Business Planning

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Business Planning

• Pandemic Influenza Preparedness

Susan Campbell, MS, RN Columbus Public Health
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Pandemic Influenza Preparedness
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Pandemic Influenza Preparedness

• What is Pandemic Influenza?
• Global or worldwide disease outbreak
• Occurs when a new influenza A virus
• emerges for which there is little or no
• resistance in humans, begins to cause
• serious illness, and then spreads easily
• from person to person.

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Pandemic Influenza Preparedness

• How Likely is a Flu Pandemic?
• According to the U.S. Centers for Disease
  Control and Prevention Pandemic Influenza is
  our biggest worldwide challenge.
• Not a question of If, but When.

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Pandemic Influenza Preparedness
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Pandemic Influenza Preparedness

• CORNFUSION
• Avian Flu-Bird Bird
• Influenza-Human Human
• Pandemic can be either

Acchooo!
I dont feel so good
My nose wont stop running
I think I have a fever
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Pandemic Influenza Preparedness

• Characteristics and Challenges of a Pandemic
• Rapid worldwide spread
• Health Care Systems overloaded
• Inadequate medical supplies
• Economic and social disruption

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Pandemic Flu in the 20th Century
Pandemic Influenza Preparedness

• 1968-1969 Hong King Flu
• At least 700,000 people died worldwide
• 34,000 deaths in US
• 1957-1958 Asian Flu
• At least 1.5 million people died worldwide
• 70,000 deaths in US
• 1918 1919 Spanish Flu
• Spread around the globe in 4-6 months
• At least 40-50 million people died worldwide
• 500,000 650,000 in US
• Pandemic affected everyone not just young and
  elderly
• Typical Influenza Season
• 36,000 deaths in US

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Pandemic Influenza Preparedness

• General info
• Avian Flu aka bird flu, H5N1
• spreads among birds
• Does not normally infect humans
• Can be deadly
• No confirmed human to human transmission

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Avian Influenza (Bird Flu)
Pandemic Influenza Preparedness

• Avian influenza is an infection caused by avian
  (bird) influenza (flu) viruses.
• These influenza viruses occur naturally among
  birds. Wild birds worldwide carry the viruses in
  their intestines, but usually do not get sick
  from them.
• However, avian influenza is very contagious among
  birds and can make some domesticated birds,
  including chickens, ducks, and turkeys, very sick
  and kill them.

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Current Outbreak of Avian Flu
Pandemic Influenza Preparedness

• Most cases of avian influenza infection in humans
  have resulted from direct or close contact with
  infected poultry (e.g., domesticated chicken,
  ducks, and turkeys).

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Pandemic Influenza Preparedness

• Implications for Human Health
• Infection with the virus results in very serious
  disease especially in young adults.
• Concern that the virus will become highly
  infectious for humans and spread easily from
  person to person. That could mark the start of a
  global outbreak.

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Current Outbreak of Avian Influenza (Bird Flu) in
the World
Pandemic Influenza Preparedness

• As of October 19, there are 256 cases 151
  deaths in Azerbaijan, Cambodia, China, Djibouti,
  Egypt, Indonesia, Iraq, Thailand, Turkey and
  Vietnam

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Pandemic Influenza Preparedness

• MIGRATION
• LEGAL TRANSPORT
• ILLEGAL SMUGGLING

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Routes of Nonpandemic H5N1 Introduction to the
U.S.
Pandemic Influenza Preparedness

• High Likelihood
• Smuggling of infected birds or eggs
• Thai eagles hidden in suitcase confiscated in
  Belgiumpositive for H5N1 AI, Oct 2004

UNCLASSIFIED
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Pandemic Influenza Preparedness

• Food Safety
• Eating properly handled and cooked poultry is
  safe.
• Poultry products imported into the US must meet
  all safety standards.
• No poultry from countries with confirmed bird flu
  (H5N1) can be imported into the US.

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Pandemic Influenza Preparedness
WHO Phases of Pandemic Alert
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Pandemic Influenza Preparedness

• Transmission
• Spread by droplets from coughing, sneezing,
  talking and contact with infected contaminated
  surfaces.
• Typical incubation period 2 days.
• Infected persons are contagious one day before
  symptoms, even more so in first several days of
  symptoms.

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Pandemic Influenza Preparedness

• Pandemic Influenza
• Global outbreak
• New flu virus
• Vaccine not on hand at first
• Serious human illness
• Easily spread from person to person

• Seasonal Flu
• Seasonal
• Viruses not new
• Vaccine on hand
• More than 200,000 hospitalizations per year
  (36,000 deaths)
• Easily spread from person to person

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FORMULA FOR WHY PHARMACEUTCAL COMPANIES ARE NOT
JUMPING ON THE VACCINE BANDWAGON

• Sum of (Incentives-Disincentives) x Investor
  Perception
• Time in Years

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Pandemic Influenza Preparedness

• Impact of a Pandemic Health Care Vaccine will
  probably not be available in the early stages of
  a pandemic, and the need for vaccine is likely to
  outstrip supply when it does become available.

