1. Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
Pandemic Influenza and Schools: Preparing to Respond
Presented by Harris County Public Health& Environmental Services (HCPHES)

2. Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
Learning Objectives
Understand the history and current status of avian influenza and the potential for pandemic influenza
Describe the issues and efforts surrounding preparations for pandemic influenza
Identify components to be included in your district's crisis management and/or pandemic influenza plan
Describe steps districts can take to develop their pandemic influenza plan
Presented by Harris County Public Health& Environmental Services (HCPHES)

3. Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
Outline
Background
Planning for Pandemic Influenza
How Can Schools Prepare?
Developing Your Plan
Questions and Discussion
Evaluation
Presented by Harris County Public Health& Environmental Services (HCPHES)

4. Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
Background
Presented by Harris County Public Health& Environmental Services (HCPHES)

5. Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
Influenza-Speak
Seasonal flu
Avian flu
Pandemic flu
What do they mean? How are they different?
Presented by Harris County Public Health& Environmental Services (HCPHES)

6. Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
Seasonal Flu
Illness in humans caused every year by influenza viruses
e.g. H1N1, H1N2, H3N2 influenza A viruses, influenza B viruses
5%-20% of the U.S. population gets the flu every year
Estimated 36,000 annual deaths in U.S.
Adapted from CDC Influenza (Flu) Key Facts
Presented by Harris County Public Health& Environmental Services (HCPHES)

7. Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
Seasonal Flu
Spread by respiratory droplets (coughing and sneezing)
Usually person-to-person: can infect others from 1 day before getting sick to 5 days after becoming sick
Sometimes from touching infected surfaces
Vaccine offers effective protection
Vaccines are developed to match the viral strains expected to circulate each year
Adapted from CDC Influenza (Flu) Key Facts
Presented by Harris County Public Health& Environmental Services (HCPHES)

8. Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
Avian (Bird) Flu
Illness in birds caused by avian influenza viruses
Low pathogenic types
Highly pathogenic types (e.g. H5N1)
Illness in humans caused by avian influenza viruses
Spread by direct or close contact with infected poultry or contaminated surfaces
No vaccine currently commercially available
Adapted from CDC Influenza (Flu) Key Facts
Presented by Harris County Public Health& Environmental Services (HCPHES)

9. Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
Pandemic Flu
Increased and sustained transmission of influenza in the general population
Generally caused by a “new” influenza virus to which few, if any, people have immunity
New viruses result from new combinations on viral proteins: i.e. a major change in influenza A virus (“antigenic shift”)
Results in viruses that can spread easily from person to person and can cause serious illness due to low levels of immunity in a population
Presented by Harris County Public Health& Environmental Services (HCPHES)

10. Pandemics in the Past 100 Years
Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
Pandemics in the Past 100 Years
: H1N1 influenza A virus
500,000 U.S. deaths
20-50 million worldwide deaths
H1N1 still in circulation today
: H2N2 influenza A virus
70,000 U.S. deaths
: H3N2
32,000 U.S. deaths
H3N2 still in circulation today
Adapted from CDC Influenza (Flu) Key Facts
Presented by Harris County Public Health& Environmental Services (HCPHES)

11. Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
WHO Pandemic Phases
Inter-Pandemic Period
Phase 1: No new influenza virus subtypes have been detected in humans. An influenza virus subtype that has caused human infection may be present in animals. If present in humans, the risk of human infection or disease is considered low
Phase 2: No new influenza virus subtypes have been detected in humans. However, a circulating animal influenza virus subtype poses a substantial risk of human disease
Presented by Harris County Public Health& Environmental Services (HCPHES)

12. Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
WHO Pandemic Phases
Pandemic Alert Period
Phase 3: Human infection(s) with a new subtype, but no human-to-human spread, or at most rare instances of spread to a close contact
Phase 4: Small cluster(s) with limited human-to-human transmission but spread is highly localized, suggesting that the virus is not well adapted to humans
Presented by Harris County Public Health& Environmental Services (HCPHES)

13. Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
WHO Pandemic Phases
Pandemic Alert Period
Phase 5: Larger cluster(s) but human-to-human spread still localized, suggesting that the virus is becoming increasingly better adapted to humans, but may not yet be fully transmissible (substantial pandemic risk)
Pandemic Period
Phase 6: Pandemic occurring – increased and sustained transmission in the general population
Presented by Harris County Public Health& Environmental Services (HCPHES)

14. Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
Current Status
Through February 2007, there have been 273 laboratory-confirmed cases of avian influenza A/H5N1 among humans reported to WHO
167 deaths
11 countries – far and middle east, Indonesia, northern Africa
Avian influenza A/H5N1 has been confirmed in poultry and/or wild birds in these areas as well as India, Russia and Europe
Presented by Harris County Public Health& Environmental Services (HCPHES)

15. Planning for Pandemic Influenza
Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
Planning for Pandemic Influenza
Presented by Harris County Public Health& Environmental Services (HCPHES)

16. Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
Planning Goals
Prevent/minimize morbidity and mortality
Limit disease spread
Mitigate disease, suffering and death
Minimize social disruption
Minimize economic effects
Presented by Harris County Public Health& Environmental Services (HCPHES)

17. Reducing Morbidity and Mortality
Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
Reducing Morbidity and Mortality
Primary strategies for combating pandemic flu
Vaccination
Antiviral medications
Community control measures
Presented by Harris County Public Health& Environmental Services (HCPHES)

18. Primary Strategies - Vaccination
Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
Primary Strategies - Vaccination
Vaccination would be the single most effective intervention, BUT:
Unlikely that a well-matched vaccine will be available when a pandemic begins
Current technology would require 4-6 months for vaccine development after the pandemic begins
Once developed, production capacity would limit availability
Presented by Harris County Public Health& Environmental Services (HCPHES)

19. Primary Strategies - Antivirals
Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
Primary Strategies - Antivirals
Antivirals could be used for both treatment and prophylaxis, BUT:
Effectiveness of current antivirals against a future pandemic strain is unknown
Quantities are limited
Presented by Harris County Public Health& Environmental Services (HCPHES)

20. Primary Strategies – Community Control Measures
Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
Primary Strategies – Community Control Measures
Two approaches:
Decrease the probability that contact will result in infection
Cough etiquette, hand hygiene, infection control
Decrease contact between infected and uninfected individuals
Isolation, quarantine, travel advisories, cancellation of mass gatherings, social distancing, school closures
Presented by Harris County Public Health& Environmental Services (HCPHES)

21. Primary Strategies – Community Control Measures
Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
Primary Strategies – Community Control Measures
These “nonpharmaceutical interventions” will
Help buy time for production and distribution of vaccine
Reduce the total number of cases, thus reducing community morbidity and mortality
Presented by Harris County Public Health& Environmental Services (HCPHES)

22. Primary Strategies – Community Control Measures
Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
Primary Strategies – Community Control Measures
Pandemic outbreak:
no intervention
Daily
cases
With intervention
Days since first case
CDC, 2007
Presented by Harris County Public Health& Environmental Services (HCPHES)

23. Primary Strategies – Community Control Measures
Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
Primary Strategies – Community Control Measures
Collins SD, Frost WH, Gover M, Sydenstricker E:
Mortality from influenza and pneumonia in the 50 largest cities of the United States
First Edition Washington: U.S. Government Printing Office 1930.
Presented by Harris County Public Health& Environmental Services (HCPHES)

24. Primary Strategies: Community Control Measures
Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
Primary Strategies: Community Control Measures
Mayor closes “theaters, moving picture shows, schools, pool and billiard halls, Sunday schools, cabarets, lodges, societies, public funerals, open air meetings, dance halls and conventions until further notice”
Closing order withdrawn
Levins, H. What he knew in 1918 could save millions of lives. St. Louis Post-Dispatch Jul
Presented by Harris County Public Health& Environmental Services (HCPHES)

25. Primary Strategies – Community Control Measures
Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
Primary Strategies – Community Control Measures
Mathematical modeling has shown that closing schools at the outset of a pandemic could decrease attack rates in a community by about 33%
Compared to the attack rate when not implementing any control measures
School closures would likely occur in concert with other control measures
National Academy of Sciences, 2006
Presented by Harris County Public Health& Environmental Services (HCPHES)

