Pandemic Influenza Continuity of Operations Guide & Template

Transcription

1 Building Community Resilience Pandemic Influenza Continuity of Operations Guide & Template For San Mateo County Vulnerable Populations Provided by: San Mateo County Health Department San Mateo County Pandemic Influenza Vulnerable Populations 1

2 TABLE OF CONTENTS Important Information from the San Mateo County Health Officer.Section 1 Pandemic Flu Information Sheet......Section 2 Planning Checklist......Section 3 Pandemic Response Strategy.....Section 4 Frequently Asked Questions Section 5 Common Pandemic Planning Terms.. Section 6 Role of the San Mateo County Health Department......Section 7 Available Assets and Resources Form......Section 8 Preparedness Reporting Form. Section 9 Additional Information and Resources..Section 10 2 San Mateo County Pandemic Influenza Vulnerable Populations

3 1. IMPORTANT INFORMATION FROM THE SAN MATEO COUNTY HEALTH OFFICER The global health community is closely monitoring the occurrence of the H5N1 avian influenza (bird flu) virus prevalent throughout Asia, parts of Europe and now Africa. Although it primarily affects birds, there is significant concern that the virus could change to a type that spreads more easily from person to person, producing a worldwide influenza epidemic (referred to as a pandemic ). Although no one knows for sure when the next pandemic will occur, or what new influenza virus will cause a pandemic, the impact on society could be enormous. Individuals and organizations need to prepare themselves for the possibility of a severe pandemic. A key operating principle of the planning should be one of self-sufficiency. Because of the world-wide nature of pandemics, and the potential for social and economic disruptions, we all need to be as selfsufficient as possible. Critical shortages of workers and supplies are likely to occur as people remain home due to their own illness or to care for sick family members, etc.. This Pandemic Influenza Continuity of Operations Guide and Template has been developed by the San Mateo County Health Department to assist organizations like yours, throughout the County, to think through critical issues related to pandemic influenza and to help create comprehensive plans to address your needs. Once finalized this plan should be folded into your organization s overall emergency response plan. The content within the template should be considered a starting point. It will be necessary to create a final plan that effectively serves your organization. We are pleased to provide you with these materials to assist you with your pandemic planning efforts. Please remember that pandemic planning is not something we can do alone. We all have a part in getting ready. Sincerely, Scott Morrow, MD Health Officer County of San Mateo 3 San Mateo County Pandemic Influenza Vulnerable Populations

4 2. PANDEMIC FLU INFORMATION SHEET There are many steps that can be taken now to help prepare for and respond to a possible influenza pandemic. The following planning assumptions should be considered as you and your organization work to develop your Pandemic Influenza Continuity of Operations Plan: Current Alert Level - We are currently in the Green stage. This is the stage for planning. The later stages are for plan execution. The time interval between the Green stage and the Yellow stage is unknown. The time interval between all stages may be rapid, ranging from days to weeks to months. Duration The pandemic may last anywhere from 9 to 24 months. It will occur as 3 separate waves (or cycles) lasting from 6-18 weeks each. Mortality and morbidity will be highest in the first wave. Arrival of the Outbreak - The pandemic will arrive with less than six weeks notice. Personnel - expect an employee absenteeism rate of approximately 40-50%; employees will either be directly ill or taking care of family members that are ill or fearful of coming to work Community Issues- Assume any public gatherings or congregate settings will be closed. Restaurants, malls, theaters and other events are likely to be closed. Family Issues -Schools and childcare settings are likely to be non-operational. Inventory/Raw Materials/Supply Deliveries will be disrupted; transported materiel will be delayed or unavailable. Assume no re-supply for 6-8 weeks. Stockpiles of essential items need to be developed. Contractors/Vendors/Consultants Critical functions carried out by contractors, vendors, or consultants cannot be guaranteed. Medical treatment/prophylaxis Vaccine Not available for at least six months; when available, supply will be short. There will be a priority set of individuals who receive vaccine. Anti-virals Very expensive and in short supply; no guarantee that they will be effective against the new strain Medical care- All levels of medical care, including critical care, may be rationed. Travel All modes of transportation may be limited. Civil Society- infrastructure will be stressed, but remain functional at a low level. Surveillance-The Health Department will regularly communicate to partners as to the level of transmission locally. 4 San Mateo County Pandemic Influenza Vulnerable Populations

