after exposure. Health care workers with unprotected exposure to a patient with
H1N1 influenza may be considered for chemoprophylaxis.
 SHMG and mmpc offices may access the Spectrum Health antiviral stockpile of Tamiflu by contacting
Laura Steinmetz-Malato, Director of Pharmacy Services, via email at laura.steinmetz-malato@spectrumhealth.org
 For patients needing pediatric suspension doses of Tamiflu, physicians can simply write a prescription and
have patients fill the suspension at any area pharmacy. A listing of local pharmacies that have the capacity
to compound Tamiflu suspension is located on the InSite toolkit.
Friday, October 23, 2009
Guidelines for Staff Who Become Ill with Respiratory/Influenza-like Illness
 Staff members with a fever (100 degrees Fahrenheit/37.8 degrees Centigrade) and respiratory symptoms
should stay home to avoid spreading infections to others.
 Staff members should not return to work until they have been free from fever without the use of feverreducing medicines for at least 24 hours.
 Individuals caring for members of their household with the flu or H1N1 may report to work as long as the
staff member is fever free and is not exhibiting flu-like symptoms including fever and respiratory symptoms.
 Additional considerations are necessary for staff working in areas where severely immunocompromised
patients are provided care.
Frequently Asked Human Resources Policy Questions
We understand that there are many questions relating to associate absences due to flu related illness. Below are
answers to two of our most frequently asked questions. If you have other specific questions, please speak with
your immediate supervisor.
(1) What if my absence related to the flu exceeds the amount of absences allowed in the policy?
The attendance policy is in place so that we all understand how being present for our scheduled shifts directly
impacts the service we provide to our coworkers and the patients who count on us. There is flexibility within the
policy to allow for unscheduled absences and managers are encouraged to review patterns of absence over time.
We understand that this is a highly unusual time in the health care climate. In the event absences exceed the
standards, the manager will review the circumstances and consider the previous history of unplanned absences.
(2) Do I need a note from my doctor to return to work?
No, provided you meet the standards for returning to work (fever/symptom-free for 24 hours).
Additional Information and Resources
Visit flu.gov, a Web site maintained by the U.S. Department of Health & Human Services, for information about the
novel H1N1 vaccine.
The H1N1 (Swine) flu toolkit on InSite is up to date and should be used as the primary resource for information
regarding seasonal and H1N1 flu. Please print and post this All Staff Alert for those who are unable to easily
access the information.
Contact the Spectrum Health flu information hotline for staff at (616) 486-5511 with questions about influenza.
Friday, October 23, 2009