UNIVERSITY OF MANITOBA INSTITUTIONAL PANDEMIC PREPAREDNESS PLAN (IPPP) DRAFT

Transcription

1 UNIVERSITY OF MANITOBA INSTITUTIONAL PANDEMIC PREPAREDNESS PLAN TITLE PAGE UNIVERSITY OF MANITOBA INSTITUTIONAL PANDEMIC PREPAREDNESS PLAN (IPPP) DRAFT Revised: October 20, 2008

2 TABLE OF CONTENTS TABLE OF CONTENTS Description Tab Page 1.0 Introduction Authority Preparedness Principles and Objectives Institutional Goals Purpose and Scope General Planning Assumptions Legal / Legislative Framework Pandemic Influenza Background Information Understanding the hazard and its effects Characteristics of influenza Influenza and assumptions about pandemic influenza Effects on the population Management of influenza Area affected by a pandemic Warning period Duration Impact Overview Employee absenteeism Student absenteeism Supply chain problems Facility closures Financial impacts Roles and Responsibilities President and Vice-Chancellor Pandemic Planning Committee (PPC) Emergency Operations Centre (EOC) Deans, Directors, Department Heads (DDD) University Employees University Students Pandemic Influenza Preparedness Campus Wide Issues Academic Research / Animal Care Communications Human Resources Facilities Management Travel Information Technology Infrastructure 13 Revised: September 9, 2009 i

3 TABLE OF CONTENTS TABLE OF CONTENTS Residences / Housing and Student Life (HSL) Health and Safety Public Order and Security Financial Services Food Services Awareness and Education External Issues / Stakeholders Health and Allied Health Professional Facilities Body Management Response Concept of Operations General Pandemic Planning Committee (PPC) Emergency Operations Centre (EOC) Deans, Directors, and Department Heads (DDD) University Staff University Students Post Pandemic Recovery Recovering from the Impact Psychological Support Resuming Operations Staff Replacement Analysis and After Action Reports 20 Appendix A External Leadership Organizations A Appendix B U of M Pandemic Planning Committee Terms of Reference and Membership List B Appendix C Pandemic Planning Checklist for Academic Units C Appendix D Frequently Ask Questions for Supervisors and Employees D Appendix E Infection Control University Personnel E Appendix F Self Care F Appendix G H1N1 Influenza (Flu) and You (Student Handout) G Appendix H Template Guideline H Appendix I Template Forms I Revised: September 9, 2009 ii

4 UNIVERSITY OF MANITOBA INSTITUTIONAL PANDEMIC PREPAREDNESS PLAN 1.0 INTRODUCTION This document is the University of Manitoba Institutional Pandemic Preparedness Plan (IPPP), which is a dynamic and evolving document that identifies preparedness activities to be undertaken before a pandemic occurs that will enhance the effectiveness of a pandemic response and recovery. Traditional emergency / disaster response and recovery plans focus on the impact / damage to property, equipment, and machinery with limited focus on the loss of personnel. Pandemic influenza preparedness shifts the focus of the impact to the loss of personnel and anticipates high rates of absenteeism. This document was written with input from several source documents. The University of Manitoba would like to acknowledgement these documents, which include: City of Winnipeg Winnipeg Pandemic Plan (WPP), January 2008; University of California, Davis Influenza Pandemic Emergency Operations Plan, September, 2006; and Manitoba Health Pandemic Influenza Preparedness Guidelines for Manitoba Local Government, November AUTHORITY STATEMENT The University of Manitoba IPPP is issued under the authority of the University of Manitoba Vice-President (Administration) through the University of Manitoba Pandemic Planning Committee (PPC). 1.2 PREPAREDNESS PRINCIPLES AND OBJECTIVES This document is guided by the following preparedness principles and objectives: 1. To coordinate with and not supersede the University s Emergency Response Plan, while in operational response to and recovery from pandemic influenza; 2. To define and recommend preparedness activities (i.e. tasks, actions, etc.) to be undertaken before a pandemic occurs that will enhance the effectiveness of a pandemic response and recovery; 3. To make recommendations on interventions that should be implemented as components of an effective pandemic influenza response and recovery; 4. To develop a plan that can be adapted for other public health emergencies (i.e. communicable diseases); 5. To develop community linkages and effective working partnerships with key stakeholders to improve the University s preparedness for any public health emergency; 6. To work collaboratively with the City of Winnipeg and Winnipeg Regional Health Authority (WRHA), and provincial levels in pandemic influenza planning and to clarify roles, responsibilities and actions. 1.3 INSTITUTIONAL GOALS Goals of the University of Manitoba during a pandemic response and recovery (i.e. guiding principles) are: 1. The University of Manitoba community will strive to preserve and protect the health and safety of all its members. 2. The University will continue to operate as normally as possible to minimize disruption of instruction and research, protect and preserve the academic experience and workplace environment. 3. Communication to students/staff, other members of the University community and the general public will be a priority prior to, during and following a pandemic. 4. The University will ensure people and processes are in place to maintain control of its campuses throughout a pandemic. 5. To the best of the University s ability, students needs will be accommodated and students will be provided the flexibility necessary to complete course work and exams. 6. The University will be steadfast in its commitment to return to normal following a pandemic. Revised: September 9, 2009 Page 1 of 20

5 UNIVERSITY OF MANITOBA INSTITUTIONAL PANDEMIC PREPAREDNESS PLAN 1.4 PURPOSE AND SCOPE This plan is a guide for preparing for a pandemic influenza emergency at the University of Manitoba. As such there are several internal and external stakeholders, which include, but are not limited, to the following: University departments / faculties / units the plan provides an overview of the roles and responsibilities of departments during an influenza pandemic, as well as general information to support planning by other City divisions. External stakeholders within Winnipeg the plan provides general information which will allow local stakeholders to complete their own business continuity planning. Examples include: - Winnipeg Regional Health Authority (WRHA), including its hospitals such as Health Sciences Centre (HSC); - On campus vulnerable population(s) (i.e. students in residence); - On campus day cares; - On campus businesses and / or tenants; 1.5 GENERAL PLANNING ASSUMPTIONS Although there is agreement with the planning assumptions within the federal and provincial plans, the IPPP has adapted the following general assumptions: The U of M IPPP will be an evolving document and the PPC will revise and continue to build on it as local, provincial and federal planning proceeds; Pandemic influenza will simultaneously affect the City of Winnipeg and the Province of Manitoba and other jurisdictions, thus mutual aid will not be possible; Pandemic influenza will be caused by a new or novel sub-type of influenza A virus; Winnipeg will likely have very little lead time between when the WHO declares pandemic phase 6 and when the pandemic influenza strain is identified in Winnipeg; The impact of illness upon Winnipeggers will be significant. There will be an attack rate of 15-35% during the first wave; There will be multiple waves of influenza pandemic activity; More severe illness and mortality than the usual seasonal influenza is likely in all population groups. The specific pandemic epidemiology (i.e. age cohorts, severity and distribution of illness in the population) will not be known until the pandemic virus emerges; Children and otherwise healthy adults may be at greater risk because elderly adults may have some residual immunity from exposure to a similar virus earlier in their lives if the pandemic is caused by a recycled influenza strain; The psychological impact on the public will likely be significant; Community activities may need to be curtailed or cancelled to prevent further spread of the infection (This will be a decision made by authorized public health officials); Supply chains of resources from every sector will be disrupted; The City of Winnipeg will activate its Emergency Control Committee (ECC) and open its Emergency Operations Centre (EOC) early in the response. Revised: September 9, 2009 Page 2 of 20

6 1.6 LEGAL / LEGISLATIVE FRAMEWORK UNIVERSITY OF MANITOBA INSTITUTIONAL PANDEMIC PREPAREDNESS PLAN Legislation at both the provincial and federal level provides government officials with certain authority / capabilities during an emergency or disaster situation. When preparing for the pandemic it is important to be aware of this fact, which could be obtained through public health orders, declarations of state of emergency (i.e. local, provincewide, and / or country-wide). Currently governments across Canada are introducing new or revised bills to provide government officials with the authority / capabilities that are required to response to and recover from a pandemic. The relevant legislation includes, but is not limited, to the following: Public Health Act (Manitoba); Emergency Measures Act (Manitoba); and Emergencies Management Act (Canada). The above legislation empowers authorities / governments to compel organizations, such as the University of Manitoba, to follow a specific course of action. This action could include cessation of specific operations / functions or the continuation of specific operations / functions. The specific decisions that will be made by authorities / governments cannot be predicted, yet it is possible to be able to anticipate future decisions by liaising and maintaining relationships with emergency / disaster management contacts within these external authorities / governments. Revised: September 9, 2009 Page 3 of 20

7 UNIVERSITY OF MANITOBA INSTITUTIONAL PANDEMIC PREPAREDNESS PLAN 2.0 PANDEMIC INFLUENZA BACKGROUND INFORMATION In order to develop a continuity of operations response and recovery plans it is useful to apply a plausible, worstcase scenario describing the nature of the event causing the emergency and the specific challenges that the community will face. Sources cited for this section include: Pandemic Influenza Preparedness Guidelines for Manitoba Local Government, Manitoba Health, November Public Health Agency of Canada (PHAC) or World Health Organization (WHO) UNDERSTANDING THE HAZARD and ITS EFFECTS CHARACTERISTICS OF INFLUENZA Influenza is highly infectious and can spread easily from person to person. Every year, minor changes occur in influenza viruses. Based on these changes, scientists develop annual vaccines that are effective against the current strains. Each year, at-risk Manitobans are encouraged to Get the Shot, not the Flu. Pandemic Influenza is different. It is the result of a major change (a.k.a. a shift) in an influenza virus that results in a completely new strain. Most people will not have any specific immunity to such a strain; consequently, large numbers of people can become infected as the disease spreads. There have been at least three pandemics in the past century: Spanish Flu, Asian Flu, and Hong Kong Flu. Influenza A is the type involved in all known influenza pandemics. Viruses can undergo major changes or shifts in makeup, producing a completely new strain. Most people do not have specific immunity to these strains of influenza and large numbers of individuals will become infected as it spreads. For a new influenza virus to cause a pandemic, it must be able to: infect people (not just mammals and birds); cause illness in a high proportion of those infected; and spread easily from person to person. All previous influenza pandemics had these characteristics. Although no one knows exactly how the next pandemic will affect us, we can make a number of assumptions, based on previous pandemics and medical research have been made for planning purposes INFLUENZA and ASSUMPTIONS ABOUT PANDEMIC INFLUENZA One of the key planning assumptions held by public health experts is that a pandemic influenza will behave somewhat like ordinary influenza. Influenza transmission: Influenza is highly contagious and spreads very quickly among the population, especially in crowded situations. The influenza virus enters the body through the nose or throat by: inhaling droplets produced by the coughing or sneezing of infected persons touching the mouth, eyes or nose after: - hand-to-hand contact with infected individuals - touching surfaces or handling objects contaminated by infected individuals Once someone is infected with the influenza virus, it usually takes from one to three days to develop symptoms. The disease typically follows these steps: Revised: September 9, 2009 Page 4 of 20

8 UNIVERSITY OF MANITOBA INSTITUTIONAL PANDEMIC PREPAREDNESS PLAN Persons with influenza can be contagious from the day before they develop symptoms up to seven days afterwards (typically three to five days in healthy adults and up to seven days in children). This time frame may be longer in people with decreased immune systems. Not everybody who comes in contact with influenza virus will become ill, however they may still spread the infection to others. Forty-eight hours after exposure, the symptoms start to appear. Flu symptoms can last four to seven days. A cough and general fatigue may persist for several weeks afterward. It is important to note that people can be infected and contagious before they become ill. This is why it is difficult to contain influenza. Some people who get influenza also develop secondary bacterial infections including pneumonia, prolonged illness or death EFFECTS ON THE POPULATION During an influenza pandemic, much of the population will become infected, many will get sick and some will die. It is expected that there will be greater amounts of illness and death during a pandemic than experienced during a regular influenza season. This may be made worse by decreased availability of hospital care during the pandemic. Public health experts assume that, during an influenza pandemic, 35 per cent of people will get sick enough to miss at least one half of a day of work, and that of those who get sick,.5 per cent could die. Ordinary influenza typically has the greatest effects (such as medical complications and death) on the very young, the very old and those with suppressed immunity. Pandemic influenza may, based on historic evidence, affect different age groups than ordinary influenza, such as 20 to 40 year olds, as was the case during the pandemic MANAGEMENT OF INFLUENZA A) Vaccines Vaccination is the most effective way to protect the public from pandemic influenza. Vaccines cause the body to produce specific antibodies against the flu virus in the vaccine, providing immunity from the virus. The vaccine contains inactive virus, so it cannot cause influenza. Developing a vaccine to protect the population from a specific strain of influenza is our best defence. To develop a pandemic influenza specific vaccine, the virus must be isolated in the laboratory before production can start. It could take four to six months before the first shipment of vaccine is available in our province. Manitoba Health s goal is to immunize the entire population as quickly as possible once the vaccine becomes available. The vaccine will be available in batches, so Manitobans will be immunized according to nationally agreed upon priority groups. B) Antiviral Drugs Antivirals are drugs used to prevent and treat influenza early. If taken within 48 hours of getting sick, they can reduce influenza symptoms, shorten the length of the illness and potentially reduce serious complications and deaths. Antivirals work by reducing the ability of the virus to reproduce but they do not provide immunity from the virus. Antiviral drugs, given at the onset of influenza, may help but are not likely to be available in sufficient quantities to treat the majority of the population. Priority groups have been proposed through national collaboration and agreement. Manitoba will be using these priority groups for antiviral distribution during a pandemic. C) Antibiotics Since influenza is not caused by bacteria, antibiotics will be of no value other than to help combat secondary infections, such as bacterial pneumonia. Revised: September 9, 2009 Page 5 of 20

