Pandemic H1N1 Response Overview Michael J. Fielding Chief of Emergency Preparedness Columbus Public Health

3 Areas of Discussion I. Local health department (LHD) plans for the fall II. How businesses should be preparing III. Roles that businesses may be asked to play

I. LHD Plans for the Fall

Local Health Departments Columbus Public Health (CPH) Responsible for the cities of Columbus and Worthington Approximately 400 employees Franklin County Board of Health (FCBH) Responsible for the remainder of the county Approximately 65 employees

Responding to an Emergency In the event of a Public Health (PH) emergency: CPH and FCBH respond together Incident Command System (ICS) is activated PH may be the lead responder, but is just part of a community wide response

Incident Command System (ICS)

7 Functions of Pan Flu Response Epidemiology and Surveillance Clinical Guidelines Measures to Limit the Spread of Disease Distribution of Antivirals and Vaccines Education and Training Communications Health Systems and Critical Infrastructure

1. Epidemiology and Surveillance Monitor 85 data and healthcare sources Emergency Department visits Over the counter medicine sales School absenteeism Analyze data Report surveillance results

2. Clinical Guidelines Receive credible source information from Epidemiology and Surveillance Assess credible sources for changes in: Medical Process Send clinical guidelines to function leaders Oversee clinical portion of hotline

3. Measures to Limit the Spread of Disease Community Containment and Referral Monitor all community containment data Advise command staff regarding triggers Case and Contact Investigation Look for epidemiological links in case data Conduct case and contact investigation Facilitate lab testing

4. Distribution of Antivirals and Vaccines Monitor local and state caches Request, receive Strategic National Stockpile (SNS) assets Distribute and transport SNS assets Coordinate operations at Points of Distribution (PODS)

5. Education and Training Receive education and presentation requests Conduct education and trainings for organizations and groups Conduct Just in Time (JIT) trainings for staff and volunteers Provide materials for release

6. Communications Represent PH in the Joint Information Center Create messages for a variety of outlets Develop press releases and update websites Set up hotlines

7. Health Systems and Critical Infrastructure Coordinates planning and response efforts between local agencies Ensure that public health goals are represented Critical Infrastructure Activate COOP plans for affected organizations

II. How Businesses Should be Preparing

To Keep in Mind… The amount and severity of illness that H1N1 and seasonal influenza will cause during the 2009–2010 season cannot be predicted with a high degree of certainty. Seasonal influenza viruses may cause illness at the same time as 2009 H1N1 this fall and winter.

Four Basic Objectives Reduce transmission among staff Protect people who are at increased risk of influenza related complications from getting infected with influenza Maintain business operations Minimize adverse effects on other entities in supply chains.

Key Indicators for Decision Making Disease prevalence and severity where business is located Amount of worker absenteeism in your business Impact of disease on vulnerable and higher risk employees pregnant women, employees with certain chronic medical conditions Other factors that may affect employees’ ability to get to work School dismissals, closures

Actions Employers Should Take Now Review or establish a flexible influenza pandemic plan and involve your employees in developing and reviewing your plan Conduct a focused discussion or exercise using your plan to identify gaps or issues Understand your organization’s normal seasonal absenteeism rates and monitor your personnel for any unusual increases in absenteeism through the fall and winter.

Actions (continued) Confirm local health department channels of communication and methods for dissemination of local outbreak information Allow sick workers to stay home without fear of losing their jobs Develop flexible leave policies to allow workers to stay home to care for sick family members or for children in the event of school closure

Actions (continued) Share your pandemic influenza plan and information with employees that explain: human resources policies workplace and leave flexibilities pay and benefits Share best practices with other businesses in your communities (especially those in your supply chain), chambers of commerce, and associations

Pandemic Influenza Plan Elements Implement a layered approach, with multiple measures, to protect workers and ensure business continuity Identify possible work-related exposure and health risks to your employees Review human resources policies to make sure they are consistent with public health recommendations and state and federal workplace laws Establish policies and practices, such as flexible worksites and flexible work hours

Plan Elements (continued) Identify essential business functions, essential jobs or roles, and critical elements within your supply chains Set up authorities, triggers, and procedures for activating and deactivating the company’s response plan Plan to minimize exposure to fellow employees or the public if public health officials call for social distancing Establish a process to communicate information to workers and business partners

2 Scenarios for 2009-2010 Flu Season A continuation of the current level of severity of influenza as was observed during the spring and summer of 2009 A more severe outbreak.

Scenario 1: Similar Severity Sick employees should stay home Sick employees at work should go home Cover coughs and sneezes Improve hand hygiene Clean and sanitize surfaces with frequent hand content

Scenario 1: Similar Severity (cont’d) Encourage employees to get vaccinated Protect employees at higher risk for complications Prepare for increased numbers of employee absences Advise travelling employees to take certain steps Prepare for the possibility of school dismissal

Scenario 2: Increased Severity Consider active screening of employees who report to work Consider alternate work environments for those at higher risk for complications Increase social distancing in the work place Consider canceling non-essential business travel Prepare for the possibility of school dismissal

III. Roles that businesses may be asked to play

Within Your Business… Promote and ensure a culture of infection control and prevention in the workplace Post signage Provide hand sanitizer Set expectations of hand washing, covering your cough, staying home when ill Develop home care kits for influenza and emergencies Host an immunization clinic

Assist in the Response… Encourage employees to participate in volunteer emergency response organizations: Community Emergency Response Team (CERT) and Medical Reserve Corps (MRC)  Keep up to date on communication sent through the Columbus Chamber of Commerce Support and follow LHD guidance Consider adding company assets to EMA resource lists

Resources and Links Local www.columbuspandemicflu.com www.publichealth.columbus.gov www.co.franklin.oh.us/board_of_health National www.flu.gov/plan/workplaceplanning/index.html www.cdc.gov/h1n1flu