Colorado Novel Influenza A (H1N1) Response Gerrit Bakker, Deputy Director Emergency Preparedness and Response Division Colorado Department of Public Health and Environment Saturday, June 13, 2015

History Emergency Preparedness and Response Division created after the Anthrax attacks Pandemic Influenza planning began Strategic National Stockpile (SNS) Receipt, Storage and Staging planning began – 2008 Statewide exercises.

Climate Presence of a “novel” virus in the United States. People are dying in Mexico. No vaccine, uncertain response to anti-virals. Expectation that a pandemic is inevitable. Duty to warn v. Duty not to panic History with this virus.

Definitions Pandemic: A reflection of amount and type of “spread” and a declaration that allows for the release of resources Emergency: A similar declaration by a local jurisdiction for the release of resources Social Distancing: A step short of Isolation or Quarantine. Separation of contagious persons from those who are susceptible.

Swine flu outbreak Fort Dix case President Gerald Ford is inoculated on Oct. 14, 1976 as part of the "Roll Up Your Sleeves, America" campaign following an outbreak of swine flu in Fort Dix, N.J. that left a young recruit dead. (Via doctorzebra.com) 1976 swine flu outbreak at a glance: * In 1976, hundreds of soldiers at Fort Dix army base in New Jersey became infected with a form of swine flu. One man died. * Fearing a repeat of the 1918 bird flu outbreak that killed 675,000 people, President Gerald Ford ordered a nationwide vaccination program. About 40 million Americans were vaccinated. * The program was stopped after more than 500 Americans developed a severe paralyzing nerve disease as a result of the vaccinations. Thirty people died. The handling of the 1976 case is now seen as a public health debacle.

Timeline Thursday, 4/23 – “There is Swine Flu in the U.S., Texas and California.” Friday, 4/24 – St. Francis School, Queens, N.Y., potentially 100 cases. Saturday, 4/25 – Getting Organized Sunday, 4/26 – Full Activation, Governor Ritter press conference.

Timeline: 4/27 – 5/1 Daily Press Conferences –Case counts –Guidance releases Conference Calls Precautionary Methods Lab Testing Epidemiology

Events Since May 1 Testing limited to those who are most symptomatic Research continues – Vaccine, response to anti-virals, At risk populations Withdrawal of travel restrictions Monitoring of events in the southern hemisphere “Guessing” about the next vaccine.

Number of confirmed (N = 394)* and probable (N = 414)† cases of novel influenza A (H1N1) virus infection with known dates of illness onset --- United States, March 28--May 4, 2009§

U.S. Human Cases of H1N1 Flu Infection Updated June 5, 2009, 9:00 AM MT StatesCasesDeaths California973 Colorado75 New York8588 Texas16703 Wisconsin2217 Total13,21727

Risk Communication Traditional Methods –Press Releases –Press Conferences –CoHELP Call Line Specialized Guidelines –Business –Education –Health Care –Social Distancing

Risk Communication Social Media –Website: Subscribe for updates –SATool.org –Google listserv –You Tube Demos –Facebook: COHealth –Twitter for breaking news –Blog: Be Ready Be Healthy Be Informed

Anti – Virals / PPE Assessment of current status –COPharm –Fit Testing SNS –Receipt, Storage, Staging –Regional Transfer Points –Personal Protective Equipment

Current Circumstances Monitor –Testing –Surveillance –Investigation Next Flu season –Vaccine –Messaging –Testing

Shared Responsibility Individuals have an important role in protecting themselves and their families. –Stay informed. Health officials will provide additional information as it becomes available. –Everyone should take these everyday steps to protect your health and lessen the spread of this new virus: Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.

Shared Responsibility Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective. Avoid touching your eyes, nose or mouth. Germs spread this way. Try to avoid close contact with sick people. If you are sick with a flu-like illness, stay home for 7 days after your symptoms begin or until you have been symptom-free for 24 hours, whichever is longer. This is to keep from infecting others and spreading the virus further. Follow public health advice regarding school closures, avoiding crowds and other social distancing measures.

Lessons Learned Planning has paid off Many different methods of communication are needed Messages must be clear, concise and specific Pandemic can come from sources other than Avian Flu Tolerance for ambiguity Flexibility

Resources Website: subscribe for updates cdphe.state.co.us Situational Awareness Tool: Google Groups listserv: COHealth Twitter: COHealth Facebook page: COHealth Blog: “Be Ready Be Healthy Be Informed” COHelp: