H1N1新型流感防疫系統危機管理之研究：以臺北市為例

The Crisis Management of Influenza A (H1N1) : A Case Study of Taipei City

洪淑珍(Shu-Chen Hung)

指導教授 ： 陳志瑋

淡江大學/管理學院/公共行政學系公共政策碩士在職專班/碩士(2011年)

https://doi.org/10.6846/TKU.2011.00370

摘要

2009年流感大流行(H1N1)始於3月下旬墨西哥，病毒迅速在人與人之間傳播，至當年6月11日全球已逾75個國家出現疫情，確定病例達2萬餘例。WHO同時將流感流行疫情等級提升至第六級，宣布2009年流感大流行開始。因應全球H1N1新型流感大流行，臺北市啟動「因應流感大流行準備計畫」，為瞭解臺北市H1N1新型流感危機管理機制及其防疫系統在處理H1N1新型流感危機管理出現之問題。本研究以資訊、防疫機制、人力資源及危機領導為探討面向，為改善臺北市H1N1新型流感危機管理機制提出建議。
本研究所運用的研究方法有文獻分析與深度訪談法，透過文獻分析的方法，建構本研究之架構。以深度訪談結果，探討臺北市在面臨H1N1新型流感疫情發生之問題及其如何因應，並提出建議。
經研究發現，在資訊方面：臺北市的防疫資訊系統與災害防救系統待整合；在防疫機制方面：H1N1新型流感危機管理機制防救災組織以風災為主、平時缺乏橫向聯繫機制，災時以EOC為橫向聯繫之管道及H1N1新型流感防治的SOP待建置；在人力資源方面：缺乏民間防疫人力資源的協助、社區防疫人員缺乏穩定性、跨部門人力支援不易、平時防疫訓練不足，災時臨時調訓緩不濟急、防災演習以颱洪為主，不適用於疫災及業務主管機關人力不足，指揮出現多頭馬車的情形；在危機領導方面：防救災體系以層級節制的架構為主，疫災的危機領導與風災不同。本文就研究發現結果提出建議：（一）建置臺北市傳染病防治網、建置防疫決策分析系統、以資訊科技輔助人員經驗之不足；（二）制訂應變計畫及相關SOP，定期修正並進行災後檢討；（三）社區防疫人員重新編制，將公共衛生工作人員納入社區防疫團隊；結合社區組織，建立社區防疫團隊；（四）疫災主政機關角色重新定位。以做為日後因應疫災危機之參考。

關鍵字

H1N1新型流感 ； 危機管理 ； 管理機制

並列摘要

The pandemic (H1N1) 2009 was discovered in Mexico in late March; the virus has spread rapidly from human to human. As of June 11, 2009, more than 75 countries worldwide reported flu outbreak events and more than 20,000 confirmed cases were found. Meanwhile, WHO raised the flu pandemic phase to 6 and announced the outbreak of the 2009 flu pandemic. Due to the pandemic(H1N1) worldwide, Taipei City Government started the “Strategic flu pandemic preparedness plan” in order to understand problems derived from the crisis management strategy and the epidemic prevention system of the influenza A(H1N1) in Taipei City. The current study discussed from the aspects of information, epidemic prevention strategy, human resource and crisis guidance, so that suggestions for improving the current crisis management of influenza A(H1N1) in Taipei City can be provided.
The methods used in this study included literature review and in-depth interviews. Through literature review, the framework of the study was established; through in-depth interviews, problems and solutions on facing influenza A(H1N1) pandemic in Taipei City were discussed. To conclude, suggestions were provided.
The study found that from the aspect of information: the epidemic prevention information system and the disaster prevention and response system in Taipei City were awaiting an integration procedure. From the aspect of epidemic prevention strategy: influenza A(H1N1) crisis management and disaster prevention organization were focused on typhoon events; usually, there was a pack of lateral communication strategy. In a disaster event, the lateral communication channel based on EOC and the influenza A(H1N1) prevention strategy SOP were waiting to be established. From the aspect of human resources: there was a lack of public assistance on the epidemic prevention human resource; the epidemiologists were unstable, and the manpower support across the departments was difficult. General training on epidemic prevention was insufficient; thus, it was difficult to source temporary support which was required in a disaster event. The disaster prevention exercises were focused on typhoon and flood events, which were not suitable for pandemic disaster events. Also, the authoritative human resource for the related tasks was insufficient, which led to a hydra-headed situation on commands and directions. From the aspect of crisis guidance: a disaster prevention system was based on a hierarchy framework, but the crisis guidance for pandemic disasters should be different from the one for typhoon disasters. The study results and findings provide the following suggestions: (1) establish a Taipei City infectious diseases prevention website and establish an epidemic prevention and strategy analysis system, using information technology to support experience deficiency of workers; (2) set up a response plan and the related SOP, and routinely revise and review them after a disaster event; (3) reorganize the epidemiologists, include public health workers in the community epidemic prevention team, combine the community organizations and establish community epidemic prevention teams; (4) reposition the roles of the authoritative organization for pandemic disasters. The above suggestions can be references for future pandemic disaster crisis and response.

並列關鍵字

Influenza A (H1N1) ； crisis management ； mechanism of crisis management

參考文獻

吳振龍（2008）。「臺灣禽流感防治政策評估」。北市醫學雜誌，第5卷第3期，頁60-79。

呂淑妤、彭玉章、石富元（2007）。「嚴重急性呼吸道症候群流行期間臺灣民眾對於媒體報導之看法」。北市醫學雜誌，第4卷第8期，頁26-37。

金傳春（2009）。「新型H1N1流感的防疫策略與國際合作」。臺灣民主季刊，第6卷第2期，頁229-240。

詹長權、蔡奉真（2009）。「新流感與全球治理-全球衛生與外交政策」。臺灣民主季刊，第6卷第2期，頁219-227。

陳美霞（2009）。「病毒無祖國：新流感與跨域治理」。臺灣民主季刊，第6卷第2期，頁11-218。