1. Pandemic Influenza: A Primer for Organizational Preparation Pandemic Influenza: A Primer for Organizational Preparation Kristine Perkins, MPH Director, Office of Public Health Emergency Preparedness Maine Center for Disease Control and Prevention

2. Public Health plays a major role in Emergency Preparedness Protect the health of communities from natural Protect the health of communities from natural and manmade disasters Serves as the nations first line of defense against numerous threats such as: Serves as the nations first line of defense against numerous threats such as: Infectious disease Infectious disease Food borne and water borne illness Food borne and water borne illness Biological, chemical, radiological attack Biological, chemical, radiological attack Overview

3. What is Avian Influenza ? Bird Flu A viral infection caused by avian (bird) influenza normally a subtype of a type A influenza virus Occurring naturally among birds (low pathogenic and high pathogenic) Often carried by wild birds in their intestines Can cause domestic birds, including chickens to become very ill and die Occasionally some strains can infect

4. What is Pandemic Influenza? Pandemic Influenza is a widespread outbreak of a new influenza virus that humans have no immunity to thus causing a global outbreak of serious illness that spreads easily from person to person. Currently, there is no pandemic flu.

6. What if … An Influenza Pandemic Struck Maine State population: 1,274,923 State population: 1,274,923 Number of ill persons: 382,477 (30% attack rate) Number of ill persons: 382,477 (30% attack rate) Number of persons seeking outpatient care 167,405 (50% of those ill minus persons who are hospitalized or die) Number of persons seeking outpatient care 167,405 (50% of those ill minus persons who are hospitalized or die) Number of persons hospitalized: 38,582 (range: 14,549- 48,699) Number of persons hospitalized: 38,582 (range: 14,549- 48,699) Number of deaths: 9,086 (range: 5,421 -- 14,837) Number of deaths: 9,086 (range: 5,421 -- 14,837)

7. Community Impact Hospitals working to capacity/ turning away some ill Hospitals working to capacity/ turning away some ill Alternate care sites limited—homecare is the norm Alternate care sites limited—homecare is the norm Assistance from the federal government limited Assistance from the federal government limited Antiviral and vaccine supplies depleted Antiviral and vaccine supplies depleted Mortuaries unable to manage increased mortality Mortuaries unable to manage increased mortality Food supplies limited/ trucks, trains not moving Food supplies limited/ trucks, trains not moving Increased security at groceries, pharmacies Increased security at groceries, pharmacies Schools, many gov’t offices closed Schools, many gov’t offices closed Others dying from lack of support Others dying from lack of support

8. Lessons from SARS Toronto--2003 438 probable or suspect cases 438 probable or suspect cases 43 deaths 43 deaths 23% decline in tourism 23% decline in tourism 20-30% decline in retail sales 20-30% decline in retail sales $30 million per day cost to Canada’s economy $30 million per day cost to Canada’s economy Decrease in growth from 2.5% to 1% Decrease in growth from 2.5% to 1% Travel advisory Travel advisory Organizational/governmental disaster Organizational/governmental disaster

12. What About My Town? County? In a population of 30,000— 9,000 will become ill 9,000 will become ill 900 will require hospitalization 900 will require hospitalization 213 will die 213 will die

13. How will I be Affected? In a “Social or Business Circle” of 100 30 will acquire the disease 30 will acquire the disease 3 will require hospitalization 3 will require hospitalization Nearly 1 will die Nearly 1 will die

14. What’s my Responsibility? Personally Stay up with the worldwide epidemic Stay up with the worldwide epidemic Participate in prevention strategies Participate in prevention strategies Practice and teach “personal protective behaviors” Practice and teach “personal protective behaviors” Sneeze and cough properly Sneeze and cough properly Stay home when ill Stay home when ill Monitor friends who are ill Monitor friends who are ill Learn about homecare for influenza Learn about homecare for influenza Stockpile supplies, food and water Stockpile supplies, food and water Fill fuel tanks Fill fuel tanks

15. What’s My Responsibility? Professionally Participate in planning Participate in planning Develop a catalog of “critical operations” Develop a catalog of “critical operations” Plan to provide those services with ~40% fewer staff Plan to provide those services with ~40% fewer staff Practice and support Personal Protective Behaviors Practice and support Personal Protective Behaviors at work at work Consider volunteer support Consider volunteer support Consider engineering controls Consider engineering controls Reduce direct close client contact Reduce direct close client contact Ask for technical assistance Ask for technical assistance

16. Sample COOP Outline and Process Define “Critical Functions” Define “Critical Functions” Define critical staff and backup (deep) Define critical staff and backup (deep) Cross train non-critical staff in critical functions Cross train non-critical staff in critical functions Ensure infrastructure support Ensure infrastructure support Develop/test operations management plan Develop/test operations management plan Develop operations/ public communications plan Develop operations/ public communications plan

17. Are We Sure ??? No, but… No, but… The conditions are right The conditions are right Highly pathogenic bug--H5N1 (in birds) Highly pathogenic bug--H5N1 (in birds) High mortality rate in humans (~ 50%) High mortality rate in humans (~ 50%) Extensive coverage worldwide (in birds) Extensive coverage worldwide (in birds) Limited human to human transmission Limited human to human transmission Influenza mutates constantly Influenza mutates constantly Global shipment and migration of birds Global shipment and migration of birds