To the Editor: Influenza experts have warned of the possibility of an influenza pandemic, and planning for such an event is underway.1,2 The provision of health care during a pandemic will pose particular challenges. Health care workers will be at risk of exposure, and will become ill at rates similar to those for the general population. Compounding inevitable staff shortages will be health care workers absent from work because of a need to care for dependents or fear of catching influenza. Prompted by discussions on an appropriate response to pandemic influenza, we solicited opinions from employees within our network (including medical, nursing, clinical support, catering and administrative staff) about their attitudes to working during a pandemic.

Between 1 February and 30 April 2007, a survey that could be self-administered and completed anonymously was placed on our hospital intranet. Our staff were advised of its presence by email and through advertising on the intranet. The survey could also be completed when attending for influenza vaccination. Participants could complete surveys directly onto an electronic database, or return them to the investigator.

We received 1440 completed surveys, including those from 137 medical staff (10%), 628 nursing staff (43%), and 352 clinical support staff (25%). The overall response rate was approximately 14% (1440/10 000). The mean age of respondents was 42 years (range, 18–73 years); 83% were female and 36% had dependent children.

Overall, 74% agreed they needed more education on pandemic influenza (medical staff, 66%; nursing staff, 78%; P = 0.025) and 48% believed a pandemic would occur in the next decade (medical staff, 39%; nursing staff, 52%; P = 0.025). Sixty-seven per cent stated they would be available to work during a pandemic; 26% (medical staff, 18%; nursing staff, 27%; P = 0.05) stated they would stay home to care for dependents, while 10% admitted they would stay away because of fear of catching influenza.

Most employees expected to be provided with personal protective equipment (92%), antiviral medications (90%) and vaccine (89%). Sixty-four per cent believed the hospital should supply their families with antiviral medications, and 63% thought their families should receive vaccine. Twenty per cent believed they would require a place of residence while working during a pandemic (medical staff, 32%; nursing staff, 24%; P = 0.05), 45% were prepared to be relocated to another site (medical staff, 58%; nursing staff, 40%; P < 0.001) and 36% were prepared to change to another duty (medical staff, 30%; nursing staff, 39%; P, not significant).

Our survey has highlighted areas that may need attention in preparing for a pandemic. As a minimum, we believe targeted education is required now for all health care workers who will be expected to work during a pandemic. Our ability to cope will depend on the depth of our preparation.