Pandemic Influenza Preparedness & Response Part 2: Key Elements of a Plan

Pandemic Influenza Preparedness & Response Part 2: Key Elements of a Plan Occupational Safety and Health Course for Healthcare Professionals

Who Should Have a Plan? • All business and organizations should have an updated plan for a pandemic now. • Lack of continuity planning can result in a cascade of failure as employers attempt to address the challenges of a pandemic when it occurs. • Critical infrastructure / key resource industries have a special responsibility to plan for a pandemic.

Importance of Planning • Value of planning: will make continuity of our healthcare services smoother and easier, decrease fear and anxiety among employees, and be supportive to the community. • Pandemics come in multiple waves – need to plan for disruption/challenges over a long period of time. • If a plan has been developed, important to update on a regular basis.

Critical Infrastructure & Key Resources 85% of the nation’s critical infrastructure is in the hands of the private sector; the business community plays a vital role in ensuring national pandemic preparedness and response.

Critical Infrastructure & Key Resource Organizations Critical Infrastructure Key Resources • Food & Agriculture Gov’t facilities • Public Health & Healthcare Dams • Banking & Finance Commercial Facilities • Water & Energy Nuclear Power Plant • Defense Industrial Base • Emergency Services • Information Technology • Telecommunications • Postal & Shipping • Transportation **http://www.flu.gov/plan/pdf/CIKRpandemicinfluenzaGuide.pdf

Your Preparedness Plan: First Steps • The most difficult step is the first one. • Who is your planning team? • Organize and identify a central team of people to serve as a communication source so that employees, customers/clients, suppliers, the community can have accurate information during the crisis. • Work with community planners & agencies to integrate a pandemic plan into local and state planning.

First Steps (cont) • Work with employees and their union(s) to address all relative HR policies/procedures, including leave, pay, transportation, travel, childcare, absence and other human resource issues. • Plan for downsizing some services but also anticipate any scenario which may require a surge in services. • Prepare and plan for operations with a reduced or changed workforce.

Key Business Planning Issues 1. Essential Functions: * Financial/Operations * Supply Chain * Security 2. Human Resources 3. Communication/ Information Technology 4. Community and government 5. Employee Needs and Education

1. Essential FunctionsA. Financial and operational functions • What aspect(s) of your services will see a surge/increase? • What aspect(s) will experience a decline/reduced need? • Plan needs to address how financial processes will be managed during a pandemic. • How will operations, with reduced staff, be managed?

1. Essential Functions: B. Supplies * Supply chain in a pandemic will be disrupted, slower, inaccessible in some cases. * Who are your suppliers, and what are your alternate sources? * What do you need, what can be stockpiled safely? * What are your current and potential storage capabilities?

Stockpiling • Stockpile items such as soap, tissue, hand sanitizer, cleaning supplies and recommended personal protective equipment (will not be able to access extra in a Pandemic situation). • Stockpile essential materials for your business to continue – consider your current needs, project over a number of weeks, look at alternate sources. • When stockpiling items, be aware of each product’s shelf life and storage conditions and incorporate product rotation into your stockpile management program. • Resources – Respirator and Facemask Stockpiling Guidance – available on osha.gov

1. Essential Functions: C. Security • In the midst of a pandemic influenza there will be widespread panic and fear. • Your business location may be seen as a resource or haven. • Control of cash access and material goods. • Control of entry and exit points. • Employee and customer safety at all times.

Security Concerns • We will all be dealing with distressed individuals, less accessibility to services and fewer staff; overall, dealing with a scared and potentially combative public. • Provide training to security personnel. • Coordinate with local and state agencies.

2. Human Resources • Most challenging area of your plan. • Staff shortages will occur. • What are your critical staff needs? • What other resources are available when critical staff are not there? • What will you need from employees – are they cross-trained?

Human Resources Policy Considerations • Sick leave – do you encourage staff to stay home when they are sick? • If employees are sick at work, what is your current policy? • Will you mandate preventive measures, including vaccinations for staff? • How is all of this communicated to staff – i.e. protection of other workers, customers. • Policy consideration: when employees’ families are ill or schools close, what can you offer? • Clear, well communicated business policies will support the control of worker and customer exposure and promote safety and continuity of service.

3. Communication and Information Technology • Communicating with employees: critical part of the plan. • Communicating accurate data and updates, policies, and support mechanisms. • Communicating with the community agencies, state and local groups, and customers. • What are your current IT capabilities? What will you need for IT support in the midst of a pandemic influenza?

Information Technology • Must plan in advance for easy connectivity/compatibility with emergency services, law enforcement, public health services, government agencies. • During a Pandemic, all businesses and employees will increase their reliance and use of information technology – for updated information, to replace meetings, to education and share information with employees, to support employees working from home, to access experts, contact family, etc. • Plan for the increase in use of all information technology.

Information Technology • What are your current IT capabilities? • What will you need for IT support in the midst of a pandemic influenza? • Telephone/cell phone capacity in your area, for your business?

4. Community & Government • What plans currently exist in your community/state? • Access information from all of the government websites, contacts. • How can you get involved in community planning? • Are there other businesses you can collaborate with on your planning?

5.Employee Needs & Education • Some employees will have individual risk factors that should be considered (e.g., immuno-compromised individuals and pregnant women). • Assist employees in managing additional stressors related to the pandemic (mental health, family situations). • Access to health professionals – making it easy and close to work environment.

Employee Needs • Consider community volunteers to support employees. • Plan Human Resource approaches, responses, supports. • Consider employee needs for food, housing, places to rest, child care. • Provide information on how & where they can access health services. • Social & psychological support services for employees, family members.

