Avian Influenza Preparedness Planning and Response -- GIS Applications --

1. Avian Influenza Preparedness Planning and Response -- GIS Applications -- Reno Fiedler Director, European Operations Global Health Business Development Charles Schable Director, Global Health Business Development

2. STC - The Company

3. Office Locations

4. STC Products and Services

5. Pubic Health Solution Delivery Model

7. Charles Schable

8. Reno Fiedler Director European Operations, Global Health Business Development 9 years public health informatics consultation 15 years GIS planning, development, and applied research emphasis on GIS, strategic planning, and system design System design and planning experience: environmental health, early warning and detection, diseases and outbreak management, integrated public health animal health orphan disease registries Stationed onsite in Bermuda, Senegal, and Hong Kong

9. STC and ESRI New York City (2) Hong Kong Publications and Awareness

10. STC Software � ESRI Products

11. Overview Avian Influenza Planning Preparation Surveillance Response Preparation Response Recovery Evaluation Discussion

12. WHO Pandemic Phases Source: WHO website Get better screenshotGet better screenshot

13. WHO, US, Local Planning Phases

14. WHO, US, Local Planning Phases Troop deployment of misplaced communities could be one level of planningTroop deployment of misplaced communities could be one level of planning

15. Challenges Multi-agency, multi-sector, multi-location response, communication, information sharing Differentiated responsibilities will create uncorrelated data, but must be reviewed and analyzed together Comprehension, communication, and decision making from multi-source data is a very complex problem

16. Supportive Technology One commonality, every information has (should have) a time and space element Where are the bird migratory routes? What is the path of poultry meat from farm to table? How can someone with expertise be reached? Geographic Information Systems can display time and space bound, but otherwise unrelated, information for: Planning Research Decision support Logistics Recovery

17. Preparation

19. Select Tasks Establish communication and data sharing channels Store: population demographics, resources (age distributions, hospital beds, PPEs, skill sets, volunteers, etc.), satellite imagery (best for unforeseen needs) Premises ID system Laboratory capacity (see IHR requirements) Conduct simulations, trainings, and exercises No particular order technical and administrative tasksNo particular order technical and administrative tasks

20. 1) US Pan Flu Authorities and Responsibilities

21. 2) Demographics used for Gap Analysis Dosage inventory & population by health district Supports public health policy

22. 3) Simulations, Exercises

23. Select Tasks Prepare for mass prophylaxis and treatment deliveries to local distributors Conduct research on pathways for spread of disease to support prevention Enhance existing technology with emergency capabilities (mass immunization, logistics, etc.)

24. 4) Placement Decision Support - Distribution Centers

25. 5) Research

26. 6) Technology Enhancements

27. Surveillance

28. Select Tasks Monitor pre-encounter and early encounter events (OTC, emergency department, etc) Monitor wildlife (birds, rodents, mosquitoes Monitor media around the world Establish sentinel surveillance (if warranted) Monitor influenza strains No particular order technical and administrative tasksNo particular order technical and administrative tasks

29. 1) Early Warning and Detection Surveillance for Early Warning OTC, ED Visits, Absenteeism Operational 1/1/2003

30. 2) Animal SurveillanceTundra Swans in Northern Alaska Personnel from my branch flew out to northwest Alaska near Kotzebue to capture swans and sample them for avian influenza. Here is a flock of swans as seen from a small airplane.Personnel from my branch flew out to northwest Alaska near Kotzebue to capture swans and sample them for avian influenza. Here is a flock of swans as seen from a small airplane.

31. One of the species that was sampled by people in the Waterfowl Branch of the MBM division, USFWS, this summer was tundra swan. You can see these swans breed around the arctic and there is some movement between Alaska and Russia. One of the species that was sampled by people in the Waterfowl Branch of the MBM division, USFWS, this summer was tundra swan. You can see these swans breed around the arctic and there is some movement between Alaska and Russia.

32. 2) Animal Surveillance The swans were banded with a standard USFWS leg band, outfitted with neck collars, then a cloacal swab was taken for avian influenza testing.The swans were banded with a standard USFWS leg band, outfitted with neck collars, then a cloacal swab was taken for avian influenza testing.

34. 3) Media Monitoring

35. 4) Sentinel Surveillance

36. Response Preparation

37. Select Tasks Open an Emergency Operation Center for Situational Awareness Deploy vaccines and PPEs to key sites Communicate response plans to media and public Intensify case management regimes and increase case contact tracing No particular order technical and administrative tasksNo particular order technical and administrative tasks

38. 1) Emergency Operation Centers Managing a public health situation is critical to the reputation of any national health ministry. Assessments must be made quickly and accurately using the best information available. Her we see the way GIS is used by the United States health ministry (the Department of Health and Human Services) to follow and track unfolding events that have an impact on health and human resources in a local area. The command center uses many different GIS applications to monitor, display, and analyze situations along with relevant resources, medical assets, and public health capabilities.Managing a public health situation is critical to the reputation of any national health ministry. Assessments must be made quickly and accurately using the best information available. Her we see the way GIS is used by the United States health ministry (the Department of Health and Human Services) to follow and track unfolding events that have an impact on health and human resources in a local area. The command center uses many different GIS applications to monitor, display, and analyze situations along with relevant resources, medical assets, and public health capabilities.

39. 2) Prophylaxis and Vaccine Deployment

40. 3) Media Communication

41. 4) Case Management and Contact Tracing

42. Response

43. Select Tasks Distribute PPEs, prophylactic medication, vaccines Manage hospital capacities, worried well, laboratory samples Manage control measures (isolations, quarantines, social distance measures, e.g., school closings) Deploy informed field staff onsite No particular order technical and administrative tasksNo particular order technical and administrative tasks

44. 1) Distribute PPEs

45. 2) Resource capacities

46. 2) Manage hospital capacity, worried well, laboratory samples

47. 3) Manage Control Measures Control Measure Categories Social Distance Susceptibility Reduction Personal Hygiene and Conduct

48. What if Fever Clinic Were Set Up One Week Earlier in BJ?A Real Example: A SARS Infection Chain in Beijing(F.C. created 4/17/03, 4/20/03 SARS Outbreak announced by Gov )

49. 4) Deploy Informed Field Staff

50. Recovery

51. Select Tasks Manage resources, resume non-response functions Find people Continue deploying vaccines for subsequent waves No particular order technical and administrative tasksNo particular order technical and administrative tasks

52. Post-Event Evaluation

53. Select Tasks Prepare lessons learned, communicate events Improve planning and preparedness Replenish stockpiles Monitor for second waves No particular order technical and administrative tasksNo particular order technical and administrative tasks

54. Discussion

55. Summary GIS can support preparedness and response in many different ways GIS can deliver public health and emergency functionality from one set of implemented core technology GIS is THE technology to combine multi-purpose data How can multi-agency, multi-sector, and multi-location response be mounted, when IT systems are designed to deliver peace functionality, yet must support functionality for emergency response. One big integrated system? Diligent planning to coordinate data and interface standards? Loosely coupled systems with specific functionality �integrated� by the common standard of time and space descriptors? How can multi-agency, multi-sector, and multi-location response be mounted, when IT systems are designed to deliver peace functionality, yet must support functionality for emergency response. One big integrated system? Diligent planning to coordinate data and interface standards? Loosely coupled systems with specific functionality �integrated� by the common standard of time and space descriptors?

56. Observation

57. Lessons Already Learned Preparedness/Planning activities will quickly give way to response activities GIS must be integrated into technology stack before the event, dual use technology New technology can not easily be deployed in pressure situations GIS must be implemented purpose driven and by end users