Disaster Response Team Pandemic Flu January 22, 2009
Topics History Pandemic Characteristics Seasonal Flu vs Pandemic Flu Pandemic Estimates Sea Ranch Plans Sonoma County Public Health Pandemic Flu Planning Home Care for Pandemic Flu Vaccine Allocation Guidelines Resources
History 1918 influenza pandemic 500,000 US deaths, 50 million worldwide 1957 influenza pandemic 70,000 US deaths, 1-2 million worldwide 1968 influenza pandemic 34,000 US deaths, 700,000 worldwide
What is a pandemic? It is an epidemic of an new infectious disease, easily spread person to person, infecting a large proportion of the population, worldwide.
Pandemic Characteristics There Will Be Rapid Worldwide Spread Health Care System Will Be Overloaded Medical Supplies Will Be Inadequate There Will Be Economic and Social Disruption
Why is a Pandemic Flu different from any other disasters, such as floods, earthquakes, etc? Expect all infrastructure to be in place-such as electricity, internet, etc. At least most of the time. May be 1-2 weeks to activate plans before needing to respond. Influenza outbreaks occur in waves of 6-12 weeks, and may recur every 6 months for up to 2 years. There is no effective treatment to cure the flu-so the response must be community-based. Because whole countries will be affected as the same time, we can t count on mutual aid.
Flu Comparison Seasonal Flu Seasonal patterns Some immunity Healthy adults not at risk Health systems meet need Vaccine developed Adequate anti-virals US deaths at 36,000/yr Symptoms: fever, cough, runny nose, muscle pain Modest impact on society Manageable impact on economy Pandemic Flu Occurs rarely Little or no immunity Increased risk for healthy Health systems overwhelmed Vaccine not available early Limited supply of anti-virals US deaths very high (500K+) Symptoms more severe, complications more frequent Major impact on society Severe impact on economy
Pandemic Estimates Result United States Sonoma County Severe Illness 40 120 million 122,000 Hospitalized 314,000 734,000 1,400 Death 89,000 207,000 330. Economic Losses $71 billion - $166 billion $1 billion - $3 billion
Cumulative confirmed H5N1 cases since 2003-Update 10/9/08
World Health Organization Data: Cumulative confirmed human cases by Country and Deaths since 2003 (updated 9/10/08)
Country Cases Deaths Azerbaijan 8 5 Bangladesh 1 0 Cambodia 7 7 China 30 20 Djibouti 1 0 Egypt 50 22 Indonesia 137 112 Iraq 3 2 Lao People's Democratic Republic 2 2 Myanmar 1 0 Nigeria 1 1 Pakistan 3 1 Thailand 25 17 Turkey 12 4 Viet Nam 106 52
Information Flow World Health Organization (WHO) Centers for Disease Control (CDC) Sonoma County Public Health Division Sea Ranch Emergency Manager Sea Ranch Medical Response Team Sea Ranch Disaster Response Team
Sonoma County Public Health - What we have: Planning groups Public Health Preparedness Task Force Healthcare Disaster Preparedness Forum Infectious Disease Task Force MRC Program Community partners Mass vaccination plans
What we have: Operational components County Emergency Operations Center (EOC) Department of Health Services Operations Center (DOC) Regional Medical Disaster Mutual Aid System Inter-hospital Communication System Emergency Exercise/Drill Program
What will Public Health do? Surveillance-what is that? Infection Control measures-like what? Vaccination-based on availability and priority group Help coordinate health care response PLUS... Community Mitigation Strategies Risk Communication- public information
Public Health Response Plans: Community Mitigation Strategies Declaration Health Emergency by Health Officer (Orders Isolation and Quarantine, orders Social distancing measures.) What is Isolation? Separation of person with illness from others. What is Quarantine? Separation of those who have had contact with the ill person/s from others who have not.
What s on the horizon? Surveillance: H5N1 info on poultry (DNA typing) Prevention: New study finds significant death in 1918 due to bacterial pneumonia-what are the implications for planning? Prevention: Vaccine production increase using faster technology Treatment: Peramivir-new flu treatment?
