Pandemic Influenza Preparedness & Response Part 2: Key Elements of a Plan Occupational Safety and Health Course for Healthcare Professionals

All business and organizations should have an updated plan for a pandemic now. Lack of continuity planning can result in a cascade of failure as employers attempt to address the challenges of a pandemic when it occurs. Critical infrastructure / key resource industries have a special responsibility to plan for a pandemic. 2

 Value of planning: will make continuity of our healthcare services smoother and easier, decrease fear and anxiety among employees, and be supportive to the community.  Pandemics come in multiple waves – need to plan for disruption/challenges over a long period of time.  If a plan has been developed, important to update on a regular basis. 3

85% of the nation’s critical infrastructure is in the hands of the private sector; the business community plays a vital role in ensuring national pandemic preparedness and response. 4

Critical Infrastructure Key Resources - Food & Agriculture Gov’t facilities - Public Health & Healthcare Dams - Banking & Finance Commercial Facilities - Water & Energy Nuclear Power Plant - Defense Industrial Base - Emergency Services - Information Technology - Telecommunications - Postal & Shipping - Transportation ** 5

The most difficult step is the first one. Who is your planning team? Organize and identify a central team of people to serve as a communication source so that employees, customers/clients, suppliers, the community can have accurate information during the crisis. Work with community planners & agencies to integrate a pandemic plan into local and state planning. 6

Work with employees and their union(s) to address all relative HR policies/procedures, including leave, pay, transportation, travel, childcare, absence and other human resource issues. Plan for downsizing some services but also anticipate any scenario which may require a surge in services. Prepare and plan for operations with a reduced or changed workforce. 7

1. Essential Functions: * Financial/Operations * Supply Chain * Security 2. Human Resources 3. Communication/ Information Technology 4. Community and government 5. Employee Needs and Education 8

 What aspect(s) of your services will see a surge/increase?  What aspect(s) will experience a decline/reduced need?  Plan needs to address how financial processes will be managed during a pandemic.  How will operations, with reduced staff, be managed? 9

* Supply chain in a pandemic will be disrupted, slower, inaccessible in some cases. * Who are your suppliers, and what are your alternate sources? * What do you need, what can be stockpiled safely? * What are your current and potential storage capabilities? 10

Stockpile items such as soap, tissue, hand sanitizer, cleaning supplies and recommended personal protective equipment (will not be able to access extra in a Pandemic situation). Stockpile essential materials for your business to continue – consider your current needs, project over a number of weeks, look at alternate sources. When stockpiling items, be aware of each product’s shelf life and storage conditions and incorporate product rotation into your stockpile management program. Resources – Respirator and Facemask Stockpiling Guidance – available on osha.gov 11

 In the midst of a pandemic influenza there will be widespread panic and fear.  Your business location may be seen as a resource or haven.  Control of cash access and material goods.  Control of entry and exit points.  Employee and customer safety at all times. 12

 We will all be dealing with distressed individuals, less accessibility to services and fewer staff; overall, dealing with a scared and potentially combative public.  Provide training to security personnel.  Coordinate with local and state agencies. 13

 Most challenging area of your plan.  Staff shortages will occur.  What are your critical staff needs?  What other resources are available when critical staff are not there?  What will you need from employees – are they cross- trained? 14

 Sick leave – do you encourage staff to stay home when they are sick?  If employees are sick at work, what is your current policy?  Will you mandate preventive measures, including vaccinations for staff?  How is all of this communicated to staff – i.e. protection of other workers, customers.  Policy consideration: when employees’ families are ill or schools close, what can you offer?  Clear, well communicated business policies will support the control of worker and customer exposure and promote safety and continuity of service. 15

 Communicating with employees: critical part of the plan.  Communicating accurate data and updates, policies, and support mechanisms.  Communicating with the community agencies, state and local groups, and customers.  What are your current IT capabilities? What will you need for IT support in the midst of a pandemic influenza? 16

 Must plan in advance for easy connectivity/compatibility with emergency services, law enforcement, public health services, government agencies.  During a Pandemic, all businesses and employees will increase their reliance and use of information technology – for updated information, to replace meetings, to education and share information with employees, to support employees working from home, to access experts, contact family, etc.  Plan for the increase in use of all information technology. 17

 What are your current IT capabilities?  What will you need for IT support in the midst of a pandemic influenza?  Telephone/cell phone capacity in your area, for your business? 18

 What plans currently exist in your community/state?  Access information from all of the government websites, contacts.  How can you get involved in community planning?  Are there other businesses you can collaborate with on your planning? 19

Some employees will have individual risk factors that should be considered (e.g., immuno- compromised individuals and pregnant women). Assist employees in managing additional stressors related to the pandemic (mental health, family situations). Access to health professionals – making it easy and close to work environment. 20

 Consider community volunteers to support employees.  Plan Human Resource approaches, responses, supports.  Consider employee needs for food, housing, places to rest, child care.  Provide information on how & where they can access health services.  Social & psychological support services for employees, family members. 21

