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PLANNING FOR PANDEMIC FLU

PLANNING FOR PANDEMIC FLU. Pandemic influenza is the“the most important threat that we are facing right now.’’. Julie Gerberding, CDC director, 2005. WHY PREPARE?. HOW TO PREPARE?. 1918-1919 influenza pandemic. Worst of past century 20-40% of world population ill

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PLANNING FOR PANDEMIC FLU

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  1. PLANNING FOR PANDEMIC FLU

  2. Pandemic influenza is the“the most important threat that we are facing right now.’’ Julie Gerberding, CDC director, 2005

  3. WHY PREPARE? HOW TO PREPARE?

  4. 1918-1919 influenza pandemic • Worst of past century • 20-40% of world population ill • 40-50 million deaths (600,000 in US) • High mortality in young adults • 15 deaths at Colorado Ag College (enrollment only 300)

  5. October 11, 1918 October 24, 1918 Colorado Ag College closes November 18, 1918 College reopens

  6. Engineering Building, Colorado Agricultural College, 1918

  7. Influenza Virus • Type A: Infects humans and other animals • Causes regular epidemics and pandemics • Type B: Human only • Causes epidemics; less severe illness • Incubation period 1-4 days • Contagious 24 hours before and for 5+ days after onset of symptoms • Spread by respiratory droplets

  8. Seasonal Flu vs Pandemic Flu Seasonal Pandemic Infrequent Occurs every year Occurs during winter Year-round Most recover in 1-2 weeks without tx High mortality Very young, very old, most at risk Young adults at highest risk 250,000 to 500,000 deaths/year globally Higher mortality Affects limited areas (epidemic) Global Virus strains may recur New strain

  9. Why we are concerned now…. • Current avian flu virus similar to 1918 • Virus is evolving • Avian flu is widespread – and spreading – in birds • Sporadic human cases (218 reports to date) of Avian Flu • Most in young and healthy • >50% died • Person-to-person transmission has been rare …so far • Sustained and rapid person-to-person transmission MAY develop, causing a PANDEMIC

  10. Over the past 500 years: • 3 pandemics per century, although (interval variable) • The longest period of time between pandemics is 42 years • It’s now been 38 years since the last influenza pandemic…

  11. Where the birds are

  12. What might happen in a severe pandemic?

  13. If it happens soon… • Little or no vaccine for 6 - 9 months • Very limited supplies of antiviral medicines (enough for ≤1% of population) • All communities hit about the same time We need a plan that does not depend on shots or medicines.

  14. U.S. DHHS planning assumptions • Everyone susceptible • Disease rate ~ 30% • Absenteeism may reach 40% in severe pandemic • Closing schools and businesses and quarantine will affect absenteeism • 50% of ill persons will seek care • The pandemic will last 6-8 weeks in each community

  15. What might occur in a pandemic • Health system overwhelmed • Essential services at risk (fuel, power, water, food, etc.) • “Just-in-time” supply lines disrupted • High death rates • Social disruption (closed schools, no public transportation)

  16. Why we are LESS at risk in 2006 • Better and faster communications • Fewer people in each household • Better medicine and protective equipment • More travel, more daily contact • More elderly and immune-compromised • Fewer excess beds in hospitals • Less self-reliance; we depend on “just-in- time” supplies and imported goods Why at MORE risk in 2006

  17. Overall, are we at more or less risk than in 1918? • Depends on uncontrollable aspects of the virus’s evolution • And on our investment in preparedness

  18. Who will help us? • Little or no state and federal assistance • Local assistance limited • Churches, neighbors, friends and families would need to help each other • Advance planning and stockpiling of necessities could help.

  19. Who will help us? “It will be absolutely essential that local communities are well prepared, have a plan, and have sorted out who will be responsible for what.” Michael Leavitt, U.S. HHS director

  20. What CSU can do: • Maintain Essential Services • Increase Social Distance • Decrease Contact Exposure • Provide Personal Protective Equipment • Teach Protective Actions • Prepare Communication Plan • Educate employees and customers

  21. Maintain Essential Services • Identify essential activities • Cross train to maintain essential services • Create written instructions/procedures for critical processes • If possible, stockpile essential supplies and parts in advance to maintain services.

  22. Increase Social Distance • Determine how to provide services with less person-to-person contact (3 foot rule) • Web-based classes for students • Increase telecommuting for staff • Use phone, web, virtual conferences to replace face-to-face meetings.

  23. Decrease contact exposures • Increase cleaning of doorknobs, faucet handles, keyboards, telephones, etc. • Use/provide tissues, hand sanitizers, disposable gloves (could be scarce) • Masks may reduce exposure, but EFFECTIVENESS UNCERTAIN!

  24. Teach protective actions • Hand washing without recontamination • Covering cough, not using hands • Avoid putting hands to face, mouth, nose, eyes. • Staying home if any signs of illness • Self-care

  25. Prepare Communications Plan • How will administrators and managers communicate among themselves? • How will information be conveyed to students and employees?

  26. Education • Educating university community • Education on symptoms and self-care (especially important for Housing staff) • Information about available services • Approaches • Telephone, e-mail , web-sites, mass media (systems may crash!) • Links to other resources

  27. HHS Pandemic Influenza Plan • Outlines planning assumptions, pandemic preparedness and response • Specific checklists • Other resources: ACHA, NACAS, other institutions, state and county public health officials

  28. State and Local Business Education (K-12) Colleges & Universities Preschool Faith-based & Community Organizations Physician Offices and Ambulatory Care Home Health Emergency Medical Services Travel Industry Families and Individuals Pandemic Influenza Checklists Further information can be found at www.pandemicflu.gov.

  29. WHAT DO WE DO NOW? • Pandemic Influenza Planning Committees • University-wide • Each division and department • Checklists • Define and plan staffing for essential services • Emphasize prevention • Begin communication plans • Educational Briefs on • Flu - seasonal and pandemic • Travel Guidelines • Self-Care

  30. Take home messages • We don’t know when a pandemic will occur or how bad it will be. • Avian flu cases in humans could be sporadic in U.S. That is NOT a pandemic, but will raise fears and stimulate efforts to prepare. • Preparations for a severe pandemic are vital -- not because one is imminent, but because the cost of being unprepared is unacceptable. Hoping for the best is good, but is not an adequate plan.

  31. Take home messages • We can’t stop a pandemic, but we can lessen the harm by planning and preparing Unprepared Impact Prepared Weeks

  32. "Every day a pandemic doesn't happen is another day we have to prepare.”-Michael Osterholm Minnesota State Epidemiologist

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