5 3. PLANNING CHECKLIST ORGANIZATIONS SERVING VULNERABLE POPULATIONS PANDEMIC INFLUENZA PREPAREDNESS CONTINUITY OF OPERATIONS CHECKLIST Please read the information contained in this Continuity of Operations Guide & Template before considering the questions on this checklist. The collaboration of community organizations with public health agencies will be essential in protecting the public s health and safety if and when an influenza pandemic occurs. This checklist provides guidance for social service agencies in developing and improving influenza pandemic response and preparedness plans. Many of the points suggested here can improve your organization s ability to protect your community during emergencies in general. You can find more information at Organizational and Operations Plan Plan for the impact of a pandemic on the organization and its mission Questions to consider: 5 Not Started In Progress Completed 1 Which key staff person is responsible for maintaining and acting upon the influenza pandemic continuity of operations plan? 2 What is the potential impact of a pandemic on the organization s usual activities and services? What situations are likely to require increasing, decreasing or altering the services the organization delivers? What services are essential? Are there alternative ways clients can access services? 3 What is the potential impact of a shortage of outside resources that the organization depends on to deliver its services (e.g., vendors, supplies)? Who and/or what are the alternatives? What critical supplies can be stockpiled? 4 What organizational structure will be used during an emergency? Who are the key contacts? Back-ups? What are the roles and responsibilities? Who is supposed to report to whom? 5 Which essential services can be done remotely? What is the plan to deliver these services? Are resources in place to deliver services remotely? Communication Plan Communicate with and educate staff, clients and people in the communities served during a pandemic Questions to consider: Not Started In Progress Completed 1 Are up-to-date, reliable pandemic information and other public health advisories from the state and the local health department, emergency management agencies, and CDC available to our staff and clients? 2 Have materials with basic information about pandemic influenza: signs and symptoms, how it is spread, ways to protect yourself and your family (e.g., respiratory hygiene and cough etiquette), family preparedness plans, and how to care for ill persons at home been distributed to staff and clients? 3 Has basic information about pandemic influenza been included in public meetings (e.g. sermons, classes, trainings, small group meetings and announcements)? 4 Has information about the pandemic preparedness and response plan been shared with staff, and San Mateo County Pandemic Influenza Vulnerable Populations

6 persons in the communities that we serve? 5 Are the communication systems (i.e. radios, cell phones, laptops) operational? Can they handle increased use? 6 Is there a plan for addressing rumors, misinformation, fear and anxiety? 7 Is important contact information, including after hours and emergency numbers, up to date? 8 How will urgent information be communicated (e.g. change in schedules)? Staff Plan Plan for the impact of a pandemic on staff, clients and people in the communities served Not Started In Progress Completed Questions to consider: 1 What are the minimum staffing requirements? 2 Is there a plan for staff absences (including full-time, part-time and volunteer staff) during a pandemic due to personal and/or family illnesses, quarantines, and school, business, and public transportation closures? 3 Is essential staff (including full-time, part-time and unpaid or volunteer staff) trained to carry on the organization s work during a pandemic? Are there back up plans to cross-train staff in other jobs so that if staff are sick, others are ready to come in to carry on the work? 4 Have staff, clients, and persons in the communities served been encouraged to obtain the yearly influenza vaccination? 5 Is there access to mental health and social services during a pandemic for staff, clients, and persons in the communities served? 6 Have persons with special needs (e.g. elderly, disabled, limited English speakers) been identified? 7 Are their needs included in the response and preparedness plan? Policy Plan Set up policies to follow during a pandemic Not Started In Progress Completed Questions to consider: 1 Are there policies for non-penalized staff leave for personal illness or care for sick family members during a pandemic? 2 Is there a mandatory sick-leave policy for staff suspected to be ill, or who become ill at the worksite? 3 Are there policies for flexible work hours and working from home? 4 How will staff access healthcare services during a pandemic? 5 Will the organization s usual activities and services (including rites and religious practices if applicable) facilitate virus spread from person to person? If so, are there policies to modify these activities to prevent the spread of pandemic influenza (e.g. guidance for respiratory hygiene and cough etiquette, and instructions for persons with influenza symptoms to stay home rather than visit in person.)? 6 What are the procedures for activating the organization s response plan when an influenza pandemic is declared by public health authorities? 7 What methods will be used to expedite purchases that may be necessary and unforeseen? Protective Resource Allocation Plan Allocate resources to protect staff, clients, and people in the communities served during a pandemic Questions to consider: Not Started In Progress Completed 1 What is the amount of supplies needed to promote respiratory hygiene and cough etiquette and how they will be obtained (e.g. PPE)? 2 What is the procedure for cleaning work areas if someone becomes ill at the worksite? 6 San Mateo County Pandemic Influenza Vulnerable Populations

7 Coordination Plan Coordinate with external organizations Not Started In Progress Completed Questions to consider: 1 Is there an understanding of the roles of federal, state, and local public health agencies and emergency responders and what to expect and what not to expect from each in the event of a pandemic? 2 Is there a point of contact for communication and coordination between the organization and state and local public health systems? 3 Is there a plan to obtain medical advice and timely/urgent healthcare services and treatment for staff, clients, and persons in the communities served? 4 Is there a plan to work together with other Faith-Based and Community Organizations in the local area and through networks (e.g. denominations, associations, etc) to share best practices and help communities prepare for pandemic influenza? 5 Is there a list of resources and assets that could be used or made available to local and/or state public health agencies, emergency responders, and/or local healthcare facilities? 7 San Mateo County Pandemic Influenza Vulnerable Populations

