Pandemic Planning

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Pandemic Planning

• State of Minnesota

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Influenza Pandemics 101

• Pandemic Flu

Avian Flu

• Avian Flu

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Seasonal vs. Pandemic Flu

• Seasonal Influenza
• Occurs every year from October to April
• Affects 10 of the population
• Normally not life-threatening to healthy people
• Very young and very old most at risk of serious
  illness
• Annual vaccination available
• Antiviral drugs available

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Seasonal vs. Pandemic Flu

• Pandemic Influenza
• Occurred 3 times in the last 90 years
• Can occur anytime during the year
• Typically a more serious infection for all
• Minimum of 6 months to develop a limited amount
  of vaccine
• Limited supply of antiviral drugs likely

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Why are we concerned about Pandemic Influenza?

• Needed for a Pandemic
• A new influenza virus subtype emerges
• It infects humans
• Causes serious illness
• It spreads easily and is sustainable among humans

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How Does the Virus Change?

• Genetic Drift Small Changes
• Minor changes in the virus usually in the H and
  N surface proteins
• Genetic Shift Big Changes
• Mixing and matching whole segments of the viral
  genome
• 16 varieties of H and 9 varieties of N

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Something to Think About

• Two influenza viruses infecting the same cell can
  produce 256 different strains of virus.
• The deadly 1957 Asian Flu contained five human
  and three bird genes.

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Influenza A Evolution

• 1918 --- (H1N1)..........Spanish Flu pandemic
• 1957 --- (H2N2)..........Asian Flu pandemic
• 1968 --- (H3N2)..........Hong Kong Flu pandemic
• Today -- (H5N1)..Best candidate for pandemic

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Sept. 2007
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Confirmed Human Cases of H5N1 Reported to WHO
(Sept. 2007 61 Death Rate)
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Response and Preparedness Activity Levels in
Todays Environment

• Incidents
• Emergencies
• Disasters
• Major Disasters
• Catastrophic Events
• Pandemic Events

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Frequency and Impact of Events
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Pandemic Events

• Worldwide impact.
• Generally occurs everywhere at the same time.
• Exceeds the capacity of all existing support
  structures.
• Everybody is a victim including the responders.
• Emergency response structure cannot save the day
  for each person.

• Pre-event preparedness is the essential building
  block of successful management, without it we are
  in trouble.

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Pandemic Severity Index - HHS
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Legal Basis For Preparedness

• MN Response Plan

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MN Statutes Chapter 12Minnesota Emergency
Management Act of 1996

• Establishes
• General and Specific Authority of the Governor
• Emergency Powers for the Governor
• Role of Homeland Security and Emergency
  Management
• Emergency Declaration Authorities
• Declarations Due to a Public Health Emergency
• Governors Powers to Provide Fast Emergency Aid

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History of Activities in Minnesota

• 37 Federally Declared Major Disasters since 1957.
• 14 Federal Disasters in the last decade.
• 1993-2002 508,986,131 eligible costs
• Catastrophic Events, 1997 Floods 269M.
• Pandemic Events
• 1918, 1957, 1968-Flu
• Y2K Preparedness
• 20?? Flu

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Avian and Influenza Pandemic Supplement to the
MEOP

• Supplements
• Are used as interim steps for updating the
  overall plan.
• Provide information on state agency coordination
  to a unique event.
• Clarify roles and responsibilities that were not
  already addressed in the all hazard plan.
• Past supplements include
• Y2K
• NE MN Wildfire
• And now Influenza Pandemic.

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MINNESOTA RESPONSE TO HPAI OUTBREAK
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MN Response Phases for Pandemic Influenza
Outbreaks
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Service Continuation
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COOP vs. Pandemic Service Continuation

• COOP
• Impact is Regional
• Physical structures/ technology is affected
• The event is short in duration and triggers the
  COOP Recovery Phase
• No notice of the event
• Mainly effects buildings, equipment and
  technology
• One time event

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Pandemic Service Continuation
Pandemic Service Continuation

• Worldwide impact
• Physical Structures/ Technology are initially not
  affected
• Pandemic waves may last 6 to 8 weeks
• Some notice although it may be short
• Mainly effects staffing levels
• Could have multiple waves

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Planning Assumptions . . .

• Pandemic could include several waves of 6 8
  weeks duration
• Up to 30 of the workforce may be out ill
• Additional 10 out caring for the sick, or afraid
  to come to work

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Differences in Pandemic Planning

• Everybody is impacted at the same time.
• Resources we are accustom to having are not
  available.
• Extra federal and or state assets will be
  limited.
• Nationwide resources will be impacted.
• Basic no frills services is all that will be
  available.

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Know your Workforce

• How many of your staff are the primary dependent
  care provider?
• Will closing schools and daycares have an impact
  on your available workforce?
• Are employees families prepared?
• Dont double count staff that wear multiple hats!
• Are there any special certifications and or
  licenses required for employees delivering
  priority one services?

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Service Continuation Support Network

• Track available staffing and absenteeism during
  an outbreak.
• Expect to reallocate staff internally to support
  priority activities.
• State and Local Emergency Operations Centers will
  not be able to provide additional staffing.
• Pandemic response is not disaster response as
  usual!

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Prioritization of Service . . .

• A pandemic will impact your ability to provide
  services, and demand for those services will
  increase.
• Clearly identify the level of service you intend
  to provide throughout the phases of a pandemic.

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Where to Begin?

• Pan Flu Executive Committee

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Develop a Pan Flu Executive Committee

• Committee could be comprised of
• Human Resources, Emergency Management, Public
  Health, other key department heads.