9 2.1.5 AREA AFFECTED BY A PANDEMIC UNIVERSITY OF MANITOBA INSTITUTIONAL PANDEMIC PREPAREDNESS PLAN A pandemic is anticipated to affect all Manitobans, the rest of Canada, North America and the world. In some emergencies, neighbouring local governments, other levels of government and nongovernmental organizations can focus their personnel and resources on a small area. In a pandemic, demand for people and resources will likely be high across the province and outside support will be limited WARNING PERIOD Given the mobile nature of today s society, a disease can spread very rapidly. Disease surveillance and attempts to contain a pandemic may slow the spread of the disease but it is likely it will be impossible to contain it. We anticipate having up to three months warning from the time a pandemic is declared by the World Health Organization to the time the virus arrives in Canada. This is based on the assumption that a pandemic will start elsewhere in the world and then spread to North America. It is possible that the warning period may be shorter DURATION A pandemic may last up to two years and, based on previous pandemics, may occur in waves. Each wave could last six to eight weeks and be separated by three to nine months. 2.2 IMPACT OVERVIEW During an influenza pandemic, much of the population will become ill and some will die. It is expected that there will be more illness and death during a pandemic than experienced during a regular influenza season. This may be made worse by decreased availability of health care during the pandemic. Influenza typically has the greatest impact (complications, death) on the very young, the very old and those with suppressed immunity. However, pandemic influenza has affected different age groups in the past, including 20 to 40 year olds, as was the case during the pandemic. The widespread nature of a pandemic is expected to have a significant impact on many aspects of society in Manitoba. There are several anticipated operational impacts to post secondary institutions: EMPLOYEE ABSENTEEISM The most serious organizational risk posed by a pandemic is loss of personnel. This may be due to: Family commitments related to caring for sick family members, friends or neighbors, institution or day care closures. Volunteering their time in the community to other essential pandemic related needs. Fear of becoming infected at work and other public places. Illness / self quarantine due to exposure to the virus. Death. Absenteeism will also be impacted by subsequent waves of the pandemic. Consider also that some key employees may become ill or even die during the pandemic possibly resulting in a significant loss of knowledge and skills. Based on information gathered during a mild pandemic ( ), it is estimated that absenteeism rates could be around 20% and up to one-third of health care providers could miss work over the course of a pandemic. In a more severe pandemic, these rates could be much higher, depending on the nature of the virus and which age groups are most severely affected. Revised: September 9, 2009 Page 6 of 20

10 UNIVERSITY OF MANITOBA INSTITUTIONAL PANDEMIC PREPAREDNESS PLAN STUDENT ABSENTEEISM Fear of attending public places and illness will cause increases in student absenteeism. Lost instructional time may become a serious issue and alternative methods of education delivery or means of catching up after the waves of the pandemic may require consideration and preparation SUPPLY CHAIN PROBLEMS All organizations depend on suppliers for services, materials, equipment, parts or supplies. You should expect that, during a pandemic, suppliers, both locally and those located in other impacted areas, are likely to experience operational, production and shipping difficulties - due to loss of workforce, loss of their own suppliers, and shipping difficulties relating to possible border closures or delays as countries try to contain the spread of the disease. To make matters worse the demand for certain types of supplies may increase dramatically during a pandemic and therefore may be very difficult to obtain in a timely manner. Some supplies may not be available at all FACILITY CLOSURES At the start of a pandemic public health officials, in order to control the spread of influenza, may close facilities where people congregate, including post secondary institutions. Public health officials will make this decision after consideration of the scientific information available at the time of a pandemic. Consideration should be given to the fact that aspects of post-secondary institutions operations may be unable to completely cease. For example, students, who because of distance from home, may have to stay in residences requiring ongoing food, janitorial and, security services), or due to research requirements (in particular, the care of animals, etc.). These issues are more complicated in winter when consideration would have to be given to heating needs and snow clearance. During a pandemic, a university or college would have to consider how to reduce its operational tempo to meet public health directives regarding closure while still ensuring that vital services are maintained FINANCIAL IMPACTS These operational problems may have a variety of financial implications for institutions. Lost productivity and increased costs associated with preparing for, responding to and recovering from the influenza pandemic. Loss of revenue from tuition fees resulting from reduced student attendance or cessation of educational operations due to a public health directive. Loss of reputation and reduced enrollment. Revised: September 9, 2009 Page 7 of 20

11 3.0 ROLES AND RESPONSIBILITIES UNIVERSITY OF MANITOBA INSTITUTIONAL PANDEMIC PREPAREDNESS PLAN All governments and all sectors have a role to play in preparing for, responding to and recovering from an influenza pandemic. It is critical that roles and responsibilities are clear and that there is good communication and coordination of efforts. The roles and responsibilities of the various organizations are detailed in Appendix A. This section focuses on the roles and responsibilities of individuals and units at the University of Manitoba. 3.1 PRESIDENT AND VICE-CHANCELLOR The President and Vice-Chancellor (designated to the Vice-President (Administration)) may declare that an emergency situation exists or has been terminated on University property. The President and Vice-Chancellor or designate determines the overall or guiding principles / policies regarding the response to and recovery from a particular emergency or disaster, including a pandemic. 3.2 PANDEMIC PLANNING COMMITTEE (PPC) The University of Manitoba (U of M) Pandemic Planning Committee (PPC) is the group assigned the responsibility of coordinating the development and implementation of pandemic preparedness, response, and recovery plans for the University. The PPC represents University stakeholders and is chaired by the Vice President (Administration). For more details please refer to the Committee s terms of reference and membership list in Appendix B. The University will maintain a web site dedicated to communicating information related to on-campus pandemic preparedness, response, and recovery. You are encouraged to visit this web site regularly, as the information is expected to change over time. The address of the web site is EMERGENCY OPERATIONS CENTRE (EOC) The Emergency Operations Centre (EOC) is responsible for coordinating the response to and recovery from any emergency or disaster that impacts the University of Manitoba. The specific location of the EOC has not been identified, but it shall contain the necessary personnel, physical facilities and communications for the central coordination of the emergency response. The EOC is activated when any event, emergency or disaster, overwhelms the day-to-day ability of the campus to manage its response and subsequent recovery. 3.4 DEANS, DIRECTOR, AND DEPARTMENT HEADS (DDD) The Deans, Directors and Department Heads (DDD) are responsible for maintaining individual Unit Pandemic Influenza Preparedness, Response and Recovery Plans in compliance with the University of Manitoba Pandemic Influenza Planning Guideline for Academic, Research and Administrative Units, which is available online via Please refer to Appendix C to review a pandemic preparedness planning check list for Academic units. 3.5 UNIVERSITY EMPLOYEES It is important for University staff and faculty to keep themselves informed of the progress of and appropriate response to any emergency situation, and provide such a model to our students and visitors. Personal preparedness at home is also important to being able to provide assistance and support to the University as it deals with an emergency such as a pandemic. General emergency preparedness information for families and individuals is available from this location: and / or A frequently asked questions (FAQ) document for employees and supervisors is attached in Appendix D. Revised: September 9, 2009 Page 8 of 20

12 University employees are expected to: UNIVERSITY OF MANITOBA INSTITUTIONAL PANDEMIC PREPAREDNESS PLAN Immediately contact their supervisor if they are experiencing any influenza symptoms; Follow the directions of their supervisor, including immediately departing campus and contacting their physician by telephone. If a University campus shut down / closing has been announced, employees are expected to: Report to their supervisors / managers / department heads prior to leaving campus; Remain off-campus during the campus shut down with the exception of those employees identified as essential service providers; Keep in contact with their Department Head by phone or and / or the University through the Main Home Page and Jump portal to determine the state of alert on the campus and establish when they are to return. Once a re-opening of the campus has been announced, employees are expected to: Report to work on the identified day, unless they have been advised otherwise by their supervisor / manager / department head; If they are unable to report they are to contact their department head to indicate the reason (e.g. under quarantine, nursing an Infected Person, are ill with the Pandemic Influenza, etc.). 3.6 UNIVERSITY STUDENTS Providing safety and security for students is a concern for the University of Manitoba. Students also have a responsibility to participate in their own safety and security by staying informed of current events and taking the necessary precautions. As a potential pandemic situation develops, students are expected to follow all recommendations issued by various departments within Student Affairs, including University Health Services, the Registrar s Office and Housing and Student Life. All students are encouraged to prepare themselves and their families for significant impacts due to emergency situations. If a University shut down has been announced, students are expected to: Remain off-campus during the campus shut down whenever possible; Keep in contact with the University through the Main Home Page to determine the state of alert on the campus and establish when they are to return. Emergency information has been provided via the University of Manitoba website via the Main Emergency Information number ( ) or via . Once a re-opening of the campus has been announced, students are expected to: Report to class on the identified day; If they are unable to report to class due to quarantine, nursing an Infected Person, or are ill with the Pandemic Influenza, they can contact their Department office. Revised: September 9, 2009 Page 9 of 20

13 4.0 PANDEMIC INFLUENZA PREPAREDNESS UNIVERSITY OF MANITOBA INSTITUTIONAL PANDEMIC PREPAREDNESS PLAN 4.1 CAMPUS WIDE ISSUES The pandemic planning process has identified issues that are campus-wide in scope and could not be planned for on an individual unit level ACADEMIC The University of Manitoba Senate will be developing policies and procedures for making emergency decisions, waivers of regulations regarding examinations and required days of instructions as relevant to an event that would require postponing or cancelling classes. The Senate also will encourage faculty to consider developing alternate methods to deliver classroom instruction and materials in the event of a campus shut-down. Implementation of these policies and procedures will be coordinated with the Dean s office in each faculty and school, as well as with the Registrar s office. Information as available will be distributed to the campus and posted online. Academic assumptions are: 1. The interest of the students is paramount in the determination of academic concerns in the event of a pandemic. 2. Students will be educated about flu prevention and symptoms, and will be encouraged to make appropriate personal health decisions during a pandemic. 3. During a pandemic, every attempt will be made to continue to offer classes and laboratories and maintain library services as normally as possible. 4. Where possible and if resources are available, continuation of course work and assignments may be facilitated through independent course work and technology. 5. Decisions on instructional matters that do not require Senate approval will be the responsibility of the Vice- President (Academic) and Provost in consultation with the relevant Deans and Directors. 6. Decisions to alter the academic schedule, as recommended by the Pandemic Planning Steering Committee, will be made by Senate or Senate Executive. A special meeting of Senate will be called by the Chair of Senate where time permits. 7. Students will be given flexibility to complete their coursework missed during illness or will be allowed to withdraw from courses without penalty RESEARCH / ANIMAL CARE While work in many research laboratories or studies can be postponed or delayed, there are some critical areas where research must be maintained. The Office of the Vice President (Research) will develop directives and guidance for all critical research and facilities that must be continued. During an event that requires activation of the campus Emergency Operations Centre (EOC), the Office of Vice President (Research) will assist the EOC in prioritizing response to those research areas and facilities. The Office of Research will work with the Principal Investigators to ensure plans for absenteeism issues are developed for critical personnel. Animals that depend on the University of Manitoba staff, faculty and students for their care and shelter must be considered in any emergency plan. There are a number of facilities housing animals and there is a coordinated plan through the Animal Care and Usage Program to ensure proper animal care during an emergency. Revised: September 9, 2009 Page 10 of 20