8 4. PANDEMIC RESPONSE STRATEGY Phase GREEN Little or no human transmission (Preparation Phase) YELLOW Limited to moderate human transmission County of San Mateo Department of Public Health Monitor status worldwide Monitor status locally Assist general public to become self-sufficient Establish close working relationships with businesses, local communities and community-based organizations Design exercises and drills Ensures communication systems are in place to support: - Alert notifications - Disease surveillance, contact tracing - Tracking vaccine and antiviral supplies - Monitoring vaccine and antiviral adverse events -Tracking hospital resources and needs. Communicate change in status to the public Implement phased public health legal strategies- Individually based isolation/quarantine orders, selected school and business closures, limitation of public gatherings Monitor status worldwide Monitor status locally Begin disease surveillance, contact tracing Track vaccine and antiviral supplies Monitor vaccine and antiviral adverse events Track hospital resources and needs. All Agencies and Organizations Begin pandemic flu planning using Health Department guidelines Review and update existing emergency plans and procedures Ensure essential services are identified Ensure essential supplies necessary to provide essential services are available (stockpile) Identify how essential services will be delivered with when there are shortages of key personnel and essential supplies Develop communication mechanisms with vendors and partners Regularly update staff about situation Train staff on their role in an emergency Participate in exercises and drills Issue PPE (masks) to selected staff Cooperate with Health Department (HD) instructions Communicate change in status to all staff Prepare to perform essential services only Increase use of telecommuting and social distancing strategies Distribute PPE to assigned personnel Ensure staff understand self-protection strategies Encourage use of surgical masks, basic respiratory hygiene strategies, and social distancing 8 San Mateo County Pandemic Influenza Vulnerable Populations

9 Pandemic Response Strategy Phase RED Extensive human transmission BLACK Uncontrolled and uncontrollable transmission County of San Mateo Department of Public Health Communicate change in status to the public Implement full scale public health legal strategies- Individually based isolation/quarantine orders, selected school and business closures, limitation of public gatherings Monitor status worldwide Monitor status locally Continue disease surveillance, contact tracing Track vaccine and antiviral supplies Monitor vaccine and antiviral adverse events Track hospital resources and needs. Communicate change in status to the public Enforce full scale public health legal strategies-individually based isolation/quarantine orders, selected school and business closures, limitation of public gatherings Minimal, if any, government service will be available Only austere medical care will be available Monitor status worldwide Monitor status locally Continue disease surveillance, contact tracing Track vaccine and antiviral supplies Monitor vaccine and antiviral adverse events Track hospital resources and needs. All Agencies and Organizations Initiate response plans Follow HD instructions Communicate change in status to all staff and clients Perform essential services only Maximize telecommuting option Deploy PPE to assigned personnel Ensure staff follows self-protection strategies Follow HD instructions Communicate change in status to all staff and clients Perform essential services, if possible Ensure staff follows self-protection strategies Maximize telecommuting option Communicate to staff that they are on their own and should not expect any outside assistance 9 San Mateo County Pandemic Influenza Vulnerable Populations

10 5. FREQUENTLY ASKED QUESTIONS GENERAL QUESTIONS Q. What is an influenza pandemic? A. An influenza pandemic is a global outbreak that results from the emergence of a new influenza virus that can cause serious illness in humans, and spreads easily from person to person. Q. What s the difference between a pandemic and a seasonal outbreak of influenza? A. Influenza pandemics are caused by the emergence of a virus that is new or radically different from flu viruses that circulated previously. Because people have no or little natural resistance to a new virus, and there is no readily-available vaccine, influenza pandemics often result in much more severe illness and death. Q. When will the next pandemic occur? A. No one can predict when a pandemic might occur, but many scientists from around the world are watching the H5N1 avian (bird) influenza situation in Asia and Europe very closely. They are preparing for the possibility that the virus in birds may change and become more easily transmissible among people. There were three influenza pandemics in the 20th century, in 1918, 1957 and Experts believe we are overdue for the next influenza pandemic. H5N1 AVIAN (BIRD) INFLUENZA Q. Why is there concern about the H5N1 avian influenza outbreak in Asia and other countries? A. This bird flu virus, known as highly pathogenic H5N1, has raised concerns about a potential human pandemic because: This H5N1 virus is widespread and persistent in poultry in many countries in Asia and has spread to birds in several countries in Europe The virus has been transmitted from birds to a few species of mammals and in some limited circumstances to humans Among humans known to have become infected with the avian H5N1 virus, many have developed serious illness and approximately 50 percent have died Wild birds and domestic ducks have been infected without showing symptoms and have become carriers of viral infection to other domestic poultry species Although most humans who were infected with the H5N1 virus had close contact with infected birds, a few cases of limited person-to-person transmission have been reported Genetic studies confirm that this H5N1 influenza virus, like other influenza viruses, is continuing to change and may change in a way that enables it to be easily transmitted from person-to-person 10 San Mateo County Pandemic Influenza Vulnerable Populations

11 Q. Is the influenza A (H5N1) virus the only avian influenza virus of concern regarding a pandemic? A. Although H5N1 probably poses the greatest current pandemic threat, other avian influenzas have also infected people in recent years. For example, in 1999, human H9N2 infections were identified in Hong Kong; in 2002 and 2003, human H7N7 infections occurred in the Netherlands and human H7N3 infections occurred in Canada. These viruses also have the potential to give rise to the next pandemic. VACCINE AND ANTIVIRAL MEDICATIONS Q. Is there a pandemic influenza vaccine? A. No. Federal officials have contracted with a manufacturer to produce a small supply of human vaccine against H5N1 bird flu, and clinical trials are underway. The vaccine might not be effective if the H5N1 virus changes to a strain that more easily infects humans. Q. Why isn t there a vaccine available? A. Large amounts of vaccine cannot be made before knowing exactly which virus is causing a pandemic. Production of a new vaccine takes approximately six months. Q. Why won t the annual flu vaccine protect people against pandemic influenza? A. Influenza vaccines are designed to protect against specific viruses that have already been identified, so a pandemic vaccine cannot be produced until a new influenza virus emerges and causes significant human illness. A virus that could cause a pandemic would be very different from the seasonal flu viruses for which there is already vaccine. Q. Can I get the vaccine once it s developed? A. Very few people would be able to get vaccinated at first. If a pandemic occurs, federal, state and local governments will work with partner groups to make specific recommendations on the early use of vaccine. Current recommendations are to target limited vaccine supplies to people at high risk and healthcare workers. Q. What are influenza antiviral medications? A. These are prescription drugs that can reduce influenza symptoms and shorten the length of time people are sick. The drugs may also make a person less likely to spread influenza to others. To be effective, they must be taken within two days of becoming sick. Some antiviral medications may also be used to prevent influenza if they are taken over a long period of time. Q. Which antiviral medications would be used in an avian flu pandemic? A. At this time, Tamiflu and Relenza are the most likely antiviral medications to be used in a pandemic caused by the H5N1 virus. The effectiveness of these antivirals would vary depending on the level of resistance an influenza virus may have to one or more of these medications. 11 San Mateo County Pandemic Influenza Vulnerable Populations

