Some regions in Canada squandered a golden opportunity this summer and are not as prepared as they should be for an expected second wave of swine flu, some experts say.
Anand Kumar, a Manitoba intensive-care specialist who worked when the virus first hit last spring, said the province learned the hard way how to deal with an overwhelming flood of patients.
But despite calls for help and shared research from other hospitals across Canada, Manitoba found only complacency, said Dr. Kumar, who also teaches at the University of Manitoba.
"We had at least four to six weeks head's start because we got hit first," he said as a national conference on the virus concluded Thursday.
"Health ethics boards [were]saying, 'What's the hurry? We'll start the research in the fall.' It's something that really bothers me."
Manitoba was particularly hard hit by the virus last spring. Many patients were airlifted from a cluster of northern First Nations reserves where there are fewer than 10,000 residents.
The end result is that some health regions are better prepared to deal with another wave of swine flu than others, Dr. Kumar said.
"There are ... significant variations in how ready different hospitals and different regions are for what we might experience. If we're going to get a heavy wave and I'm going to be sick with H1N1, or at least severely sick, I think I'd rather be in Manitoba because I think we're as ready as we can be."
David Butler-Jones, Canada's chief public health officer, said if some health authorities don't have a plan, now is the time. But he believes many regions did draw from the country's experience in the spring and Canada is now "readier than we've ever been" for a resurgence.
"We are in as good, if not better, position than anywhere else in the world," Dr. Butler-Jones said. "That having been said, the reality is that flu is inventive. It's uncertain what we're going to face. We will have surprises as we move forward, but I think the systems that we have in place will help us to respond quickly."
Frank Plummer, scientific director of Canada's National Microbiology Laboratory, said conferences like the one that just ended in Winnipeg are an important part of flu preparations. About 175 delegates from across the country will now draw up clinical guidelines on how to deal with H1N1 and talk about how to share resources with hardest-hit areas, he said.
The conference should fill some research gaps by answering questions such as how long patients should remain in intensive care, he said.
"That is of very, very practical importance to ICUs because managing someone in isolation is very resource-intensive and if they don't have to be isolated, you can use those resources somewhere else," Dr. Plummer said.