14 Research and animal care assumptions are: UNIVERSITY OF MANITOBA INSTITUTIONAL PANDEMIC PREPAREDNESS PLAN 1. In the event of a shut down, most research and equipment can be shut down in 1-2 days. 2. Freezers and/or equipment that cannot be shut down will be identified, and a schedule of people and backups will be developed to check on them. In addition, a supply of liquid helium and nitrogen, as well as a delivery mechanism, will be needed. 3. During a shut down, all endotherms will be transferred to one of the central animal care facilities, as opposed to remaining in labs, in order to facilitate care during a shut down. Ectotherms require much less care, and could be maintained for longer periods by lowering the temperature. 4. Genetic strains will be identified in advance, and plans made to preserve them. 5. Decisions on research matters will be the responsibility of the Vice President (Research) or designate in consultation with the relevant Deans and Directors. 6. Every effort will be made to accommodate graduate students and extend their financial support in the event that their project is delayed by a year due to a pandemic COMMUNICATIONS Communication strategies are an important component in managing any infectious disease outbreak and are essential in the event of a pandemic. Accurate, timely, and consistent information at all levels is critical in order to minimize unwanted and unforeseen social disruption and economic consequences and to maximize the effective outcome of the response and recovery. A campus pandemic planning website and homepage link have been established at to post pertinent information to assist the campus in their planning efforts. A mailing list was established to send updated information to subscribers. Communications to employees, students and the University community before, during, and after a pandemic will follow the Public Affairs Crisis Communications Response Plan and will be coordinated by Public Affairs. This plan is to outline the triggers and actions for communicating notices, information and actions to the campus. That plan defines the methods of distributing information through the normal campus modes of web sites, publications, voice mail, and regular mail HUMAN RESOURCES The primary effects of a pandemic are on staffing and student levels. Unlike other disasters, pandemics do not damage property or equipment; the effects are mainly human resource oriented. Absenteeism may be high for a variety of reasons: illness / incapacity; caring for other family members, or school closures. Each of the University of Manitoba faculties, schools, and units has an internal system for tracking and recording employee absences. During a pandemic situation, those systems should be used to determine individual and campus absenteeism rates, and provide the basis for decisions made within the campus Emergency Operations Centre (EOC) for implementing social isolation issues (e.g. postpone or delay classes and other public activities). Human Resource assumptions are: 1. Initially, if the University is shut down, all employees who would be scheduled to work will continue to be paid. This decision will be reviewed as the duration of the shut down is being assessed. 2. Employees who are unable to attend work due to illness will be covered by the existing sick leave provisions in appropriate collective agreement or University Policy and Procedures. 3. Employees may be required to work from home. 4. Maintenance of payroll, pension and benefits will be given priority. In instances where inaccurate disbursements are being made, the University will take corrective steps in the post pandemic stage. 5. Managers and Human Resources staff will work with employees and their union/association representatives to provide cross training/reassignment of employees and/or employee duties. 6. Employees will be educated on flu symptoms and will be required to stay home if showing symptoms. Revised: September 9, 2009 Page 11 of 20

15 Key human resources issues include: UNIVERSITY OF MANITOBA INSTITUTIONAL PANDEMIC PREPAREDNESS PLAN Issues have yet to be identified regarding HR and pandemics, the corporation must be flexible and able to respond, and deal with special circumstances individually; Absenteeism - potentially 35-50% of employees over a period of time, depending on the severity of the pandemic; Company profile, e.g. gender/age distribution, may affect absenteeism; Concern about lost wages is the largest deterrent to self-quarantine; Deaths may occur among our peers; Employees who recover and return to the workplace will likely be immune; Collective agreements may be affected; Confidentiality of employee information will be a concern; Increased workload for all staff FACILITIES MANAGEMENT The decision to keep a building open or closed will require input and consultation from the primary users, Physical Plant, Security Services, Information Services and Technology and the Environmental Health and Safety Office (EHSO), in coordination with the Emergency Operations Centre (EOC). There are two potential reasons for closing a building 1) the primary occupants cannot staff the building and its use is no longer required or 2) there are not enough support staff to ensure a clean, healthy, and safe work environment for the primary users. Thus, the decision making regarding the opening and closure of buildings must be coordinated through the EOC to assist with the most efficient allocation of human resources during a pandemic. Physical Plant assumptions are: 1. Fort Garry Campus and Bannatyne Campus buildings will be kept going as long as possible. During a prolonged power failure, buildings will be drained to eliminate freeze up and shut down if not in use. 2. Health Sciences Centre (HSC) will be able to provide heat to Bannatyne Campus Buildings. 3. Services will be maintained as long as possible provided there are adequate staffing levels. Cleaning of washrooms and public areas will be a priority. New construction will be minimal. 4. Support to satellite research stations may not be possible during a pandemic outbreak. 5. Manitoba Hydro and other major utility providers will continue to provide service. 6. In the event of a shut down, only essential services will be maintained eg. Powerhouse. Minimal to no snow clearing, maintenance etc. will be done TRAVEL A global pandemic will severely limit both domestic and international travel. While it is unlikely that travel restrictions will be imposed on a local, state or Federal level, they will certainly be advised and strongly encouraged. It is expected that each University of Manitoba faculty, school, or unit shall be aware of students, staff and faculty traveling on University business (e.g. domestically or internationally). When the World Health Organization (WHO) Phase 3 (i.e. confirmed human outbreak overseas) is reached, unit action plans should include activating plans for travelers and making decisions about future travel based on the situation. Those decisions could include recalling from travel, restricting or limiting current travel and cancelling future travel. In all situations, assistance for international students, scholars and researchers and visa management will be part of the campus-wide response (i.e. it is important that the Emergency Operations Centre is aware of the status of traveling faculty, staff, and / or students in order assist). Government of Canada travel health notices can be found at this internet web address: Revised: September 9, 2009 Page 12 of 20

16 4.1.7 INFORMATION TECHNOLOGY INFRASTRUCTURE UNIVERSITY OF MANITOBA INSTITUTIONAL PANDEMIC PREPAREDNESS PLAN Our business and personal lives depend to a great deal on the availability of an information technology infrastructure for voice and data communications. During a pandemic event, it is likely that those systems will become less reliable as they overloaded with increased volume. If public health plans call for social isolation i.e.: directing the closure of schools and public events and encouraging the public to stay home more staff, students and faculty will be trying to telecommute and that will result in a change in normal network traffic patterns and increased demand placed upon network border equipment and communication links to the internet. The University of Manitoba Information Services and Technology (IST) has developed business continuity plans to address continuity of operations. IST shall inform the campus faculties, schools, and units about issues surrounding telecommuting, alternatives to meetings and presentations, and step-by-step instructions for establishing temporary home offices. Information Services and Technology (IST) assumptions are: 1. In the shut down scenario the IST server and network infrastructure can normally run without on site staff for 2 weeks. After that time staff will have to come on campus to perform some maintenance functions. 2. During a shut down there will be a protocol for allowing IST staff access to the computer room in Engineering and to other locations such as voice data rooms on all campuses to perform maintenance and recovery functions. 3. IST will provide call centre infrastructure for an off site help desk, student staff and public queries and other functions. 4. In all scenarios it will be necessary to keep the web space, core data network, and Jump running. 5. While the University is open it will be necessary to keep all online learning functions available. 6. Suppliers such as Cisco, Sun, Bell, Shaw and MTS will continue to provide normal functions and support during all phases of a pandemic. 7. In administrative systems, what IST provides will be defined by the requirements from the business units RESIDENCES / HOUSING AND STUDENT LIFE (HSL) Housing and Student Life (HSL) is preparing to meet the housing needs of students in the event of an influenza pandemic. The plan identifies critical services / equipment / supplies, Emergency Response Team (ERT), roles and responsibilities and addresses the evacuation of students, as well as providing services to the students who remain in residence. It is anticipated that not all students will be able to return home, particularly ill, out-of-province and / or international students. These students will need information, activities, health care, psychological care, housekeeping, feeding, etc. Residences assumptions are: 1. Residences will continue to operate as normally as possible during a pandemic. 2. In the event of a shut down, residences will be kept open for those students who are unable to return home. 3. Procedures will be established to isolate sick students and provide necessary medical care and services. 4. Students will be recruited to augment areas where staff are ill and services need to be maintained e.g. Cleaning, food services. 5. A Health Services Coordinator will be required to work in the residence to monitor the health status of students. Revised: September 9, 2009 Page 13 of 20

17 UNIVERSITY OF MANITOBA INSTITUTIONAL PANDEMIC PREPAREDNESS PLAN HEALTH AND SAFETY As access to vaccines and antiviral drugs during a pandemic will be extremely limited, non-medical interventions may be the only way to delay the spread of the disease. Non-medical interventions would include social isolation (i.e.: prohibition of mass gatherings), and infection control measures to avoid spreading the disease. The following information condenses the current guidance available. In the event of a pandemic, the Centers for Disease Control (CDC) and WHO websites may offer more updated information. The following are guidelines provided by the CDC in the event of any infectious disease outbreak. Avoid close contact with people who are sick; Stay home and away from work or errands when you are sick; Cover your mouth and nose with a tissue, handkerchief, or the sleeve of your clothing when coughing or sneezing; Clean your hands schools/colleges/units should consider providing waterless antibacterial hand cleansing solutions to individuals; Avoid touching your eyes, nose or mouth; Persons with respiratory infection symptoms can use a disposable surgical mask to help prevent exposing others. Please refer to Appendix E Infection Control University Personnel and Appendix F Self Care for more details. Environmental Health and Safety Office (EHSO) assumptions are: 1. The University will continue, so far as is reasonably practicable, to provide a safe and healthy environment in which to carry on the University's affairs during a pandemic outbreak. 2. The Environmental Health and Safety Office (EHSO) will continue to provide advice, guidance, technical support and core field services to department and administrative units on safety, health and environmental matters as EHSO staffing resources permit during a pandemic. 3. EHSO response to requests for service will be based on a prioritized risk assessment of the issue/hazards. 4. EHSO will liaise with external organizations / authorities regarding mitigation, preparedness, response, and recovery action during a pandemic; 5. EHSO will evaluate and promote measures that are proven effective during a pandemic in protecting employees as endorsed by the public health authorities of Manitoba (i.e. Public Health Agency of Canada, Manitoba Health, Regional Health Authorities, etc.); PUBLIC ORDER AND SECURITY Emergencies during a pandemic will still occur and the University s responding units (i.e. Security Services, Physical Plant, and Environmental Health and Safety Office) will respond as resources allow. Furthermore, the City of Winnipeg response agencies (i.e. Winnipeg Police Service, Winnipeg Fire Paramedic Service, and Emergency Social Services) will also respond as resources allow. The Winnipeg Pandemic Plan (WPP) has identified that further planning is needed in order to review Police Services roles in responding to influenza related calls. Security Services assumptions are: 1. In the event of a pandemic, the Bannatyne Security Office can be shut down with one patrol officer on duty 24/7. Constant radio communication can be maintained with the Fort Garry Campus. Staffing levels can be augmented as needed. 2. In the event of pandemic, staffing on the Fort Garry Campus will be maintained on a 24 / 7 basis, however it is assumed that a large portion of an officer s duties will be dedicated to residential issues. This will likely result in slower response times for other calls for service. Sick time and staff absences will also likely hamper services provided by the department. Revised: September 9, 2009 Page 14 of 20

18 UNIVERSITY OF MANITOBA INSTITUTIONAL PANDEMIC PREPAREDNESS PLAN 3. Emergency services provided by the City of Winnipeg to the University will still be in place, however nonemergency calls to he University will likely not occur due to staffing shortages within the City of Winnipeg. 4. An appropriate Emergency Operations Centre (EOC) meeting area will be assigned in the event of a pandemic to coordinate all operations between the University and the City of Winnipeg. In addition, Security Services will coordinate with other University departments to address issues as they arise. 5. Security Services staff are equipped with safety equipment and First Aid training. Any further training or equipment can be arranged as needed in the event of a pandemic. 6. A response protocol / policy with local hospitals for the conveyance of students / staff in non-emergency situations will be developed in conjunction with University Health Services and the Winnipeg Regional Health Authority FINANCIAL SERVICES Public health authorities have identified that a pandemic is a society issue and that one of their priorities is to minimize society disruption, which includes decisions and actions that cause the least disruption to the economy. As such, the Comptroller will take the necessary steps to ensure the continuation of the payroll function. The University has committed to maintaining the processing of the payroll without an up to date accounting of the time sheets. If a pandemic is imminent, the Comptroller will instruct the Manager of Purchasing Services to ensure that the shipping and receiving functions are maintained. Particular attention shall be given to perishables and system contract deliveries. Other duties of the Comptroller include: review the employees obligations with respect to Canada Savings Bonds, Bookstore time purchases, parking deductions, and any other indebtedness or deductions All possible steps are taken to accept and receipt the student payment of registration fees; Ensuring that at least emergency ordering and emergency payments are handled; Ensuring that safes with combinations are secure or are changed as necessary, with healthy individuals aware of the combinations FOOD SERVICES The General Manager of Food Services is responsible for the necessary arrangements for the continued operations and supplying of food services on campus. The priority will be to provide food services for the residences and the Emergency Operations Centre (EOC). If human resources and food supplies allow for or are required in other areas of the University the General Manager of Food Services will arrange for food services to be provided. 4.2 AWARENESS AND EDUCATION An important effort when increasing resiliency to any emergency / disaster is increasing awareness and education regarding the key information about the hazard / risk. Pandemic awareness and educational resources available to University of Manitoba faculties, schools, and units include the following: Pandemic Awareness Course (no charge / free) from the Canadian Centre for Occupational Health and Safety (CCOHS) - Pandemic Influenza website of the Public Health Agency of Canada (PHAC) or Pandemic Influenza website of the Government of Manitoba (Manitoba Health and Health Living and Manitoba Emergency Measures Organization) - Revised: September 9, 2009 Page 15 of 20

