Pandemic Influenza Toppenish School District Informational Presentation

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

May 20, 1980

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

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

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

Excess US Deaths in Previous Influenza Pandemics 1918-19: Spanish 500,000 - 650,000 Ten times as many Americans died of flu than died in WW I 1957-58: Asian 70,000 1968-69: Hong Kong 40,000 Typical annual influenza season: 36,000

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.

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

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

Estimated National Impact Up to 200 million people infected 40 - 90 million people clinically ill 20 - 46 million (low range estimate only) outpatient medical visits 104,000 – 2,200,000 deaths Many geographic areas affected at the same time

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

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

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

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.)

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

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.

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

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

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.

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

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

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

Incident Command System Mitigation and Prevention Preparedness Response Recovery

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

"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