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Kentucky Prepares

Kentucky Prepares. Pandemic Influenza Planning January 20, 2006 William D. Hacker, M.D., F.A.A.P., C.P.E. Commissioner Department for Public Health. Integrating Levels of Response Plans. International : WHO Pandemic Influenza Plan National : HHS Pandemic Influenza Plan (11/05)

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Kentucky Prepares

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  1. Kentucky Prepares Pandemic Influenza Planning January 20, 2006 William D. Hacker, M.D., F.A.A.P., C.P.E. Commissioner Department for Public Health

  2. Integrating Levels of Response Plans • International: WHO Pandemic Influenza Plan • National: HHS Pandemic Influenza Plan (11/05) • State: Kentucky’s Pandemic Influenza Plan (since 2003 and updated regularly) • Local: local health departments, communities, and HRSA planning regions • Individual: citizens’ and families’ plans Cabinet for Health and Family Services

  3. All-Hazards Approach to Planning in KY • Pandemic plans are a subset of State/Local Public Health’s Disaster Response and Recovery Plan • Flexible, yet comprehensive plans • Plans must be exercised and updated, not left on a shelf • Pandemic planning is the “ultimate plan”: if prepared for a pandemic, we can respond to any communicable disease threat Cabinet for Health and Family Services

  4. Planning Assumptions • Pandemic is NOT preventable • Universal susceptibility to novel virus • Pandemic outbreak will last 6 - 8 weeks • Multiple (2 – 3) pandemic waves are likely • Clinical disease attack rate • up to 30%children (40%); adults (20%) Cabinet for Health and Family Services

  5. Planning Assumptions • Half of those ill seek outpatient medical care • Hospitalization/death rates up to 10-fold variation depending upon virulence of virus • Demand for services will exceed supply, non-traditional interventions may be required Cabinet for Health and Family Services

  6. Possible Impact of Pandemic in KY* • Health • Deaths: 3000 – 7000 • Hospitalizations: 9,200 – 21,400 • Outpatient visits: 455,000 – 1.06 million • Economic • Infrastructure: Thousands at home either ill or caring for the ill • Agricultural: if pandemic strain is avian flu *Model assumes attack rates of 15-35 % and is based on the 1968 pandemic, and a US population of 290 million persons. Meltzer M, et al. Emerging Infectious Diseases 1999;5:659-671. Cabinet for Health and Family Services

  7. Key Components of Pandemic Planning • Surveillance systems • Quarantine / isolation procedures • Public health personnel (staff + training) • Medical surge capacity (staff + equipment) • Predetermined Priority Groups as antivirals drugs and/or vaccine becomes available • Distribution systems (e.g. Strategic National Stockpile) • Government / Business contingency plans Cabinet for Health and Family Services

  8. Pandemic Planning Committee From CHFS (28): Director of Div. of Epi. Preparedness Branch (9) Communicable Dis. Br. (5) Immunization Br. (3) Lab (3) CDC Epidemiologist DPH Veterinarian Vital Statistics (2) Local Health Operations Public Health Protection and Safety Div. of Communications Other agencies (14 ): Local Health Dept. (3) KyEM (2) KOHS UK UL Lexington MMRS Louisville MMRS Northern KY MMRS US Army (Fort Campbell) Justice Cabinet State Representative Cabinet for Health and Family Services

  9. DPH Flu Surveillance Activities • Kentucky state statutes require reporting of communicable diseases to DPH • Reports are analyzed by regional epidemiologists and by local “Epidemiology Rapid Response Team” members • Participation in the “122 Cities Influenza and Pneumonia Mortality System” • Participation during flu season in the “State and Territorial Epidemiologists Report” Cabinet for Health and Family Services

  10. DPH Flu Surveillance Activities • Each week, 11 Kentucky “Sentinel physicians” and 20 local sentinel health departments report influenza-like illnesses to DPH and we report to CDC • DPH Lab is one of 75 “WHO Collaborating Laboratory Surveillance” facilities Cabinet for Health and Family Services

  11. Kentucky’s Strengths • Long tradition of collaboration across a tightly knit state: state/local and public /private health • “Pop Quizzes” test our response plans: West Nile virus, anthrax threats, SARS, tornados, chemical spills, Katrina, etc… • Innovations in Public Health Information technology: telehealth, Health Alert Network, and e-Health Board • Strategic National Stockpile plan (CDC telecast 4/05) Cabinet for Health and Family Services