19 4.3 EXTERNAL ISSUES / STAKEHOLDERS UNIVERSITY OF MANITOBA INSTITUTIONAL PANDEMIC PREPAREDNESS PLAN Many organizations (i.e. governments, institutions, businesses, agencies, etc.) are increasing dependent on each other to provide services to the public, clients, and other businesses. When there is a disruption of services in one organization there is a potential impact in those organizations that depend on their partner organization. The University of Manitoba is either dependant on external organizations or is depended on by external organizations, such as: The delivery and provision of food services on campus is dependent on ARAMARK and it s suppliers. The provision of library services at all hospitals within the Winnipeg Health Region (WHR) are dependant on the University of Manitoba to staff and operate those libraries. 4.4 HEALTH AND ALLIED HEALTH PROFESSIONAL FACULTIES During a pandemic the health and allied health professional faculties and schools (i.e. Medicine, Nursing, Dentistry, Pharmacy, School of Medical Rehabilitation, and School of Dental Hygiene) are expected to be additionally impacted due to the human resource needs of the health and allied health delivery agencies. It is possible that both faculty and students of these facilities and schools could be seconded by the Province of Manitoba to work in public health immunization clinics, hospitals, personal care homes, and community health services. 4.5 BODY MANAGEMENT The total number of deaths (including all other causes) during a pandemic wave of six to eight weeks is estimated to be similar to that which usually occurs over a period of six months. Planning for mass fatalities / body management is therefore necessary as there will be a strain on the current system for a prolonged period of time. Manitoba Health and Manitoba Justice Coroner s Office is working with stakeholders to outline a plan for managing deaths that occur in the community as a result of pandemic influenza. This plan will outline the assessment of the deceased in their home, pronouncement protocols to follow transportation of the body to the funeral home and death certification. Some of the issues that need to be addressed include: pronouncement and certification of deaths; transportation of bodies; morgue capacity, including in acute care facilities; planning and gathering at funerals; supply management. A document providing guidance for planning around these and other related matters is already in place: The Canadian Pandemic Influenza Plan provides an annex that contains guidelines to assist local authorities and other relevant agencies in planning for the management of mass fatalities during a pandemic influenza, including dealing with issues such as corpse management, temporary morgues, transportation, social/religious considerations, etc. Temporary storage facilities must be considered; these may include refrigerated trucks. Use of local businesses for the storage of human remains is not recommended and should only be considered as a last resort. The postpandemic implications of storing of human remains at these sites can be very serious and may result in negative impacts on business with ensuing liabilities. Revised: September 9, 2009 Page 16 of 20

20 5.0 RESPONSE CONCEPT OF OPERATIONS Revised: September 9, 2009 UNIVERSITY OF MANITOBA INSTITUTIONAL PANDEMIC PREPAREDNESS PLAN The following is not a detailed institutional pandemic response plan but it does describe the concept of operations that a pandemic response would follow. 5.1 GENERAL Anticipating the specific impact of the pandemic is difficult because there are several factors that are unknown or over which the University has little control. These include an un-known number of sick or ill staff and students and the future actions of public health officials. This results in a dynamic situation that can change regularly and requires a flexible response planning structure. The following is well accepted response planning structure: 1. Analyze the situation (i.e. conduct a threat / hazard assessment what is the impact); 2. Plan how to respond to the situation and the potential impacts (i.e. write an Incident Action Plan or IAP); 3. Implement the planned response to address the situation and the potential impacts (i.e. implement the Incident Action Plan or IAP); 4. Evaluate the implementation of the response actions, there are three (3) options depending on the evaluation: a. Re-analyze and re-plan the response because the current planned response is not achieving its objectives; b. Continue implementation the current planned response because the response objectives are being achieved; or c. Terminate the planned response because the response objectives have been achieved; 5. Terminate the response and begin after-action / recovery activities. 5.2 PANDEMIC PLANNING COMMITTEE (PPC) The Pandemic Planning Committee (PPC) will coordinate the overall pandemic response planning and actions of the University. Current response activities will include, but are not limited, to the following: 1. Meeting on a regular basis to assess and review the impact of the pandemic to the University. 2. Receive briefings from the Emergency Management Coordinator (EMC) and other key University personnel regarding pandemic related issues. 3. Liaise with other on-campus stakeholders, including Dean s Offices, Dean s Council, Senate, Board of Governors, Collective Bargaining Units / Unions, etc. 4. Communicate regularly with the University community through the University s web home page (i.e. H1N1 Virus link and 5. Assess the need for the Emergency Operations Centre (EOC) to activate / open to assist with the above activities. 5.3 EMERGENCY OPERATIONS CENTRE (EOC) When the Emergency Operations Center (EOC) is activated / opened is the location from which pandemic response information will be coordinated from on behalf of the Pandemic Planning Committee. Activities will include, but are not limited, to the following: 1. Notifying all stakeholders (e.g. PPC, Dean s Offices, external liaisons, etc.) that the EOC has opened and will, at that time, identify how to communicate with the EOC (e.g. address, room / building location, telephone number, fax number, etc.). 2. Will receive faculty specific communications only from the Dean s Office and / or the designated faculty specific liaison. In other words the communication between the EOC and faculties will be restricted to authorized personnel within the Dean s offices. 3. Will receive administrative unit s specific communications only from the directors / heads of administrative units and / or the designated liaison. In other words the communication between the EOC and administrative units will be restricted to authorized personnel within the administrative unit offices. 4. Liaise with public health officials of Manitoba Health and Healthy Living and the Winnipeg Regional Health Authority (WRHA). Page 17 of 20

21 UNIVERSITY OF MANITOBA INSTITUTIONAL PANDEMIC PREPAREDNESS PLAN Note: In order for the EOC to be effective the faculties and administrative units need to regularly communicate their status to the EOC (i.e. are you operating normally, do you have resources available to share, are your capabilities reduced, do you need assistance with critical functions, etc.). 5.4 DEANS, DIRECTORS, AND DEPARTMENT HEADS (DDD) The Deans, Directors and Department Heads (DDD) having been responsible for coordinating unit specific pandemic plans as per the Pandemic Influenza Planning Guideline for Academic, Research and Administrative Units. Current response activities should include, but are not limited, to the following: 1. Ensuring their unit specific Pandemic Plan is complete and up to date. 2. Completing the Pandemic Preparedness Planning Checklist in Appendix C of this document. 3. Activating unit specific pandemic plans as required and notifying the PPC and / or EOC when this occurs. 4. Providing regular updates regarding unit status to the PPC / EOC. 5. When addressing the needs of your unit or units attempt to do so through normal / regular channels. When normal / regular channels are unable support your needs you can then request assistance through the EOC. 6. Inform professors and instructors that they can request students to not attend classes or laboratories if the student has influenza like illness. 7. U of M resources available to you: - Pandemic web site: - Pandemic Preparedness Planning Checklist: Appendix C. - Frequently Asked Questions (FAQs) for Supervisors and Employees: Appendix D. - Infection Control University Personnel: Appendix E. - Student Hand Out: H1N1 Influenza (Flu) and You: Appendix G. - Pandemic Preparedness Template Guideline: Appendix H. - Pandemic Preparedness Black Template and Forms: Appendix I or online via (follow the Pandemic Documents link). 8. Manitoba Health resources available to you: - H1N1 web site: - Frequently Asked Questions (FAQs): - Self Care for Influenza: Appendix F or online via: - Copying with the Psychological impact of H1N1: - Poster: Hand Hygiene: - Poster: Cough Etiquette: Revised: September 9, 2009 Page 18 of 20

22 UNIVERSITY OF MANITOBA INSTITUTIONAL PANDEMIC PREPAREDNESS PLAN 5.5 UNIVERSITY STAFF University staff / employees are responsible for notifying his / her director supervisor if he / she have an influenza symptoms or illness. Depending on the severity of the illness and work to be preformed the supervisors and employee can work together to determine a solution. Both supervisor and employees current response activities should include, but are not limited, to the following: 1. Prepared for the potential of reassignment to other duties that are not written in the job description. Employees are entitled to be paid the appropriate rate of pay for the performance of duties which are outside their normal job responsibilities. 2. Monitor the University s web site for pandemic related updates. 3. Update your current contact information to ensure you can both communicate with each other. 4. Read the Frequently Asked Questions (FAQs) for Supervisors and Employees document available in the Appendix D of this document on via UNIVERSITY STUDENTS Students current response activities should include, but are not limited, to the following: 1. Familiarize yourself with the University s pandemic web site 2. Register your telephone number with the Emergency Notification System (ENS) through the JUMP portal. 3. Review the H1N1 Influenza (Flu) and You handout available in Appendix G of this document or online 4. Know that a professor and / or instruction could ask you to leave a class or laboratory if you have influenza like symptoms. 5. Identify someone in your classes who can be a Study Buddy and share notes and handouts with you if you are ill. 6. Identify someone who can be a Health Buddy to you, who will contact you regularly to check if you are well or not. 7. Know that there are doctors and nurses at the University Health Service (UHS) that are focused on the health of students at the University of Manitoba. Revised: September 9, 2009 Page 19 of 20

23 6.0 POST PANDEMIC RECOVERY UNIVERSITY OF MANITOBA INSTITUTIONAL PANDEMIC PREPAREDNESS PLAN 6.1 RECOVERYING FROM THE IMPACT Recovery is generally one of the most overlooked aspects of emergency planning. The University must realize that staff, faculty and students have gone through a difficult time and may need some special considerations to get through their recovery period. Small businesses may be struggling and many small and medium sized businesses will not survive a pandemic. Specific sectors such as tourism and public venues which maybe be closed during a pandemic are likely to be the hardest hit. Recovery begins immediately and continues throughout the response phase of any emergency / disaster. With a pandemic, recovery efforts may be thwarted by an unknown duration of the actual event and the unknown number of faculty, staff and students effected. Planning for recovery before an event occurs will assist available faculty, staff and students to make the transition as seamless as possible. 6.2 PSYCHOLOGICAL SUPPORT After a pandemic wave is over, it can be expected that many people will be affected in a variety of ways. They may have lost friends and relatives, suffer from fatigue, or have financial losses as a result of the interruption of work. There will be low morale and temporary loss of productivity as a result of the loss of co-workers, family and friends. There will be high levels of anxiety and long term psychological recovery as people deal with the impact and loss of loved ones. It is critical the University provide empathy and support for staff and make arrangements for psychological support counseling for the individuals that have difficulty getting over their experience (e.g. Employee Assistant Program, peer counseling, pastoral care, WRHA Mental Health Program, etc.). This includes regular communications regarding the services available to the staff, faculty and students through campus resources. 6.3 RESUMING OPERATIONS Based on information as developed by the EOC and ongoing reviews of the international / national / local situation and discussions with each University of Manitoba faculty, school, college, and unit, the EOC will recommend a partial, incremental or total return to normal operations. Any such decisions would be communicated to and coordinated with each faculty, school, college, and unit. Questions that will have to be considered include: Adjustments necessary to the academic calendar; Resumption or rescheduling of research activities; Rescheduling special events that were cancelled or postponed. 6.4 STAFF REPLACEMENTS It is realistic that a number of staff will die or have long term disability as a result of a pandemic. The emotional stress will result as others require extended absences or treatment. Any major emergency can affect the workforce and it is important to have succession planning in place. There may be significant recruitment and training requirements. And there will be a backlog of work caused by the business disruption. There can also be a loss of critical institutional or corporate knowledge. Eliminate the only person who can do that job scenario and encourage key staff to document their special knowledge for the benefit of others in the future. 6.5 ANALYSIS AND AFTER ACTION REPORTS Once the operational resumption is underway, debriefings will be convened to discuss the response and recovery, changes necessary to current plans, and opportunities for improvement to future disasters. A formal after action report will be developed and distributed to the campus. Revised: September 9, 2009 Page 20 of 20

