Pandemic InfluenzaPandemic Influenza
Getting the Community ReadyGetting the Community Ready
Goals of Public HealthGoals of Public Health
Protect the community from diseaseProtect the community from disease
EducationEducation
Create a county-wide planCreate a county-wide plan
Coordination (The Players)Coordination (The Players)
EMAEMAUtilitiesUtilitiesIndustryIndustryHospitalsHospitalsDHRDHRARCARCLaw EnforcementLaw EnforcementFire/RescueFire/RescuePort of MobilePort of Mobile
The County PlanThe County Plan
Written as an annex to the County EOP Written as an annex to the County EOP (Emergency Operations Plan)(Emergency Operations Plan)
Since all emergency operations are Since all emergency operations are coordinated through the EMA, it was coordinated through the EMA, it was logical that coordination of resources logical that coordination of resources during a pandemic would also be located during a pandemic would also be located at the EMA.at the EMA.
How we are doing itHow we are doing it
Scheduled meetings at the EMAScheduled meetings at the EMA
Review of all plansReview of all plans
Revise format and enter into EOPRevise format and enter into EOP
Mobile County Health Department Mobile County Health Department PlanPlan
Flu Kits for employeesFlu Kits for employees
Educate the public (news releases)Educate the public (news releases)
Cross TrainingCross Training
MASS vaccination planMASS vaccination plan
POD planPOD plan
Plan for 30 – 40% absenteeismPlan for 30 – 40% absenteeism
Strategically shut down clinicsStrategically shut down clinics
““Any community that fails to prepare, with the Any community that fails to prepare, with the expectation that the federal government or, for expectation that the federal government or, for that matter, the state government will be able to that matter, the state government will be able to step forward and come to their rescue at the step forward and come to their rescue at the final hour, will be tragically wrong, not because final hour, will be tragically wrong, not because the government will lack a will, not because we the government will lack a will, not because we will lack a collective wallet, but because will lack a collective wallet, but because there is there is no way that you can respond to every hometown no way that you can respond to every hometown in America at the same timein America at the same time.” .”
Secretary Michael LeavittSecretary Michael Leavitt
April 20, 2006April 20, 2006
What is a Pandemic?What is a Pandemic?
No one has immunity to virusNo one has immunity to virus
Virus transmits easily person-to-personVirus transmits easily person-to-person
Virus causes large increases in illness and Virus causes large increases in illness and deaths deaths
1918 Pandemic in Alabama1918 Pandemic in Alabama
9/28/19189/28/1918 – 1 – 1stst AL case was in Huntsville AL case was in Huntsville10/05/1918 – > 1100 cases in Huntsville 10/05/1918 – > 1100 cases in Huntsville 10/07/1918 – Governor called for “closing of schools, 10/07/1918 – Governor called for “closing of schools,
churches, theatres and picture shows….”churches, theatres and picture shows….”10/13/1918 – 2367 cases at Camp Sheridan (outside 10/13/1918 – 2367 cases at Camp Sheridan (outside
Montgomery) Montgomery) 10/13/1918 - All physicians, druggists and prescription 10/13/1918 - All physicians, druggists and prescription
clerks in Huntsville, except one, ill with influenzaclerks in Huntsville, except one, ill with influenza10/15/1918 - Huntsville: Business demoralized; 10/15/1918 - Huntsville: Business demoralized; Postal Postal
Service crippled; Alabama Power having Service crippled; Alabama Power having difficulty difficulty finding employees; Business ordered to finding employees; Business ordered to curtail hours of curtail hours of operationoperation
10/22/191810/22/1918 - 12,000 cases reported in - 12,000 cases reported in MontgomeryMontgomery
Forecasted Impact of Pandemic Influenza
MobileMobile AlabamaAlabama
CharacteristicCharacteristic Severe (1918-like)Severe (1918-like) Moderate Moderate (1958/68-like)(1958/68-like) Severe (1918-like)Severe (1918-like)
IllnessIllness 120,000 (30%)120,000 (30%) 1.8 million (30%)1.8 million (30%) 1.8 million (30%)1.8 million (30%)
Outpatient medical Outpatient medical carecare 60,000 (50%)60,000 (50%) 900,000 (50%)900,000 (50%) 900,000 (50%)900,000 (50%)
HospitalizationHospitalization 14,143 14,143 17,300 17,300 198,000 198,000
ICU careICU care 2,121 2,121 2,575 2,575 29,700 29,700
Mechanical Mechanical ventilationventilation 1,065 1,065
1,298 1,298 14,910 14,910
DeathsDeaths 2,719 2,719 4,180 4,180 38,060 38,060
Based upon Table 1 of HHS Planning Assumptions
Number of Episodes of Illness, Healthcare Utilization, and Death Associated with Moderate and Severe Pandemic Influenza Scenarios
Special Collections Division, University of Washington LibrariesSpecial Collections Division, University of Washington Libraries
Situational UpdateSituational Update
April 30April 30thth, 2008 – Indonesia – A 3 year old , 2008 – Indonesia – A 3 year old developed symptoms on April 14developed symptoms on April 14thth and and died on April 23died on April 23rdrd..
This is the 133This is the 133rdrd case in Indonesia. 108 have case in Indonesia. 108 have been fatal. (been fatal. (81%81%))
Situational UpdateSituational Update
April 17April 17thth, 2008 – Egypt – Reported three , 2008 – Egypt – Reported three cases in the month of April:cases in the month of April:
1. 19 yo male died on April 41. 19 yo male died on April 4thth. .
2. 30 yo female died on April 112. 30 yo female died on April 11thth..
3. 2 yo male hospitalized on April 143. 2 yo male hospitalized on April 14thth..
