Pandemic Planning

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Pandemic Planning

• The Next Generation of Health Preparedness
  Planning

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Dallas County Health and Human Services

• ENVIRONMENTAL DIVISION
• Vector Control
• Food Safety
• Childcare Inspection
• Animal Control
• Water Quality
• PREVENTIVE HEALTH
• Vaccines for Children
• Adult Immunizations
• Well Baby Clinics
• Health Education Program

• COMMUNICABLE DISEASE DIVISION
• STD
• HIV
• Mobile Medical Clinic
• Tuberculosis prevention / treatment
• Homeless Special populations
• Refugee Outreach
• Disease Outbreak Control

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Dallas County Health and Human Services

• PREPAREDNESS DIVISION
• Laboratory BSL-III
• Epidemiology
• USPS Bio Detect (2)
• Bio-Watch
• Tier-1 City -CRI
• Medical Reserve Corps
• SNS
• GIS
• PIO
• Pandemic Planning
• All Hazards Response

• HUMAN SERVICES
• Older Adult Services
• Energy Assistance Program
• Weatherization Assistance Program
• Welfare Program
• Home Loan Counseling Center
• Section 8 Housing and Homeownership
• HIV Grants 12 counties

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Whats Different About Pandemic Planning

• Duration
• Magnitude
• Vast scope of unforeseen needs
• Severe personnel shortages
• Severe resource shortages
• Early saturation of healthcare system
• Disproportionate Effects

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Katrina/Rita Lessons Can Help
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Katrina/Rita Lessons Can Help

• Clarity of Response Roles
• ESF 8 Lead Agency make-it-known-now
• Testing all existing response role assumptions
• Negotiate assign roles to newer partners
• Ensure role agreement among partners
• Drill down further on State Agency response
  roles, resources, and local contact persons (24
  /7/ 365)

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Katrina/Rita Lessons Can Help

• Clarity in Planning Among Partners
• Dallas County HHS is Lead Planning Agency
• Dallas County receives planning progress reports
  from all cohorts
• Clarity in Data Collection Reporting
  Responsibilities
• Pre-Event, established responsibilities

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Is ICS Really for Public Health?

• All Fire/EMS/Rescue, Law Enforcement other
  city/county resources are
• Locally owned
• Commanded and controlled through a single
  infrastructure (e.g. a city)
• Therefore directives execution are more easily
  assured

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Is ICS Really for Public Health?

• Conversely, public health, hospitals, healthcare,
  behavioral health, Morgue Mortuary, and
  Environmental assets are
• P R I V A T E
• A U T O N O M O U S
• _at_ separate C O M M A N D S
• D I S P A R A T E E Q U I P M E N T
• D I S P A R A T E L O C A T I O N S
• D I S P A R A T E I N F O S H A R I N G

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EXAMPLE Anthax / D. C. / 2001

• No information management among
• Public Health, Hospitals, Practitioners
• Therefore practitioners received no aggregate
  data on which to extrapolate size/scope of
  exposed population
• Inadequate data sharing among public health
  entities in 4 jurisdictions affected
• Therefore conflicting prophylaxis
  recommendations.
• How will that play out in a Pandemic?

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Large Scale Complex

• Surveillance Activities
• Community Health
• Patient
• Animal
• Epidemiologic Investigation
• Profiling, etc.
• Anomaly Confirmation
• Laboratory Activities
• Environmental lab
• Clinical lab
• Bioterror/All-Hazard lab

• Pre-Hospital Activities
• EMS
• Victim Extraction
• Triage
• Field Treatment Facility
• Field Stabilization
• Patient Distribution
• Medical Care
• Acute Care
• Supporting Field Care
• Post-Acute Care
• Patient Diagnostics

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Large Scale Complex
Disease Containment

• Population-based
• Mass Prophy Ops
• Isolation / Quarantine
• Evacuation
• Decontamination

• Environmental
• Vector Animal
• Food Water
• Hazard Site

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Large Scale Complex

• Mass Fatality
• Body Recovery
• Identification
• Pathology
• Autopsy
• Forensics
• Post Morgue Service
• Family Assistance

• Behavioral / Mental Health
• Victim Interventions
• Victim Families
• General Population
• Responders

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Theres more to Pandemic Planning

• Adding the Private Sector to planning
• Establish your LHD as Trusted Source of health
  info so they automatically turn to LHD for basis
  of all information they deliver
• Determine available Private sector resources
• Federal/State resources spread thin
• Education Outreach to employees
• EXAMPLE TXU

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Large Scale Complex
Public Information

• ISD PIOs
• City PIOs
• Hospital PIOs
• Law Enforcement PIOs
• Non-Governmental Agency PIOs

• Fire/Rescue PIOs
• State Agency PIOs
• Public Health PIOs
• Business PIOs
• Faith-based Orgs
• Community-based Orgs

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Public Information Strategy

• One Message, Many Voices not enough
• Pandemic Planning means
• Communities will turn to their Trusted Source
  as verification of LHD messages
• Meeting with CBOs, FBOs, NGOs, as Trusted Source

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Large Complex

• Transport
• Personnel
• Equipment
• Supplies
• Multiple Sites
• Vehicle sized-for-job

Support Functions

• Sustaining Personnel
• Feeding / Housing
• Medical Care
• Child Care
• Preventive Health
• Prophylaxis
• CISM / family
• Surveillance

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• Dont forget logistics
• Redundant Communications
• Specialized Equipment
• Technical Assistance SMEs
• Social Workers
• Translators

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MRC In Katrina

• By establishing a skill set-diverse Corps, the
  Dallas County MRC was able to
• Meet the un-anticipated, non-traditional-public-h
  ealth responses that the required
• Dental ? Social Work
• Eye care ? Prescriptions
• Enforcing Control measures etc.

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Developing MRC Surge Capacity

• Epidemiology Support Training
• Conducting Interviews
• Sample packaging
• Sample Transport
• PPE

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Phase 1 Planning Strategy

• Obtain Commissioners Court Support
• Obtain critical responder support
• Hire two positions
• Begin planning-by-cohort to achieve
• Roles of each responder cohort
• Key contacts 24 /7/ 365
• Available resources
• Response overlap
• Barriers
• Gaps in Response

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Phase 1 Activities To Date

• Awarded Pandemic Planning Funding Meadows
  Foundation
• Commissioners Court briefed approves pandemic
  planning positions
• Key Response Partners actively On-board
• Wrote County Pandemic Plan
• Updated Quarantine / Isolation documents
• Launched public information campaign

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Phase 1 Activities

• Educate Stakeholders/Response Partners
• Created our own Stakeholder checklists
  Preparedness Guide
• Deliver Presentations City Managers/ NGOs/
  Private/ etc.
• Newsletter monthly Pandemic articles
• Planning meetings, by cohort

• Contacted, Provided Our Planning Guide, Obtained
  contact info with
• ISDs
• Cities
• Day Care Centers
• Colleges/Universities
• FBOs / CBOs / NGOs
• Private Sector / Lrg

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Phase 1 Activities To Date

• Requested Pandemic POCs of Cohorts
• Developed County Pandemic website
• Pandemic Tabletop (April 21st)
• Pandemic Symposium (August)
• MRC Surge Preparedness Training

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Phase 2 Activities

• Analyze county-wide pandemic planning status
• Perform Response Gap Analysis
• Perform Resource Gap Analysis
• Partner Gap Analysis
• Perform Barrier Analysis
• Report Results to State Feds
• Construct Phase 3 Strategy