Pandemic Preparedness

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Pandemic Influenza Planning in Pennsylvania
Michael K. Huff Deputy Secretary for Health
Planning and Assessment Pennsylvania Department
of Health Donna M. Hoskins-Helm Chief, Workplace
Support Services Division Executive Offices,
Office of Administration
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Pandemic Influenza Planning in Pennsylvania

• Facts About Flu Pandemic
• Global disease outbreak.
• Unknown timing or severity (many experts agree
  that a significant threat exists).
• WHO has developed a global influenza preparedness
  plan.
• CDC has published Interim Pre-Pandemic Planning
  Guidance Community Strategy for Pandemic
  Influenza Mitigation in the United States.

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Pandemic Influenza Planning in Pennsylvania
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Pandemic Influenza Planning in Pennsylvania
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Triggers for Implementation of Community
Containment Mitigation Strategies
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Pandemic Influenza Planning in Pennsylvania

• Seasonal Influenza
• Globally 250,000 to 500,000 deaths each year
• In the United States each year
• 36,000 deaths
• gt200,000 hospitalizations
• 37.5 billion in economic costs from influenza
  and pneumonia
• Pandemic Influenza
• An ever-present threat

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Pandemic Influenza Planning in Pennsylvania

• Influenza pandemics are inevitable naturally
  recur at cyclical intervals.
• Influenza Pandemics can cause
• High levels of sickness and death
• Drastic disruption of critical services
• Severe economic losses
• Impacts for weeks to months.
• A disproportionate effect in younger, working-age
  people.

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Pandemic Influenza Planning in Pennsylvania

• The appearance of a novel virus is the first step
  toward a pandemic.
• The novel virus must cause disease or death.
• The novel virus must be easily transmissible from
  human-to-human.

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Situation Report Avian Influenza

• Widespread and spreading prevalence in migratory
  birds broad host range.
• Continued outbreaks among domestic poultry.
• Mammalian infection (cats, pigs, etc.) lethal.
• Virus is evolving.
• Sporadic human cases (306 reports as of May 16,
  2007).
• Most in young and healthy
• Case-fatality gt50 (185 deaths as of May 16,
  2007)
• Rare person-to-person transmission
• Sustained and rapid person-to-person
  transmission.

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Estimated morbidity and mortality during an
influenza pandemic (within 12-16 weeks)
Pandemic Influenza Planning in Pennsylvania
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Pandemic Influenza Planning in Pennsylvania

• Pandemic Impact
• High absenteeism.
• Disruption of transportation, commerce,
  utilities, public safety and communications.
• Psychological impacts will be extreme.
• Social distancing efforts may dramatically change
  hours of operation or close businesses
  temporarily.
• Economic losses small businesses at greatest
  risk.

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Pandemic Influenza Planning in Pennsylvania

• Pandemic Impact Health Care System
• Extreme staffing shortages.
• Shortage of beds, facility space.
• Shortage of key supplies (ventilators, drugs).
• Hospital morgues, Medical Examiner and mortuary
  services overwhelmed.
• Extreme demands on social and counseling
  services.
• Demand will outpace supply for months.

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Pandemic Influenza Planning in Pennsylvania

• A pandemic is global, but the response is local.
• Limited to no assistance from the federal
  government due to nationwide impact.
• Assistance from the state government limited due
  to the statewide impact

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Pandemic Influenza Planning in Pennsylvania

• Department of Health Planning Activities
• Influenza pandemic response activities are
  coordinated within the following workgroups
• Human Avian Influenza Prevention Detection
  Policies and Processes
• Workforce Planning
• Isolation and Quarantine Procedures
• Vaccine and Medication Distribution
• Incident Coordination Response
• Public Communications Planning
• Legal Review
• Local Government

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Human Avian Influenza Prevention Detection
Policies and Processes

• Focus Surveillance, data exchange, and
  prevention through early detection, both avian
  and human
• Activities
• Epidemiology Work Group
• BSL-3 modular unit for Pennsylvania Animal
  Diagnostic Laboratory System
• Development of inter-laboratory communications
  systems to enhance rapid communications of
  Health and Agriculture Diagnostic State
  Laboratories

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Workforce Planning

• Focus Telecommuting, succession planning,
  business partner preparation, business education,
  workforce communication, absenteeism policies and
  workers compensation programs and issues
• Activities
• Pandemic flu flyers currently available
• Handwashing posters
• Information technology approach to support social
  distancing

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Isolation and Quarantine

• Focus Community containment of diseases,
  isolation and quarantine procedures with and
  without a disaster declaration.
• Activities
• Toolkit for schools
• Draft Isolation and Quarantine plan (Community
  Containment Plan) that includes the need for
  isolation/quarantine facilities.
• Establishing protocols and guidance for
  determination of quarantine order, type of
  community containment and other related issues.