Of the 50 cases, 22 have been fatal (Of the 50 cases, 22 have been fatal (44%44%))
Situational UpdateSituational Update
April 3April 3rdrd, 2008 – Pakistan, 2008 – Pakistan
A case reported on October 29A case reported on October 29thth, 2007 has , 2007 has been confirmed AND been confirmed AND TRANSMITTEDTRANSMITTED to 3 to 3 other family members. This was the FIRST other family members. This was the FIRST case reported in Pakistan. Of the 4 case reported in Pakistan. Of the 4 patients who contracted the disease, two patients who contracted the disease, two cases were fatal.cases were fatal.
Image from the School of Photographic Arts and Sciences at the Rochester Institute of Technology http://www.rit.edu/~andpph/photography.html
Don’t Count on Don’t Count on Vaccine or AntiviralsVaccine or Antivirals
Vaccine not available for at least Vaccine not available for at least
6-18 months after the PI strain identified 6-18 months after the PI strain identified and then only for and then only for prioritypriority groupsgroups
In 2008, U.S. will have enough antivirals In 2008, U.S. will have enough antivirals for for 25%25% of the U.S. population in a of the U.S. population in a priority grouppriority group
Protecting Your AgencyProtecting Your Agency
PLAN for the impact on agencyPLAN for the impact on agency
Protect employees and their familiesProtect employees and their families
ALLOCATE/OBTAIN resourcesALLOCATE/OBTAIN resources
Coordinate with external Coordinate with external organizationsorganizations
Plan for Rates of Plan for Rates of Absenteeism up to 40%Absenteeism up to 40%
IllnessIllnessFear of InfectionFear of InfectionCare ProvisionCare ProvisionPlus Public Health MeasuresPlus Public Health Measures– School ClosuresSchool Closures– Quarantining HouseholdsQuarantining Households– ““Snow Days”Snow Days”
HHS Pandemic Planning AssumptionsHHS Pandemic Planning AssumptionsThese assumptions, based largely on the 1918 influenza epidemic, are being used throughout the federal government to define a severe case These assumptions, based largely on the 1918 influenza epidemic, are being used throughout the federal government to define a severe case scenario. scenario.
Planning AssumptionsPlanning Assumptions
Attack Rate 30% or higherAttack Rate 30% or higher– 40% School-aged Children40% School-aged Children– 20% Working Adults20% Working Adults
½ of Ill Will Seek Care½ of Ill Will Seek Care
Plan for Most SeverePlan for Most Severe– Extremes of age, pregnancy, chronic Extremes of age, pregnancy, chronic
conditionsconditions
HHS Pandemic Planning AssumptionsHHS Pandemic Planning AssumptionsThese assumptions, based largely on the 1918 influenza epidemic, are being used throughout the federal government These assumptions, based largely on the 1918 influenza epidemic, are being used throughout the federal government to define a severe case scenario. to define a severe case scenario.
Planning Assumptions - cont’d.Planning Assumptions - cont’d.
Can spread virus up to 2 days before you feel Can spread virus up to 2 days before you feel sicksickViral Shedding Viral Shedding – 1 Day Before - 5 Days After Onset1 Day Before - 5 Days After Onset– Highest 2 Days of OnsetHighest 2 Days of Onset– Children Shed MoreChildren Shed More
One sick person will make 2 sickOne sick person will make 2 sickOutbreaks 6-8 weeksOutbreaks 6-8 weeksMultiple WavesMultiple Waves
HHS Pandemic Planning AssumptionsHHS Pandemic Planning AssumptionsThese assumptions, based largely on the 1918 influenza epidemic, are being used throughout the federal government to define a severe case These assumptions, based largely on the 1918 influenza epidemic, are being used throughout the federal government to define a severe case scenario. scenario.
BusinessBusiness ChecklistChecklist
Plan for the impact on businessPlan for the impact on businessIdentify a pandemic coordinator or teamIdentify a pandemic coordinator or teamIdentify mission essential functionsIdentify mission essential functionsCross-trainCross-train
Plan for the impact on employeesPlan for the impact on employeesForecast employee absencesForecast employee absences
Assess the type of face-to-face contactAssess the type of face-to-face contact
Business ChecklistBusiness Checklist
Establish policiesEstablish policiesSick leave and compensationSick leave and compensation
Flex work hours/sitesFlex work hours/sitesPrevention policiesPrevention policies
Allocate resourcesAllocate resourcesProvide sufficient infection control suppliesProvide sufficient infection control supplies
Enhance communicationsEnhance communicationsPrepare for financial lossPrepare for financial loss
Business ChecklistBusiness Checklist
Communicate to and educate Communicate to and educate employeesemployeesDevelop and disseminate programs and Develop and disseminate programs and materialsmaterials
Anticipate employee fear and anxietyAnticipate employee fear and anxiety
Provide info to employees about at-home careProvide info to employees about at-home care
Identify community resources for accurate Identify community resources for accurate pandemic informationpandemic information
PlanPlan
Federal “checklists”—Federal “checklists”—www.pandemicflu.govwww.pandemicflu.gov– BusinessesBusinesses– State and local planningState and local planning– Individuals and familiesIndividuals and families– Community and faith-based organizationsCommunity and faith-based organizations– EducationEducation– Home health careHome health care
www.adph.orgwww.adph.orgwww.cdc.govwww.cdc.govwww.who.intwww.who.int/en/en
Remember!Remember!
We ARE with the government We ARE with the government
AND we are here to help!AND we are here to help!
Cindy Lesinger (ADPH) (334) 206-2018Cindy Lesinger (ADPH) (334) 206-2018
Melissa Tucker (MCHD) (251) 690-8884Melissa Tucker (MCHD) (251) 690-8884
Sandy Evans (MCHD) (251) 544-2196Sandy Evans (MCHD) (251) 544-2196