 Critical importance of education for employees in your business: * the hazards they may encounter. * definitions and facts about influenza and pandemics. * safety measures, daily hygiene practices. * use of PPE. * the organization’s pandemic influenza plan. * their accountability for complying with policies related to hygiene and cleaning, as well as anything specific to their role/responsibilities. 22

 Need to assure employees that they will have the necessary PPE while at work.  Key: what is appropriate based on their tasks, role, and contact with the general public.  Monitoring compliance?  Access to equipment/supplies? 23

 Exposure Risk Assessment – for each task and role that employees carry out – at each site/location of work.  Utilize the OSHA Risk Pyramid and guidance materials.  Assess risk if there are any changes in your business over time; new services, new locations, etc. 24

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 Very High Exposure Risk: Performing aerosol-generating procedures on known/suspected pandemic patients. HCW/lab staff collecting or handling specimens from known or suspected pandemic patients.  High Exposure Risk: HCW and support staff exposed to known or suspected pandemic patients. Medical transport of known or suspected pandemic patients in enclosed vehicles. Performing autopsies on known or suspected pandemic patient(s).  Medium Exposure Risk: Employees with high-frequency close contact with the general population (e.g., schools, high-volume retail).  Lower Exposure Risk (Caution): Employees who have minimal close contact with the general public and other coworkers (e.g., office workers). 26

Engineering controls involve making changes to the work environment to reduce work-related hazards. Work practice controls are procedures for safe and proper work that are used to reduce the duration, frequency or intensity of exposure to a hazard. Administrative controls include controlling employees' exposure by scheduling their work tasks in ways that minimize their exposure levels. Personal Protective Equipment (PPE) includes all clothing and other work accessories designed to create a barrier against workplace hazards. 27

 Outpatient services and clinics – how will your employees access healthcare? (estimated 45 million will seek outpatient care in a pandemic event)  Alternate Business & Care Sites – who/what can help your organization deal with a surge in need for services/goods? 28

 Many communities do have a pandemic preparedness plan; many do not.  Having a Preparedness Team that represents all relevant stakeholders in the community.  Follow the state plans – gain from state and national efforts.  Planning for the potential impact – how will it affect usual activities, processes, and services – both business and social? 29

 Government  Public health  Other Healthcare agencies and emergency response  Education  Business  Communication  Agriculture  Faith-based organizations  Community-based groups 30

 If a plan does exist, it may need to be updated.  Connectivity and collaboration between business, government, and community leaders will be critical in a pandemic.  Examples  State and Local Planning Guide – use available resources.  Most important: Get involved! 31

 Encouraging people who are ill to stay home.  If family members are ill, encourage other family to stay home for 5-7 days.  Schools to dismiss students to home for up to 12 weeks (dependent on severity of the event)  Promote Social Distancing practices.  Travel may be disrupted, including use of mass transportation systems.  Large social gatherings may be discouraged and/or cancelled.  Sharing accurate information throughout the community. 32

 Collaboration with public health and government agencies will be very important.  Assess potential impact of a pandemic on usual activities/events, and services delivered to members.  How could services and activities be managed and still reduce exposure and spread of an influenza virus?  Develop emergency procedures, plans.  Communicate – share the up-to-date, accurate information and dispel myths.  Encourage preventive measures as recommended by national and state government agencies. 33

 What are we doing to prepare our families for a pandemic?  Do we encourage prevention now among our family members?  Share information – facts help to dispel fear.  Family Planning Guide – available resources.  Key: plan now, so that there will be less stress and worry during the pandemic. 34

 Storing a two week supply of water, food, and necessary supplies.  Prescription and non-prescription medications: be certain to have a readily-accessible and continuous supply.  Plan with family and friends about how you and they would be cared for if they get sick.  Teach everyone how to limit spread!  Access preventive interventions. 35

 Many businesses have grown because of positive relationships with their customers.  Have to help employees maintain these relationships with each other and their customers, even in the midst of “restrictions” and “fears”.  Recognize everyone’s accountability to prevent spread and mitigate negative health outcomes. 36

 Recognize the critical importance of planning in order to protect workers and customers, continue business.  Engaging others is not always easy.  Until recently, a Pandemic influenza event may have seemed “unreal” to many; and now?  Share your information!  Gather the latest statistics – draw the picture for our world, our country, state, community, your organization.  Make the “event” real, make the plan realistic.  Practice! 37

Develop, reassess and update a disaster/business continuity plan that addresses Pandemic Influenza. Strongly encourage all prevention strategies. Monitor and promote good hygiene practices. Monitor compliance with use of PPE. Get involved in your community’s planning efforts. 38

 Any additional areas that you want to add to the Plan?  Let’s look at the Planning checklists that are in your handouts.  Make a Planning List that is specific to your organization – make it relevant for your work and your employees. 39