6. Prevention & Mitigation ● Preparedness ● Response ● Recovery

9. Participant Guide

13. The Pandemic Influenza Preparedness for Schools multi-media training program was made possible through the dedication, time, and resources of the following people and organizations:

15. Project Lead: Leslie Heyden, MA (CDHS)

16. Project Coordinator: Kerdlyn Henry (CDHS)

18. Broadcast team:

19. Suzi Bouveron, MPH (CDHS) - Lead

20. Bruce Golden (CDLHN) - Producer

21. Everly Macario, ScD, MS, MEd (CDHS) - Content developer

22. Violet Macias-Reynolds, MS, MEd (CDLHN) - Producer

23. Stu Smith (Tamarisk Productions) - Director

25. Tabletop team:

26. Leslie Heyden, MA (CDHS) - Instructional designer and lead

27. Kathleen Harriman, PhD, MPH, RN (CDHS) – Content developer

28. Christina Sadorra (CDHS) – Production Editor

30. Website/online toolkit team:

31. Rebeca Boyte (CDHS) - Lead

32. Kerdlyn Henry (CDHS) - Editorial assistant

33. Eric Lindsey (CDHS) - Web and graphic designer

34. Mey Phu (CDHS) - Editorial assistant

35. John Reichel (CDHS) - Editorial assistant

36. Jake Richardson, MA (CDHS) - Web content manager

37. Christina Sadorra (CDHS) - Editorial assistant

38. Jana Stone, MPH (CDHS) - Editorial assistant

40. Promotion:

41. Ricky Dailey (CDLHN)

42. Mario Gutierrez (CDHS)

43. Kerdlyn Henry (CDHS)

44. Yvette Huerta (CDLHN)

45. Nicole Newman (CDLHN)

46. Max Nichols (CDLHN)

47. Scott Southward (CDLHN)

49. Advisors:

50. Howard Backer, MD, MPH (CDHS)

51. Marcy Connell Jones

52. Linda Davis-Alldritt, RN, PHN (CDE)

53. Natalie Nakahara, MFA (CDHS)

54. Tammy Pilisuk, MPH (CDHS)

55. John Talarico, DO, MPH (CDHS)

56. Special thanks to:

57. Tom Berry (Napa County Office of Education)

58. Kate Cummings, MPH (CDHS)

59. Sara Kaminske (Orange County Department of Education)

60. Megumi Kano, DrPH (UCLA School of Public Health)

61. Harvey Kayman, MD, MPH (CDHS)

62. Frank Kwan (Los Angeles County Office of Education)

63. Terry Longoria (Napa County Office of Education)

64. Jessica Micheletti (CDHS)

65. Bob Spears (Los Angeles Unified School District)

66. Nancy Spradling (CSNO)

67. Terri Stratton, MPH (CDHS)

68. Steve Vantine, LVN (CDHS)

69. Diane Visencio, MPH, RN, BC, PHN (Ventura County Public Health)

71. Pandemic Influenza Preparedness for Schools is a multi-media training program consisting of a satellite broadcast, a tabletop exercise, and the website ReadyCaSchools.org. It is a collaboration of the California Department of Health Services (CDHS), the California Department of Education (CDE), and the California Distance Learning Health Network (CDLHN). This statewide collaboration between California’s public health and education communities is designed to help schools (preschool through university) plan and increase their preparedness for a possible influenza pandemic.

72. After viewing the broadcast, you will be able to describe:

73. After participating in the tabletop exercise you will be able to:

74. The World Health Organization has identified 6 phases of a pandemic. They are: INTERPANDEMIC PERIOD WHO Phase 1: No new influenza virus subtypes have been detected in humans. If present in animals, the risk of human infection or disease is considered to be low. WHO Phase 2: No new influenza virus subtypes have been detected in humans. However, a circulating animal influenza virus subtype poses a substantial risk of human disease. PANDEMIC ALERT PERIOD WHO Phase 3: Human infection(s) with a new subtype but no human-to-human spread, or at most - rare instances of spread to a close contact. WHO Phase 4: Small cluster(s) with limited human-to- human transmission but spread is highly localized, suggesting that the virus is not well adapted to humans. WHO Phase 5: Larger cluster(s) but human-to-human spread still localized, suggesting that the virus is becoming increasingly better adapted to humans but may not yet be fully transmissible (substantial pandemic risk). PANDEMIC PERIOD POSTPANDEMIC PERIOD