12 Q. Are there enough antiviral medications for everyone if a pandemic occurred now, and if not, who will get them? A. No. Although the government is stockpiling antiviral medications, there are not enough now for everyone. The federal government has made recommendations about prioritizing who will be the first to receive antiviral medications based on their risk, role in fighting the pandemic, and severity of illness. Discussion continues on the best way to allocate these medications. PREPARING FOR AN INFLUENZA PANDEMIC Q. What effect would an influenza pandemic have on our communities? A. The effects of a pandemic could be severe. Many people could become sick at the same time and be unable to go to work. Many of us might have to stay at home to care for sick family members. Schools and businesses might close for a time to try to reduce the spread of disease. Large group gatherings might be canceled. These are examples of challenges that are being considered as we plan for a pandemic response. Q. What can I do right now to prepare for a possible pandemic? A. One of the most important things you can do is to help prevent spread of the disease. Begin now to practice simple but important habits that reduce the spread of germs: Cover your mouth and nose with a tissue when coughing and sneezing. Throw out the tissue in the nearest wastebasket and wash your hands If you don t have a tissue, don t cough or sneeze into your hand. Instead, cough or sneeze into the crook of your arm so you won t get germs on your hands and spread them to others Wash your hands often with soap and water. When hand washing is not possible, use antiseptic hand gels that contain alcohol Stay at least three feet away from people who are coughing or sneezing Always practice good hand washing after contact with an ill person or soiled materials, such as tissues Stay at home when you are sick Keep your children home from school or daycare when they are sick If you go to the doctor s office or emergency department when you are sick, ask for a mask Keep a supply of non-perishable food and other essential household items on hand so you can minimize trips to stores and other crowded places in the event of a pandemic Take steps to plan now for the possibility of a pandemic at home and at your facility or organization Stay informed 12 San Mateo County Pandemic Influenza Vulnerable Populations

13 6. COMMON PANDEMIC PLANNING TERMS Antiviral Medications Avian Influenza Contact Essential Services Essential Supplies H5N1 Hand Hygiene Human-to-Human Transmission Infection Control Infectious Disease Influenza Medicines that can help to lessen the symptoms of diseases that are caused by viruses, such as influenza. Avian influenza, also referred to as bird flu, is a disease of birds (e.g. ducks, chickens). Between 2003 and 2006 the H5N1 avian influenza virus has infected millions of birds. Although it is primarily a disease of birds a small number of people have also been infected after having close contact with birds. Also see influenza, seasonal influenza, and pandemic influenza. A contact refers to someone who has been in close proximity with an individual who is, or is suspected of being, infected with an infectious disease like influenza. Examples of essential services: delivery of clean water, delivery of food, delivery of fuel, delivery of essential medications, maintaining the communication infrastructure, and maintaining the electricity grid. Examples of essential supplies: water, food, cleaning supplies, medications, fuel, medical equipment, etc. H5N1 is the latest avian influenza virus subtype of concern. There appears to be little human immunity to it. The predominant winter strain of human influenza is H3N2. Most adults have some partial immunity to this strain, which caused a pandemic in 1968 when it evolved from avian influenza. Hand hygiene is a term that applies to the cleaning of one s hands. This is usually done with soap and water, hand sanitizer, or hand wipes. To kill an influenza virus hands must be washed with soap and water for 15 seconds and hand sanitizers or wipes must be used for 10 seconds and have an alcohol content of at least 60%. Human-to-human transmission refers to the ability of an infectious diseases to be passed from one person to another. Infection control is broad term used to describe a number of measures designed to detect, prevent, and contain the spread of infectious disease. Some measures include hand washing, respiratory etiquette, use of personal protective equipment (PPE), prophylaxis, isolation, and quarantine. An infectious disease, or communicable disease, is caused by the entrance of organisms (e.g. viruses, bacteria, fungi) into the body which grow and multiply there to cause illness. Infectious diseases can be transmitted, or passed, by direct contact with an infected individual, their discharges (e.g. breath), or with an item touched by them. Influenza is a viral disease that causes high fever, sore throat, cough, and muscle aches. It usually affects the respiratory system but sometimes affects other organs. It is spread by infectious droplets that are coughed or sneezed into the air. These droplets can land on the mucous membranes of the eyes or mouth or be inhaled into the lungs of another person. Infection can also occur from contact with surfaces contaminated with infectious droplets and respiratory 13 San Mateo County Pandemic Influenza Vulnerable Populations