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Vaccine and Medication Distribution

• Focus Activating Point of Dispensing (PODS),
  staffing, and security of PODS and medications.
• Activities
• POD Notification
• POD Site Assessments
• POD Security Surveys
• Volunteer Recruitment
• Development of state antiviral stockpile
  strategies
• Identification of priority groups

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Incident Coordination

• Focus Incident command structure and
  communications. State agency roles in Emergency
  Support Functions. NIMS/ICS/National Response
  Plan. Concept of Operations and planning
  assumptions regarding incident command during a
  pandemic event. Local readiness considerations.
• Activities
• State agency pandemic checklists by Agency
• County level emergency management preparedness
  checklist
• Community Pandemic Planning Toolkit

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Communications

• Focus Messages to the general public,
  development of prevention materials,
  communication plan development (stakeholder
  groups and messages), business education
  (workforce community), tourist impact, special
  needs populations and non-emergency updates
  (non-Emergency Operations Center) to the general
  public.
• Activities
• Development of communication pieces
• Creation of Powerpoint Presentations
• Foreign language translation
• Briefing Packets
• Website development
• Radio and TV spots

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Office of General CounselPreparedness Committee

• Focus The committee addresses any legal issues
  relating to the Commonwealths authority to act
  in a pandemic situation.
• Activities
• Addressing issues surrounding the use of a
  volunteer workforce
• Governors draft proclamation
• Drafted a flowchart matrix outlining agency
  responsibilities
• Continue to research general authority of the
  Commonwealth
• Discussed and drafted responses to frequently
  asked questions
• Discuss and research mutual aid issues
• Other legal issue

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Local Government

• Focus Roles and responsibilities at the local
  level for planning, command and control, critical
  infrastructure, disease containment and
  communication.
• Activities
• Coordinating pandemic planning activities with
• PA School Boards Association
• PA Municipal Authorities
• County Commissioners Association of PA
• PA League of Cities and Municipalities
• PA State Association of Township Commissioners
• PA Station Association of Township Supervisors
• PA State Association of Boroughs

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Pandemic Influenza Planning in Pennsylvania

• Everyone has at least one of the following roles
• Employers
• Continuity of operations
• Succession planning
• Communicating to employees
• Prevention
• Education
• Educate stakeholders regarding pandemic
  influenza.
• Educate on what steps they should take to
  prepare.

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Pandemic Influenza Planning in Pennsylvania

• Everyone has a role (continued).
• Service Provider
• Plan to continue those services
• Surge capacity for goods and people
• Increased prevention
• Protection and detection capability
• Disease containment measures

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Pandemic Influenza Planning in Pennsylvania

• Ongoing Activities
• Antiviral purchase and stockpile strategy.
• Regional summits for school districts.
• Multi-agency pandemic planning.
• Community Containment Strategy.
• Vaccine and Medication Distribution Strategy.

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Pandemic Influenza Planning in Pennsylvania

• Personal Preparedness
• Get a flu shot each year.
• Stay home when you are sick.
• Avoid close contact with people who are sick.
• Cover your mouth and nose with a tissue when
  coughing or sneezing.
• Wash your hands.

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Pandemic Influenza Planning in Pennsylvania

• Seasonal Influenza Preparedness

Pandemic Influenza Preparedness

• Preparing for a pandemic now will mean
• Create awareness not anxiety.
• Lives saved during seasonal influenza
• Create sense of confidence and provide peace
• of mind.

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Business Preparedness - Prevention and Planning
1. Health Coverage
2. Employee Wellness and Illness Prevention

• Promote annual flu shots

3. Communications

• Employees/Employers

• Local Government and Other Networks

4. Union Collaboration
5. Identification of Critical Business
Functions and Operations
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Business Preparedness - Prevention and Planning

• Leave, Absenteeism, and Presenteeism

• Staffing and Succession Planning

• Travel Restrictions and Suspended Work Functions

• Workers Compensation and Unemployment Compensation

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Pandemic Influenza Planning in Pennsylvania

• www.pandemicflu.state.pa.us