  12. Collaborative Planning Partners • State and Local Public Health • Private Healthcare professionals (hospitals, physicians, pharmacist, EMS, etc.) • Kentucky Emergency Management (state/local) • Kentucky Department of Agriculture • Kentucky Office of Homeland Security • Kentucky Law Enforcement (Justice Cabinet) • Government Officials ( state/local) • Kentucky National Guard (41st Civil Support Team) Cabinet for Health and Family Services

  13. Office of Rural Health KY Community Crisis Response Board Dept. for Local Government Office of Aging KY Labor Cabinet Natural Resources and Environmental Protection Cabinet Kentucky Fire Commission VA and Fort Knox MMRS Regions HRSA Advisory Committee Bioterrorism Advisory Committee State/Local Public Health Hospitals Physicians Academic Medical Centers KY EMS Kentucky Veterinary Medical Association Dept. of Agriculture KyEM KY Office of Homeland Security American Red Cross Primary Care Association Cabinet for Health and Family Services

  14. HRSA Regions Trimble Boyd Carter Shelby Rowan Bath Elliott Woodford Spencer Morgan Menifee Hancock Nelson Union McLean Webster Ohio Taylor Green McCracken Ballard Carlisle Hickman Calloway Fulton Area 1 Area 10 Area 2 Area 11 Boone Kenton Campbell Area 3 Area 12 Gallatin Bracken Pendleton Grant 7 Carroll 8 Mason Area 4 Area 13 Lewis Greenup Owen Robert son Harrison Henry Fleming Area 5 Area 14 13 Oldham Nicholas 6 9 Scott Franklin Bourbon Area 6 Jefferson Lawrence Fayette Montgomery Anderson Area 7 Clark Bullitt Meade Johnson 14 Jessamine Martin Powell Area 8 Mercer Breckinridge Wolfe Henderson Magoffin Madison Washington 3 Daviess Estill Hardin Floyd 5 Lee Garrard Boyle Area 9 Pike 10 Breathitt Marion Larue Lincoln Jackson Owsley Grayson Rockcastle Knott Crittenden Perry Casey 11 Hopkins Hart 2 Butler 12 Livingston Muhlenberg Edmonson Clay Leslie Letcher Caldwell Pulaski Laurel Adair 4 Lyon Warren Metcalfe Russell Barren 1 Knox Logan Marshall Christian Harlan Wayne Todd Trigg Cumberland Whitley McCreary Bell Graves Allen Clinton Simpson Monroe Cabinet for Health and Family Services

  15. Challenges • Some decisions cannot be made until the science (epidemiology) of the actual pandemic unfolds • Unknown if antiviral drugs will be effective • Likely limited availability of effective vaccine early in pandemic; priority groups a necessity • Surge capacity limited; must depend on routine public health interventions, for example… Cabinet for Health and Family Services

  16. Challenges • “Social Distancing” • sheltering at home - a “snow day” concept, telecommuting to work/school • Successful response requires plans that work--- plans must be tested and updated regularly Cabinet for Health and Family Services

  17. Lessons Learned from Recent Events • Public may not prepare even if repeatedly warned • Real disasters may be worse than expected • Outside help may be delayed in coming • Concerns over health and safety of their family will affect responders • Communications and logistics are critical success factors • Impact may be both medical and economic Cabinet for Health and Family Services

  18. How every Kentuckian can prepare. . . Advice for both seasonal and pandemic influenza • Develop an “all hazards” emergency preparedness family plan • Get a flu shot each fall • Wash hands frequently • Cough / sneeze into tissue or elbows • Avoid crowds during outbreaks • If sick stay home from work / school Cabinet for Health and Family Services

  19. A Pandemic Effect on Kentuckians • Goal: prevent illness and death, and preserve critical community infrastructures • Mother Nature does not “aim”; all are at risk • The public/private health care system can not protect us from a pandemic • We must respect the potential impact a Pandemic poses to all parts of society • Therefore all sectors must participate in planning, exercising, and responding Cabinet for Health and Family Services

  20. Closing Thoughts • A pandemic does not appear imminent at this time • Do not panic, but do get prepared • Another pandemic will occur, we just don’t know when • A prepared community is stronger • Next step: engage with your local health department to hold a community wide summit to address these issues Cabinet for Health and Family Services

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