24 U of M INSTITUTIONAL PANDEMIC PREPAREDNESS PLAN TITLE PAGE APPENDIX A EXTERNAL LEADERSHIP ORGANIZATIONS Revised: September 9, 2009 Page 1 of 1

25 LEADERSHIP ORGANIZATIONS LEADERSHIP ORGANIZATIONS There are several organizations that are providing leadership in preparing for the next pandemic. Your efforts may not include interactions with these organizations, but it is important for you to know and understand that there are both global and local efforts supporting pandemic preparedness. An overview of these organizations is provided below. International - World Health Organization (WHO) The global leader in pandemic preparedness is the World Health Organization (WHO), which is the United Nations specialized agency for health. It was established on April 7, WHO's objective, as set out in its Constitution, is the attainment by all peoples of the highest possible level of health. Health is defined in WHO's Constitution as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. The WHO is responsible for coordinating a global response to an influenza pandemic. The WHO has conducted influenza surveillance since 1947 to detect prevalent and emerging strains. The mandate of the WHO with respect to pandemic influenza is to: Conduct world-wide surveillance and reporting of disease; Identify the beginning of a pandemic through the use of the phased response; Coordinate global response to a pandemic; Provide recommendations on the management of a pandemic. National / Federal Public Health Agency of Canada (PHAC) The leader in national / federal pandemic preparedness, response, and recovery within Canada is the Public Health Agency of Canada (PHAC) and has established the Canadian Pandemic Influenza Plan. PHAC is focused on more effective efforts to prevent chronic diseases, like cancer and heart disease, prevent injuries and respond to public health emergencies and infectious disease outbreaks, the PHAC works closely with provinces and territories to keep Canadians healthy and help reduce pressures on the health care system. PHAC is responsible for coordinating the nation-wide health response to pandemic influenza. Federal responsibilities include entering into agreements and arrangements with international organizations such as WHO to support surveillance, coordination and investigation activities. The mandate of the PHAC with respect to pandemic influenza is to: Liaise with the WHO, the US Centers for Disease Control and other national / international organizations to coordinate surveillance, investigation and vaccine activities; Procure/distribute diagnostic reagents and technical information to provincial / territorial public health laboratories; Establish domestic influenza vaccine manufacturing capacity; Acquire influenza vaccine and antiviral drugs and allocate them equitably to provinces and territories; Work with provinces and territories to provide vaccine and antiviral drugs to specific populations for which the federal government is responsible (e.g., First Nations, RCMP, military personnel); Develop communication strategies, plans and framework; PHAC connects with provinces and territories through the Pandemic Influenza Committee (PIC) and does not connect directly with Winnipeg or any other city. Manitoba Health The leader in provincial pandemic preparedness is Manitoba Health through the Office of the Chief Public Health Officer of Health, Office of Disaster Management, and the Public Health Division. Manitoba Health is responsible for coordinating the province-wide response to an influenza pandemic, including the declaration of a provincial emergency. Revised: September 5, 2009 Page 1 of 2

26 LEADERSHIP ORGANIZATIONS The mandate of the Manitoba Health is to: Implement national recommendations on influenza surveillance and immunization programs; Maintain provincial surveillance activities, report diseases caused by influenza and participate in national surveillance activities; Coordinate investigations of outbreaks and clusters of febrile respiratory illness (FRI)/influenza-like illness (ILI); Undertake tasks most effectively done at the provincial level (e.g. bulk purchasing equipment, stockpiling and distributing vaccine and antiviral, distributing medical supplies); Provide guidelines and direction to local public health authorities to ensure a consistent planning and response across the province; Support special studies to enhance the province s capacity to manage a pandemic; Coordinate public education programs; Provide guidelines and direction to local pandemic planning groups; Provide guidance to the health field during a pandemic. Manitoba Intergovernmental Affairs - Manitoba Emergency Measures Organization (EMO) The leader in general or all-hazards provincial emergency preparedness is the Manitoba Emergency Measures Organization (EMO). Manitoba EMO is responsible for the overall provincial emergency management program, ensuring safety for citizens, their property and the environment. Regional Health Authorities (RHAs) The leaders in regional pandemic preparedness are the Regional Health Authorities (RHAs). Together, Manitoba Health and the RHAs are responsible for policy, assessment of health status and ensuring effective health planning and delivery. The RHAs that the University may interact with include the Winnipeg Regional Health Authority (WRHA), the Regional Health Authority Central Manitoba Inc., and the South Eastman Health Inc. regarding research stations. Municipalities The leaders in general local / regional emergency preparedness are the municipalities of Manitoba (e.g. City of Winnipeg, Rural Municipality of Richot, etc.). The municipalities that the University may interact with includes the City of Winnipeg, Rural Municipality of Portage le Prairie, Rural Municipality of Ritchot, and those within which research stations are location (e.g. Glen Lea, Delta Marsh, Carman, Star Lake, etc.). The mandate of municipal government for pandemic influenza planning as outlined in the Manitoba Health Preparedness Guidelines for Local Governments is to: Understand the hazard and its effects; research on past and current health facts; Form a planning team; developing goals and terms of reference; Plan objectives, clearly define who, what, where, when, why; Plan development, networking with major stakeholders; Preparedness and plan maintenance. Revised: September 5, 2009 Page 2 of 2

27 U of M INSTITUTIONAL PANDEMIC PREPAREDNESS PLAN TITLE PAGE APPENDIX B PANDEMIC PLANNING COMMITTEE (PPC) Revised: September 5, 2009 Page 1 of 1

28 U of M PANDEMIC PLANNING COMMITTEE TERMS OF REFERENCE DRAFT 1.0 PURPOSE The University of Manitoba (U of M) Pandemic Planning Committee is a group assigned the responsibility of coordinating the development and implementation of pandemic preparedness, response, and recovery plans for the University. 2.0 CHAIR AND MEMBERSHIP The President has appointed the Vice President (Administration) to Chair the Pandemic Planning Steering Committee. Four (4) groups of membership are established: 1) Standing Members (voting), 2) Resource Persons (non-voting), 3) Consultants (non-voting), and 4) Stakeholders (non-voting). Standing Members these voting members shall be comprised of representatives from various internal sectors of the University: Senior Management: - Vice President (Administration) - Associate Vice President (Administration) - Associate Vice President ( Research) - Vice Provost, Student Affairs Vice President (Academic) Departments and/or Units: - Libraries - Student Services - University Health Services Faculties: - Faculty of Arts (Dean or Dean s Designate) - Faculty of Medicine (Dean or Dean s Designate) - Faculty of Science (Dean or Dean s Designate) Vice President (External) Departments and/or Units: - Public Affairs Vice President (Administration) Departments and/or Units: - Human Resources - Physical Plant - Information Services and Technology (IST) - Financial Services - Office of Legal Counsel - Environmental Health and Safety Office (ESHO) - Security Services - Ancillary Services: Residences Food Services Students: - University of Manitoba Students Union (Executive Director) Resource Persons personnel that can be employed to support the Committee to achieve its purpose, which may include: Emergency Management Coordinator, who shall also be a Standing Member of the Committee; Administrative personnel providing support to the committee and its members for pandemic planning tasks (minute taking, etc.) Consultants external individuals and/or organizations that have been engaged / contracted to assist the Committee to achieve its purpose. Revised: October 17, 2008 File No.: Page 1 of 3

29 U of M PANDEMIC PLANNING COMMITTEE TERMS OF REFERENCE DRAFT Stakeholder Members representatives from organizations that have a vested or direct interest in the Pandemic efforts of the University, which include, but are not limited to, those listed below. The involvement or participation of these members in the activities of the Committee or Sub-Committees shall be as required. City of Winnipeg Emergency Preparedness Coordinator Winnipeg Regional Health Authority (WRHA) - Disaster Management Program (DMP) Director Disaster Management - Public Health Program Pandemic Planning Specialist - Medical Officer of Health (MOH) Manitoba Health - Office of the Chief Medical Officer of Health - Office of Disaster Management (ODM) Tenants / Service Providers that occupy space on University property (e.g. Cangene, ARAMARK, Freshwater Institute, etc.) 3.0 FUNCTIONS The U of M Pandemic Planning Committee shall: 3.1. Provide advice and recommendations to the University of Manitoba Administration: - in establishing Pandemic guidelines and action plans; - in establishing Corporate standards and common terminology; and - in establishing sub-committees and in appointing sub-committee members; 3.2. Identify issues and recommendations to the Administration that require approval by the University of Manitoba Senate and / or Board of Governors as appropriate; 3.3. Review, discuss, and recommend the requirement for changes to existing, or for new Emergency Management policies and guidelines; 3.4. Define accountability, responsibility, and resources for those involved in Pandemic planning, which includes timelines, deliverables, and performance measures; 3.5. Facilitate the development and implementation of faculty and administration unit specific Pandemic response plans by providing guiding principles, goals, and strategies as well as a standardized format or template for documenting response actions; 3.6. Develop and implement a strategy for communicating with students, employees, and families before, during, and after the Pandemic, including the publication of the University s pandemic response preparation activities and response plan; 3.7. Educate and increase awareness within the University community (i.e. students, faculty, employees, tenants, visitors, etc.) regarding the facts and realities of a Pandemic, which are consistent with the World Health Organization (WHO), Public Health Agency of Canada (PHAC), Manitoba Health, and the Winnipeg Regional Health Authority (WRHA); 3.8. Work with local authorities, provincial authorities, and the Winnipeg Regional Health Authority (WRHA) to identify legal authority, decision making and triggers to initiate response / action plans (e.g. community containment measures); 3.9. Ensure that the pandemic response / action plan is consistent with the existing Emergency Response Plan and Incident Management System (IMS) and is coordinated with the pandemic response planning of Manitoba Health and the Winnipeg Regional Health Authority (WRHA); Exercise and update the University pandemic response plan at least annually; Support and review the work of sub-committees; Revised: October 17, 2008 File No.: Page 2 of 3

30 U of M PANDEMIC PLANNING COMMITTEE TERMS OF REFERENCE DRAFT 4.0 QUORUM Fifty percent of the Standing Member group, plus one member, constitutes a quorum. Members not able to attend a meeting should arrange to be suitably represented. 5.0 MEETINGS The Committee shall meet at the call of the Chair. 6.0 AGENDA FORMAT Call to order Review agenda Review previous minutes / action register and approval Business arising from previous minutes / action register New business Round table discussion Next meeting Adjournment 7.0 TERMS OF REFERENCE The Committee, on an annual basis or as necessary, shall review its terms. Revised: October 17, 2008 File No.: Page 3 of 3

31 U of M PANDEMIC PLANNING COMMITTEE MEMBERSHIP LIST MEMBERSHIP LIST NAME McCallum, Mrs. Deborah Beyak, Ms. Leta Brown, Ms. Debby Damianakos, Ms. Peggy Danakas, Mr. John Danis, Mr. Joe Deane, Susan Dowd, Ms. Cathy Embree, Dr. Joanne Friesen, Mr. Kenton Hahlweg, Dr. Ken Hay, Mr. Tom Hodges, Dr. Richard Jayas, Dr. Digvir Juliano, Mr. Gregory Lavallee, Ms. Linda Lucyk, Mr. Daryl Mazurat, Dr. Nita McConnell, Mr. Keith Miller, Mr. Gerry Moore, Sean Mork, Ms. Mary Ann Morphy, Dr. David Reid, Ms. Pat Ristock, Dr. Janice Rivers, Mr. Brian Sigurdson, Dr. Richard Simms, Mr. Alan Smith, Dr. Lynn Stockton, Dr. Lawrence Stone, Mr. Barry Voss, Mr. Terry Whitmore, Dr. Mark TBA Program / Organization / Affiliation Vice President (Administration) - Chair Manager, Bookstore Associate Director, Libraries General Counsel, Legal Services Director, Public Affairs Director, Housing and Student Life Director, ICM Executive Director, UMSU Head, Medical Microbiology / Pediatrics Emergency Management Coordinator Director, University Health Service Comptroller Clinical Veterinarian, Office of Research Services Vice President (Research) Legal Counsel Director, Security Services General Manager, Aramark Higher Education Infection Control, Faculty of Dentistry Director of Operations, Faculty of Medicine Executive Director, Information Services and Technology (IST) Communications Officer, Public Affairs Director, Audit Services Vice Provost, Student Affairs Director, Ancillary Services Acting Dean, Faculty of Arts Director, Physical Plant Dean, Faculty of Arts Associate Vice President (Administration) Executive Director, Student Services Associate Dean (Clinics), Faculty of Dentistry Assistant Director, Housing and Student Life (HSL) Executive Director, Human Resources Dean, Faculty of Science Director, Risk Management and Emergency Services RESOURCE PEOPLE NAME Perich, Ms. Carroll Program / Organization / Affiliation Assistant to VP (Administration) Revised: September 9, 2009 UofM Emergency Management Program File No.: Page 1 of 1

