Colorado Novel Influenza A H1N1 Response

1
Colorado Novel Influenza A (H1N1) Response

• Gerrit Bakker, Deputy Director
• Emergency Preparedness and Response Division
• Colorado Department of Public Health and
  Environment
• Friday, November 13, 2009

2
History

• 2001 - Emergency Preparedness and Response
  Division created after the Anthrax attacks.
• 2002 - Pandemic Influenza planning began.
• 2003 - Strategic National Stockpile (SNS)
  Receipt, Storage and Staging planning began.
• 2006 2008 Statewide exercises.

3
Climate

• Presence of a novel virus in the United States.
• People are dying in Mexico.
• No vaccine, uncertain response to anti-virals.
• Expectation that a pandemic is inevitable.
• Duty to warn v. Duty not to panic
• History with this virus.

4
Definitions

• Pandemic A reflection of amount and type of
  spread and a declaration that allows for the
  release of resources
• Emergency A similar declaration by a local
  jurisdiction for the release of resources
• Social Distancing A step short of Isolation or
  Quarantine. Separation of contagious persons
  from those who are susceptible.

5
Swine flu outbreak 1976 - Fort Dix case
President Gerald Ford is inoculated on Oct. 14,
1976 as part of the "Roll Up Your Sleeves,
America" campaign following an outbreak of swine
flu in Fort Dix, N.J. that left a young recruit
dead. (Via doctorzebra.com) 1976 swine flu
outbreak at a glance In 1976, hundreds of
soldiers at Fort Dix army base in New Jersey
became infected with a form of swine flu. One man
died. Fearing a repeat of the 1918 bird flu
outbreak that killed 675,000 people, President
Gerald Ford ordered a nationwide vaccination
program. About 40 million Americans were
vaccinated. The program was stopped after more
than 500 Americans developed a severe paralyzing
nerve disease as a result of the vaccinations.
Thirty people died.The handling of the 1976
case is now seen as a public health debacle.
6
Timeline

• Thursday, 4/23 There is Swine Flu in the U.S.,
  Texas and California.
• Friday, 4/24 St. Francis School, Queens, N.Y.,
  potentially 100 cases.
• Saturday, 4/25 Getting Organized
• Sunday, 4/26 Full Activation, Governor Ritter
  press conference.

7
Timeline 4/27 5/1

• Daily Press Conferences
• Case counts
• Guidance releases
• Conference Calls
• Precautionary Methods
• Lab Testing
• Epidemiology

8
Events Since May 1

• Testing limited to those who are most symptomatic
• Research continues Vaccine, response to
  anti-virals, At risk populations
• Withdrawal of travel restrictions
• Monitoring of events in the southern hemisphere
• Guessing about the next vaccine.

9
Number of confirmed (N 394) and probable (N
414) cases of novel influenza A (H1N1) virus
infection with known dates of illness onset ---
United States, March 28--May 4, 2009
10
U.S. Human Cases of H1N1 Flu InfectionUpdated
June 5, 2009, 900 AM MT 
11
Risk Communication

• Traditional Methods
• Press Releases
• Press Conferences
• CoHELP Call Line
• Specialized Guidelines
• Business
• Education
• Health Care
• Social Distancing

12
Risk Communication

• Social Media
• Website Subscribe for updates
• SATool.org
• Google listserv
• You Tube Demos
• Facebook COHealth
• Twitter for breaking news
• Blog Be Ready Be Healthy Be Informed

13
Anti Virals / PPE

• Assessment of current status
• COPharm
• Fit Testing
• SNS
• Receipt, Storage, Staging
• Regional Transfer Points
• Personal Protective Equipment

14
Current Circumstances

• Monitor
• Testing
• Surveillance
• Investigation
• Next Flu season
• Vaccine
• Messaging
• Testing

15
Shared Responsibility

• Individuals have an important role in protecting
  themselves and their families.
• Stay informed. Health officials will provide
  additional information as it becomes available.
• Everyone should take these everyday steps to
  protect your health and lessen the spread of this
  new virus
• Cover your nose and mouth with a tissue when you
  cough or sneeze. Throw the tissue in the trash
  after you use it.

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Shared Responsibility

• Wash your hands often with soap and water,
  especially after you cough or sneeze.
  Alcohol-based hand cleaners are also effective.
• Avoid touching your eyes, nose or mouth. Germs
  spread this way.
• Try to avoid close contact with sick people.
• If you are sick with a flu-like illness, stay
  home for 7 days after your symptoms begin or
  until you have been symptom-free for 24 hours,
  whichever is longer. This is to keep from
  infecting others and spreading the virus further.
  
• Follow public health advice regarding school
  closures, avoiding crowds and other social
  distancing measures.

17
Lessons Learned

• Planning has paid off
• Many different methods of communication are
  needed
• Messages must be clear, concise and specific
• Pandemic can come from sources other than Avian
  Flu
• Tolerance for ambiguity
• Flexibility

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Resources

• Website subscribe for updates cdphe.state.co.us
• Situational Awareness Tool www.SATool.org
• Google Groups listserv COHealth
• Twitter COHealth
• Facebook page COHealth
• Blog Be Ready Be Healthy Be Informed
• COHelp 877-462-2911