79. Source: CDC Interim Pre- pandemic Planning Guidance: Community Strategy for Pandemic Influenza Mitigation in the United States, February 2007 Pandemic Influenza Community Mitigation Interim Planning Guide for Elementary and Secondary Schools

80. (Appendix 6 of the CDC Interim Pre-pandemic Planning Guidance: Community Strategy for Pandemic Influenza Mitigation in the United States)

81. Purpose

83. This Interim Planning Guide for Elementary and Secondary Schools is provided as a supplement to the Interim Pre-Pandemic Planning Guidance: Community Strategy for Pandemic Influenza Mitigation in the United States—Early, Targeted, Layered Use of Nonpharmaceutical Interventions. The guide is intended to assist in pre-pandemic planning. Individuals and families, employers, schools, and other organizations will be asked to take certain steps (described below) to help limit the spread of a pandemic, mitigate disease and death, lessen the impact on the economy, and maintain societal functioning. This guidance is based upon the best available current data and will be updated as new information becomes available. During the planning process, Federal, State, local, tribal, and territorial officials should review the laws, regulations, and policies that relate to these recommendations, and they should include stakeholders in the planning process and resolution of issues.

85. Schools will be essential partners in protecting the public’s health and safety when an influenza pandemic occurs. This Pandemic Influenza Community Mitigation Interim Planning Guide for Elementary and Secondary Schools provides guidance to educational institutions, describing how they might prepare for and respond to an influenza pandemic. When an influenza pandemic starts, public health officials will determine the severity of the pandemic and recommend actions to protect the community’s health. People who become severely ill may need to be cared for in a hospital. However, most people with influenza will be safely cared for at home.

87. Community mitigation recommendations will be based on the severity of the pandemic and may include the following:

89. Recommendations for dismissing students from classes will depend upon the severity of the pandemic. The current three-tiered planning approach includes 1) no dismissals in a Category 1 pandemic, 2) short-term (up to four weeks) dismissal of students during a Category 2 or Category 3 pandemic, and 3) prolonged (up to 12 weeks) dismissal of students from schools during a severe influenza pandemic (Category 4 or Category 5 pandemic).

91. In the most severe pandemic, the duration of these public health measures would likely be for 12 weeks, which would have educational implications for students. Planning now for a prolonged period of student dismissal may assist schools to be prepared as much as possible to provide opportunities for continued instruction and other assistance to students and staff. Federal, State, local, tribal, and territorial laws, regulations, and policies regarding student dismissal from schools, school closures, funding mechanisms, and educational requirements should be taken into account in pandemic planning. If students are dismissed from school but schools remain open, school- and education-related assets, including school buildings, school kitchens, school buses, and staff, may continue to remain operational and potentially be of value to the community in many other ways. In addition, faculty and staff may be able to continue to provide lessons and other services to students by television, radio, mail, Internet, telephone, or other media. Continued instruction is not only important for maintaining learning but also serves as a strategy to engage students in a constructive activity during the time that they are being asked to remain at home.

93. Planning now for a severe pandemic will ensure that schools are prepared to implement the community interventions that may be recommended. Be prepared to activate the school district’s crisis management plan for pandemic influenza that links the district’s incident command system with the local and/or State health department/emergency management system’s incident command system(s).

95. The Pandemic Flu Planning Checklist for K-12 School Districts describes approaches to school planning for a pandemic and can be found at www.pandemicflu.gov/plan/school/ index.html and www.ed.gov/admins/lead/safety/em ergencyplan/pandemic/planning- guide/index.html. Recommendations for implementation of pandemic mitigation strategies are available at www.pandemicflu.gov, and reliable, accurate, and timely information on the status and severity of a pandemic will also be posted on the Web site. Additional information is available from the Centers for Disease Control and Prevention (CDC) Hotline: 1-800- CDC-INFO (1-800-232- 4636). This line is available in English and Spanish, 24 hours a day, 7 days a week. TTY: 1-888- 232-6348. Questions can be e- mailed to cdcinfo@cdc.gov. www.pandemicflu.gov/plan/school/ index.html and www.ed.gov/admins/lead/safety/em ergencyplan/pandemic/planning- guide/index.html. Recommendations for implementation of pandemic mitigation strategies are available at www.pandemicflu.gov, and reliable, accurate, and timely information on the status and severity of a pandemic will also be posted on the Web site. Additional information is available from the Centers for Disease Control and Prevention (CDC) Hotline: 1-800- CDC-INFO (1-800-232- 4636). This line is available in English and Spanish, 24 hours a day, 7 days a week. TTY: 1-888- 232-6348. Questions can be e- mailed to cdcinfo@cdc.gov.