32 U of M INSTITUTIONAL PANDEMIC PREPAREDNESS PLAN TITLE PAGE APPENDIX C PANDEMIC PREPAREDNESS PLANNING CHECKLIST FOR ACADEMIC UNITS Revised: September 9, 2009 Page 1 of 1

33 PANDEMIC PREPAREDNESS PLANNING CHECKLIST FOR ACADEMIC UNITS CHECKLIST Activity Complete In progress Not started PREPAREDNESS / PLANNING 1. Has the faculty developed a basic understanding of the characteristics and effects of pandemic influenza and held a discussion at a planning or monthly meeting. 2. Has a faculty pandemic planning / contingency committee been established? 3. Has someone in the Daen s Office been designated as the Pandemic Planning Coordinator? 4. Has the faculty pandemic planning / contingency committee reviewed the U of M Pandemic Planning Guideline ( Including the Institutional Goals. 5. Are the faculty personnel familiar with the flu prevention measures promoted by the Public Health Division of Manitoba Health and Healthy Living? (e.g. cover your cough, washing hands, social distancing, etc., which are detailed on this website: ACADEMIC ACTIVITIES 1. List the specific essential / critical academic or instructional activities to be maintained. For each activity detail how it will realistically be maintained. 2. List the specific academic or instructional activities that can be deferred during periods of heightened influenza activity. For each activity detail how it can be re-activated and the expected time needed to do so. 3. List the specific academic or instructional activities that can be cancelled. 4. Has a procedure / protocol for professors, instructors, and / or teaching assistances to monitor and record absenteeism of students within classrooms and / or laboratories been implemented? 5. Have you identified alternate methods of course delivery in the event of prolonged faculty/student absenteeism? eg. classes / sections that can be combined; provision of lecture/course material to students via Angel or JUMP. 6. Have you considered how you will communicate to students, faculty and staff regarding course/schedule changes/cancellations? RESEARCH ACTIVITIES 1. List current essential / critical research projects that cannot be deferred along with the Principle Investigator (PI), location, and general nature of all the activities related to the research and specific proposals for how each project can be continued. 2. List the current research projects that can be deferred during periods of heightened influenza activity. For each research project identity the Principle Investigator (PI) and details concerning how it will be re-activated. 3. Have key research personnel and their alternates / backups received necessary crosstraining to sustain the essential / critical research projects? Revised: September 9, Page 1 of 2

34 PANDEMIC PREPAREDNESS PLANNING CHECKLIST FOR ACADEMIC UNITS ADMINISTRATION ACTIVITIES 1. Has the chain of command / succession for continued decision-making within the faculty / department been identified? Have alternates been identified to make decisions when the primary individual in unable to make decisions? (e.g. alternates for Deans, Associate Deans, Department Head, Associate Department Heads, etc.) 2. List essential / critical administration activities that are to be maintained if there is a university closure. For each administration activity listed describe specifically how these essential activities would be provided and who would provide them. 3. List administrative activities that can be deferred. For each deferred administrative activity detail how it will be re-activated and the expected time it would take to do so and the expected time to make up for the resulting backlog. 4. Have key administrative personnel and their alternates / backups received necessary cross-training to perform the essential / critical administration activities? DOCUMENT CONTROL AND MAINTENANCE 1. Has the pandemic plan been approved by faculty management? 2. Is the emergency contact list / phone number list current? 3. Is the plan being kept current? Revised: September 9, Page 2 of 2

35 U of M INSTITUTIONAL PANDEMIC PREPAREDNESS PLAN TITLE PAGE APPENDIX D PANDEMIC PLANNING FREQUENTLY ASKED QUESTIONS (FAQs) FOR SUPERVISORS and EMPLOYEES Revised: September 5, 2009 Page 1 of 1

36 FREQUENTLY ASKED QUESTIONS (FAQs) BACKGROUND PANDEMIC PLANNING FREQUENTLY ASKED QUESTIONS (FAQs) FOR SUPERVISORS and EMPLOYEES What is pandemic influenza (aka flu)? The term pandemic influenza refers to a world-wide spread of a new influenza virus the current virus of concern is the H1N1 virus. Because it is new, most people do not have immunity to it. What is the University doing to prepare for the pandemic influenza? The University of Manitoba has been involved in pandemic planning and has developed an institutional plan. Deans, Directors, and Heads of Administrative Units have also been requested to develop their own unit plans in a template format. A Pandemic Planning Committee is actively involved in overseeing and communicating the planning activities. How is the virus transmitted? The H1N1 virus is spread like other seasonal / annual influenzas person-to-person through close contact with droplets produced by coughing or sneezing. Although people are most infectious to others while they are sick with the flu, the virus can be spread about a day before symptoms begin and sometimes even if symptoms do not appear. This is why is important for people to take precautions at all times. The best defense against the H1N1 virus is as follows: - Cover your cough by coughing into your elbow or sleeve or use a tissue to cover your nose and mouth when coughing or sneezing. - Washing your hands often with soap and water, especially after coughing or sneezing. Hand sanitizers are also effective. - Reduce the spread of germs by limiting touching your eyes, nose or mouth and by washing your hands frequently. - Maintain your health by taking care of yourself and those in your care including eating a health balanced diet, avoiding cigarette smoke and other harmful substances, being active and getting enough rest and sleep. What are the symptoms of influenza? The symptoms of influenza include a sudden fever of 38 C (100.4 F) or higher, a cough, a runny nose and one or more of the following: sore throat, muscle aches, or physical exhaustion. If you have symptoms of a respiratory infection, you should: - Stay home from school or work and limit unnecessary contact with others. - Contact your health-care provider or visit your nearest health-care centre if you are concerned that you may need care especially if your symptoms are severe of worsening. How will pandemic influenza information be shared amongst the University community? The University will provide information regarding the H1N1 virus situation and its planning efforts through a variety of communication channels, which include the University web-site, Dean s, Directors, and Department Heads, etc.. Revised: September 5, 2009 File No.: Page 1 of 3

37 SENDING EMPLOYEES HOME PANDEMIC PLANNING FREQUENTLY ASKED QUESTIONS (FAQs) FOR SUPERVISORS and EMPLOYEES May I send an employee home if he/she shows symptoms of influenza? Can the employees be required to take sick leave? Can I prevent employees from coming to work? The Employment Standards Code permits employers to send employees home when they present at work with influenza-like symptoms. However there are other ways to address situations in which employees have this condition. In some cases employees may be isolated from other workers by working from home, limiting their work to private offices, etc. Employees with severe symptoms and who appear to be at risk of transmitting the virus at work may be sent home with a request that they seek medical attention. It is recommended that employees keep in regular contact with their supervisor for the duration of their illness until it is agreed that a return to work is advisable. May I mandate employees to stay home if members of their family are known or suspected to have influenza or they have been exposed to someone with influenza? The recommendation of Manitoba Health and Healthy Living is that employees should stay home only when they exhibit symptoms. Employees who think they have been exposed to someone with H1N1 should take extra care to follow personal hygiene and other preventative measures as outlined above. LEAVE / SICK LEAVE POLICIES Must an employer grant leave to an employee who is caring for a family member that is sick? The University has provisions for employees to make arrangements for the continuing care and supervision of a family member during a serious illness. The number of days allocated to employees is contained in the employee s collective agreement or in the University s Temporary Absences Policy and Procedures documents. RETURN TO WORK May an employer require an employee who is out sick with influenza to provide a doctor s note, submit to a medical exam, or remain symptom-free for a specified amount of time before returning to work? Unnecessary burdening of the health care system by requesting return to work certificates is not something the University wishes to promote. The University would rather the employee and the supervisor keep in regular contact to assess the employee s ability to return to work. A period of isolation and or working from home may be an option. Revised: September 5, 2009 File No.: Page 2 of 3

38 PANDEMIC PLANNING FREQUENTLY ASKED QUESTIONS (FAQs) FOR SUPERVISORS and EMPLOYEES REFUSAL TO WORK During an influenza pandemic, can a healthy employee refuse to come to work, travel, or perform other job duties because of a belief that by doing so, he or she would be at an increased risk of catching influenza? An employee has a right under the Workplace Safety and Health Act to refuse to perform dangerous work. Steps such as regular hand washing by all workers, use of protective clothing or equipment in some jobs, having work performed in isolation are valid methods of protecting all workers. A refusal to perform work is a serious matter and any such refusal should be reported to the Environmental Health and Safety Office (EHSO) and will be reviewed by the Workplace Safety and Health Division of Manitoba Labour and Immigration. REASSIGNMENT OF WORK Can an employee be required to perform work outside of the employee's job description? Employee s duties are not restricted to what is written in the job description. Employees are entitled to be paid the appropriate rate of pay for the performance of duties which are outside their normal job responsibilities. As part of their pandemic planning units heads have been encouraged to cross train employees to ensure adequate backup is available for critical functions. WORKING AT HOME AND SOCIAL DISTANCING May employers change work hours / schedules to minimize contact between employees? Yes this is another option to working in isolation or working from home. Once a pandemic begins, may employers implement alternative work schedules (e.g., flextime, staggered shifts) or alternative work arrangements (e.g., telework) to promote social distancing? Yes, although there are usually notice periods required to changing the hours of work of employees. Revised: September 5, 2009 File No.: Page 3 of 3

39 U of M INSTITUTIONAL PANDEMIC PREPAREDNESS PLAN TITLE PAGE APPENDIX E INFECTION CONTROL UNIVERSITY PERSONNEL Revised: September 5, 2009 Page 1 of 1

40 APPENDIX C INFECTION CONTROL INFECTION CONTROL UNIVERSITY PERSONNEL Note: this appendix has been adapted from the City of Winnipeg Pandemic Plan. Introduction This appendix outlines the basic principles of infection control related to influenza. General information on influenza is presented in accordance with factual health information provided by Manitoba Health and Winnipeg Regional Health Authority (WRHA); including modes of transmission, communicability, incubation period and symptoms. Infection control practices are outlined for city personnel, but directly related to the same information provided to the general public. In addition, infection control references for health care and community settings are provided. Adherence to infection control practices is essential to minimize the transmission of influenza. Frequent and careful hand washing is emphasized as a key infection control strategy and may be the only significant preventive measure available, particularly early in a pandemic. If the pandemic virus behaves differently (e.g., different routes of transmission, longer incubation period or period of communicability) infection control practices will be adjusted accordingly. General Information on Influenza Influenza Influenza, the flu, is a highly contagious and common respiratory illness caused by a virus. Understanding how influenza is spread can help people take precautions to prevent or minimize its transmission. Modes of Transmission Influenza spreads when the infected respiratory secretions from the mouth or nose of one person come into contact with the mucous membranes (eyes, mouth or nose) of another person. The vast majority of influenza is spread from person to person by droplet spread or direct contact. Outside the body the influenza virus may persist for sometime, especially in conditions of low relative humidity and cooler temperatures. Specifically, the influenza virus can survive for 1-2 days on hard surfaces, 8-12 hours on soft surfaces and 5 minutes on hands, resulting in some spread by indirect contact. Droplet spread refers to spray with relatively large, short range droplets produced by sneezing, coughing, talking or singing. These droplets may spray a distance of up to one meter (about three feet) before dropping to the ground. Direct contact occurs when there is immediate transfer of the virus through skin to skin contact or kissing. For example, an infected person may cough into his hand and then shake hands with another person who may then rub his/her eyes. Indirect contact occurs when the virus is transmitted from an infected person on to an inanimate object and then on to another person. For example, an infected person may blow their nose, then touch an elevator button and then another person touches the same elevator button and touches his/her eyes. There is controversy over the role of airborne transmission in spreading influenza. Airborne transmission occurs when aerosolized, infected droplets of a small size (< 5 μm in diameter) remain suspended in air for long periods of times. Communicability Communicability refers to the time period during which the influenza virus can be spread from an infected person to another person. Most adults infected with influenza can transmit the virus from 1 day before and up to 3-5 days after the onset of symptoms. This period may be longer (7 or more days) in children and some adults. Revised: October 20, 2008 Page 1 of 4

