1. Pandemic Influenza Toppenish School District Informational Presentation

2. Chicken Little and the Sky is Falling!!!!! or The Next Major Disaster?
Which is it?
When have we asked this before?

3. May 20, 1980

4. Not if…..but WHEN Influenza pandemics are inevitable
They recur at more-or-less cyclical intervals

5. Epidemic: An increase in disease above what is normally expected
Definition
Epidemic: An increase in disease above what is normally expected
Pandemic: A worldwide epidemic

6. How Do Influenza Pandemics Arise?
When avian influenza viruses experience sudden changes in genetic structure
And
Are capable of infecting humans
Can reproduce and spread from person to person….a pandemic occurs

12. Excess US Deaths in Previous Influenza Pandemics
: Spanish , ,000
Ten times as many Americans died of flu than died in WW I
: Asian 70,000
: Hong Kong 40,000
Typical annual influenza season: 36,000

13. This slide series illustrates the spread of influenza in the U. S
This slide series illustrates the spread of influenza in the U.S. during the 1918 pandemic. In a matter of weeks, influenza had spread across the entire country.
It is thought that this rapid spread may have been facilitated by seeding of the virus the previous spring.

14. We are Here Phases of a Pandemic World Health Organization
Mitigation and Preparedness
Response
Phase I
Phase 2
Phase 3
Phase 4
Phase 5
Phase 6
A classification system developed by the WHO for global pandemic preparedness planning and response activities.
Includes 6 phases of increasing public health risk associated with the emergence and spread of a new influenza virus subtype that may lead to a pandemic:
Interpandemic – Phases 1 & 2
Pandemic Alert – Phases 3, 4 & 5
Pandemic – Phase 6
Interpandemic
Pandemic Alert
Pandemic
We are Here
Declared globally by the World Health Organization
Declared nationally by the Department of Health and Human Services

15. Current Outbreak: Avian Influenza (H5N1)
Began in fall, 2003
238 confirmed human cases; 139 deaths in 10 countries as of 8/14/06
No efficient person-to-person transmission
Isolated human disease
Outbreak spreading in birds, not controlled

16. Estimated National Impact
Up to 200 million people infected
million people clinically ill
million (low range estimate only)
outpatient medical visits
104,000 – 2,200,000 deaths
Many geographic areas affected at the same time

17. Pandemic Impact Consequences will effect all organizations:
Extreme staffing shortages (30%)
Impacts on Law Enforcement:
25% - 35% of officers absent due to illness, death, caring for family members
911 dispatch centers operating with reduced staff, higher call volumes
Large numbers of people unable to purchase food, pay bills – high unemployment and schools closed
Potential for civil unrest over weeks / months
Hospitals may become high security areas
No mutual aid available
Impacts on Transit / Transportation
25% - 35% of drivers, maintenance crews, leadership absent due to illness, death, caring for family members
Mechanics unavailable to affect repairs
Fuel deliveries reduced in frequency or erratic
Contractors normally relied upon also impacted
The very system we’ll need to triage, diagnose and treat our residents will be severely strained in a pandemic outbreak:
25-35% of our health care workforce will be personally affected by the disease and unable to work
We will not have sufficient hospital beds to take the number of patients who should be admitted
Our current supplies of items like ventilators and drugs will be insufficient
The deaths will overwhelm our hospital morgues, the Medical Examiner’s capacity, and mortuary services
Our residents will have a very high need for social and mental health services; and that need will outstrip supply

18. Assumptions Illness will spread quickly and globally
No vaccine (or very limited) for first 6 to 8 months antivirals will also be very limited
Health care delivery system may be overwhelmed with significant mortality and morbidity
Two or three waves likely
Extreme workplace staffing shortages (30%) due to illness, death, or caring for family members

19. Pandemic Planning Group
Develop a District Plan for a Pandemic Flu Event (60 days)
Roles of Each Member (Prevent,Prepare,Response,Recovery)
Incident Commander and Communications -Robert Shipek
Public Information Officer-John Cerna
Liaison Officer with Outside Agencies -Steve Myers
Health Service - Susan Vahlakis
Transportation - Dave Beltran
Food Services - Renee Miles
Buildings and Grounds and Custodial -Manuel Orozco
Logistics and Fiscal -Dave Andrews
Human Resources and Legal Issues -Jo-Ellen Thomas
Liaison with Building Principals - Matt Piper
Liaison with Certified Staff –Erinne Steinmetz
Liaison with building and district level secretarial staff -Nora Flores
Liaison with PSE Staff- Debbie Voorhees

20. Prepare for difficult HR issues
If offices are closed, will staff be paid?
If staff are needed, can they refuse to come to work?
If required to report, what protective equipment, if any, will be provided?
Can employer force someone who may be ill NOT to work? (Employees without sick leave may try to work while ill.)

21. Influenza Prevention What Can We Do?
Specific Recommendations:
Infection Control in Schools :
Pandemic preparedness planning
Distribution of educational messages
and infection control guidance
Social distancing: people stay home when ill
Promotion of respiratory etiquette
Provision of materials for respiratory hygiene/
etiquette: tissues and disposal receptacles

22. Respiratory Etiquette:
Not just being polite!
These particles are about 1 to 5 microns in diameter. Droplet nuclei can remain suspended in the air for several hours, depending on the environment. The most effective droplet nuclei tend to have a diameter of 5 micron. Droplet nuclei are generated during talking, coughing and sneezing.  One cough can generate 3000 droplet nuclei. Talking for 5 minutes can generate 3000 droplet nuclei and singing can generate 3000 droplet nuclei in one minute. Sneezing generates the most droplet nuclei by far (tens of thousands), which can spread to individuals up to 10 feet away.

23. Pandemic Preparedness Responsibilities of Parents
Store an extended supply of food and water at home
Store nonprescription drugs and health supplies at home
Plan with family members about the following:
Caring for loved ones who get sick
Caring for children if the schools are closed
Other impacts on your life if you need to stay at home for an extended period of time
Use separate triage area or designated outpatient clinic sites for persons with fevers or respiratory symptoms.
Have separate sites for persons with highest risk of illness
Consider triage officer’s to manage patient flow and referrals
Anticipate equipment shortages – respiratory care, mechanical ventilation

24. Pandemic Preparedness Responsibilities of Group Leaders
Continuity of Operations Planning
Identify key functions
Cross train staff
Identify telecommuting opportunities
Review HR policies (sick leave, flex shifts)
Identify ways to maintain payroll functions
Make alcohol gel, disinfectant wipes available

25. Who will help us? Little or no state and federal assistance
Local government also limited in what it can do to assist citizens
Churches, neighbors, friends and families would need to help each other
Vulnerable groups would need extra assistance
Advance planning and stockpiling of necessities could help.

26. Key Steps for District Preparedness: Mitigation
Identify a district committee to provide support and guidance to schools
Review communicable disease policy and procedures (communication, human resource management, prevention messages, reporting)
Develop pandemic flu plan including school closure plan

27. Key Steps for District Preparedness: Action
Review current public health, district and school pandemic flu plans
Continue staff, student and parent education
Implement incident command protocol

28. Key Steps for District Preparedness: Response
Track and report absenteeism
Ensure information is translated
Activate incident command management
System
Document actions taken
Conduct debriefings

29. Incident Command System
Mitigation and Prevention
Preparedness
Response
Recovery

30. How Ready Are We?
Used with permission of the Minneapolis Star-Tribune

31. "Every day a pandemic doesn't happen is another day we have to prepare
"Every day a pandemic doesn't happen is another day we have to prepare.” Michael Osterholm