Community Providers

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Community Providers

• Pandemic Flu Planning

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Objectives

• As participants in this workshop, you will be
  able to
• Define pandemic influenza (flu)
• Understand the difference between avian influenza
  and pandemic flu
• Recognize the potential impact of pandemic flu on
  your agency and services
• Identify steps to personal preparedness
• Be familiar with the steps to continuity planning
  for your agency

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What is Pandemic Influenza?
A pandemic means a global outbreak of a novel
(new) disease to which humans have no
immunity In 1918-1919, a global pandemic of
Spanish Flu killed about 50 million people
worldwide. Three serious flu pandemics during
20th century 1918, 1957, 1968 They tend to occur
in cycles. There has been no major pandemic in
many years. Experts believe we are due for
another pandemic.
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• Pandemic flu
• Influenza virus goes through changes (mutations)
  and body cannot fight off
• Much worse than seasonal flu
• Flu shots will not be available at first
• It may take 4 to 6 months or longer to prepare a
  flu shot for this virus

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• There is no pandemic influenza anywhere in the
  world right now.

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Who Phases of Pandemic Alert
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www.pandemicflu.gov

• The greatest risk of hospitalization and death
  as seen during the last two pandemics in 1957 and
  1968 and during annual influenza will be
  infants, the elderly, and those with underlying
  health conditions.
• However, in the 1918 pandemic, most deaths
  occurred in young adults. Few if any people would
  have immunity to the virus.

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How is the flu virus spread?

• The flu virus spreads when people cough or
  sneeze.
• Droplets spray into the air, and then into the
  eyes, mouth and nose of people nearby.
• Droplets also fall on surfaces people touch
  before they touch their mouth or nose.
• Infected people leave the virus on surfaces they
  touch if their hands are not clean.

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What is Avian Flu?Should we be concerned?

• Also known as bird flu or H5N1.
• Primarily found in certain types of birds.
• In its current form, H5N1 virus does not pass
  easily from birds to humans
• When rare cases of human infection with H5N1
  virus occur, the virus does not pass easily from
  human to human.

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What is Avian Flu?Should we be concerned?

• H5N1 could change into a type of virus that
  easily spreads from person to person.
• If so, a worldwide flu pandemic could result.

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What is the potential impact of a flu pandemic?

• An estimated 1/3 of the worlds population could
  become ill.
• Missouris Population 5,800,000
• 1/3 1,914,000 Missourians ill
• Expect 40 absenteeism

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What is the potential impact of a flu pandemic?

• Many more would have to stay home to care for
  them.
• Hospitals could become overwhelmed with the
  number of people seeking treatment.
• Supply chains could be reduced leading to
  shortages of food, medicine and daily essentials.

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Incubation Period

• Incubation period the time between
  acquiring the infection and becoming ill
• 2 days
• Persons can shed virus (transmit infection) for ½
  to 1 day before they have symptoms

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Occurrence

• In an infected community
• Pandemic outbreak will last 6 8 weeks
• At least two pandemic wave periods are likely
• Seasonality cannot be predicted
• 1957 pandemic
• 1st. Cases June
• No community outbreaks until August
• 1st. Wave of illness peaked in October

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Services Potentially Affected by Pandemic Flu

• Banks
• Stores
• Restaurants
• Utilities
• Police
• Fire and EMS
• Agriculture

• Medical care
• Hospitals
• Nursing homes
• Day care
• Transportation
• Communications
• Schools

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What are federal, state and local governments
doing to prepare?

• Federal government
• Stockpile medications and supplies
• Research new vaccines
• Monitor and respond quickly to virus outbreaks
• Help state and local authorities develop pandemic
  response plans
• Establish public health guidelines

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• State and Local Public Health Agencies
• Develop and update statewide and local pandemic
  plans
• Develop mass immunization strategies
• Organize cooperative efforts involving essential
  community services
• Test plans through exercises

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What can you do to prepare?

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Step 1 Create a PlanSelf, Staff, Consumers

• Know how to reach your family members if someone
  gets sick
• Be sure you consider
• If you have a child in school or day care
• What to do about your job
• If you have special needs or care for someone who
  does

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Step 2 Prepare Supplies

• Have at least a 2-week supply of basic
  items.
• Include a variety of supplies that will help you
  survive at home with little or no outside help.
• A wave of influenza may run as long as 6 to 8
  weeks.

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Supplies

• Water at least 1 gallon per person per day
• Canned or dried food
• Prescription medicine
• Non-aspirin pain reliever
• Thermometer

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Supplies

• Household cleaning supplies
• Extra bath and hand soap
• Battery powered radio
• Manual can opener
• Flashlight
• Extra batteries
• First aid kit

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If you have special needs, your supplies should
include

• A list of your medicines
• A list of allergies and other medical conditions
• Extra eyeglasses and hearing-aid batteries
• Extra wheelchair batteries or other special
  equipment
• A list of the brand/style and serial numbers of
  medical devices

• Copies of medical insurance and Medicare and
  Medicaid cards
• A list of doctors
• A list of emergency contacts and family
• Phone numbers of close neighbors who can help
• Alternate clinics

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For additional information

• Missouri Department of Health and Senior Services
  
• www.dhss.mo.gov
• (Click on Pandemic Influenza)
• 1-800-392-0272
• -or-
• Your local public health agency
• -or-
• www.pandemicflu.gov

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WHY WE ARE PLANNING NOW?

