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Schools’ Pandemic Influenza & Public Health Emergency Exercise Program

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Presentation on theme: "Schools’ Pandemic Influenza & Public Health Emergency Exercise Program"— Presentation transcript:

1 Schools’ Pandemic Influenza & Public Health Emergency Exercise Program
EXERCISE NAME A part of the LACOE Series sponsored by the Los Angeles County Department of Public Health EXERCISE DATE

2 Welcome & Introductions

3 Exercise Logistics Phones, Pagers, Blackberries, iPhones, etc.
Restrooms Refreshments Parking Validation Seating Arrangements

4 Situation Manual Exercise Schedule Introduction
Module 1:Pandemic Outbreak Overseas Module 2: Outbreak in the U.S. Module 3: Outbreak in LA County Schools Appendices Acronyms & Glossary of Terms Toolkit Overview The PSI & Student Dismissal/Social Distancing FAQs Pandemic Influenza & COI Resources Presentations and Notes Pages Walk through SITMAN Meant to serve as a resource during and AFTER the exercise Point out CD Information is provided in the order that it is presented Please follow along in your SITMAN Slides = overview; SITMAN = Supplemental information

5 Feedback Form Broken down by Exercise Section/Module
Record Notes, Thoughts, Issues, Strengths, Recommendations Complete throughout exercise Be thorough Turn in at the conclusion of the exercise Does everyone have one?

6 A detailed agenda can be found under the “Exercise Schedule” tab.
8:00 am – Welcome and Introduction 8:20 am – Presentation Presentation Name 8:50 am – Presentation 9:10 am – Presentation 9:30 am – Break 9:40 am – Module 1: Pandemic Outbreak Overseas 10:20 am – Module 2: Outbreak in the U.S. 11:05 am – Module 3: Reported Cases within LA County Schools 11:50 am – Evaluations and Closing Remarks A detailed agenda can be found under the “Exercise Schedule” tab.

7 Exercise Overview

8 Exercise Program Overview
The Schools’ Pandemic Influenza and Public Health Emergency Exercise Program is sponsored by LACDPH and is being conducted to: Facilitate partnerships, communication and coordination between schools, school districts and LACDPH; and To increase awareness of the issues regarding planning for and responding to an influenza pandemic or other public health emergency. Please turn to page 5 in your SITMAN 8

9 Exercise Scope This exercise will focus on the roles of LACDPH, LACOE and individual schools in mitigating, preparing for, and responding to, a potential influenza pandemic or other infectious disease outbreak. Participants should focus on the overall big picture rather than the minute details. The emphasis will be on coordination, integration of capabilities, and intra-/inter-agency communication. Please turn to page 6 in your SITMAN

10 Exercise Purpose The purpose of this exercise is to provide participants an opportunity to assess current capabilities for an influenza pandemic or other public health emergency in Los Angeles County. The exercise will focus on the policies and procedures that guide public health, schools and LACOE in command and control coordination, critical decisions, notifications, and the integration of external assets necessary to save lives and protect public health and safety. The role of public information strategies will also be critical to the overall response effort. Please turn to page 6 in your SITMAN 10

11 Goal To provide relevant, timely and useful information to school districts in Los Angeles County to enhance schools’ ability to mitigate, prepare for, and respond to an influenza pandemic or other public health emergency. Please turn to page 8 in your SITMAN

12 Objectives Familiarize participants with the specific roles, responsibilities and capabilities of LACDPH and LACOE in managing the response to an influenza pandemic or other public health emergency. Discuss the issues, concerns and impact regarding potential social distancing measures and school closure/distance learning strategies. Please turn to page 8 in your SITMAN

13 Objectives (cont.) Present ideas, methodologies and materials regarding pandemic influenza and other public health emergencies to assist schools in educating children, parents, teachers, support staff, and administrators. Please turn to page 8 in your SITMAN

14 Exercise Structure Presentations Scenario & Discussion
Facilitated Feedback Evaluation & Adjournment

15 Informational Presentations

16 Please return in 10 minutes.
BREAK Please return in 10 minutes. gimme a break!

17 Schools’ Toolkit

18 Schools’ Toolkit Purpose
The purpose of the Schools’ Toolkit is to assist schools and school districts in Los Angeles County to mitigate, prepare for, respond to, and recover from an influenza pandemic or other public health emergency. Structure & Layout Master Administrator Toolkit Note: Toolkit provided via CD-ROM in your SITMAN.

19 Schools’ Toolkit Parent & Staff Letters
Disease Catalogue that provides approved language for a number of public health diseases of concern to schools, such as pandemic influenza and MRSA FAQs for each disease in the Catalogue COOP information Informational Posters PowerPoint Presentations NIMS/ICS resources Annotated index describing the Toolkit elements Introduction that explains how to use the Toolkit

20 Exercise Scenario

21 Roles and Responsibilities
Participants respond to the situation presented based on expert knowledge of plans and procedures. Observers support the discussion groups as they develop responses to the situation in the caucus sessions. Facilitators provide situation updates and moderate discussions.