14 secretions. Also see seasonal, avian, and pandemic influenza. Isolation Pandemic Influenza Personal Protective Equipment (PPE) Points of Dispensing (PODs) Prophylaxis Quarantine Respiratory Etiquette Seasonal Influenza Social Distancing Worried Well Isolation is when sick people are asked to remain in one place (e.g. home, hospital), away from the public, until they are no longer infectious. A pandemic influenza, or pandemic flu, occurs when a new subtype of influenza virus: 1) develops and there is little or no immunity (protection due to previous infection or vaccination) in the human population; 2) it is easily passed from human to human; 3) is found in many countries; and, 4) causes serious illness in humans. Also see influenza, seasonal influenza, and avian influenza. PPE is specialized clothing or equipment worn to protect someone against a hazard including an infectious disease. It can range from a mask or a pair of gloves to a combination of gear that might cover some or all of the body. Locations at which mass vaccinations or mass distribution of medicine would be carried out if vaccine and/or antivirals became available. Prophylaxis is an infection control measure whereby antimicrobial, including antiviral, medications are taken by a healthy individual (e.g. nurse, contact) to prevent illness before or after being exposed to an individual with an infectious disease (e.g. influenza). A quarantine is when people who have been in close proximity to an infected person, but appear healthy, are asked to remain in one place, away from the general public, until it can be determined that they have not been infected. Respiratory etiquette, or good coughing and sneezing manners, is one way of minimizing the spread of viruses which are passed from human-to-human in the tiny droplets of moisture that come out of the nose or mouth when coughing, sneezing, or talking. Healthy and sick people should cover their nose and mouth when sneezing, coughing, or blowing their nose and then put the used tissue in the trash to prevent the spread of germs. Seasonal influenza, commonly referred to as the flu, is an infectious disease. In the United States, flu season usually occurs between December and March. The influenza virus is one that has the ability to change easily; however, there is usually enough similarity in the virus from one year to the next that the general population is partially immune from previous infection or vaccination. Each year experts monitor the influenza virus and create a new vaccine to address changes in the virus. For this reason people are encouraged to get a flu shot each year. Also see influenza, avian influenza, and pandemic influenza. Social distancing is an infection control strategy that includes methods of reducing the frequency and closeness of contact between people to limit the spread of infectious diseases. Generally, social distancing refers to the avoidance of gatherings with many people. Individuals who are experiencing symptoms of a disease because they are anxious or stressed. 14 San Mateo County Pandemic Influenza Vulnerable Populations

15 7. ROLE OF THE SAN MATEO COUNTY HEALTH DEPARTMENT San Mateo County Health Department The San Mateo County Health Department will be the lead government agency in coordinating city/county wide public health and emergency medical response and will activate its Department Operations Center (DOC) and request the activation of the city-wide Emergency Operations Center (EOC) when a unified response is necessary. The development and pattern of the new influenza virus strain and the current situation will influence the health department s response. Specific guidance and policies, based on up-to-date intelligence, will be communicated throughout each alert stage. The table Pandemic Response Strategy outlines the specific stages of the San Mateo County Health Department s pandemic influenza response strategy and selected activities, along with those for all agencies and organizations. The guidelines encourage community organizations to play a role in quelling panic and misinformation in the event of widespread disease outbreaks, evaluate ongoing access to social services, and identify people with special needs, such as the elderly or the disabled. For more detail on the County s complete activities during each stage of a possible pandemic situation, see the Pandemic Flu Preparedness Response Plan: Phase 1 which can be found on at: Because of the possibility of severe adverse impacts to our community, the San Mateo County Health Department has made preparation for pandemic flu one of its highest priorities. Every individual, as well as all sectors of our community, has a role to play in preparing for pandemic flu. 15 San Mateo County Pandemic Influenza Vulnerable Populations

16 8. AVAILABLE ASSETS AND RESOURCES FORM ORGANIZATIONS SERVING VULNERABLE POPULATIONS PANDEMIC INFLUENZA PREPAREDNESS AVAILABLE ASSETS AND RESOURCES In a pandemic emergency, it may become necessary for officials to locate and use various assets and resources within the county to address vital health and safety needs that may exist. It is difficult to anticipate what the specific needs may be. Please list any assets and resources your organization would be willing to make available in an emergency situation. Examples include: extra storage space, meeting rooms, specialized equipment (i.e. generators, etc.), refrigeration capacity, etc. Name of Organization Address Contact Name Phone Asset/Resource Size or Quantity 16 San Mateo County Pandemic Influenza Vulnerable Populations

17 9. PREPAREDNESS REPORTING FORM ORGANIZATIONS SERVING VULNERABLE POPULATIONS PANDEMIC INFLUENZA PREPAREDNESS REPORTING FORM Name of Organization Address Contact Name Phone Organizational and Operations Plan Plan for the impact of a pandemic on the organization and its mission Communication Plan Communicate with and educate staff, clients and people in the communities served during a pandemic Staff Plan Plan for the impact of a pandemic on staff, clients and people in the communities served Not Started Not Started Not Started In Progress In Progress In Progress Completed Completed Completed Policy Plan Set up policies to follow during a pandemic Not Started In Progress Completed Protective Resource Allocation Plan Allocate resources to protect staff, clients, and people in the communities served during a pandemic Coordination Plan Coordinate with external organizations Not Started Not Started In Progress In Progress Completed Completed 17 San Mateo County Pandemic Influenza Vulnerable Populations

