CIO Council Pandemic Workgroup

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CIO Council Pandemic Workgroup

• February 9, 2007
• Morris Hall, House Office Building
• Tallahassee, FL

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Women sell geese at an open air market in Luxor
February 6, 2007. An Egyptian girl has died of
bird flu, bringing the number of confirmed deaths
from the disease in Egypt to 12, a World Health
Organisation official said on Monday.
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A/H5N1 acquires polymorphisms E627K, (A/H9N2)
S227R, M230I, N294S
The NAMRU-3 detection of Tamiflu resistance
polymorphism, N294S, in the NA sequences from the
Gharbiya cluster, has caused concern. 
An E627K substitution in the viral polymerase
basic protein 2 (PB2), which is associated with
adaptation and virulence of H5N1 viruses in
mammals, is universally found in H1, H2, and H3
isolates from humans. 
A search of the Los Alamos flu database
identified 42 exact matches representing the
S227N polymorphism.  All were in H9N2 HA and were
in the Middle East in chickens, turkeys, geese,
and an ostrich.H9N2 has become endemic in
Israel and millions of migratory birds pass
through the area annually.  Thus, the potential
for dual infections by H9N2 and H5N1 is high. 
The nucleotides offer an opportunity for
homologous recombination that would create the
S227N polymorphism and increase the efficiency of
H5N1 human transmission.
The sequence also has an alteration, M230I, near
the receptor binding domain.
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CIDRAP Conference Summary
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The Fog of Pandemic Preparedness

• How our global just-in-time economy will affect
  access to goods and services
• How effective and plentiful antiviral drugs and
  vaccines will beand when they'll be ready
• How many waves of the pandemic will occur, and
  how severe they'll be
• How high mortality rates will be
• How our overloaded healthcare systems will cope
• How our communities will mitigate damage

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The Fog of Pandemic Preparedness

• Learn from veterans. We need to look at those in
  the military who have studied the fog of war to
  explore what to do when unsure about what steps
  to take.
• Work around "just in time." "Don't try to change
  the global just-in-time economy," he said.
  "That's like swimming up Niagara Falls. Forget
  it. You've got to work around it."
• Overcome pandemic fatigue. Recognize that some
  executives may see pandemic planning as no longer
  important, Osterholm said, calling the phenomenon
  "pandemic fatigue" and saying, "Acknowledge,
  accept, and plan around pandemic fatigue."
• Maintain flexibility. Osterholm recognized the
  uncertainty involved in pandemic planning and
  stressed that plans need malleability so they can
  adapt to the elusive realities of a pandemic.
  "Anyone who develops a concrete plan is making a
  mistake," he said. "Be capable and be flexible.
• "You're not stuck to a plan," Osterholm said.
  "You're stuck to a process."

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Highlights

• There are now over 1,600 different subtypes of
  H5N1.
• N95 masks and respirators are becoming
  constrained as demand outpaces supply.
• Risk communications must remain constant and must
  stay on message. England is failing in this
  regard.
• Legal issues regarding employee family leave,
  HIPAA and the like are emerging as serious
  impediments to corporate and government
  preparedness
• Growing concern the Internet may fail
• Experts all agree that Tamiflu must be stockpiled
  and is the only reliable weapon against the
  virus. It is proven to be effective at keeping
  healthy people from catching the virus.

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Quote of the Month

• "I wouldn't bet my familys life on H5N1 not
  becoming the next pandemic. Dr. Michael
  Osterholm.
• Key Deliverables
• Deloitte cross-training matrix
• San Francisco business preparedness guide

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Methodology

• Categorize all operating tasks within one of four
  operating quadrants
• Supporting Break and fix oriented tasks user
  issues application outage, etc
• Operating Task needed to keep the wheels turning
  -- backups, routine jobs, admin work
• Changing Application updates, small code drops
  hardware renewal
• Optimizing Large projects, version upgrade,
  performance management
• Determine in which quadrant the critical tasks
  are located
• What type of work will we focus on in the event
  of a crisis
• What type of work can we stop doing without
  affecting our services
• Determine amount of time spent on activities from
  within each quadrant
• Calculate how many FTEs are assigned to each
  quadrant
• Determine how many FTEs can be reassigned to
  other functions.

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Geographic Skill Matrix Overview
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Individual Skill Matrix Overview
Blank No experience 1 limited experience 2
some experience - basic knowledge 3 good
experience - can do configuration setup, some
basic troubleshooting 4 strong experience -
strong troubleshooting, configuration, setup
skills 5 very strong experience - configure,
troubleshoot - go to person
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Next Steps

• Distribution of agency cross-training matrix
• Adoption of agency pandemic checklists
• Identification of IT needs that require budgetary
  approval
• Symposium on cross-training, work-at-home plans
• Focus on specific topics, speakers for future
  meetings
• Ordering of masks, gloves, eye protection,
  antimicrobial hand sanitizer