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Pan Flu Executive Committee Responsibilities

• Develop Priority Service Goals
• Priority Service Goal Framework
• Government must be able to sustain the core
  services they provide to the community everyday.
• Government must be prepared for increased demand
  for some services (surge capacity).
• Government must be prepared to sustain critical
  services with reduced staffing (Service
  Continuation Plan).

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Pan Flu Executive Committee Responsibilities

• Appoint Agency Pandemic Flu Coordinators

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Agency Pandemic Flu Coordinator

• Define Agencys Priority Service Functions 1-4.
• Define Priority Service 1 and 2 functions as to
  certification and training requirements.
• Re-allocate staff internally during a pandemic.
• Request assistance from Pandemic Flu Exec
  Committee if unable to staff Priority Service 1
  and 2 functions.
• Compile and report absenteeism to Pandemic Flu
  Exec Committee as requested.
• Conduct training and exercises throughout the
  planning process.

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MN Prioritization of Service

• Factors to determine Priority Service Level
  functions
• Health, welfare and safety of employees.
• Health, welfare and safety of citizens.
• Economic impact of not providing service
• Impact of performing (not performing) service.
• Ability to provide services during a pandemic
• Availability of alternate methods of delivering
  services

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Priority 1 Services

• Immediate threat to public health, safety or
  welfare.
• These functions must remain uninterrupted.
  Generally, these would include functions that
  operate 24 hours a day and/or 7 days a week.
• Priority Service One functions do not cease on
  holidays or weekends.

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Priority Service OneExamples

• Emergency and disaster response functions
• Correction facility operations and security
• All dispatch centers
• Law enforcement patrol
• Emergency medical operations
• Water treatment operations

• Emergency Operations Center Staffing
• Maintaining building HVAC systems
• Emergency road repair Patient Care
• Snow removal
• Security
• Fire Suppression

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Priority 2 Services

• Direct economic impact
• Constitutionally or statutorily mandated time
  frames for completion.
• May be disrupted temporarily or might be periodic
  in nature, but must be reestablished within a few
  days.

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Priority Service TwoExamples

• Emergency equipment repair
• Payment to vendors
• Benefit payment to individuals
• Time sensitive inspections for construction
  activities
• Cleaning and disinfecting facilities during a
  pandemic
• Phone and internet communication services

• City Council/County Commissioner meetings
• Emergency procurements and contracting
• Insurance payments
• Disaster recovery assistance
• Workers compensation
• Processing payroll
• Legal services

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Priority 3 Services

• Regulatory functions required by law, rule or
  order that have the ability to be suspended
  during an emergency.
• May be disrupted temporarily but must be
  re-established sometime before the pandemic wave
  is over.

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Priority Service ThreeExamples

• General inspections services (not time sensitive)
  
• Vehicle maintenance services
• Issuing building permits
• Project management
• Shipping and receiving
• Investigation of complaints
• Vehicle registration
• Mail services

• Collective bargaining with labor unions
• License renewals
• Grant and contract management
• Maintaining websites for information
• Employee right-to-know program
• Filling job vacancies

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Priority 4 Services

• All other services that could be suspended during
  an emergency that are not required by law or
  rule.
• May be deferred for the duration of a pandemic
  wave (6-8 weeks).

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Priority Service FourExamples

• Records retention
• General maintenance programs
• Educational programs
• Training
• Reception desks
• Internal audit

• Crime and fire prevention programs
• Grounds maintenance (lawn mowing)
• Youth service programs
• Financial analysis
• Research
• General education and outreach programs

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Pan Flu Executive Committee Responsibilities

• Develop a Compiled Priority Service Function Task
  List
• List required skills needed by various Agencies.
• Catalog employee qualifications and
  certifications accordingly for re-allocation
  purposes to maintain Priority Service 1 and 2
  functions throughout the state.

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Pan Flu Executive Committee Responsibilities

• Ensure Agency Pandemic Influenza Plans are
  Updated
• Plans must define in detail the operations,
  actions, services and structure of the Agency in
  the event of a pandemic.

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Pan Flu Executive Committee Responsibilities

• Activation of Service Continuation Plan
• Ensure that Agencies have developed a strategy
  for activating their Service Continuation Plan.
• Monitor absenteeism, proximity of outbreaks, and
  the State of Minnesotas Response Phase.

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Reallocation of Personnel

• Reallocate personnel to fulfill Priority Service
  1 and 2 functions.
• Establish single point of contact to develop
  procedures to reallocate the available resources
  within the Agency.
• If allocation can not be done at the Agency
  level, Pan Flu Coordinator can submit Priority
  Service 1 and 2 functions to the Pandemic Flu
  Executive Committee for assistance.
• If allocation cant be done at the PFEC level, it
  is submitted to the SEOC.
• Communicate expectations now.

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Develop Service Continuation Communications Plan

• Accurate and prompt communications to Agencies
• Coordination of support services
• Coordination with SEOC JIC
• Media relations and public statements associated
  with Service Continuation
• Communications to employees

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Closing Thoughts

• Priority one services dont take extended
  holidays.
• Make sure you can staff what you have before you
  build more.

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Closing Thoughts

• Not everybody can work from home.
• Have a plan B.
• Tell me if I am in your plan!
• We can close the Zoo but somebody still needs to
  feed the animals.

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Resources

• State of Minnesota
• www.birdflu.state.mn.us
• MN HSEM Infectious Disease Outbreak Program
• www.hsem.state.mn.us/
• Federal Government
• www.pandemicflu.gov
• World Health Organization (WHO)
• www.who.int/csr/disease/avian_influenza/en/

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Contact Information Kevin
Leuer kevin.leuer_at_state.mn.us 651-201-7406