18 10. ADDITIONAL INFORMATION AND RESOURCES The following informational materials are provided by the San Mateo County Health Department prior to, during, and after a pandemic at 1. Pandemic Influenza: Continuity of Operations Guide for organizations serving vulnerable populations For current version see: and click on Pandemic Flu 2. Pandemic Influenza: Planning Forms and Tools for Continuity of Operations See: and click on Pandemic Flu to download the following planning forms and tools: Form 1 Form 2 Form 2A Form 2B Form 2C Form 2D Form 2E Form 2F Form 2G Form 3 Form 3A Form 3B Form 4 Form 4A Form 4B Form 4C Form 5 Form 6 Form 6A Form 6B Form 6C Form 7 Form 7A Form 7B Form 8 Form 8A Form 8B Form 9 Form 9A Form 9B Form 10 Form 10A Form 10B Form 10C Pandemic Influenza Planning Team Authority & Procedures Activation Procedures Alterations to Initial Procedures Terminating Procedures Other Planning, Response, or Recovery Procedures Communication with Health Department Communication with the Public Communication with Local Organizations Essential Operations Security Needs Financial Processes Essential Job Functions Reassignments Telecommuting Training for Essential Job Functions Pandemic Policies Management of Ill Employees Illness Notification & Recordkeeping Workplace Cleaning Return to Work Product & Service Vendors Stockpile Critical Supplies Vendor Continuity Information Dissemination Plan Communication Testing Communication Layers of Redundancy Informational Materials Infection Control Supply Inventory Social Distancing Considerations Infection Control Infection Control Product Inventory Personal Protective Equipment (PPE) Control Containment Strategies 18 San Mateo County Pandemic Influenza Vulnerable Populations

19 3. Avian Influenza (Bird Flu): Frequently Asked Questions Available in English, Spanish, and Chinese. For recent versions: see 4 Pandemic Influenza Infection Control Strategies for Work & Home Information sheet is available at 5. Personal and Family Disaster Kit Information sheet is available at 6. Order Form for free Hand Washing Posters Available at 19 San Mateo County Pandemic Influenza Vulnerable Populations

20 Disclaimer and Copyright The County of San Mateo pulled from a number of public domain sources including the CDC (Centers for Disease Control), the WHO (World Health Organization), the City/County of San Francisco, among others, to develop this template for the use in San Mateo County. This document is not subject to copyright protection and may be reproduced or modified free of charge in any format or media without requiring specific permission. This document and other avian and pandemic influenza information can be found on our website in Adobe PDF and Microsoft Word formats and may be updated periodically. The Pandemic Influenza Continuity of Operations Guide and Template provides general guidance for organizations planning to respond to the threat of pandemic influenza. The information in this document should not be relied upon without reference to legal, occupational health and safety, infection control, and public health expertise tailored to your specific workplace. Because of the evolving nature of this threat, up to date information should be sought at and from other reliable sources referenced in this document. Future revisions will be available on the website. 20 San Mateo County Pandemic Influenza Vulnerable Populations

21 Building Community Resilience Pandemic Influenza Forms For San Mateo County Vulnerable Populations Provided by: San Mateo County Health Department 1

22 Disclaimer and Copyright The County of San Mateo pulled from a number of public domain sources including the CDC (Centers for Disease Control), the WHO (World Health Organization) the City/County of San Francisco, among others, to develop this template for the use in San Mateo County. This document is not subject to copyright protection and may be reproduced or modified free of charge in any format or media without requiring specific permission. The Pandemic Influenza Vulnerable Population Continuity Guide and Template provides general guidance for organization planning to respond to the threat of pandemic influenza. The information in this document should not be relied upon without reference to legal, occupational health and safety, infection control, and public health expertise tailored to your specific workplace. Because of the evolving nature of this threat, up to date information should be sought at and from other reliable sources referenced in this document. Future revisions will be available on the website. 2

23 OLS SAMPLE FORMS & REPORTING TOOLS Form 1 Pandemic Influenza Planning Team Form 2 Authority & Procedures Form 2A Activation Procedures Form 2B Alterations to Initial Procedures Form 2C Terminating Procedures Form 2D Other Planning, Response, or Recovery Procedures Form 2E Communication with Health Department Form 2F Communication with the Public Form 2G Communication with Local Organizations Form 3 Essential Operations Form 3A Security Needs Form 3B Financial Processes Form 4 Essential Job Functions Form 4A Reassignments Form 4B Telecommuting Form 4C Training for Essential Job Functions Form 5 Pandemic Policies Form 6 Management of Ill Employees Form 6A Illness Notification & Recordkeeping Form 6B Workplace Cleaning Form 6C Return to Work Form 7 Product & Service Vendors Form 7A Stockpile Critical Supplies Form 7B Vendor Continuity Form 8 Information Dissemination Plan Form 8A Communication Testing Form 8B Communication Layers of Redundancy Form 9 Informational Materials Form 9A Infection Control Supply Inventory Form 9B Social Distancing Considerations Form 10 Infection Control Form 10A Infection Control Product Inventory Form 10B Personal Protective Equipment (PPE) Control Form 10C Containment Strategies