22 Assumptions/Artificialities
Scenario is based upon a pandemic influenza outbreak; but the exercise takes an all-hazards approach. Scenario time period: September 2008 and continues through March 2009. Scenario is plausible and events occur as presented. Use existing plans, policies, procedures. In any exercise, a number of assumptions and artificialities may be necessary to complete play in the time allotted. These apply. Also, There are no “trick questions”!

23 Ground Rules Exercise Ground Rules This is a safe, open environment.
there is no “textbook” solution. Keep the goals and objectives in mind. Treat the scenario as real. Play your role. Participate openly. respect the observations, opinions and perspectives of others. This is an opportunity to discuss and present multiple options and possible solutions. Ask questions, share thoughts, offer solutions. Stay focused. Ground Rules

24

25 Background Pandemics occur cyclically: 3 in the 20th Century
Experts agree: We are long overdue Bird/Avian Flu (H5N1) incited global concern in recent years. 1997 Hong Kong Outbreak (6 deaths) WHO Alert Phase 3 since November 2005. 1918 “Spanish Flu” – 20-40M deaths worldwide; 546,000 in US The “Asian Flu” pandemic of 1957 killed 2M globally; 70,000 in U.S. 1968, “Hong Kong Flu” killed 1M globally; 34,000 in the U.S. 1997: Hong Kong Outbreak of Avian Influenza A (H5N1) virus. Infected domestic poultry and humans 18 hospitalizations and 6 deaths. Since then, other outbreaks of avian viruses (H9N2 in 1999, H7N2 in 2002, H7N7 in 2003, and H5N1 again in 2004) have occurred and have been found to directly infect people.

26 Background Schools are potential sites for the spread of disease, including influenza. Schools are an information source for community residents. Schools are sources of valuable resources for emergency response. Schools are sources of health monitoring information. 1918 “Spanish Flu” – 20-40M deaths worldwide; 546,000 in US The “Asian Flu” pandemic of 1957 killed 2M globally; 70,000 in U.S. 1968, “Hong Kong Flu” killed 1M globally; 34,000 in the U.S. 1997: Hong Kong Outbreak of Avian Influenza A (H5N1) virus. Infected domestic poultry and humans 18 hospitalizations and 6 deaths. Since then, other outbreaks of avian viruses (H9N2 in 1999, H7N2 in 2002, H7N7 in 2003, and H5N1 again in 2004) have occurred and have been found to directly infect people. 26

27 September 2008 Human-to-human transmission of avian influenza – 8 cases total. Viral cultures collected are identified as type AH7N1, a subtype never before isolated in humans. Chain of infection began with a 37-year old woman exposed to dead poultry & chicken feces. She passed the virus to her 10-year old nephew who then passed it on to his father. The World Health Organization (WHO) Director General indicated that the findings were based on an analysis of a cluster of eight flu cases in northern Sumatra. “Using a computerized disease-transmission model … our scientists… produced the first statistical confirmation that humans have contracted the disease from each other rather than birds.” This strain has characteristics similar to the strain that caused the 1918 pandemic. The vaccination, in its current form, is unlikely to prevent infection, but may reduce the severity of illness.

28 September/October 2008 A containment strategy was implemented, however, several additional cases were reported. The WHO solicits Tamiflu donations, while the CDC begins work on a reference strain for vaccine. Riots begin to occur in major cities throughout Southeast Asia. The Indonesian government asks the U.S. for vaccine and antiviral drugs. The Centers for Disease Control and Prevention (CDC) indicates that it will be at least 3-6 months before a vaccine will be available. Key U.S. government officials are briefed on a daily basis as surveillance is intensified. The WHO has indicated that the rapidly adaptive H7N1 strain is efficiently transmitted human to human.  

29 September/October 2008 Additional outbreaks are confirmed throughout Southeast Asia at an average attack rate of 30%. The novel influenza virus begins to make headlines worldwide and becomes the lead story on major U.S. new networks and newspapers. WHO investigations indicate extensive person to person transmission and multiple strains.

30 October 2008 In the U.S., pre-pandemic vaccine and antiviral stockpiles are deployed as supplies allow. The WHO notifies the CDC and other national health agencies of the progress of the pandemic. LACDPH coordinates with school districts to review pandemic guidance documents. LACOE Superintendent schedules an impromptu conference call to discuss preparedness measures.

31 Reported Cases of Pandemic Influenza, as of November, 2008:
Casualties Reported Cases of Pandemic Influenza, as of November, 2008: Worldwide 1,090 436 381 U.S. Additional scenario information in your SITMAN if needed for reference.

32 Breakout Group Session
You have 25 minutes to discuss the questions. Select a spokesperson. Your facilitator will let you know which questions to focus on. Identify: Additional Questions Critical Issues Decisions to be addressed Record notes on the Evaluation & Feedback Form. Focus on Strengths & Areas for Improvement Use the information available & make the best decision possible. Elect a different group spokesperson if desired You are NOT required to address every question. Review each question thoroughly and then focus on areas of major concern for your group at this point in the exercise. Make the best possible decision based on the available information. Use your Feedback & Evaluation Forms – KEY!!!

