1. PANDEMIC INFLUENZA RESPONSE GUIDE LAWRENCE CAMPUS Presented By: Carol Seager and Mike Wildgen

2. Agenda I.Introduction II.Definition of Terms III.Purpose IV.Pandemic History V.Pandemic at KU VI.WHO Pandemic Phases VII.Pandemic Guide Format

3. Definition of Terms Pandemic – A widespread out break of disease that occurs throughout the world for which there is no natural immunity. Isolation – Separation of people who are ill from those who are healthy and the restriction of their movement to stop the spread of the illness. Quarantine – Separation and restriction of movement of persons who are not yet ill but have been exposed. Social Distancing – Infection control strategies that reduce the duration of social contact and thereby limit the transmission of influenza.

4. Guide Purpose Build a structure for decision-making that: 1.Follows the pandemic stages of the World Health Organization (WHO) 2.Identifies Response Outcomes and Response Units In order to: SAVE and PROTECT lives Ensure institutional continuity and recovery.

5. PANDEMIC HISTORY

6. Pandemic Historical Perspective 1918 – 1919: Spanish Flu Most Severe – Caused at least 675,000 U.S. deaths and up to 50 million deaths worldwide. 1957 – 1958: Asian Flu Moderately Severe – Caused at least 70,000 U.S. deaths and 1-2 million deaths worldwide. 1968 – 1969: Hong Kong Flu Caused at least 34,000 U.S. deaths and 700,000 deaths worldwide. IT IS DIFFICULT TO PREDICT WHEN THE NEXT PANDEMIC WILL OCCUR OR HOW SEVERE IT WILL BE.

7. KU’s History with Pandemic Flu Spanish Flu Pandemic – October 1918 KU was to be closed for a week. Instead, it was closed for a month. Students were forbidden to leave Lawrence to prevent the spread of infection. Nearly 1,000 faculty, students and staff were afflicted with the disease. Resulted in 24 deaths.

8. Future Pandemic? 1997 – First Outbreak of Avian Influenza (H5N1) reported in Hong Kong. Domestic birds died suddenly and tested positive for H5N1. Public Health officials recommended destroying 1.5 million birds, which successfully eradicated the outbreak. There have been 277 cases worldwide (as of 3/5/07). 167 deaths Fatality rate = 60%

9. Avian to Human Transmission Migratory birds can be flu virus carriers. Domesticated birds in contact with infected migratory birds also become infected. Domesticated birds usually die from lack of immunity. Humans become infected through close contact with birds. To date, very rare human-to-human transmission of avian influenza has occurred.

10. Migratory Bird Pattern There are ZERO cases of bird or human avian flu in North and South America.

11. PANDEMIC AT KU

12. KU Pandemic Response Guide The pandemic response guide is an appendix to the University’s Emergency Response Plan. This is designed to be used as a guide for responses and decisions.

13. Unique Aspects of a Pandemic Emerging/Developing (not a surprise) Global (federal and state guidance with limited resources) Long-lasting Recurring Decision-making/instructions from and/or with external entities (ex. Public Health Department)

14. What to Expect at KU The anticipated nature of the pandemic will result in: Anticipate multiple waves for 1 – 2 years Each wave could last 6 – 8 weeks resulting in campus closure of 2–3 months. Historical data shows young healthy adults will be hit the hardest. 50 – 60% mortality rate for avian influenza. During a pandemic the mortality rate is anticipated to be lower. 25 – 33% reduction in availability of university staff and services. Implementation of social distancing measures before infection hits the community.

15. WHO PANDEMIC PHASES

16. Pandemic WHO Phases 1 and 2 INTERPANDEMIC PERIOD Phase 1: No new flu virus subtypes detected in humans. A flu virus subtype that has caused human infection may exist in animals, but the risk of human infection or disease is considered low. Phase 2: No new flu virus subtypes detected in humans, however, a circulating animal flu virus subtype poses a substantial risk of human disease.

17. Pandemic WHO Phases 3, 4 and 5 PANDEMIC ALERT PERIOD Phase 3: Human infection with a new subtype has occurred, but no human-to-human spread has occurred, or at most there have been rare instances of spread to a close contact. Phase 4: Small clusters with limited human-to-human transmission are detected, but spread is highly localized, suggesting that the virus is not well-adapted to humans. Phase 5: Larger clusters but human-to-human spread is still localized, suggesting the virus is becoming increasingly better adapted to humans but may not yet be fully transmissible.

18. Pandemic WHO Phases 6 and 7 PANDEMIC PERIOD Phase 6: Transmission increases and is sustained in the general population POSTPANDEMIC PERIOD Phase 7: Return to Phase 1.

19. RESPONSE GUIDE FORMAT

20. Response Outcomes Command Leadership – University’s pandemic response will be guided by the members of the EOC. Community Support Service – University’s pandemic response efforts will be coordinated externally with all relevant external partners. Essential services and operations – Identification and purchase of essential supplies, services and operations. Fatality Management – University will work with relevant community partners to appropriately dispose of human remains.