41 APPENDIX C INFECTION CONTROL Incubation Period The incubation period for influenza is 1-3 days. This means that a person may develop symptoms of influenza 1-3 days after coming into contact with a person with the influenza virus. Symptoms Infection with influenza can result in a wide range of illness. Some people might not have any symptoms. About half infected people will experience some symptoms. These include: Sudden onset of fever, headache, chills, muscle aches, physical exhaustion, and a dry cough. Subsequent onset of sore throat, stuffy or runny nose, and worsening cough. Children may also feel sick to their stomach, vomit or have diarrhea. Elderly and immune compromised people may not develop a fever. Most people recover in 7-10 days. Infection Control Practices for the City Personnel There are a number of things staff can do to prevent or reduce the risk of getting influenza. Hand Hygiene Clean your hands frequently with soap and water or an alcohol-based hand sanitizer, especially after you cough, sneeze or blow your nose. A 60% to 90% alcohol-based hand sanitizer is the preferred agent for hand hygiene unless your hands are visibly soiled. If your hands are visibly soiled you should wash them with soap and water. If you are not near water and your hands are visibly soiled, clean your hands with a moist towelette to remove visible debris then use an alcohol-based hand sanitizer. The influenza virus is easily killed by soap, hand wash or hand sanitizer products, and household cleaning products. Therefore gloves or special antibacterial hand wash products are not needed. Hand washing/sanitizing is a very important method to prevent the spread of pandemic influenza before a vaccine becomes available. Respiratory Etiquette Cover your mouth and nose when you cough or sneeze. This will help stop the spread of germs that can make people sick. It is important to keep your distance from people who are coughing or sneezing. Avoid Touching Your Eyes, Mouth and Nose Influenza spreads when the infected respiratory secretions from the mouth or nose of one person come into contact with the mucous membranes (mouth, nose or eyes) of another person. Without even realizing it, you may touch the infected nose and mouth secretions of someone who has influenza (e.g. pushing an elevator button). If you go on to touch your mouth, nose or eyes, the influenza virus may gain entry into your body causing infection. Hand Washing Procedure 1. Wet hands and wrists. 2. Apply soap. 3. Lather for 15 seconds. Rub in between fingers, the back of your hands, wrists, and fingertips. 4. Rinse thoroughly. 5. Dry with paper towel or hot air blower. 6. Turn taps off with paper towel, if available. 7. Open bathroom door using paper towel. 8. Discard paper towel in waste basket. Revised: October 20, 2008 Page 2 of 4

42 APPENDIX C INFECTION CONTROL Hand Sanitizing Procedure 1. Follow the manufacturer's recommendations on the amount of hand sanitizer to use. 2. Apply the alcohol-based sanitizer to the palm of one hand. 3. Rub hands together. 4. Work the sanitizer in between fingers, back of your hands, wrists and fingertips (covering all parts of the hands and fingers). 5. Keep rubbing your hands until dry. Cover Your Cough Procedure 1. Cover your mouth and nose with a tissue when you cough or sneeze, or if no tissues are available, cough or sneeze into your upper sleeve, not your hands. 2. Put your used tissue into the waste basket. 3. Wash your hands with soap and water or clean with alcohol-based hand sanitizer. Stay Home if You are Ill to Avoid Infecting Others Most adults infected with influenza can transmit the virus from 1 day before and up to 3 to 5 days after the onset of symptoms. This period may last for 7 or more days in young children and some adults. Some experts believe that the highest concentration of viral shedding occurs early on and decreases quite a bit after 3 days of illness. However there is no clear data on how long a person should wait before returning to their usual activities (e.g. work) in order to minimize the risk of infecting others. The best advice at this time is that adults should return to their usual activities at least 5 days after the onset of symptoms or when they feel well enough to return to their duties, whichever is longer. Corporate Services Human Resources will use the most current health related information to develop an Attendance Policy, for review by the Administration and Council, when the Pandemic actually has impacted the City of Winnipeg. Use of Masks The use of masks is a difficult and unresolved issue. There is no evidence that the use of masks in settings that involve the general public work will be protective when the influenza virus is circulating widely. However, it is acknowledged that individual people who are wearing a surgical mask properly at the time of an exposure to influenza may benefit from the barrier a mask provides. At this time, the Canadian and provincial plans recommend the use of surgical masks and eye protection for health care workers providing direct care (face-to-face contact) to patients with influenza-like illness. As well, the plans recommend that people who are ill with influenza like illness who must leave their home to receive medical attention should wear a mask. The plans do not recommend masks as a community-based disease control strategy. However the federal plan states that members of the public may wish to purchase and use masks for individual protection. At this time, the WHO does not have a formal position on the issue of masks but will likely be recommending evaluation of the effectiveness of mask use (and respiratory etiquette) with respect to prevention of cases, costs and alleviation of public concern. Although masks may provide some reassurance to staff and public, the effectiveness of this measure in preventing infection in the general community is unknown. If masks are used, they should only be used once and must be changed if wet (because they become ineffective when wet). As well, people who use masks should be trained on how to use them properly to avoid contaminating themselves when removing the mask. In addition, there may be issues of access to masks due to cost or supply shortages and other feasibility concerns. Revised: October 20, 2008 Page 3 of 4

43 APPENDIX C INFECTION CONTROL Get Vaccinated The best way to protect your self from seasonal influenza is to get vaccinated every fall. The influenza vaccine (flu shot) is made from particles of killed flu viruses. It contains three different types of influenza viruses (two types of influenza A and one type of influenza B). Doctors and scientists around the world determine the strains of influenza virus that are circulating, and the vaccine is then prepared to protect against the types that are most likely to occur each year. A person who receives the flu shot develops immunity for the types of influenza in the vaccine. The body needs about two weeks to build up protection to the virus, and this protection may last for about four to six months. The influenza virus changes each year, so a different vaccine has to be used each year. It is important to get vaccinated for seasonal influenza. Although the pandemic strain will be a new strain of influenza, getting vaccinated protects individuals against seasonal strains. Seasonal immunization may also reduce the chances of genetic re-assortment of a new influenza virus. In the event of a pandemic strain of influenza, it is estimated that it will take approximately four to six months to produce a suitable vaccine. Initially, there will not be enough vaccine for everyone. The government has developed priority groups to determine the order in which people will receive the pandemic influenza vaccine. Currently the priority groups, listed in order of highest to lowest priority, are: health care workers, essential service workers, persons at high risk of serious illness, healthy adults and healthy children. Revised: October 20, 2008 Page 4 of 4

44 U of M INSTITUTIONAL PANDEMIC PREPAREDNESS PLAN TITLE PAGE APPENDIX F SELF CARE Revised: September 5, 2009 Page 1 of 1

45 Self Care for Influenza Influenza FActs What is influenza (the flu)? Influenza is a respiratory disease caused by a virus. It can cause a variety of symptoms, such as fever, cough, aches and physical exhaustion. People usually recover from the flu without medical help. However, very young children and the elderly have a higher risk of severe illness, as well as people with lowered immunity (ex: those with chronic illnesses). How is influenza spread? Influenza spreads easily from person to person by coughing or sneezing, by handto-hand contact with an infected person, or after handling objects contaminated by infected people. The virus can survive on hard surfaces for up to 48 hours, on cloth, paper or tissue for up to 12 hours and on hands for about five minutes, long enough for you to inadvertently touch your mouth, nose or eyes and transfer the virus to your body. People can spread influenza up to 24 hours before symptoms appear and up to seven days after. Not everyone who gets influenza develops symptoms but they still may be able to spread it to others, especially if they cough or sneeze. What are the symptoms of influenza? Symptoms of influenza include: sudden fever of 38 C (100.4 F) or higher, cough, AND one or more of the following: sore throat, muscle aches, or physical exhaustion. Children may also feel sick to their stomach, vomit or have diarrhea, but these symptoms are uncommon in adults. Elderly people and people with lowered immunity may not develop a fever. How do I know if I have a fever? Fever is a sign that the body is fighting an infection or other illness. You or your child has a fever if body temperature is 38 C (100.4 F) or higher. Touching a forehead or neck is not a reliable way to check if someone has a fever. The best way to measure a person s temperature is by using a digital thermometer placed in the mouth (oral), the ear (tympanic) or under the armpit (axillary). The use of glass mercury thermometers is not recommended. You can buy a digital thermometer at your drug store. For infants and young children, the safest way to take a temperature is in the centre of the armpit. If the child is over two years of age, an ear thermometer can be used. Taking the temperature in the mouth is unsafe because young children can bite 1 June 2009

46 and break the thermometer. Also, the reading can be wrong because it is hard to keep a thermometer under a child s tongue. For more information on taking a child s temperature, please see the fact sheet Caring for a Child with a Fever available at documents/childhealth.html What basic precautions should I take if I think I have influenza? If you develop symptoms of influenza, you may be contagious for up to a week. Taking the following precautions will help to reduce the spread of the disease: Stay home from school or work and limit contact with others to reduce the chance of infecting them. Cover a cough or sneeze by coughing or sneezing into your elbow or sleeve or using a tissue to cover your nose and mouth. Place the tissue in the garbage. Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective. Avoid touching your eyes, nose or mouth to reduce the spread of germs. questions or are concerned that your child may need care, contact your health care provider or Health Links-Info Santé at or Do people I live with or visitors need to take any precautions? People who are ill should try to limit contact with others as much as possible. However, there may be times when this is not possible. To limit the spread of the virus, family members, caregivers, and other visitors, should: Wash their hands after being in direct contact with someone who has influenza (or any other respiratory infection). Wash their hands and a child s hands after wiping a child s nose. Wash their hands after coughing, sneezing or wiping their nose. Wash their hands after touching objects handled by someone who has influenza. Clean surfaces (such as toys, bathroom taps and doorknobs) with household cleaners after an ill person has touched them. What about children? Children should take the same precautions as adults, including washing their hands regularly and covering their nose and mouth when coughing. Young children may need help with hand washing. Children with flu-like symptoms should stay home from school or day care. Routinely clean surfaces in areas where children play to avoid the spread of germs. If you have What can I do at home to treat a fever? Dress in lightweight clothing and keep the room temperature around 20ºC (68ºF). Drink plenty of fluids in order to replace body fluids lost in sweat. If the person who is sick has urine (pee) that is darker than usual, they need to drink more. June

47 Offer small, nutritious meals. People sick with influenza may not be very hungry. Take acetaminophen (ex: Tylenol, Tempra ). Use the dose and schedule recommended on the package or by your doctor or pharmacist. Ibuprofen (ex: Advil, Motrin ) may be used for children older than six months and for adults. Do not give acetylsalicylic acid, also known as ASA, (ex: Aspirin ) to anyone under 18 years of age because it can lead to brain and liver damage (Reye s Syndrome). How can I treat other symptoms of influenza? Get plenty of rest. Gargle with warm salt water if you have a sore throat. Use a cool mist humidifier to help with a stuffy nose. If a baby is having problems breathing because of a stuffy nose, use a rubber suction bulb to clear the mucous. These are available at drug stores. You may also use saline nose drops or spray if the mucous is very thick. There are many over-the-counter cough and cold medicines sold in stores that do not require a doctor s prescription. These include decongestants, cough syrups, nasal drops and antihistamines. Over-thecounter cough and cold medicines should not be given to children under six years of age unless prescribed by a doctor. Check with your doctor or pharmacist before taking or giving over-the-counter medicines to anyone. This is especially important if the person is under 12 years of age, is taking other medicines or has a chronic medical condition. Be sure to read label instructions carefully and do not take more than recommended. When should I seek medical care? The decision to seek medical care will be affected by factors such as age, existing health problems or the symptoms you are experiencing at the time. People with symptoms of influenza should contact their health care provider if they: have heart or lung disease, have a chronic condition that requires regular medical attention, are frail, or have an illness or are on treatments that suppress (weaken) the immune system. People who are normally healthy and have symptoms of influenza should seek medical attention as soon as possible, if they experience any of the following: breathing is difficult or painful; coughing up bloody sputum (phlegm or saliva); wheezing; presence of fever for three to four days along with not getting better or getting worse; sudden return of high fever and other symptoms after initial improvement; extreme ear pain; 3 June 2009

