Table 2.

Major outbreak issues and possible solutions

Issues	Lessons learned/possible solutions
Lack of supplies	Develop pre-existing stockpiles of personal protective equipment. Secure supply chain
Use of personal protective equipment
Inappropriate use	Mandated infection control education about routine precautions and modes of disease transmission; mandatory refresher courses.
	Testing of staff to assess knowledge retention.
Fit testing of N95 masks	Train staff for fit testing—fit testing is a mandatory condition of employment.
Contraindicated use–ie, allergy to materials	Obtain alternative supplies for those who cannot use standard personal protective equipment
Limited entry
Patient access to health care	Regional prioritisation of health-care programmes to allow for undisturbed continuity of patient care.
Hospitalised patients and staff	Human resources policies that outline employee obligations during emergencies, including obligations of physicians.
Students & researchers	University level policies related to student attendance and expectations during external disasters. Separate clinical and research staff and physical space within hospital
Remuneration
Revenue	Contingency planning to compensate hospital at regional, provincial, national level as appropriate for extent of outbreak.
Physicians	Pre-negotiated agreements about remuneration in specified circumstances
Surveillance	Education of target population about symptoms and the importance of compliance.
	Anonymous/non-punitive reporting of ill co-workers.
Communications/public education	Within hospital: designate single spokesperson; pre-existing outbreak communication protocol.
	External working groups: creation of communications committee to specifically address messaging during outbreaks. Avoid multiple spokespersons.
Contact tracing and quarantine:	Financial incentives/compensation for compliance and
compliance	completion of quarantine