Sea Ranch Plans Activate Disaster Response Team Obtain and Administer Vaccines Medical Response Team Use 3n Emergency Message System Polling to get status and needs of residents Call-in Number Potential Visiting Care/Food Delivery Social Distancing Limit Social Gatherings Limit Group Meetings
Incident Command
Public Health Response Plans: Community Mitigation Strategies What is Social Distancing? Staggered work schedule and keeping distance for those at work Ban on public transportation and social gatherings Student dismissal Wearing face masks while in public Other legal strategies.
Possible CBO Response Roles for Pan Flu Staff telephone public information lines Coordinate volunteers Deliver food, clothing, face masks, health education materials to individuals and families in isolation/quarantine Help deliver medical and other supplies where needed Other activities?
Sea Ranch Issues Exposure Concern Absenteeism Staff and Local Businesses Cancellations Vacation Rentals Meetings and Forums Quarantines Closures Social Distancing
Pandemic Flu Planning Store a supply of water and food Ask doctor and insurance company if you can get an extra supply of your regular prescription drugs Have nonprescription drugs and other health supplies on hand including pain relievers, stomach remedies, cough and cold medicines, fluids with electrolytes, and vitamins Watch for symptoms: fever, cough, runny nose, muscle pain Prevent dehydration Reduce fever
Items to Have On-Hand Food and Non-Perishables Ready to eat canned meats, fruits, vegetables and soups Protein or fruit bars Dry cereal or granola Peanut butter or nuts Dried fruit Crackers Canned juices Bottled water Pet food Medical, Health, Emergency Supplies Prescribed medical supplies Fever medicines acetaminophen, ibuprofen Thermometer Anti-diarrheal medication Vitamins Fluids with electrolytes Cleansing agent/soap Flashlight/batteries/radio Manual can opener Garbage bags Tissues, toilet paper
Home Care for Pandemic Flu Prevent the spread Clean hands often with soap and water Cover mouth and nose when cough/sneeze Cough or sneeze into upper sleeve if no tissue Keep hands from eyes, nose, mouth If you have signs of flu Stay home from work, school, errands Wear surgical mask when around others
Home Care for Pandemic Flu When a household member is sick Keep everyone s personal items separate Disinfect door knobs, switches, handles, toys and other surfaces Can wash everyone s dishes and clothes together use detergent and very hot water Wear disposable gloves when in contact with body fluids One person should be caregiver, wear mask Disinfectant 1 gallon water and ¼ cup bleach Mix a fresh batch every time you use it
Home Care for Pandemic Flu Practice Hand Hygiene Wet hands with warm, running water and apply liquid soap Rub hands vigorously for at least 15 seconds, covering all surfaces and fingers Scrub nails by rubbing them against the palms of your hands Rinse your hands with water Dry your hands thoroughly with a paper towel and use it to turn off the faucet. A shared towel will spread germs.
Symptoms and Remedy
Vaccine Allocation Guidelines Goal: to vaccinate all persons who choose to be vaccinated Categories Homeland and National Security Health Care and Community Support Services Critical Infrastructure General Population Tiers 1 to 5 Top tiers of each group vaccinated first
Vaccine Allocation Guidelines Vaccine supply will increase incrementally limited at first Allocating and Targeting Vaccine Protect those who are essential to the pandemic response and provide care for persons who are ill Protect those who maintain essential community services Protect children Protect workers who are at greater risk of infections due to their job
What s Next? Pandemic Flu Table Top Exercises Sonoma County Public Health Sea Ranch Incident Comment Sea Ranch Medical Response Team Statewide Medical and Health Full Scale Pandemic Disaster Exercise June 18, 2009
Resources World Health Organization (WHO): www.who.int/csr/disease/influenza/pandemic/en/ Centers for Disease Control (CDC): www.panflu.gov Cal. Dept. of Public Health: http://bepreparedcalifornia.ca.gov/epo/ Sonoma County Website: www.sonoma-county.org/phpreparedness Red Cross http://www.redcross.org