Pandemic Influenza: A Primer for Organizational Preparation

1. Pandemic Influenza: A Primer for Organizational Preparation Kristine Perkins, MPH Director, Office of Public Health Emergency Preparedness Maine Center for Disease Control and Prevention

2. Overview Public Health plays a major role in Emergency Preparedness • Protect the health of communities from natural and manmade disasters • Serves as the nations first line of defense against numerous threats such as: • Infectious disease • Food borne and water borne illness • Biological, chemical, radiological attack

3. What is Avian Influenza ?Bird Flu • A viral infection caused by avian (bird) influenza normally a subtype of a type A influenza virus • Occurring naturally among birds (low pathogenic and high pathogenic) • Often carried by wild birds in their intestines • Can cause domestic birds, including chickens to become very ill and die • Occasionally some strains can infect

4. What is Pandemic Influenza? • Pandemic Influenza is a widespread outbreak of a new influenza virus that humans have no immunity to thus causinga global outbreak of serious illness that spreads easily from person to person. • Currently, there is no pandemic flu.

6. What if …An Influenza Pandemic Struck Maine • State population: 1,274,923 • Number of ill persons:  382,477 (30% attack rate) • Number of persons seeking outpatient care167,405  (50% of those ill minus persons who are hospitalized or die) • Number of persons hospitalized: 38,582 (range: 14,549- 48,699) • Number of deaths: 9,086 (range:  5,421 -- 14,837)

7. Community Impact • Hospitals working to capacity/ turning away some ill • Alternate care sites limited—homecare is the norm • Assistance from the federal government limited • Antiviral and vaccine supplies depleted • Mortuaries unable to manage increased mortality • Food supplies limited/ trucks, trains not moving • Increased security at groceries, pharmacies • Schools, many gov’t offices closed • Others dying from lack of support

8. Lessons from SARSToronto--2003 • 438 probable or suspect cases • 43 deaths • 23% decline in tourism • 20-30% decline in retail sales • $30 million per day cost to Canada’s economy • Decrease in growth from 2.5% to 1% • Travel advisory • Organizational/governmental disaster

12. What About My Town? County? In a population of 30,000— • 9,000 will become ill • 900 will require hospitalization • 213 will die

13. How will I be Affected? In a “Social or Business Circle” of 100 • 30 will acquire the disease • 3 will require hospitalization • Nearly 1 will die

14. What’s my Responsibility? Personally • Stay up with the worldwide epidemic • Participate in prevention strategies • Practice and teach “personal protective behaviors” • Sneeze and cough properly • Stay home when ill • Monitor friends who are ill • Learn about homecare for influenza • Stockpile supplies, food and water • Fill fuel tanks

15. What’s My Responsibility? Professionally • Participate in planning • Develop a catalog of “critical operations” • Plan to provide those services with ~40% fewer staff • Practice and support Personal Protective Behaviors at work • Consider volunteer support • Consider engineering controls • Reduce direct close client contact • Ask for technical assistance

16. Sample COOP Outline and Process • Define “Critical Functions” • Define critical staff and backup (deep) • Cross train non-critical staff in critical functions • Ensure infrastructure support • Develop/test operations management plan • Develop operations/ public communications plan

17. Are We Sure ??? • No, but… • The conditions are right • Highly pathogenic bug--H5N1 (in birds) • High mortality rate in humans (~ 50%) • Extensive coverage worldwide (in birds) • Limited human to human transmission • Influenza mutates constantly • Global shipment and migration of birds