Coverage of essential elements in plans. All Canadian and English plans outlined a role for general practice in clinical care for influenza. While only 41% of plans from the USA addressed clinical care for influenza by primary care practitioners (Table 3) , every US plan included guidelines on influenza management by hospital physicians. Some plans articulated a surge in demand for influenza care as a threat to general practice's survival, and proposed assessment and treatment clinics as a way of protecting them [26, 27] . In other plans [28] [29] [30] the response to a surge was to support general practices to become more resilient by collaborating and changing their work practices. In two US state plans, the failure of the ambulatory care sector in the face of a surge was assumed. The planning challenge became to find ways to redeploy workers into other health care sectors [31, 32] .