1. Pandemic Flu Preparation for individuals and families

2. CDC (Centers for Disease Control) www.cdc.gov click on the pandemic flu links Individuals and families planning Planning checklist for individuals and families Family guide, checklist and Information sheets

3. Pandemic Planning Assumptions Everyone will be susceptible to the virus 30% of the overall population will get the virus Highest among school aged children (40%) Decrease with age Working adults will be significantly affected (20%) will be ill) Some people will carry the virus but will not have symptoms of illness

4. Assumptions (continued) Fatalities will be more likely among certain groups Infants Elderly Pregnant women People with chronic medical problems Illness will be significant, however, even among young healthy persons Working adults

5. Assumptions (continued) Absenteeism May reach 40% due to Illness Need to care for ill family members Fear of infection Public health measures may necessarily increase the rate of absenteeism Closing schools Quarantine of household contacts

6. Assumptions (continued) Incubation Period Time between being exposed to the virus and having symptoms will be about 2 days Persons with virus can spread it to others even before they have symptoms Children will shed the greatest amount of virus and pose the greatest risk of transmission

7. Assumptions (continued) In any particular community the pandemic outbreak will last 6-8 weeks Depending on the fatality rate, the effects of the pandemic will last longer Waves of outbreaks across country may last 2-3 months Largest waves usually occur in Fall and Winter Pandemic may act differently - may occur in a different season

8. Illness, health care usage and death (Estimates based on past pandemics) Ilness Around 90 million persons - 1/3 of population Outpatient medical care 45 million - 1/2 of those that are sick Hospitalization 1 million to 10 million persons ICU 128,000 to 1.5 million Mechanical ventilators - 65,000 to 750,000 Deaths 200,000 to 2 million

9. Why is a pandemic different? Result of a new type of flu virus No natural immunity in population Vaccines would not prevent infection Longer lasting Even healthy adults at risk for serious complications Widespread Would affect every level of society because such a high proportion of people would be ill at same time Would affect all communities Limited ability of one community to help another

10. History 3 Pandemics in past century 1918 Most severe Almost 675,000 deaths in US 50 Million worldwide 1957 Moderately severe 70,000 US deaths and 1-2 million worldwide 1968 Least severe 34,000 US deaths and 700,000 worldwide Normally about 20-36,000 die from flu/year

11. Challenges/Disruptions Essential services Food and water supplies Schools and daycares Medical care for chronic illnesses

12. Challenges/Disruptions Essential Services Hospitals/Healthcare facilities Banks/ATMs Restaurants Govt offices Phone companies Post offices/Delivery services Stores

13. Challenges/Disruptions Public gatherings Meetings Prepare/distribute contact lists Email Conference calls Telephone chains Worship services Transportation limitations Public transportation limited Gas shortages

14. Planning Enough medications Family emergency plans Cash Fuel and fuel containers Essential supplies - decreased travel ability Rotating care schedule for family Family requiring medical care Children

15. Food and Water Problems Food distribution Farming/manufacturing Wholesale Transportation Retail Decreased ability to go to stores

16. Food and Water Planning Store 2 weeks of nonperishable food Foods that do not require refrigeration or preparation using water (save for drinking) Nuts Breads (freeze) Dried fruit Frozen meat and vegatables Canned foods Peanut butter Infant formulas Special diets for older persons Water - 2 weeks 1 Gallon per person per day

17. Workplace Problems May not be possible to work Transportation Decreased public gatherings Discuss with employer Staggered shifts Work from home Telecommuting Conference call procedures Save for loss of income

18. Schools and Daycare Schools, colleges, daycare, preschool may be closed to limit spread of illness Plan for children staying home for extended periods of time Educational materials Entertainment Recreation Plan with teachers Lesson plans Internet based courses

19. Medical care Problems Acute Emergency departments and clinics may be able to handle only the worst cases Chronic Visiting nurses and medical supply companies may have limited ability to function Drug stores may have limited supplies Hospitals may have limited resources Family care will be important

20. Medical Care Planning Continue medications to avoid problems Ensure adequate supply of: Medications Other medical supplies (glucose test strips) Speak with dialysis and chemo providers about plans to continue

21. Pandemic Influenza Prevention and Treatment Stay Healthy Cover mouth and nose with tissue when coughing or sneezing Wash hands Soap/Water Alcohol based cleaners Avoid close contact with sick persons If you are sick, stay away from others - especially groups School Work Mall

22. Vaccination Influenza viruses change over time Only helps with prevention, not treatment Short prodromal period Vaccine cannot be develop until a pandemic strain becomes identified Will take 4-6 months to develop Govt plans Develop vaccine to known strains Increase manufacturing capacity

23. Antivirals Antivirals are available to treat seasonal influenza Not a cure but shortened and less severe symptoms Unclear of how useful in pandemic flu Would not contain the spread but may shorten the period of illness Government is stockpiling antivirals Prescription only

24. Stay informed Bad information develops easily in disaster situations Refer to reliable data sources: www.pandemicflu.gov Centers for disease control hotline 800-232-4636 Local Health Department and local government web sites News media Private physician

25. Questions and Answers Is it safe to eat poultry? Cooking destroys viruses and bacteria The US has trade restrictions with countries where bird flu has been found in domestic poultry Guidelines for safe preparation: Wash hands Separate raw poultry and juices from other food Keep utensils and cutting boards clean Use a food thermometer - cook to at least 165 degrees.

26. Questions and Answers (cont) What types of birds carry bird flu? Avian influenza can infect a wide variety of domestic and wild birds including migratory birds.

27. Questions and Answers (contd) Will the flu shot protect against pandemic influenza? The usual yearly flu vaccine will not protect against pandemic influenza but can help avoid the seasonal flu which will still be present and causes 20,000 to 30,000 deaths a year. Get a pneumonia shot to help protect against pneumonia. Make sure other immunizations are up-to-date.

28. What is being done to prepare? Monitoring birds for avian flu Working with WHO to detect pandemic flu early if it occurs Improving manufacturing and testing of vaccines Supporting local governments in disseminating information through summits like this one Encouraging and assisting agencies, businesses and institutions in planning for the effects of a pandemic

29. A different focus An influenza pandemic will be severely taxing to society for a period of several months This will require a change in focus and priorities The usual institutions that we rely on will be overwhelmed and will require that each person concentrate on providing assistance to their family and neighbors Neighborhood organization Checking on elderly chronically ill Helping to care for children Volunteers that may be able to help Elderly people Single parent with small children Organized trips for fuel and water Drop offs