21. Response Outcomes Healthcare Delivery – Utilization of all available resources to meet student outpatient healthcare needs. Triage, surveillance and monitor student needs. Implement mass treatment. Infection Control / Social Distancing – Provide information, health screening and support to KU community traveling to/from pandemic area, promote receipt of the influenza vaccine and creation of public health messages. Learning Continuity – Clarification and communication of decision makers. Communication, identification and implementation of systems and processes. Identification of existing research activity.

22. Response Outcomes Operational Communications – Ensures all stakeholders have access to consistent, accurate and timely information. Public Information – Provide accurate and timely information regarding the public-at-large regarding University’s response. Vaccination Distribution – Mass distribution of vaccine and medication to members of the University and Douglas County, as prioritized by the CDC.

23. Response Units These departments will be called upon to respond: Athletics, Department of Intercollegiate CAPS Chancellor, Office of the Comptroller, Office of Deans/Directors/Chairs Dining Services, Memorial and Burge Unions Environmental Health and Safety Facilities Operations, Dept. of Faculty General Counsel, Office of HREO Information Services, Office of International Programs, Office of Kansas Board of Regents Provost, Office of Public Safety, Office of Research, Office of Vice Provost Student Health Services Student Housing Student Success, Office of Vice Provost University Communications, Office of

24. Pandemic Response Matrix EXAMPLE KU – LEVEL 0 Non-Emergency/ Administrative/ Special Events KU – LEVEL 1 Monitor KU – LEVEL 2 Standby KU – LEVEL 3 Emergency KU – LEVEL 0 Recovery RESPONSE UNIT RESPONSE OUTCOME WHO PHASES 1 – 3: Interpandemic & Pandemic Alert Period WHO PHASE 4: Elevated Pandemic Risk WHO PHASE 5: Pandemic Imminent WHO PHASE 6: Pandemic WHO PHASE 7: Recovery STUDENT HOUSING Leadership  Participate in development and practice of system wide plan.  Develop unit-specific plans. Review plans to provide housing during pandemic. Advise EOC on housing readiness. Advise EOC on housing services. Advise EOC regarding processes required to ready residence halls for occupancy Essential Services and Operations  Confirm essential staffing.  Identify sources and appropriate stock levels for supplies/ equipment.  Develop plan for financial response to occupants of closed residence halls.  Confirm staffing plans.  Monitor levels of essential supplies.  Confirm vendor lists.  Confirm communication channels with essential staff.  Stockpile essential supplies.  Modify personnel structures as needed to provide reduced services.  Stockpile necessary supplies and equipment. No action identified.  Prepare facilities for residents return  Communicate reassignment of residents, as necessary.  Re-establish traditional supply lines and staffing patterns.  Rebuild financial health of department. Healthcare Facilitate delivery of public health messages to residents.  Facilitate the delivery of public health messages to residents.  Review and further develop response plans, including expedited hall closure process, storage options, reduced staffing structures, stockpiling, sanitation and employee health and safety.  Initiate expedited checkout process and close halls, if campus is closed.  Identify students who are unable to leave campus and reassign them to a selected hall (Ellsworth, Hashinger, Lewis, Templin) as needed.  Continue to operate Stouffer Place and Jayhawker Towers apartment communities.  Facilitate the delivery of public health messages to residents.  Operate halls housing well students.  Facilitate the delivery of food, supplies and information to residents.  As able, track daily occupancy of halls. Facilitate continued delivery of public health messages and support resources to residents.

25. Response Matrix EXAMPLE (continued) KU – LEVEL 0 Non-Emergency/ Administrative/ Special Events KU – LEVEL 1 Monitor KU – LEVEL 2 Standby KU – LEVEL 3 Emergency KU – LEVEL 0 Recovery RESPONSE UNIT RESPONSE OUTCOME WHO PHASES 1 – 3: Interpandemic & Pandemic Alert Period WHO PHASE 4: Elevated Pandemic Risk WHO PHASE 5: Pandemic Imminent WHO PHASE 6: Pandemic WHO PHASE 7: Recovery STUDENT HOUSING Infection Control & Social Distancing No action identified.  Limit public eating areas.  Ill students will isolate in Oliver Hall.  Close public eating areas  Support Oliver hall housing of ill students  Facilitate the delivery of food, supplies and information to residents.  Open public eating areas.  Clean and sanitize areas where ill students have been housed. Operational Communication Develop communication channels with essential staff, University leadership and community partners. Confirm communication channels with essential staff, University leadership and community partners. Implement communications. Maintain communications.Review effectiveness of communications. Public Information Develop messages to be used in the event of closure of residence halls. No action identified.  Communicate residence hall closure and relocation facilities for those unable to leave campus.  KU Info coordinate information with EOC and University Relations.  Communicate residence hall closure and relocation facilities for those unable to leave campus.  KU Info coordinate information with EOC and University Relations. Communicate re- opening of residence halls. Vaccination and Medication Distribution Develop messages to be used in the event of closure of residence halls. No action identified.