Coping with Disaster: Planning for Pandemic Bob Mauskapf, MPA Colonel, USMC ret Director, Emergency

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Coping with DisasterPlanning for Pandemic
Bob Mauskapf, MPAColonel, USMC (ret)Director,
Emergency Operations, Planning Logistics
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Hospitalized Casualties in Past Events
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Alice and planning

• Alice
• Which way should I go?
• Cat
• That depends on where you are going.
• Alice
• I dont know where Im going!
• Cat
• Then it doesnt matter which way you go.

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H5N1 Asian Epizootic Avian flu

• Highly Pathogenic Avian Influenza (HPAI)
• Dec 2003 to present
• Poultry outbreaks in numerous countries in Asia,
  Indonesia, Europe, Middle East and Africa
  millions of birds culled
• 385 human cases in 14 countries (as of July 1,
  2008) 243 deaths (63 mortality)
• Historically unprecedented
• Geographical scope
• Economic consequences

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In Virginia, pandemic flu impact estimates
include

• 2,700 to 6,300 deaths
• 12,000 to 28,500 hospitalizations
• 575,000 to 1.35 million outpatient visits
• 1.08 million to 2.52 million people becoming sick
  

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Unique Features of Pandemic Flu

• Multiple areas affected at the same time
• More difficult to shift resources
• Could go on for months in a community, with 2-3
  different waves over 18-24 mo
• Healthcare workers will be affected
• Preventive and therapeutic agents delayed and in
  short supply
• New vaccine must be made for the pandemic virus
• Widespread illness would impact essential services

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Issue Antivirals

• Federal stockpile of antivirals growing
• States have option to stockpile antivirals at
  discounted federal contract price
• Virginia has purchased full allotted amount
  distribution plan in development (treatment)
• Goal antivirals to treat 25 of VA population
• Increasing supply and production capacity
  discussion of increased prophylaxis use

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Issue Community Containment

• Limiting community spread social distancing
• School closures
• Recommendations about telecommuting
• Snow days
• Isolation/quarantine mainly voluntary
• Discouraging/banning large gatherings
  (indoor/outdoor)
• New recommendations based on severity of
  pandemic, on a scale of 1-5

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Pandemic Influenza Planning

• Include involvement of
• DOD Installations
• Schools/Colleges and Universities
• First responders fire, EMS/Public safety, Law
  enforcement
• Business community/Private sector
• Media
• Assisted living and other social services
  programs
• Volunteer, non-profit groups/Faith community
• Coordinated planning of federal, state, local
  governments and agencies

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Pandemic Influenza Planning Health

• Risk communications
• Community containment
• Antiviral distribution plan
• Mass vaccination
• Medical surge, healthcare coalitions
• Surveillance and investigation
• Laboratory services
• Fatality management
• Altered standards of care due to resource
  limitations

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Pandemic Influenza PlanningNon-Health

• Command and Control
• Community containment measures
• Economic impact
• School closure
• Isolation
• Voluntary quarantine
• Continuity of Operations
• Government entities
• Critical infrastructure economy, trade, business
• Agriculture, water and food chain safety
• Human resource issues, policies (public and
  private)

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Exercises

• Aug 06 Tabletop Ex (TTX)
• Statewide FluEx, Oct 06
• Cabinet TTX, Sep 07
• Mid Atlantic Region NGA TTX, Nov 07
• CDC ( 5 states) Functional Exercise Sep 08
• FluEx 08, Nov 18-19 08

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PanFlu COOP

• Discuss expectations with staff early
• Communications will be key
• Need reliable, credible sources of information
• Need coordinated communication channels
• Rely on both internal/external channels
• Monitor state of transportation systems
• High exposure staff will probably need
  prophylaxis
• Security, Healthcare Providers
• May need to consider relief for regulatory
  requirements

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PanFlu-Specific Recommendations

• Initiate Activities Early
• Purchase and stockpile critical equipment and
  supplies ahead of time
• Equip key staff with needed laptops and remote
  access capabilities
• Prior to a widespread outbreak
• Determine and schedule conference calls
• Local/Company coordination
• Corporate coordination
• Customer coordination
• Key supplier coordination
• Pre-establish communications channels
• Identify local functions that need coordination
• Coordinate vertically and horizontally.

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Management Education

• Detailed presentations to all appropriate levels
  of management
• What they should expect and plan for in a
  pandemic
• What they should be doing for their employees in
  advance of a pandemic
• Promoting infection control procedures
• Promoting annual influenza vaccination
• Have needed supplies on hand
• Hand sanitizer
• Surface sanitizer
• Anti-viral tissues
• Masks

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Management Education

• What they should do if they suspect an employee
  is ill and at work
• Screening by management?
• What questions are management to ask?
• What will management tell employees based on
  responses?
• What management do once the employee is sent
  home?
• What will they tell others in the department?

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Management Education

• What will be the health information source in a
  pandemic?
• Common gathering area management
• Cafeteria
• Lounges
• Fitness Centers
• Etc.

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Employee Education

• What medium will be used?
• Meetings
• Newsletters
• Video display terminals
• Posters have them ready in advance
• What information will you give out?
• Infection control techniques
• Get seasonal flu immunization
• Have needed supplies
• What resources will your organization provide to
  ill employees?

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Employee Education

• Employee personal/home planning
• CDC Pandemic Flu site
• Inform employees where they can get reliable
  information during a pandemic
• Signage
• Infection control techniques
• Symptoms of the flu
• Stay home if ill
• Area closed
• Where to get information

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More PanFlu Recommendations

• Verify work-at-home capabilities
• Exercise regularly
• Consider provisioning multiple access methods for
  critical staff (broadband, DSL, air cards, etc.)
• Prepare for psychological aspects
• Prepare for labor shortage
• Develop pools of available staff
• Refresh/train pools regularly or at trigger point
• Remain flexible/adaptable

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Vendor Discussions Management

• What do you expect of them?
• What is their plan for a pandemic?
• Working with critical vendors
• Housekeeping
• Food services
• Non-critical vendor relationships
• Employer of choice programs

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Miscellaneous Issues

• How do you know which employee is absent due to
  illness, due to caring for the ill, etc.?
• What is your HR policy of employee absences in a
  pandemic?
• Is your attendance system up to the challenge?

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Miscellaneous Issues

• Screening of employees prior to coming into the
  building?
• What cross function support do you have?
• How will you handle employees calling into work
  with questions?
• What questions will they ask?

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Miscellaneous Issues

• Prepare ready-to-go communications that can be
  updated easily for each Stage/Phase of a pandemic
• For management
• For employees
• For vendors
• For the public
• Develop relationships with health resources

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Questions? http//www.vdh.virginia.gov/eprhttp
//www.vdh.virginia.gov/pandemicfluhttp//pandem
icflu.gov