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Pandemic Influenza Preparedness

• Medical Treatment During a Pandemic
• Antiviral Agents
• Can prevent complications if taken in time
• May not be effective against a pandemic virus
• Supplies at this time are extremely limited
• Resources would be prioritized (based on national
  guidance)

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Pandemic Influenza Preparedness

• Avian Flu In Humans
• What are the symptoms of avian flu in humans?
• Typical flu-like symptoms (fever, sore throat,
  cough)
• Rapidly progresses to serious lung disease
• - Pneumonia
• - Severe respiratory distress
• Other severe and life threatening complications

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Pandemic Influenza Preparedness

• Pandemic Influenza
• in U.S.
• What if?

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Pandemic Influenza Preparedness

• Preparing for the Pandemic
• Federal Response
• Stockpiling anti-viral medications and vaccines
  while working with industry to expand capacity.
• State Response
• Strategic National Stockpile (SNS) may be used.

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Preparing for the Pandemic
Pandemic Influenza Preparedness

• Local Health Departments are the first
• line of response in a flu pandemic

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Pandemic Influenza Preparedness

• Preparing for the Pandemic
• Role of the local health
• department
• Declaration of Public Health Emergency
• Surveillance and Tracking
• Isolation and Quarantine as Appropriate
• Vaccine and Pharmaceutical Delivery
• Public Information and Communication

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Pandemic Influenza Preparedness

• Preparing for the Pandemic
• Local response Whats in place
• Early Warning Systems (Abstrac, RODS / OTC)
• Communicable Disease Reporting System (CDRS)
• Emergency Operations Plan and Departmental
  Operations Center Activated in an Emergency
• DRAFT Influenza Pandemic Response Plan

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Pandemic Influenza Preparedness

• Mass Clinic Plans for Vaccine or Medication
  Distribution
• PODS Point of Distribution
• 20 Clinics in Columbus 10 clinics in Franklin
  County -geographically located
• Wireless access needed for documentation
• Personnel Needs public health/safety/ other
  staff/volunteers
• POD hours and duration will be determined by
  nature of the emergency

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Pandemic Influenza Preparedness

• What Can You Do Now?
• Create a pandemic plan, both for your family and
  business
• Are you Ready in 3?

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WHOS STRATEGY WORKED?
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HOW WILL WE BE JUDGED?
Modeling indicates a minimum of 5 interventions
to achieve prepared
Unprepared
Prepared
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Pandemic Influenza Preparedness
Prevention
In the event of a pandemic, practicing
containment activities to minimize risk of
further infection. Site Controls Social
Distancing Infection Control
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Pandemic Influenza Preparedness

• Site Controls
• Plan to minimize the chance of infectious persons
  entering work site
• Applies to staff visitors

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Pandemic Influenza Preparedness

• Site Controls
• Set up prominent notices at all entry points to
  the facility, advising staff and visitors not to
  enter site if they have symptoms of influenza
• Set up Key General Infection Control (basic
  hygiene hand hygiene) notices around workplace
• Ensure the workplace have adequate supplies of
  tissues, hand hygiene products,
  cleaning/disinfectant supplies as well as masks
  for people who become ill at work
• Consider implementing entry screening process and
  at what stage

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Pandemic Influenza Preparedness

• Educate employees employers on current criteria
  for returning to work
• 5 days have passed since symptoms of illness
  began
• Fever has resolved for 24 hours
• Cough is improving
• Recovery is 4-6 weeks even though may be back to
  work

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Pandemic Influenza Preparedness

• Social Distancing Definition
• Is a plan to reduce your risk of catching the flu
• It refers to a plan to reduce the frequency of
  contact between people.
• Generally it refers to mass gatherings but the
  same plan can be used in the workplace

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Pandemic Influenza Preparedness
Welcome to Pandemic Free
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Pandemic Influenza Preparedness

• Social Distancing Strategies
• Avoid meeting people face to face
• Use telephone, video conferencing and the
  Internet to conduct business as much as possible,
  even when participants are in the same building
• If a face to face meeting is unavoidable
• -Minimize meeting time, choose a large meeting
  room and sit at least 3 feet away from one
  another, avoid shaking hands

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Pandemic Influenza Preparedness

• Social Distancing Strategies
• Bring lunch
• Avoid the cafeteria and crowded restaurants
• Do not congregate in lunchrooms or other areas
  where people socialize
• Do what needs to be done then leave the area.
• Avoid public transport
• Walk, cycle, drive a car or go early or late to
  avoid rush hour crowding at the workplace.