97. Recommendations for Planning

99. 1. Plan for ill individuals to remain at home

100. 2. Plan for all household members of a person who is ill to voluntarily remain at home

101. 3. Plan for dismissal of students and childcare closure for employees

103. 4. Plan for dismissal of students

105. 5. Plan for workplace and community social distancing measures

107. 6. Communicate with faculty, staff, students, and parents/families

109. 7. Help your community

110. 8. Recovery

112. References:

114. American Academy of Pediatrics. Children in Out-of- Home Child Care: Classification of Care Service. In: Pickering LK, ed. Red Book: 2003 Report of the Committee on Infectious Diseases. 26th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2003:124.

116. Bradley RH. Child care and common communicable illnesses in children aged 37 to 54 months. Arch Pediatr Adolesc Med. 2003 Feb;157(2):196-200.

117. Pandemic Flu Checklist for Local Educational Agencies in California

119. California Department of Education August 2006

121. CompletedIn Progress Not Started

122. CompletedIn Progress Not Started 1.2 Review communicable disease policies as well as district and school emergency/crisis response and safe school plans. 1.3 Determine if any additional policies or procedures are needed.1.4 Develop procedures for communicating with the local health department and the media during normal and emergency conditions. 1.5 Prepare for the possibility of schools functioning with up to 30 percent of all school staff absent. 1.6 Assess the financial impact of alternate scheduling, school closures, and before- and after- school programs closures.1.7 Assess the requirements of medically fragile students and students with special needs and incorporate the requirements into the emergency/pandemic response plan. 1.8 Develop communication and dissemination plans for staff, students, and families, including information about schedule changes, busing changes, and possible school closures.

124. CompletedIn Progress Not Started 1.9 Develop information about alternative instructional delivery systems and communicate that information to staff, students, and families to ensure that students continue to receive instruction and academic credit in the event of school closures. 1.10 Identify school-based individual(s) to work with the local health department pandemic planning committee on the possible need for school sites to help meet temporarily the health-related needs of the community.1.11 Identify strategies to provide meals for those children who rely on school meals as their primary source of daily nutrition. 1.12 Identify school-based individual(s) to educate all staff, including before- and after-school program staff, about pandemic flu and the school plan. 1.13 Identify school- based individual(s) to educate students, staff (including before- and after-school program staff), and parents about washing hands, following hygiene/cough etiquette, obtaining seasonal influenza vaccine, and staying home when sick. 1.14 Identify individual(s) to ensure (1) each room has adequate supplies of soap/water/paper towels or waterless hand sanitizer for hand washing and receptacles for disposal; and (2) basic hygiene supplies are replaced daily and trash is disposed of daily.1.15 Distribute and display “Stop the Spread of Germs” posters in each classroom. Posters are downloadable at http://www.cdc.gov/flu/protect/co vercough.htm and http://www.cdc.gov/germstopper /materials.htm. 1.16 Identify individual(s) to educate families about pandemic flu and the school plan. Family resources are available online at http://pandemicflu.gov/plan/tab3.html and http://pandemicflu.gov/planguid e/checklist.html.

126. CompletedIn Progress Not Started 1.17 Anticipate the potential fear and anxiety of staff, students, and families due to rumors and misinformation and plan communications accordingly. Consider developing key messages for various scenarios. 1.18 Identify school-based individual(s) to implement a tabletop exercise/drill to practice the emergency/pandemic response plan.

127. CompletedIn Progress Not Started

139. –Centers for Disease Control and Prevention, “Child Care and Preschool Pandemic Influenza Planning Checklist.” http://www.pandemicflu.gov/plan/preschool.ht ml –Centers for Disease Control and Prevention, “School District (K-12) Pandemic Influenza Planning Checklist.” http://www.pandemicflu.gov/plan/schoolcheckl ist.html –Tacoma/Pierce County Health Department, “Pandemic Flu Model Plan—Planning Tool for Schools.” http://www.tpchd.org/files/library/a4eaa3b511a 9687a.pdf –U.S. Department of State, “Pandemic Response Matrix.” http://www.state.gov/m/a/os/c17204.htm