24 FORM 1: PANDEMIC INFLUENZA PLANNING TEAM The (sample) pandemic influenza planning team responsible for developing the continuity of operations plan is: Role Name Phone # Emergency # Continuity of Operations Plan Coordinator Information Coordinator Technical Processes Human Resources Financial Information Legal Responsibilities Data Security Building Security Health and Safety Officer Representative on San Mateo County Pandemic Flu Planning Team Regular Meeting Times: Plan Completion Date: Plan Exercise Date: 4

25 FORM 2: AUTHORITY & PROCEDURES The following sections outline the authority and procedures for activating and implementing the Pandemic Influenza Continuity of Operations Plan: Tip Your agency may already have this information as part of their overall emergency response plan. If so, attach to Form 2. LEADERSHIP SUCCESSION During an influenza pandemic, management of the agency is delegated to the following persons in the order of succession shown below: 1. Director: 2. Deputy Director: 3. Deputy Officer: 4. Deputy Officer: 5. Deputy Officer: 6. Deputy Officer: 7. Deputy Officer: 8. Deputy Officer: If a designated individual is unavailable, authority will pass to the next individual on the list. Unavailable is defined as: The designated person is incapable of carrying out the assigned duties by reason of death, disability, or distance from/response time to the operations facility. The designated person is unable to be contacted within [#] minutes. The designated person has already been assigned to other emergency activities. The designated individual retains all assigned obligations, duties, and responsibilities until officially relieved by an individual higher on the list of succession. DELEGATION OF AUTHORITY To ensure that [Agency] staff identified in the leadership succession are aware of their responsibilities and are appropriately authorized to execute functions assigned to them, explicit emergency authority has been pre-delegated. In the event of a disaster or emergency, and the [Agency] Director is unavailable (as defined above), alternate personnel are authorized to perform the following functions: All operational tasks normally performed by the Director. Expenditure approval consistent with established San Mateo County Health Department procedure. Personnel task and work assignments. Policy level authority and decision making 5

26 PLAN ACTIVATION The San Mateo County Health Department will alert city agencies of the emergence of a pandemic influenza strain internationally and locally. Updates on the spread of the virus in San Mateo County (a few local cases, clusters of cases, and widespread infection) will be made regularly. The [Agency] director or their appointee or successor activates the Pandemic Influenza Continuity of Operations Plan and the DOC when it is necessary to manage and coordinate a response. This decision will be made in consultation with key [Agency] and city partner leaders. [Insert additional protocols] 6

27 FORM 2A: ACTIVATION PROCEDURES Trigger Procedure Date Initiated Time Initiated Designated Authority 7

28 FORM 2B: ALTERATIONS TO INITIAL PROCEDURES Trigger Procedure Date Initiated Time Initiated Designated Authority 8

29 FORM 2C: TERMINATING PROCEDURES Trigger Procedure Date Initiated Time Initiated Designated Authority 9

30 FORM 2D: OTHER PLANNING, RESPONSE, OR RECOVERY PROCEDURES Trigger Procedure Date Initiated Time Initiated Designated Authority 10

31 FORM 2E: COMMUNICATION WITH HEALTH DEPARTMENT WHO MADE THE CONTACT WHO RECEIVED THE CONTACT HOW WAS THE CONTACT MADE (phone, , etc) DATE CONTACT MADE TIME CONTACT MADE ACTION TAKEN 11

32 FORM 2F: COMMUNICATION WITH THE PUBLIC Who Made the Contact Who Received the Contact How was the contact made (phone, , etc) Date Contact Made Time Contact Made What was communicated (ie. Interrupted services, emergency sites or shelters, etc.) 12

33 FORM 2G: COMMUNICATION WITH LOCAL ORGANIZATIONS Who Made the Contact Who Received the Contact How was the contact made (phone, , etc) Date Contact Made Time Contact Made What was communicated (ie. Until pandemic is over, there will be weekly meetings at...., we will be sending the public to you for....,etc.) 13

34 FORM 3: ESSENTIAL OPERATIONS The information below details the [Agency s]: 1) routine operations; 2) essential operations; 3) services that may be in high and low demand; and 4) regulatory requirements. The attached forms provide additional detail on each of the [Agency s] operations. [Copy and attach additional forms as needed] ROUTINE OPERATIONS The operations carried out by the [Agency s units/sections/departments] on a routine basis include: Unit Operation [Add additional lines as needed] ESSENTIAL OPERATIONS The following operations are deemed essential for the [Agency] to maintain mission-critical operations and services at 20%, 35%, and 50% absenteeism: Absenteeism Unit Operation 20% 35% 50% The following operations can be suspended temporarily without causing immediate or irreparable damage to the [Agency]: Can be suspended Unit Operation for the time period: 14

35 CUSTOMER/CLIENT DEMAND CHANGES Tip Determine how the needs of your customers may change and plan to deliver on those needs. If some of the products or services you normally provide would be in low demand, find ways to re-deploy assets normally dedicated to providing those, to areas that experience increased demand. The following services/operations may be in high demand during a pandemic: The following services/operations may be in low demand during a pandemic: REGULATORY REQUIREMENTS The following regulatory requirements may be difficult to fulfill during a pandemic: 15

