1. Expect the Unexpected on Campus Sandra Samuels, MD Medical Director, Rutgers University Health Service - Newark

2. What is College Health? Traditional and Public Health Roles Medical & Counseling Service for ill and injured students or employees Educational and preventive health services for the campus community ADD – responsibility for campus safety, along with police, public health officials and central administration

3. Historical Context of our Current Public Health Concerns Trade Center Attack Sept 11, 2001 Inhalation Anthrax – Nov, Dec 2001 SARS - Feb, March 2003 AVIAN FLU in humans since Jan 2004 CDC warnings Nuclear, chemical and biological agents

4. Orderly Planning for Possible Threats Educate Health & Counseling Services Educate All Administrators on campus Training Programs - workshops, drills Collaboration – within the university, administration, student services, police Collaboration - with Public Health officials – local and state

5. AVIAN FLU – A LIKELY MODEL All about Avian Flu, the virus Detection, Prevention, Protection What if it hits our campus? Community? How prepared will we be? How well are we linked to our Public Health system? How will we know in advance?

6. KNOW YOUR ENEMY AVIAN FLU is a likely enemy – now in phase 3 of infectivity – will be pandemic at phase 5, by mutation, in <> 2yr Expect no one will be immune, Infectivity rate is 30%, death rate 50%, cycles of 8 – 12 weeks, may last one year Incubation 3 – 10 days, history of travel to high risk zones, case contact

7. FIGHT THE ENEMY Social distancing, Hygiene, Quarantine Diagnostic skills, self-protection Immunization – may take 8 months to develop vaccine Prophylaxis and treatment – Oseltamivir (Tamiflu) and Relenza (Zanamivir) useful – may not be useful by then ER, Hospitalization, respirators, nursing

9. Some Decision Points re Campus Life Organize Checklist for college campuses Open or close campus – distance learning? Public Health Officials will advise and guide Housing – international students, quarantine Who are essential personnel?

10. Decision Points Continued Communications Proper role for Campus Police Health Services – limited staff, self protection of staff, absences, isolation rooms, triage on site or by phone, points of distribution for vaccines, prophylaxis, treatment, mental health

11. FLIES IN THE OINTMENT Absenteeism – expect 40% or more Effect of absenteeism on administrative and other support systems – physical plant, research, teaching, patient care, law and order,nourishment, fear factor Referral to hospitals – overcrowded ERs and morgues

12. PUBLIC HEALTH LINKS

13. Importance of Public Health Links Guidelines per CDC, State & Local health officials On-Line Early Warning System LINCS Relate faces to names and telephone numbers – personal links Regular contact through meetings and trainings, participation in drills with local officials

14. Public Health & Health Services Bond Public officials have access to resources needed in case of mass emergency – vaccines, medication, respirators, masks, knowledge and experience Health Services are a source of trained providers to extend community service Campus community can be recruited and trained as medical reserve corps

15. LET US BE PREPARED to avoid crisis and confusion!