Editorial comments--anticipated behaviors of emergency prehospital medical care providers during an influenza pandemic.

Tippett and co-authors are to be congratulated for an insightful and well written paper that addresses an important issue in prehospital care. Governments and emergency operations personnel often plan for future pandemics with a focus on distribution of " stuff " such as gloves, masks, beds, and ventilators. Inadequate attention is directed to healthcare provider staffing, including staffing of prehospital care units. A basis for the focus on " stuff " is an assumption that healthcare workers have a " duty-to-care " and will respond willingly with generous disregard of personal safety and personal obligations to provide staffing during increased demand for care of a pandemic affected population. In their paper, Tippett and co-authors examine the willingness of prehos-pital providers to respond to different health emergencies. The paper appropriately studies the association of pandemic response willingness to perceived safety for the healthcare provider and their family as well as support from their employers. As the authors note, there is little in the way of literature that has looked at response of prehospital providers in the setting of a pandemic. While the response to the structured survey used by the authors was 24.7%, they were able to show that the response group reflected the demographics of the study population and the results of this study probably reflect that of the prehospital providers in Australia. This study should be valid for other developed nations with advanced life support-level prehospital emergency medical services. The conclusions of this study were dramatic. It was shown that there is a strong concern for adequate prehospital provider response during a pandemic due to an unwillingness to expose oneself to the infection, a consideration for the concerns of the prehospital providers' relationship partners, and ambiguity in the employer-employee relationship. These findings parallel those found and published in three papers describing other subgroups of healthcare providers. 1–3 While the current H1N1 pandemic may be controlled with the development and distribution of an effective vaccine, the recent severe acute respiratory syndrome (SARS) pandemic shows the vulnerability of healthcare systems and governments when faced with a rapidly expanding pandemic for which all who are exposed are at risk. The World Health Organization estimates that approximately 30% of reported SARS cases were among healthcare workers. Further World Health Organization estimates were that SARS had an overall 10% mortality rate. Despite these estimates and concern expressed by healthcare workers, there has been little …