36 [Use the attached to assess each operation carried out by the Agency and attach to Form 3] ROUTINE AND ESSENTIAL OPERATIONS 1. Daily operation: 2. Unit responsible for operation: 3. Description of operation: 4. Purpose of operation: Client Service Partner Service Internal Service (e.g. administrative, financial) Other 5. Number of staff required to perform operation on a routine basis: Required Staff Number Job Classification 6. Supplies required to perform operation: * Detailed information attached in Form 7, Product and Service Vendors 7. Is this an essential operation if workforce absenteeism equals: 20% 35% 50% 8. Changes in demand that may occur during a pandemic: 9. Strategy for scaling back operation: 10. Alternative ways to provide services that limit human-to-human contact: 16

37 FORM 3A: SECURITY NEEDS Area (i.e. Building A, back door of garage area, employees lockers, etc.) What kind of action is needed? (ie. Secure emp s belongings, keep Bldg A locked 24/7) Action Taken (ie. Locked 24/7 Security to be notified when access is needed, auto unlock at 8am, manually locked every night, etc.) Date Completed 17

38 FORM 3B: FINANCIAL PROCESSES Service/Supply Needed Vendor How will you pay for it (ie. vendor agreement, petty cash, emergency charge card, etc.) Authorized By (ie. Director, Deputy Director, etc.) 18

39 FORM 4: ESSENTIAL JOB FUNCTIONS ESSENTIAL JOB CLASSIFICATIONS The table below details the job classifications found at the [Agency], number of individuals employed with this job classification, the essential operations that rely on employees with these skills, and number of employees with this job classification required to maintain essential services. [Attach job action sheets for essential operations] Job Classifications # of employees with this classification Essential operation(s) that require this classification # of employees required to maintain essential services [Insert additional rows as needed] JOB ACTION SHEETS Job action sheets with clear instructions on how to perform essential job functions are attached to Form 4. CROSS TRAINING Cross training of workers for essential job functions will take place on [insert dates] and be coordinated through [enter unit name]. 19

40 FORM 4A: REASSIGNMENTS Essential Job Function Person responsible Reassignment to List other city agency or department Person cross-trained Date Just In Time or refresher training held 20

41 FORM 4B: TELECOMMUTING Essential Service Can it be done remotely? Y or N What resources needed for remote access? Designated employee to use remote access? Date resources were put in place for remote access? Date resources were tested for remote access? 21

42 FORM 4C: TRAINING FOR ESSENTIAL JOB FUNCTIONS Essential Job Function Person responsible Person cross-trained Date Just In Time or refresher training held 22

43 FORM 5: PANDEMIC POLICIES The following policies will be activated as part of the Pandemic Influenza Continuity of Operations Plan: 1. Employee Leave [Department of Human Resources to provide.] 2. Flexible Work [Department of Human Resources to provide.] 3. Health Care [Department of Human Resources to provide.] 4. Travel Policies. [Department of Human Resources to provide.] 23

44 FORM 6: MANAGEMENT OF ILL EMPLOYEES RESTRICT WORKPLACE ENTRY OF PEOPLE WITH INFLUENZA SYMPTOMS During an influenza pandemic an effective way to limit the spread of disease is to ask infected individuals to remain home. During Stages Red and Black, the [Agency] will: 1. Notify employees they should not come to work if they are unwell, particularly if they are exhibiting any influenza symptoms. 2. Post notices at all workplace/facility entry points advising staff and visitors not to enter if they have influenza symptoms. 3. Advise employees to call the Agency s health and safety staff if they become ill at home or work (provide a designated phone number for reporting illness). 4. Provide health and safety staff with protocol for employees who become ill (attached). 5. Ensure that ill employees have completed the required isolation period (guidance to be provided by the San Mateo County Health Department) and are healthy and no longer infectious before allowing them to return to work. Note that staff who have recovered from the pandemic influenza are less likely to be re-infected and should be encouraged to return to work. PROTOCOL FOR EMPLOYEES WHO BECOME ILL Advise employees that if a person feels ill, or if someone observes that another person is exhibiting symptoms of influenza at work, they are to contact their Agency s health and safety staff by telephone if possible. Duties of health and safety staff: 1. Speak with the individual by phone. 2. Check if the employee has any influenza symptoms. (The San Mateo Health Department can provide a list of symptoms). If the employee does not have any symptoms they are unlikely to have influenza and should be reassured and advised to call again later or to see their doctor if they are still concerned. If the employee has influenza symptoms they should be treated as a suspect influenza case. 3. Complete a Suspect Influenza Case Form (attached). 4. If the employee is at work provide them with a surgical mask and instruct them to put the mask on immediately. (This is to help protect other staff.). Instruct employee to leave work. If possible, public transportation should be avoided. If public transportation is unavoidable, instruct the employee to keep the mask on and cough or sneeze into a tissue while traveling. 5. Advise the employee to contact a health professional. This may involve phoning the person s normal doctor or a specially designated center to seek advice. 6. Advise the employee on how long to stay away from work (the San Mateo County Health Department website will post isolation guidance). 7. Have the employee s work station cleaned and disinfected as indicated in Form 10: Workplace Cleaning. 8. The San Mateo Health Department may ask employers to 1) identify contacts (once an employee is suspected to be infected); 2) advise contacts that they have been in 24