5. Employee Education • Critical importance of education for employees in your business: * the hazards they may encounter. * definitions and facts about influenza and pandemics. * safety measures, daily hygiene practices. * use of PPE. * the organization’s pandemic influenza plan. * their accountability for complying with policies related to hygiene and cleaning, as well as anything specific to their role/responsibilities.

Personal Protective Equipment • Need to assure employees that they will have the necessary PPE while at work. • Key: what is appropriate based on their tasks, role, and contact with the general public. • Monitoring compliance? • Access to equipment/supplies?

Part of assessing employee needs… • Exposure Risk Assessment – for each task and role that employees carry out – at each site/location of work. • Utilize the OSHA Risk Pyramid and guidance materials. • Assess risk if there are any changes in your business over time; new services, new locations, etc.

OSHA Risk Assessment Pyramid

Employee roles and risk • Very High Exposure Risk: • Performing aerosol-generating procedures on known/suspected pandemic patients. • HCW/lab staff collecting or handling specimens from known or suspected pandemic patients. • High Exposure Risk: • HCW and support staff exposed to known or suspected pandemic patients. • Medical transport of known or suspected pandemic patients in enclosed vehicles. • Performing autopsies on known or suspected pandemic patient(s). • Medium Exposure Risk: • Employees with high-frequency close contact with the general population (e.g., schools, high-volume retail). • Lower Exposure Risk (Caution): • Employees who have minimal close contact with the general public and other coworkers (e.g., office workers).

To help eliminate/reduce exposure: Know the Hierarchy of Controls • Engineering controlsinvolve making changes to the work environment to reduce work-related hazards. • Work practice controlsare procedures for safe and proper work that are used to reduce the duration, frequency or intensity of exposure to a hazard. • Administrative controlsinclude controlling employees' exposure by scheduling their work tasks in ways that minimize their exposure levels. • Personal Protective Equipment(PPE) includes all clothing and other work accessories designed to create a barrier against workplace hazards.

Additional Aspects of a Plan • Outpatient services and clinics – how will your employees access healthcare? (estimated 45 million will seek outpatient care in a pandemic event) • Alternate Business & Care Sites – who/what can help your organization deal with a surge in need for services/goods?

Community Plans • Many communities do have a pandemic preparedness plan; many do not. • Having a Preparedness Team that represents all relevant stakeholders in the community. • Follow the state plans – gain from state and national efforts. • Planning for the potential impact – how will it affect usual activities, processes, and services – both business and social?

Who might be a relevant stakeholder? • Government • Public health • Other Healthcare agencies and emergency response • Education • Business • Communication • Agriculture • Faith-based organizations • Community-based groups

Community Planning • If a plan does exist, it may need to be updated. • Connectivity and collaboration between business, government, and community leaders will be critical in a pandemic. • Examples • State and Local Planning Guide – use available resources. • Most important: Get involved!

Community Planning- a few measures: • Encouraging people who are ill to stay home. • If family members are ill, encourage other family to stay home for 5-7 days. • Schools to dismiss students to home for up to 12 weeks (dependent on severity of the event) • Promote Social Distancing practices. • Travel may be disrupted, including use of mass transportation systems. • Large social gatherings may be discouraged and/or cancelled. • Sharing accurate information throughout the community.

Faith-based and Community Organization Preparedness Planning • Collaboration with public health and government agencies will be very important. • Assess potential impact of a pandemic on usual activities/events, and services delivered to members. • How could services and activities be managed and still reduce exposure and spread of an influenza virus? • Develop emergency procedures, plans. • Communicate – share the up-to-date, accurate information and dispel myths. • Encourage preventive measures as recommended by national and state government agencies.

Family Plans • What are we doing to prepare our families for a pandemic? • Do we encourage prevention now among our family members? • Share information – facts help to dispel fear. • Family Planning Guide – available resources. • Key: plan now, so that there will be less stress and worry during the pandemic.

Planning with our Families • Storing a two week supply of water, food, and necessary supplies. • Prescription and non-prescription medications: be certain to have a readily-accessible and continuous supply. • Plan with family and friends about how you and they would be cared for if they get sick. • Teach everyone how to limit spread! • Access preventive interventions.

Be Proactive and Realistic • Many businesses have grown because of positive relationships with their customers. • Have to help employees maintain these relationships with each other and their customers, even in the midst of “restrictions” and “fears”. • Recognize everyone’s accountability to prevent spread and mitigate negative health outcomes.

Develop/Update the Plan for your organization • Recognize the critical importance of planning in order to protect workers and customers, continue business. • Engaging others is not always easy. • Until recently, a Pandemic influenza event may have seemed “unreal” to many; and now? • Share your information! • Gather the latest statistics – draw the picture for our world, our country, state, community, your organization. • Make the “event” real, make the plan realistic. • Practice!

Let’s Remember why we are doing all of this:To Protect Our Employees, Continue our Healthcare Services, Protect our Families & the Community • Develop, reassess and update a disaster/business continuity plan that addresses Pandemic Influenza. • Strongly encourage all prevention strategies. • Monitor and promote good hygiene practices. • Monitor compliance with use of PPE. • Get involved in your community’s planning efforts.

Questions? • Any additional areas that you want to add to the Plan? • Let’s look at the Planning checklists that are in your handouts. • Make a Planning List that is specific to your organization – make it relevant for your work and your employees.

Pandemic Influenza Preparedness & Response Part 2: Key Elements of a Plan