26. Primary Strategies – Community Control Measures
Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
Primary Strategies – Community Control Measures
Recommendations for closing schools will depend upon the severity of the pandemic. For example:
Category 1 – no closure
Category 2 & 3 – short-term closure (~4 weeks)
Category 4 & 5 – longer-term closure (~12 weeks)
CDC, 2007
Presented by Harris County Public Health& Environmental Services (HCPHES)

27. Who will implement these strategies?
Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
Who will implement these strategies?
Presented by Harris County Public Health& Environmental Services (HCPHES)

28. Public Health Officials
Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
Public Health Officials
Federal, state and local public health agencies maintain the lead role in preparing for and responding to pandemic influenza
Examples
Federal – Centers for Disease Control and Prevention (CDC)
State – Texas Department of State Health Services (TDSHS)
Local – Harris County Public Health & Environmental Services (HCPHES)
Presented by Harris County Public Health& Environmental Services (HCPHES)

29. Public Health’s Authority
Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
Public Health’s Authority
Chapter 81 of the Texas Health and Safety Code establishes the role of the health authority, a physician appointed to administer laws related to public health within their jurisdiction
Including laws related to community control measures
Such measures include isolation, quarantine, immunization, detention, restriction, disinfection, decontamination, disinfestation, chemoprophylaxis, preventive therapy, prevention and education
Presented by Harris County Public Health& Environmental Services (HCPHES)

30. Public Health’s Authority
Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
Public Health’s Authority
The authority to compel disease control measures is derived from the state’s inherent “police powers”
Police powers refer to the authority of a state government to enact laws and promote regulations to safeguard the health, safety and welfare of its citizens
Presented by Harris County Public Health& Environmental Services (HCPHES)

31. Public Health’s Authority
Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
Public Health’s Authority
There are 172 local health authorities in Texas, many affiliated with local health departments
Areas without local health authorities are “covered” by TDSHS regional health authorities
Contact TDSHS Region 6/5S for your local health authority
(713)
Presented by Harris County Public Health& Environmental Services (HCPHES)

32. Public Health and Pandemic Planning
Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
Public Health and Pandemic Planning
Presented by Harris County Public Health& Environmental Services (HCPHES)

33. Roles and Responsibilities
Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
Roles and Responsibilities
Federal Agencies (CDC, etc.)
Supporting the establishment of stockpiles of vaccines and antivirals
Facilitating (and funding) state and local planning
Providing guidance to the private sector
Overall domestic incident management
TDSHS
Developing and exercising preparedness and response plans
Managing federal pandemic preparedness grant funding to local agencies
Maintaining state-purchased stockpiles of medications
Presented by Harris County Public Health& Environmental Services (HCPHES)

34. Roles and Responsibilities
Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
Roles and Responsibilities
Local Health Departments
Developing and exercising preparedness and response plans
Integrating non-health entities in pandemic planning
Providing education to the public and other key stakeholders on pandemic influenza
Monitoring local disease status
Providing local incident management
In Texas, decision-making regarding pandemic influenza will be made at the local level
Presented by Harris County Public Health& Environmental Services (HCPHES)

35. Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
Assumptions
30% of population may become ill
15% of population will seek outpatient care
0.3 to 3% of population will be hospitalized
0.07 to 0.64% of population may die
Presented by Harris County Public Health& Environmental Services (HCPHES)

36. Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
Assumptions
The duration of illness for an uncomplicated case of influenza is five days
Medical care services may be severely taxed or overwhelmed
Illness rates may be up to 40% among school-aged children and 20% among working adults
30% or more of the workforce may be out of work due to illness at the peak of a major pandemic influenza wave.
This includes work loss while caring for oneself or for ill family members
Presented by Harris County Public Health& Environmental Services (HCPHES)

37. Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
Surveillance
In addition to conducting year-round monitoring of influenza in the health-care sector, DSHS collaborates with schools to track reports of influenza-like illness among students
Participating schools submit weekly reports of influenza-like illness activity to via fax
Presented by Harris County Public Health& Environmental Services (HCPHES)

38. Prevention/Containment
Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
Prevention/Containment
Discusses local plans for the three strategies of pandemic prevention and containment:
Vaccines
Antivirals
Community Control Measures
Presented by Harris County Public Health& Environmental Services (HCPHES)