33 Discussion Session

34 Feedback Session

35

36 November/December 08 The WHO recommends that each country implement its pandemic plan. Meanwhile, influenza continues to spread throughout Southeast Asia. An unusually severe influenza cluster is identified in 5 individuals living in Miami, FL. More cases identified in Europe, Africa, and Canada. Diagnostic reagents for the pandemic virus are deployed to all laboratories. Laboratory tests from the Miami cases are positive for influenza A; however, the subtype is not H1 or H3 by Hemagglutinin Inhibition test. Consequently, it is suspected to be a novel strain, and the isolates are referred urgently to a CDC collaborating center.

37 December 08/January 09 CDC confirms the pandemic strain in Miami.
Several U.S. cities and transportation hubs begin to report cases; reaching as far west as Texas. The local press contacts LACOE for a statement. Discussions take place at the Federal and State levels with unions and professional associations of educators, administrators & school boards regarding the unfolding events. LACOE maintains a proactive posture. Thus far, five confirmed cases have been identified in Miami. All five individuals have been hospitalized, and two have died. Additional human cases are reported throughout Europe and Africa, and in other parts of North America – namely Canada and Mexico. Emergency services in cities where cases have been identified are severely impacted. The overall rate of illness in affected areas ranges between 20% and 40%. LACOE encourages use of the Schools Toolkit to send informational letters to parents and encourages healthy habits such as “cover your cough”.

38 Reported Cases of Pandemic Influenza, as of January, 2009:
Casualties Reported Cases of Pandemic Influenza, as of January, 2009: Worldwide 183,750,041 61,250,035 5,145,006 U.S. 10,375,082 1,125,006 241,509 Los Angeles County Additional scenario information in your SITMAN if needed for reference.

39 Discussion Session You have 25 minutes to discuss the questions.
Select a spokesperson. Your facilitator will let you know which questions to focus on. Identify: Additional Questions Critical Issues Decisions to be addressed Record notes on the Evaluation & Feedback Form. Focus on Strengths & Areas for Improvement Use the information available & make the best decision possible. Elect a different group spokesperson if desired You are NOT required to address every question. Review each question thoroughly and then focus on areas of major concern for your group at this point in the exercise. Make the best possible decision based on the available information. Use your Feedback & Evaluation Forms – KEY!!!

40 Discussion Session

41 Feedback Session

42

43 February 2009 Pandemic influenza is confirmed in CA, with over a dozen confirmed cases within Los Angeles County schools. A Public Health Emergency is proclaimed by the LAC Health Officer. First case was identified at West Angeles Elementary School in Santa Monica where a 5th grader was sent to the nurses office for ILI. CEOC, REOC and SOC activated.

44 February 2009 Emergency Operations Centers (EOC) are activated at the State and local levels. Order to dismiss students from all schools is issued. Staff will continue to be paid under the disaster proclamation.

45 February 2009 The State issues the following guidance –
Individual services may be reduced or discontinued. Meals, school projects/assignments and phone tutoring may be modified. Delivery of health-social service programs should be re-evaluated. Continuing learning methodologies should be evaluated for implementation. School superintendents are working with school districts and health officials to facilitate coordination.

46 March 2009 2% of Americans infected with H7N1 die.
Hospitals are overwhelmed and staff shortages limited capacity at the height of the outbreak. Parents appeal to the media regarding their growing concerns of child safety once schools reopen. Rumors and misinformation are abundant among several internet sources frequented by students, such as MySpace and Facebook.

47 Reported Cases of Pandemic Influenza, as of March, 2009:
Casualties Reported Cases of Pandemic Influenza, as of March, 2009: Worldwide 551,250,041 183,750,041 15,435,006 U.S. 31,125,082 3,375,021 724,560 Los Angeles County 95,172 10,575 2,220 Additional scenario information in your SITMAN if needed for reference.

48 Discussion Session You have 25 minutes to discuss the questions.
Select a spokesperson. Your facilitator will let you know which questions to focus on. Identify: Additional Questions Critical Issues Decisions to be addressed Record notes on the Evaluation & Feedback Form. Focus on Strengths & Areas for Improvement Use the information available & make the best decision possible. Elect a different group spokesperson if desired You are NOT required to address every question. Review each question thoroughly and then focus on areas of major concern for your group at this point in the exercise. Make the best possible decision based on the available information. Use your Feedback & Evaluation Forms – KEY!!!

49 Discussion Session

50 Feedback Session

51 After-Action Report Lists strengths and makes actionable recommendations for improvement Data collected via Evaluation Documents and Evaluators Provided to exercise planning team for revision and approval Contact lead agencies to obtain a copy

52 Feedback Form Remember to Record: Notes Thoughts Issues Strengths
Recommendations

53 Concluding Remarks

54 Thank you for your participation!
Please remember to turn in: Feedback & Evaluation Forms Post-Exercise Survey


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