• Anticipate the possibility of the event
• Will be an extremely stressful time for both the
  organization and employees
• Adopt a preventive perspective
• Plan now to know how the organization will
  communicate with employees
• How the safety of clients will be assured
• How benefits will be administered
• How and by whom decisions will be made

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Components of the Plan

• Planning Assumptions
• 40 staff out
• Consumers with illness
• Elements of Continuity of Operations Plan (COOP)
  Capability
• Risk Communication Plan
• Response Stages
• Essential Functions

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Critical Mission Functions

• ID of Essential Positions and Skills
• Alternative Work Arrangements
• Home
• Staggered Work hours
• Flex time
• Tele-work
• Essential Contract Support Services
• Standing agreements/contracts
• Daily suppliers
• Impact analysis

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Staff Redeployment

• Supplementing staffing needs
• redeployment of staff from other
  locations/clinics, i.e. Outpatient Services  
• Cross-training
• Sample plan This redeployment will necessitate
  cross-training in the following areas Consumer
  records maintenance including change of shift
  logs and medication tracking, meal preparation,
  ..
• Cross- training among administration support
  staff will be necessary to assure that key
  support functions continue

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Elements of Planning

• Delegations of Authority
• Three deep per responsibility
• Geographic dispersion
• Alternate sites of operation
• Likely not needed
• Current specific intervention plans
• Social distancing
• Safe work practices contact interventions
  transmission interventions
• Dispersion of workforce
• Preventive health practices

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Other Elements of Planning

• Accessible facilities/buildings if needed for
  social distancing
• Social distancing techniques
• Medical screening of employees
• Health/medical units
• Sanitation
• Essential services
• Food and water - stockpiles

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Interoperable Communications

• Tele-work Analysis and Development of Capability
  (IT)
• Tele-work Plan
• Identified personnel
• Description of Responsibilities while
  tele-working
• Infrastructure needed to support technological
  assistance
• Test, training, exercise
• Communications Plan
• Staff
• Consumers

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Vital Records

• Consumer CIMOR registration tracking
• Ensure safety welfare of consumers
• Manage fiscal functions
• Confidentiality of consumer records
• Access from remote locations
• Periodic maintenance

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Personnel

• Staff In-Service Needs Education on self-care
  (infection control in the work place, respiratory
  hygiene, hand washing, cough etiquette, tissue
  disposal, etc.), stress management, family care
  plans, personal emotional support, support of
  staff through death of fellow staff, clients,
  family. 
• Who is responsible for developing an in-service?
• Who will deliver the in-service?
• Written materials
• Provision of Infection Control Supplies Cough
  etiquette stations hand cleaner, tissues,
  receptacles for tissue disposal, etc.

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Personnel Policies
Benefit Usage Compensation Over time? Time
off at a later date? Salary and hourly handled
differently?  Return to Work Conditions (Dr.s
note may not be practical.)  Work
Expectations/Duty to Provide Care What are your
expectations? Some will be afraid to risk
exposure by coming in. Think about how to
communicate your expectations to staff.
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Consumer/Client Care

• Education of Consumers
• Written materials should be culturally and
  linguistically appropriate.
• Basic informational brochures in appropriate
  languages
• Education efforts for consumers
• Personal Care (respiratory hygiene, coughing
  etiquette, hand washing)
• Information on the Pandemic Flu and how it is
  spread
• Stress Management Response to anticipated
  fear, anxiety
• Identification of trainers
• Medical Needs of Clients
• On-Going Communication Modes with Clients
• Identify possible modes of communication
  hotline check-in calls to priority clients, web
  site, e-mail, notes if mail delivery etc.

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Transference and Essential Functions

• Leadership succession
• Includes
• Essential functions services
• Rotating operations geographically as applicable
• Supporting tasks
• Points of contact
• Resources and phone numbers

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Reconstitution

• Recovery Operations
• Consolidation of resources to return to fully
  functional
• Replacement of employees
• Building Habitability Plan to restore normal
  functions and services

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Resource Materials Review

• PandemicFlu.gov Workplace Planning and
  Workplace Questions
• U.S. Dept of Labor OSHA Guidance for Protecting
  Employees Against Avian Flu
• Continuity of Operations (COOP) Plan Template and
  Plan Template Instructions
• Key Elements of Departmental Pandemic Influenza
  Operational Plans Standards Guidance for
  Monitoring Functions
• Pandemic Flu Plan Annex How the provider will
  function during a Pandemic Flu Event

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• Reference Materials
• DMH Continuity Plan
• MO DHSS Ready-in-3 materials
• Rhode Island Continuity of Operations
• Federal Emergency Management Agency (FEMA)
• May 2008

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• Contact Information
• Jenny Wiley, Coordinator Disaster Readiness
• Department of Mental Health
• Phone [phone]
• Jenny.wiley_at_dmh.mo.gov
• Teresa Robbins, Assistant Coordinator, Disaster
  Readiness
• Department of Mental Health
• Phone [phone]
• Teresa.robbins_at_dmh.mo.gov