Pandemic Planning A country, state and city concern Dr. Gregory N. Larkin Director Corporate Health Services

YIPES! Or YAWN?

Treatment and supply availability In a pandemic, most businesses and health care facilities will be impacted Medical care/supplies will be harder to obtain Home supplies will be harder to obtain Medication (Tamiflu) to potentially treat influenza is currently in short supply and may not be readily available in your area It is not yet known for sure if this medication will be effective Antibiotics to treat secondary infections, such as pneumonia, may also be in short supply

Key points (worst case) When the first human to human case presents, it will take 3 months to encircle the globe A community will go through 3-4 cycles each lasting 4-6 weeks causing % population infection Unknown effectiveness of present antiviral agents Effective vaccine will take 3-6 months to produce Employers need to prepare to: Continue critical processes with a reduced work force (e.g. insulin) Reduce potential infectious opportunities –Socialization and contact reduction Employees should consider a modest stockpile of home supplies

WHO Pandemic Phases

What can we expect? Lessons learned from epidemiology and the current situation in Asia 1.maximum recorded interval between pandemics is 39 years – it could be soon (but it remains unpredictable) 2.the likely origin will be SE Asia, but we can’t say for sure 3.global spread will be rapid – we either prepare now, or risk being caught by surprise 4.several epidemic waves; first may be ‘milder’ than subsequent ones – sustainability and resilience will be key issues

What can we expect? 4. excess mortality and morbidity difficult to predict but may be high (but it doesn’t follow that the next pandemic will be like 1918) 5. overall population clinical attack rate is likely to be 25-33% 6. there may be a shift from the current pattern of disease, towards younger age groups in terms of severity and mortality – with obvious implications for the business workforce 7. impacts on health services and business continuity are likely to be very considerable

What do we know and need to do TODAY? Known: WHO Phase three Potential of community being 40% absence Adverse impact on both community and business operations Need to do: Prevention, Response, Business Continuity and Communication

Prevention Overview Medically sound and consistent education What methods in place for world and community tracking Influenza characteristics (prevention, spread, treatment) Personal planning elements Worksite planning

Prevention- Personal Planning Due to possible community service breakdown; Consider stockpiling those domestic items of importance (e.g. medications, water, food (include pets, etc.), cleaning supplies) Understand the importance of ‘social distancing’ Travel, shopping, social gatherings Understand the importance of containment Hard surface cleaning, disposal of tissue, etc.

Prevention- Work Site Planning Reduce the spread of infection by: Encourage ill employees to remain at home Consider ‘screening’ protocols employees/visitors at the door Facility promotion of frequent hand washing and proper disposal of tissues. Stockpile supplies. Alternative methods for face to face meetings- Work with IT Ascertain critical vendors pandemic preparation

Response Engage prevention protocols Entrance screening (ear thermometers, masks) Close cafeterias (box lunches) Hand washing stations/supplies Isolation protocols (on site medical facilities) Disinfectant procedures (cleaning/disposal) Telecommunication where possible Limit travel of all kinds

Social distancing at home and at work Social distancing refers to methods to reduce the frequency and closeness of contact between people Generally, social distancing refers to mass gatherings of people, but the same methods can be applied to the home setting

Social distancing at home and work When around people who are coughing or sneezing, keep your distance by at least 3 feet Avoid meeting people face to face: use the telephone or have web conferences Avoid any unnecessary travel Avoid crowded places Avoid public transportation Avoid crowded restaurants

Social distancing at home and work  Stock up on basic items to minimize exposure to public places  Shop at smaller stores with smaller lines and fewer people  Shop at off hours to avoid large crowds  Arrange to pay bills by mail, online or over the phone  Cancel or postpone family gatherings, outings or trips  If you cannot avoid crowds, minimize the amount of time you spend around people

Business Continuity Expect 40-50% temporary reduction in work force Ill or caring for ill or guardianship of children Identify Business Critical Processes Core business needs including vendors –Materials to be stockpiled or expanded inventory Identify non critical processes –Employees encouraged to remain home Identify what, if any, critical business can be telecommuned –Tasks and resources needed Develop Human Resource benefit policies for absence Create redundant personnel and resource support

Communication Prepare now: Resources to provide credible education regarding Influenza tracking Work site protocols (screening, hand washing, etc.) Business critical/non critical criteria and application Benefit implications for related absences Recommended work place and home supplies

Summary Pandemic or other broad disaster merits planning The current viral threat is real although when, not if, a global spread is unknown The worst case will impact 40% to 50% of the population directly or indirectly All community and business services could be severely challenged Today- Start actions for Prevention, Response, Business Continuity and Communication.