48 extreme sleepiness, difficult to wake up, or disoriented and confused. People who need to seek medical care should contact their health care provider to report illness by telephone (or other remote means) before seeking medical care. People who have difficulty breathing or are believed to be severely ill should seek immediate medical attention by going to the nearest hospital emergency department or calling 911. When should I seek medical care for a child? Almost all children with influenza have a fever. The degrees (or height) of a fever do not tell you how serious your child s illness is. How a child acts is usually a better sign. A child with a mild infection can have a high fever, while a child with a severe infection might have no fever at all. It is recommended that you contact your doctor or take your child to an emergency department if your child has signs of influenza and: has lung or heart disease; has an illness or is taking treatment that affects the immune system; takes acetylsalicylic acid (ASA or Aspirin ) regularly for a medical condition or has a chronic illness requiring regular medical care; has a fever and is less than six months old; has a fever for more than 72 hours; is excessively cranky, fussy or irritable; is not interested in playing with toys or is unusually sleepy, listless or does not respond; has trouble breathing when resting, is wheezing, has chest pain when breathing or is coughing excessively (a lot) or coughing up bloody sputum (phlegm or saliva); drinks very little fluid and has not urinated (peed) at least once every six hours when awake; has vomited for more than four hours or has severe diarrhea; has a fever and a rash or any other signs of illness that worry you, or is still not feeling better after five days or was feeling better and suddenly develops a new fever. Take your child immediately to a hospital emergency department or call 911 if your child: has severe trouble breathing or blue lips; is limp or unable to move; is hard to wake up or does not respond; has a stiff neck; seems confused; or has a seizure (convulsion/fit). Where can I get more information? For more information on influenza and self care, contact Health Links-Info Santé at or or your primary health care provider. June

49 U of M INSTITUTIONAL PANDEMIC PREPAREDNESS PLAN TITLE PAGE APPENDIX G H1N1 INFLUENZA (FLU) and YOU [A handout to students] Revised: September 5, 2009 Page 1 of 1

50 H1N1 INFLUENZA (FLU) and YOU WHAT IS H1N1 INFLUENZA? The term pandemic influenza refers to a worldwide spread of a new influenza virus. The current virus of concern is the H1N1 virus. Because it is new, most people do not have immunity to it. It is a respiratory illness that causes symptoms similar to those of seasonal flu. HOW IS H1N1 INFLUENZA SPREAD? It is believed that it spreads the same way as regular seasonal flu. Influenza and other respiratory infections go from person to person when germs released from coughing and sneezing enter the nose and / or throat. Germs can also rest on hard surfaces like counters and doorknobs, where they can be picked up on hands and transmitted to the respiratory system when someone touches their mouth and/or nose. WHAT ARE THE SYMPTOMS? The symptoms include: Sudden Fever (100.4ºF / 38ºC); Cough; Runny nose; Sore throat; Body aches; Fatigue / physical exhaustion; and Lack of appetite. In some cases, these symptoms are accompanied by vomiting and diarrhea. HOW DO I PROTECT MYSELF AND OTHERS? The Province of Manitoba through the Manitoba Health and Health Living (MHHL) recommends the following precautions: Cover your cough by coughing into your elbow or sleeve or use a tissue to cover your nose and mouth when coughing or sneezing. Wash your hands often with soap and water, especially after coughing or sneezing. Hand sanitizers are also effective. Reduce the spread of germs by limiting touching your eyes, nose or mouth and by washing your hands frequently. Maintain your health by taking care of yourself and those in your care including eating a healthy balanced diet, avoiding cigarette smoke and other harmful substances, being active and getting enough rest and sleep. WHAT SHOULD I DO IF I GET SICK? If you have symptoms of a respiratory infection, you should: Stay home from school or work and limit unnecessary contact with others. Contact your health-care provider or visit your nearest health-care centre if you are concerned that you may need care especially if your symptoms are severe or worsening (e.g. shortness of breath, dehydration, or worsening fever, cough or weakness).

51 H1N1 INFLUENZA (FLU) and YOU Students seeking medical advice can contact University Health Service (UHS) by calling (204) or visit their web site: For personal advice on self-care or when to seek further care, those who cannot contact their primary health-care provider can phone Health Links Info Santé at any time at or toll-free at IF I AM SICK CAN A PROFESSOR / INSTRUCTOR ASK ME TO LEAVE THE CLASS? Yes, if you have influenza symptoms your professor or instructor can ask you to leave the class and not return until your symptoms are gone. If this occurs professors / instructors have been asked to accommodate and be flexible to allow you to complete your course work. DO YOU HAVE A STUDY BUDDY? If you are unable to attend class do you have a Study Buddy within your class that will share notes and hand outs after you have recovered. If you do not have a Study Buddy please ask a classmate to become yours. And if you are asked to be a Study Buddy please assist your fellow student because you may need their help if you are ill. DO YOU HAVE A HEALTH BUDDY? Many of our students come from other provinces and other countries, which means they are away from their support network of friends and family. If you are in this situation please make friends with someone who can be your Health Buddy. A Health Buddy is someone who will keep in touch with you regularly to see if you are healthy and if they cannot reach you they would be expected to find you to ensure you are healthy or to find out if you need assistance. WHAT IS THE UNIVERSITY OF MANITOBA DOING ABOUT H1N1? The University of Manitoba has been involved in pandemic planning and has developed an institutional plan. Deans, Directors, and Heads of Administrative Units have also been requested to develop their own unit plans. A Pandemic Planning Committee is actively involved in overseeing and communicating the planning activities, which includes an awareness campaign and provision of hand sanitizing stations. The primary method of communication will be via the University of Manitoba s web site, visit and follow the H1N1 Flu Virus link. WHAT ELSE DO I NEED TO KNOW? Internet resources include: - U of M pandemic planning web site: - Province of Manitoba: - Public Health Agency of Canada (PHAC):

52 U of M INSTITUTIONAL PANDEMIC PREPAREDNESS PLAN TITLE PAGE APPENDIX H UNIVERSITY OF MANITOBA PANDEMIC PREPAREDNESS TEMPLATE GUIDELINE Revised: September 5, 2009 Page 1 of 1

53 PANDEMIC PREPAREDNESS TEMPLATE GUIDELINE PANDEMIC PREPAREDNESS TEMPLATE GUIDELINE The U of M Department / Unit Pandemic Influenza Preparedness, Response, and Recovery Plan template is provided to facilitate a consistent methodology for pandemic preparedness throughout the University. The purpose is to assist Academic, Research, and Administrative departments / units with the documentation of department / unit specific preparedness, response, and recovery activities. Recognizing that each Faculty and Administrative department may be organized differently the distribution of this guideline will be done through the senior administrative departments / units. Within the Faculties the Dean s office will be tasked with coordinating the distribution and completion of the templates. Within the Administration the Emergency Management Program will be tasked with coordinating the distribution and completion of the templates. The following sections outline how departments / units are to complete the template, which includes: Documentation requirements (i.e. record of distribution, revision log, etc.); Purpose; Coordinators within the department / unit that are facilitating the pandemic preparedness, response, and recovery activities; Action plans DOCUMENTATION The development and implementation of pandemic preparedness, response and recovery plans requires maintenance. This template is provided with three forms to assist you in the maintenance of department / unit pandemic response and recovery plan, which include: Record of Distribution This form is used to record who has received a copy of the plan and when they received. When distributing your plan forward a copy to the EHSO with attention to the Emergency Management Coordinator. If you require additional copies of this form please print / photocopy or contact the Emergency Management Coordinator. Revision Log This form is used to record updates and / or changes to any section or sub-section of your pandemic response and recovery plan. It includes the date revised, person making the revision, the page being revised, whether the revision is an update or an addition (i.e. new), and space for actions, notes, or remarks. If you require additional copies of this form please print / photocopy or contact the Emergency Management Coordinator. Record of Signatures This form is used to record the names of individuals who have reviewed the pandemic response and recovery plan and have the ability to authorize the final draft. If you require additional copies of this form please print / photocopy or contact the Emergency Management Coordinator. PURPOSE The University of Manitoba Pandemic Planning Committee has established several Institutional Goals and Planning Assumptions. If department / unit specific plans identify a specific purpose please record it in the Purpose section and ensure that the purpose conforms to the University of Manitoba Institutional Goals and Planning Assumptions. Before initiating department / unit specific activities review the Institutional Goals and Planning Assumptions. Revised: September 5, 2009 Page 1 of 3

54 PANDEMIC PREPAREDNESS TEMPLATE GUIDELINE 4.3 COORDINATORS This section is provided for departments / units to identify the person or persons tasked as Coordinators for pandemic preparedness, response, and recovery activities. Include, for each Coordinator identified, name (i.e. first and last), work phone number, work fax number, work cell number, work address, home phone number, personal / home cell number, home address, and cottage number, if available. 4.4 ACTION PLAN The Action Plan is organized by the University of Manitoba Pandemic Phases. Please note that this plan does not replace existing Standard Operating Procedures (SOPs), rather this plan is to refer to existing SOPs when necessary. For example, a SOP may exist for a specific piece of equipment that details the shut down procedures. When a shut down is authorized the Pandemic plan should reference the SOP but not replace it. Each Phase has space for Departments / Units to record goals, strategies, actions, and additional information, which are explained below. Department / Unit Goals The Department / Unit Goals are specific goals not addressed by the University of Manitoba Institutional Goals and / or Planning Assumptions that are relevant your department / unit. Please ensure that the Department / Unit Goals conforms to the University of Manitoba Institutional Goals and Planning Assumptions Institutional Goal(s) Supported The University of Manitoba has established several institutional goals. Please list the Institutional Goals supported within each of the pandemic planning phases. Actions The actions / activities are specific procedures employed to achieve the Department / Unit Goals. Use the table provided to record actions / activities that are to be completed within each phase of the plan. Remember to include the person or persons responsible, resources required, and sources / contacts required to support the action / activity. Please note the table can be expanded and additional rows inserted as required. Additional Information This section is reserved for the listing of policies, procedures, technical information, or references that are relevant to the actions / activities of each phase. 4.5 SPECIFIC ISSUES / ACTIVITIES The following are examples of specific issues or activities your department / unit may encounter during the planning process. Inventories Establishing and maintaining an inventory of capabilities, resources, and services (i.e. research, classes, equipment, administrative processes, downstream stakeholders, etc.), and determining which are essential and which are non-essential. This should be part of the Pre-Pandemic Phase #1. - Inventory of research priorities (Form: Critical Functions List). - Inventory of teaching / class priorities (Form: Critical Functions List). - Inventory of essential equipment requiring maintenance (Form: Critical Functions List). - Inventory of the Chain of Command within the [department / unit] (Form: Chain of Command List). - Inventory of existing Standard Operating Procedures (SOPs) (Form: Standard Operating Procedures List) Revised: September 5, 2009 Page 2 of 3

55 PANDEMIC PREPAREDNESS TEMPLATE GUIDELINE Impact Assessment Conducting an impact assessment to determine which capabilities, resources, and services will be impacted by the pandemic. Ensure the impact assessment accounts for the time of year, duration or length of impact, or other temporal considerations. This should be part of the Pre-Pandemic Phase #1. Example impacts include: - Disruption to the supply of medical students to Manitoba hospitals; - Loss of a genetic strain due to a pro-longed shut down; - Financial and emotional impact to graduate students. Downstream Student Employer Stakeholders The supply of labour will be an important consideration during the pandemic because many people will be at home sick or attending to sick relatives. The student population of Manitoba s post secondary institutions could be a potential labour pool source. Each faculty should engage the industries, associations, and / or employers of their students and task them with identifying the capabilities of our students (i.e. determine the tasks that a 1 st year, 2 nd year, 3 rd year, 4 th year, graduate student, etc. are qualified to do). Communication Communicating with faculty, staff, and students is important to maintain. Centrally, the University has capabilities to communicate through , and a dedicated emergency telephone line 474-UofM (8636). Each Department / Unit should maintain a list of faculty and staff to disseminate and report information during and after the pandemic (Form: Emergency Contact List). Absenteeism / Surveillance The monitoring of staff and student absenteeism will be valuable to the University, but also to public health officials who maintain an active surveillance system. Each Department / Unit should ensure that regular absenteeism updates are provided to the Administration, which can then be provided to public health officials. Please note that the Administration may be operating from the University Emergency Operations Centre (EOC). Logistics Logistics is an important consideration for many reasons. If a specific action / activity is to be maintained because it is critical to your operations remember the various stakeholders (i.e. internal or external) that are required to maintain the critical service. In other words, the ability or inability of others to support your services may impact your ability to provide your service. Examples include: If your department / unit is to deliver classes with an alternative method of delivery that is based on technology please remember that those providing the solution are also impacted and may not be able to deliver to your expectations. Questions to ask yourself: - Do you have enough supplies to sustain the administration or operations of specific equipment? - Can you obtain supplies from more than one source / supplier? Cross Training During the pandemic the total number of people available to work will be reduced. A strategy to sustain essential services is to first identify the services that must be maintained (i.e. an inventory of essential services) and then cross train multiple employees to provide the service or services (Form: Critical Staffing List). The development and implementation of Standard Operating Procedures (SOPs) can assist this strategy by providing consistency. Revised: September 5, 2009 Page 3 of 3