39. Vaccines and Antivirals
Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
Vaccines and Antivirals
DSHS will coordinate decision-making regarding vaccine and antiviral allocation
Once vaccines are available, DSHS 6/5S will implement its Mass Vaccination Plan to provide flu vaccine to the public
Once antivirals are widely available, DSHS 6/5S will implement its Mass Dispensing Plan to provide public sector distribution of antivirals
Presented by Harris County Public Health& Environmental Services (HCPHES)

40. Community Control Measures
Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
Community Control Measures
DSHS in coordination with local health authorities will develop and enact control measures within jurisdictions. Examples:
Isolation and quarantine
Social distancing
Cancelling mass gatherings
Closing schools
The types of measures implemented will depend upon the location of cases, size of clusters, availability of vaccine, pandemic severity, etc.
Measures will be undertaken in coordination with other local, state and federal officials
Presented by Harris County Public Health& Environmental Services (HCPHES)

41. Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
What’s Your Plan?
Contact DSHS Region 6/5S to obtain your area’s pandemic influenza plan
(713)
Presented by Harris County Public Health& Environmental Services (HCPHES)

42. How Can Schools Prepare?
Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
How Can Schools Prepare?
Presented by Harris County Public Health& Environmental Services (HCPHES)

43. Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
School Planning
Schools face several unique challenges:
Planning assumptions estimate that in the absence of intervention, illness rates would be highest among school-aged children (~40%)
Children may be more likely to spread influenza than adults
Unlike many sectors, schools must focus upon protecting their workforce AND their students
Schools must address continuity of instruction
Presented by Harris County Public Health& Environmental Services (HCPHES)

44. Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
School Planning
Every Independent School District (or the equivalent) should ensure plans to protect the health and safety of their staff and students during a pandemic
Plans should build upon existing Emergency Operations Plans (EOPs)
Presented by Harris County Public Health& Environmental Services (HCPHES)

45. Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
School Planning
The U.S. Department of Education’s Practical Information on Crisis Planning: A Guide for Schools and Communities is a useful tool for developing and enhancing EOPs
Presented by Harris County Public Health& Environmental Services (HCPHES)

46. Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
School Planning
Four domains must be considered when developing plans to prepare for and respond to pandemic influenza:
Planning and Coordination
Infection Control Policies and Procedures
Continuity of Core Operations and Student Instruction
Communications
Presented by Harris County Public Health& Environmental Services (HCPHES)

47. 1. Planning and Coordination
Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
1. Planning and Coordination
Planning and coordination refers to:
Determining who is responsible for making decisions related to the response to a pandemic
Carrying out activities before, during and after a pandemic
Developing and maintaining the response plan
Presented by Harris County Public Health& Environmental Services (HCPHES)

48. 1. Planning and Coordination
Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
1. Planning and Coordination
Key activities:
Identify the authorities responsible for executing community response plans and activities, including case identification, isolation, quarantine and community control measures
On Page 1 of its Pandemic Influenza Plan, Tomball ISD describes the role of HCPHES, references the HCPHES pandemic influenza plan and lists HCPHES contact information
Presented by Harris County Public Health& Environmental Services (HCPHES)

49. 1. Planning and Coordination
Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
1. Planning and Coordination
Key activities:
Identify the authority responsible for activating the district’s pandemic influenza plan
Provide the contact information for this person(s) to the public health authority so that information regarding community control measures can be communicated efficiently
Presented by Harris County Public Health& Environmental Services (HCPHES)

50. 1. Planning and Coordination
Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
1. Planning and Coordination
Key activities:
Address pandemic influenza preparedness as part of your district’s crisis management plan
Involve all relevant stakeholders
Delineate accountability and responsibility
Coordinate with other relevant response plans
Establish an organizational structure to manage the execution of the plan, such as an Incident Command Structure – see page 6-19 of the DOE guide
Presented by Harris County Public Health& Environmental Services (HCPHES)

51. 1. Planning and Coordination
Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
1. Planning and Coordination
Key activities:
Test your pandemic plan
Implement an internal exercise/drill
Participate in exercises of the community’s plan
Periodically revise your plan
Presented by Harris County Public Health& Environmental Services (HCPHES)

52. Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
2. Infection Control
Infection control refers to:
Decreasing the probability that contact will result in infection
Decreasing contact between infected and uninfected individuals
Presented by Harris County Public Health& Environmental Services (HCPHES)

53. Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
2. Infection Control
Key activities:
Implement policies and procedures that can limit the spread of influenza at school
Promote of hand hygiene and cough etiquette
Ensure appropriate supplies are available – soap, tissues, hand sanitizer, waste baskets
Limit face-to-face contact, when possible
Making good hygiene a habit now can help protect children from many infectious diseases, including flu
Presented by Harris County Public Health& Environmental Services (HCPHES)

54. Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
2. Infection Control
Sample policy language from the HCPHES Occupational Health and Safety Manual:
“Following Centers for Disease Control and Prevention (CDC) hand hygiene guidelines, all HCPHES staff will maintain hand hygiene including, but not limited to, hand washing.  HCPHES will ensure that hand hygiene facilities and supplies are readily accessible”
Presented by Harris County Public Health& Environmental Services (HCPHES)

55. Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
2. Infection Control
Houston’s Grace School has permanently posted handwashing and cough etiquette signs in each restroom and classroom
The school nurse provides classroom instruction on proper handwashing techniques
Presented by Harris County Public Health& Environmental Services (HCPHES)

56. Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
2. Infection Control
Hand hygiene and cough etiquette resources
CDC/DHHS hand hygiene materials targeted to schools -
CDC hand hygiene guidelines -
CDC “Germstopper” campaign –
CDC “Cover Your Cough” campaign -
Presented by Harris County Public Health& Environmental Services (HCPHES)

57. Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
2. Infection Control
At this time, the benefit of wearing disposable surgical masks by asymptomatic persons in a community setting (such as a school) has not been demonstrated to decrease infections during a community outbreak
However, you may anticipate that persons at risk may choose to obtain and wear such masks
Presented by Harris County Public Health& Environmental Services (HCPHES)

58. Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
2. Infection Control
Key activities:
Establish special policies and procedures regarding absenteeism that may be unique to a pandemic situation
Non-punitive absenteeism policies for students
Relaxed and/or enhanced sick leave and absenteeism policies for employees
Presented by Harris County Public Health& Environmental Services (HCPHES)

59. Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
2. Infection Control
Sample policy language:
“During times of a declared public health emergency and/or large-scale disease outbreak, the district may suspend district policies that penalize students for excessive student absenteeism”
“During times of a declared public health emergency and/or large-scale disease outbreak, the district may suspend district programs regarding perfect attendance achievement”
Presented by Harris County Public Health& Environmental Services (HCPHES)

60. Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
2. Infection Control
Sample policy language:
“During times of a declared public health emergency and/or large-scale disease outbreak and school remains in session, the district may suspend district policies or temporarily adopt alternate policies regarding staff sick leave and absenteeism”
Example - Harris County has a policy that allows 24 hours of sick leave per year to be used to care for ill family members. This type of policy could be waived or expanded during a pandemic
Presented by Harris County Public Health& Environmental Services (HCPHES)

61. Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
2. Infection Control
Key activities:
Establish special policies and procedures for staff and students suspected to be ill or who become ill at school, including policies for returning to school
Grace School amended its policies to require that an employee or student must be fever-free for 24 hours without the use of fever-reducing medicine prior to returning to school
Establish policies for transporting ill students and staff
Presented by Harris County Public Health& Environmental Services (HCPHES)

62. Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
2. Infection Control
Sample policy language:
“Staff and students with a known or suspected communicable disease should not remain at school and should return only after symptoms resolve and they are physically ready. Certification of fitness for duty by a medical professional may be required”
Consider allowing for modification during a pandemic to encourage home quarantine if a family member is ill
Presented by Harris County Public Health& Environmental Services (HCPHES)

63. Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
2. Infection Control
Key activities:
Ensure that school-based health facilities follow national infection control guidelines
See for specific guidance regarding infection control procedures for healthcare facilities during a pandemic
Presented by Harris County Public Health& Environmental Services (HCPHES)

