Pandemic Influenza

1. Pandemic Influenza Getting the Community Ready

2. Goals of Public Health • Protect the community from disease • Education • Create a county-wide plan

3. Coordination (The Players) • EMA • Utilities • Industry • Hospitals • DHR • ARC • Law Enforcement • Fire/Rescue • Port of Mobile

4. The County Plan • Written as an annex to the County EOP (Emergency Operations Plan) • Since all emergency operations are coordinated through the EMA, it was logical that coordination of resources during a pandemic would also be located at the EMA.

5. How we are doing it • Scheduled meetings at the EMA • Review of all plans • Revise format and enter into EOP

6. Mobile County Health Department Plan • Flu Kits for employees • Educate the public (news releases) • Cross Training • MASS vaccination plan • POD plan • Plan for 30 – 40% absenteeism • Strategically shut down clinics

7. “Any community that fails to prepare, with the expectation that the federal government or, for that matter, the state government will be able to step forward and come to their rescue at the final hour, will be tragically wrong, not because the government will lack a will, not because we will lack a collective wallet, but because there is no way that you can respond to every hometown in America at the same time.” Secretary Michael Leavitt April 20, 2006

8. What is a Pandemic? • No one has immunity to virus • Virus transmits easily person-to-person • Virus causes large increases in illness and deaths

9. 1918 Pandemic in Alabama 9/28/1918 – 1st AL case was in Huntsville 10/05/1918 – > 1100 cases in Huntsville 10/07/1918 – Governor called for “closing of schools, churches, theatres and picture shows….” 10/13/1918 – 2367 cases at Camp Sheridan (outside Montgomery) 10/13/1918 - All physicians, druggists and prescription clerks in Huntsville, except one, ill with influenza 10/15/1918 - Huntsville: Business demoralized; Postal Service crippled; Alabama Power having difficulty finding employees; Business ordered to curtail hours of operation 10/22/1918 - 12,000 cases reported in Montgomery

10. Forecasted Impact of Pandemic Influenza 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

11. Special Collections Division, University of Washington Libraries

12. Situational Update • April 30th, 2008 – Indonesia – A 3 year old developed symptoms on April 14th and died on April 23rd. This is the 133rd case in Indonesia. 108 have been fatal. (81%)

13. Situational Update • April 17th, 2008 – Egypt – Reported three cases in the month of April: 1. 19 yo male died on April 4th. 2. 30 yo female died on April 11th. 3. 2 yo male hospitalized on April 14th. Of the 50 cases, 22 have been fatal (44%)

14. Situational Update • April 3rd, 2008 – Pakistan A case reported on October 29th, 2007 has been confirmed AND TRANSMITTED to 3 other family members. This was the FIRST case reported in Pakistan. Of the 4 patients who contracted the disease, two cases were fatal.

15. Image from the School of Photographic Arts and Sciences at the Rochester Institute of Technology http://www.rit.edu/~andpph/photography.html

16. Don’t Count on Vaccine or Antivirals • Vaccine not available for at least 6-18 months after the PI strain identified and then only for prioritygroups • In 2008, U.S. will have enough antivirals for 25% of the U.S. population in a priority group

17. Protecting Your Agency • PLAN for the impact on agency • Protect employees and their families • ALLOCATE/OBTAIN resources • Coordinate with external organizations

18. Plan for Rates of Absenteeism up to 40% • Illness • Fear of Infection • Care Provision • Plus Public Health Measures • School Closures • Quarantining Households • “Snow Days” HHS Pandemic Planning AssumptionsThese assumptions, based largely on the 1918 influenza epidemic, are being used throughout the federal government to define a severe case scenario.

19. Planning Assumptions • Attack Rate 30% or higher • 40% School-aged Children • 20% Working Adults • ½ of Ill Will Seek Care • Plan for Most Severe • Extremes of age, pregnancy, chronic conditions HHS Pandemic Planning AssumptionsThese assumptions, based largely on the 1918 influenza epidemic, are being used throughout the federal government to define a severe case scenario.

20. Planning Assumptions - cont’d. • Can spread virus up to 2 days before you feel sick • Viral Shedding • 1 Day Before - 5 Days After Onset • Highest 2 Days of Onset • Children Shed More • One sick person will make 2 sick • Outbreaks 6-8 weeks • Multiple Waves HHS Pandemic Planning AssumptionsThese assumptions, based largely on the 1918 influenza epidemic, are being used throughout the federal government to define a severe case scenario.

21. BusinessChecklist • Plan for the impact on business Identify a pandemic coordinator or team Identify mission essential functions Cross-train • Plan for the impact on employees Forecast employee absences Assess the type of face-to-face contact

22. Business Checklist • Establish policies Sick leave and compensation Flex work hours/sites Prevention policies • Allocate resources Provide sufficient infection control supplies Enhance communications Prepare for financial loss

23. Business Checklist • Communicate to and educate employees Develop and disseminate programs and materials Anticipate employee fear and anxiety Provide info to employees about at-home care Identify community resources for accurate pandemic information

24. Plan • Federal “checklists”—www.pandemicflu.gov • Businesses • State and local planning • Individuals and families • Community and faith-based organizations • Education • Home health care • www.adph.org • www.cdc.gov • www.who.int/en

25. Remember! We ARE with the government AND we are here to help! Cindy Lesinger (ADPH) (334) 206-2018 Melissa Tucker (MCHD) (251) 690-8884 Sandy Evans (MCHD) (251) 544-2196