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Pandemic Influenza Preparedness

• Prevent the Spread
• Infection Control Strategies
• Hand washing
• Cover your cough

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Pandemic Influenza Preparedness

• Infection Control Strategies
• During a pandemic period office sanitation should
  be increased.
• Telephone sets in common areas should be cleaned
  prior to use, consider individual headsets,
  keyboard covers
• Anti-bacteria solutions should be applied daily
  to all common areas (household sani-wipes work
  well against influenza)

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Pandemic Influenza Preparedness

• Coordinate with external organizations
• Share best practices with other businesses in
  your community, chamber of commerce and
  associations

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Pandemic Influenza Preparedness

• Caring for Someone with Influenza
• Recognize Pandemic Influenza Symptoms
• Supply plenty liquids, medications to relieve
  symptoms
• Know when to call Health Care Professional high
  fever, chills, coughing thick mucus, dehydration
• Reduce fever (acetaminophen or ibuprofron)

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Pandemic Influenza Preparedness

• Why Businesses Need to Plan
• No one knows for sure exactly how widespread or
  severe an impact will come from the next
  pandemic.
• The large number of sick and incapacitated people
  will include a significant segment of your
  workforce - 25 to 40 percent.
• Limitations on public gatherings and fear among
  healthy people could limit the number of
  customers who may be able to access your services.

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Why Businesses Need to Plan
Pandemic Influenza Preparedness

• Key supply and distribution networks could be
  significantly impacted.
• Close quarters and large gatherings (such as
  tight office spaces or large meetings) may
  encourage person-to-person spread of the disease.
  
• Ill children and family members may cause
  employees to miss work.

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10 Steps Your Business Can Take
Pandemic Influenza Preparedness

• Identify core business activities or essential
  services.
• Identify employees and other critical elements
  required to maintain operations.
• Cross train now to ensure uninterrupted service.
• Clearly pre-establish delegation of authority and
  order of success. Illness effects everyone.
• Plan for possible interruptions of governmental
  services such as water, power or transportation.
• The private sector owns and maintains
  approximately 85 of the U.S. critical
  infrastructure.

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10 Steps Your Business Can Take
Pandemic Influenza Preparedness

• Determine which outside activities are critical
  to maintaining operations and develop
  alternatives in case they cannot function
  normally.
• Example Just in time delivery.

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10 Steps Your Business Can Take
Pandemic Influenza Preparedness

• Allocate resources to protect your staff and your
  customers
• Supplies for respiratory hygiene/cough etiquette.
• Special assets to enable mission continuation.
• Financial contingency reserves.
• Establish ways to limit face-to face contact
  among employees and customers.

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10 Steps Your Business Can Take
Pandemic Influenza Preparedness

• Establish or expand policies and tools that
  enable employees to work from home (if possible).
• Determine if you have the capability to transfer
  authority and responsibility for essential
  functions to another facility (regional or
  national)

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10 Steps Your Business Can Take
Pandemic Influenza Preparedness

• Maintain a healthy work environment.
• Post tips on how to stop the spread of germs at
  work.
• Encourage good hand hygiene and coughing/sneezing
  etiquette.
• Ensure wide and easy availability of alcohol
  based hand sanitizer products, antibacterial
  soap, tissues and waste receptacles.
• Communicate with employees about the importance
  of staying home if they are sick.
• Develop procedures for cleaning facilities during
  an outbreak and for employees to follow.

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10 Steps Your Business Can Take
Pandemic Influenza Preparedness

• Tell your employees about the possibility of
  pandemic flu and the steps the company is taking
  to prepare for it.
• Provide updated, accurate materials covering
  basic pandemic flu facts and personal protection
  and response strategies.
• Provide information on at-home care of ill
  employees and family members.
• Educate employees about your pandemic flu plan.
• Develop ways to communicate status and actions to
  employees, vendors, suppliers and customers
  during a pandemic.

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Pandemic Influenza Preparedness
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10 Steps Your Business Can Take
Pandemic Influenza Preparedness

• Establish an emergency communications plan and
  revise it periodically. Include
• Key contacts (and back-ups)
• Chain of communication (including suppliers and
  customers)
• Process to resume normal operations as quickly as
  possible

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10 Steps Your Business Can Take
Pandemic Influenza Preparedness

• Set up pandemic policies as part of your
  emergency communications plan.
• Non-penalized and mandatory leave
• Flex-time/Work from Home?
• Compensation?
• Insurance Coverage
• Modify practices that might spread virus
• Screening facility entrants?
• Plan for long-term absenteeism rates

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10 Steps Your Business Can Take
Pandemic Influenza Preparedness

• Develop a pandemic flu planning team to help you
  accomplish 1-9.
• Impact on your business
• Impact on your employees customers
• Establish policies
• Allocate resources
• Communicate to educate employees
• Coordinate with and help your community

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Conclusion
Pandemic Influenza Preparedness

• The only thing more difficult than planning for
  an emergency is having to explain why you didnt.

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Pandemic Influenza Resources

• U.S. Pandemic Influenza
• www.pandemicflu.gov
• Columbus Public Health
• www.columbuspublichealth.gov
• Centers for Disease Control and Prevention
• www.cdc.gov/flu/pandemic/
• Ohio Pandemic Influenza
• www.ohiopandemicflu.gov
• Franklin County Board of Health
• www.franklincountyohio.gov/health
• Homeland Security
• www.ready.gov