64. 3. Continuity of Operations and Instruction
Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
3. Continuity of Operations and Instruction
Continuity of operations refers to ensuring that the capability exists to continue essential agency functions when faced with high absenteeism or temporary school closure
Continuity of instruction refers to minimizing the potential disruption to student learning
Presented by Harris County Public Health& Environmental Services (HCPHES)

65. 3. Continuity of Operations and Instruction
Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
3. Continuity of Operations and Instruction
Key activities:
Develop a continuity of operations plan (COOP) for essential central office functions
Payroll
Communication with staff, students and parents
The basic elements of a COOP can be found at
Presented by Harris County Public Health& Environmental Services (HCPHES)

66. 3. Continuity of Operations and Instruction
Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
3. Continuity of Operations and Instruction
Key activities:
Develop scenarios describing the potential impact of a pandemic on student learning, school closings and extracurricular activities
Based on various levels of illness and absenteeism, and different mandates from public health authorities
Brainstorm possible alternatives and solutions for each scenario
Presented by Harris County Public Health& Environmental Services (HCPHES)

67. 3. Continuity of Operations and Instruction
Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
3. Continuity of Operations and Instruction
Possible scenarios:
Your public health authority recommends heightening adherence to hand hygiene and cough etiquette and limiting face-to-face contact
Your public health authority recommends cancellation of large group gatherings
Your district is experiencing a 15% absenteeism rate among staff and 20% among students
Your public health authority recommends school closures for twelve weeks
Presented by Harris County Public Health& Environmental Services (HCPHES)

68. 3. Continuity of Operations and Instruction
Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
3. Continuity of Operations and Instruction
Tomball ISD’s plan contains a flow chart describing action steps for each of the following scenarios:
Less than 10% of students absent
Letter to parents, heightened surveillance, heightened infection control, etc.
10%-29% of students absent
30% or more of students absent
Presented by Harris County Public Health& Environmental Services (HCPHES)

69. 3. Continuity of Operations and Instruction
Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
3. Continuity of Operations and Instruction
Key activities:
Brainstorm alternate methods to provide instruction to students in the event of high absenteeism or temporary school closure
Tomball ISD plans to use its website and “homework hotlines” to disseminate lesson plans, with tutorials conducted through its website, s and instant messaging
Grace School will extend the school year
Presented by Harris County Public Health& Environmental Services (HCPHES)

70. Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
4. Communications
Communications planning refers to ensuring accurate and timely information regarding the impact of the pandemic on your operations
Also refers to assisting public health authorities with disseminating messages to the public
Schools are a trusted source of information within their communities
Presented by Harris County Public Health& Environmental Services (HCPHES)

71. Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
4. Communications
Key activities:
Develop a plan to disseminate information to staff, students and families
Designate a lead spokesperson
Incorporate links to other communication networks
Ensure language, culture and reading level appropriateness
Presented by Harris County Public Health& Environmental Services (HCPHES)

72. Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
4. Communications
Key activities:
Develop and test any methods for communicating to staff, students and families during a pandemic
Tomball ISD has developed templates for press releases, letters to parents and talking points for school officials in English and Spanish
Grace School has developed templates for blast alerts and “canned” answering machine messages
Presented by Harris County Public Health& Environmental Services (HCPHES)

73. Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
4. Communications
Key activities:
Maintain updated communication contacts of key public health and education stakeholders
Provide updated status information to these contacts during a pandemic as necessary, including absenteeism rates due to influenza
Presented by Harris County Public Health& Environmental Services (HCPHES)

74. Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
4. Communications
Key activities:
Inform staff, students and families where they can find up-to-date and reliable pandemic information
State website -
Federal website -
Presented by Harris County Public Health& Environmental Services (HCPHES)

75. Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
4. Communications
Key activities:
Disseminate information from public health sources about important pandemic topics:
Infection control (hand hygiene, cough etiquette)
Disease basics (signs and symptoms, modes of transmission)
Personal and family protection strategies (family preparedness, at-home care of ill family members)
Tomball ISD has developed templates of letters to parents about family preparedness, caring for ill persons at home and stress/crisis management
Presented by Harris County Public Health& Environmental Services (HCPHES)

76. Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
4. Communications
Remember to anticipate the potential fear, stress and anxiety of staff, students and families
If possible, minimize rumors and the circulation of misinformation
Share your plan with all stakeholders BEFORE a pandemic situation
Presented by Harris County Public Health& Environmental Services (HCPHES)

77. Developing Your Plan: Next Steps
Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
Developing Your Plan: Next Steps
Presented by Harris County Public Health& Environmental Services (HCPHES)

78. Developing Your Plan: Next Steps
Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
Developing Your Plan: Next Steps
Identify and engage stakeholders (internal/ external) to be included in planning
Determine areas of overlap with EOP
Develop action plan and timelines for new items
Share draft plan with your public health department for feedback (if desired)
Present completed plan to School Board for approval
Communicate plan to others
Presented by Harris County Public Health& Environmental Services (HCPHES)

79. Identify and Engage Stakeholders
Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
Identify and Engage Stakeholders
Who will assist with preparing, responding and recovering from an event?
Director of Risk Management
Superintendent
Director of Health Services
Director of Human Resources
Director of Curriculum & Instruction
Principals (elementary, middle, high school)
Teachers
Counselors/Mental Health professionals
Director of Administrative Services
Director of Transportation
Public Health
Director of Child Nutrition
Director of Maintenance
Office of Public Information
Local Emergency Response
Local Law Enforcement
Director of Technology
Parent representatives
Presented by Harris County Public Health& Environmental Services (HCPHES)

80. Develop Action Plan & Timeline
Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
Develop Action Plan & Timeline
Key activities:
Delineate roles and responsibilities for key stakeholders engaged in planning and executing specific components of the plan.
Develop Action Plan using the Pandemic Influenza Planning Tool
Ensure timelines are determined
Completion by the beginning of the ’07-’08 school year is recommended
Presented by Harris County Public Health& Environmental Services (HCPHES)

81. Pandemic Influenza Planning Tool
Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
Pandemic Influenza Planning Tool
Mitigation and Prevention
Task
Responsible Person(s)
Existing Resources
Next Steps
Timeline
Identify or create district committee to provide guidance to school sites regarding pandemic flu preparations
Example: Jim (Director of Risk Management)
EOP Strategic Planning Work Group developed EOP last year.
Identify and contact district stakeholders and schedule a time to meet.
March 14, 2007
Review district emergency response and communicable disease policies and procedure
Director of Risk Management & other key stakeholders
EOP developed last year with an existing communicable disease plan.
Stakeholders to review additional needs re: Pan Flu planning for their department.
April 2, 2007
Determine if any additional policies/procedures need to be in place
All key stakeholder stakeholders
EOP
Suggested Pan Flu policies and procedures
Stakeholders will outline further areas for development.
Develop communications plan for possible school closures
Work with Human Resources regarding schools functioning with 30% of work force absent. Look at alternatives such as staggered school times, changes in bussing, and telecommunications
Assess financial impact of alternate scheduling or school closures
Planning and Coordination
Infection Control Policies and Procedures
Continuity of Core Operations and Student Instruction
Communications
Presented by Harris County Public Health& Environmental Services (HCPHES)

82. Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
Resources
School District Pandemic Influenza Planning Checklist -
Pandemic Influenza Community Mitigation Interim Planning Guide for Elementary and Secondary Schools (see p. 87) -
Pandemic Flu: A Planning Guide for Educators -
Practical Information for Crisis Planning: A Guide for Schools and Communities -
Presented by Harris County Public Health& Environmental Services (HCPHES)

83. Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
Resources
Contra Costa Health Services Pandemic Flu School Action Kit –
Texas A&M Center for Rural Public Health Preparedness Pandemic Flu Toolkit Training – CD provided at registration table
HCPHES School Pandemic Flu Preparedness PowerPoint Template –
Presented by Harris County Public Health& Environmental Services (HCPHES)

84. Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
Recognition
Special thanks to Harris County Department of Public Health and Environmental Services for the use of this presentation.
Presented by Harris County Public Health& Environmental Services (HCPHES)

85. Pandemic Influenza and Schools: Preparing to Respond
February 27, 2007
Questions?
Brian Winegar, MPH
Public Health Preparedness Program
Presented by Harris County Public Health& Environmental Services (HCPHES)