Pandemic Flu: Preplanning for an Outbreak Presented to AACRAO Leta Finch Executive Director, Higher Education Practice Group Arthur J. Gallagher Risk Management Services, Inc. 2006 Arthur J. Gallagher & Co.
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Process of Genetic Reassortment Avian Influenza Virus High mortality rate among birds, spreads rapidly Human Influenza Virus Spreads easily from human-to-human, low mortality rate Mutated (Novel) Virus Can easily spread human-to-human 4
Pandemic Flu Previous Pandemics in the Last Century Spanish influenza in 1918 40-50 million deaths Considered one of the deadliest disease events in history. Asian influenza in 1957-2 million deaths Hong Kong influenza in 1968 1 million deaths 5
Pandemic Outbreak When? We don t know when the next destructive earthquake will occur in California We don t know when the next catastrophic hurricane will hit the Gulf Coast or the Northeast We don t know when the next tragic fire will occur on one of our workplaces, but WE PLAN FOR THEM 6
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Cumulative Number of Confirmed Human Cases of Avian Influenza A/(H5N1) Reported to WHO as of 19 February 2007 Country 2003/04 2005 2006 2007 Total Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths Azerbaijan 0 0 0 0 8 5 0 0 8 5 Cambodia 0 0 4 4 2 2 0 0 6 6 China 1 1 8 5 13 8 0 0 22 14 Djibouti 0 0 0 0 1 0 0 0 1 0 Egypt 0 0 0 0 18 10 4 3 22 13 Indonesia 0 0 19 12 56 46 6 5 81 63 Iraq 0 0 0 0 3 2 0 0 3 2 Nigeria 0 0 0 0 0 0 1 1 1 1 Thailand 17 12 5 2 3 3 0 0 25 17 Turkey 0 0 0 0 12 4 0 0 12 4 Viet Nam 32 23 61 19 0 0 0 0 93 42 Total 50 36 97 42 116 80 11 9 274 167 61% mortality rate WHO reports only laboratory-confirmed cases. Case fatality rate 59% 8
Pandemic Flu SARS Toronto is Canada s largest city of 2½ million people 2003: Toronto s economy ground to a halt Hospitals and schools closed 15,000 people were quarantined Tourism and hospitality industries collapsed Air Canada went into bankruptcy Only 252 SARS cases and 44 deaths 9
Pandemic Flu The Greatest International Risk Management Effort WHO will notify CDC PAHO EU Monitoring Program U.S. Dept of H&HS leads the Federal Pandemic Planning Process All states now have a pandemic flu response tied in with a bioterrorism response plan 10
Pandemic Flu WHO s Goals for Preparedness To minimize hospitalizations and deaths To preserve critical infrastructure To minimize social disruption 11
Pandemic Flu World Health Organization Wants everyone to know: http://www.who.int/en/ Influenza pandemics are recurring events. All countries will be affected. Widespread illness will occur. Medical supplies will be inadequate. Large numbers of deaths will occur. Economic and social disruption will be great. Every country must be prepared. WHO will alert the world as the pandemic threat increases. 12
Stages of Pandemic Influenza Current Status of H5N1 Avian Influenza Inter-pandemic phase Low risk of human cases 1 New virus in animals, no human cases Higher risk of human cases 2 Pandemic alert Pandemic alert No or very limited human-to-human transmission 3 Evidence of increased human-to-human transmission 4 New virus causes human cases New virus causes human cases Evidence of sustained human-to-human transmission 5 Pandemic Efficient and sustained human-to-human transmission 6 13
Inter-Pandemic Stage 5 Planning Steps Should have in place by now: 1. Established a Pandemic Preparedness Team 2. Created contingency plan 3. Articulated duties and delegate responsibility 4. Educated employees about influenza and the organization s response plan 5. Communicating regularly as the threat heightens 14
Pandemic Alert Stage 3 NOW Secure medication and medical supplies in safe location Continually monitor employee and student health Enforce usage of hand sanitizers, masks and gloves Continually sanitize hand railings, door knobs etc. 15
Pandemic Alert Stage 4 Management Action Enact liberal leave plan Pay sick employees to stay home Pay employees in contact with sick people to stay home Split staff into shifts to minimize intra-employee contact One person from each department per shift Quarantine whole shift if someone falls ill Let employees work from home 16
Pandemic Outbreak Virus has mutated and human-to-human infection is becoming prevalent and sustained Infections are rapidly spreading to neighboring towns and urban centers Local health officials become less able to properly care for the sick General atmosphere of fear and confusion 17
Pandemic Outbreak What to do Implement contingency plan Be prepared to forfeit present business operations for asset protection and employee and student safety Be self-reliant. Do not expect special treatment from local government Do not expect medical supplies or assistance from U.S., embassies or consulates 18
Pandemic Outbreak There is significant and prolonged absenteeism Public transportation systems shut down Government quarantines and travel restrictions are enforced Supply chain blockages will occur Illness of key personnel Expect Increased crime / pharmaceutical counterfeiting 19
Pandemic Flu OSHA May 15, 2006, Jonathan Snare, Deputy Assistant Secretary of Labor, announced that OSHA will become more involved in emergency preparedness. He said, the agency will target employers who refuse to maintain safe workplaces. 20
Pandemic Flu The three major impact areas: Financial Loss of revenues with little decrease in expenses and possible tuition reimbursements Human Resources Up to 2/3rds of the staff and faculty out sick, caring for the sick, or too afraid to come to work. Students Perhaps no place to go because of local, state and international border closings. Possible quarantines imposed on residence halls by local authorities. 21
Pandemic Flu Admissions/Registrar/Financial Aid: A few Pre-Planning needs A policy to address academic and financial concerns of students as a result of prolonged absences from class or temporary closure of the institution. A plan to address decreased tuition receivables if there is a significant reduction in returning students or faculty. A means to monitor the whereabouts of students during a pandemic. A plan to continue financial aid. 22
Pandemic Flu And, a Personal Protection Concern 23
Pandemic Flu INSURANCE IMPLICATIONS The Insurance Information Institute (III) has concluded that: Reinsurers may have to dramatically raise rates Insurers reluctant or unable to write new life and health policies A potential spike in insolvencies U.S. employers may not have adequate health care and workers compensation coverages Families without sufficient life and/or health insurance could face severe financial hardship Retirement plans with death benefits are likely to experience liquidity problems Significant delays in claims processing Liability claims from allegations of being unprepared for a pandemic No business interruption coverage 24
Online Resources State of New Jersey Department of Health and Senior Services - http://www.state.nj.us/health/flu/pandemic.shtml World Health Organization - http://www.who.int/csr/disease/avian_influenza/en/ Centers for Disease Control and Prevention - http://www.cdc.gov/flu/avian/index.htm Crisis and Emergency Risk Communication: By Leaders for Leaders - http://www.cdc.gov/communication/emergency/leaders.pdf U.S. Government Pandemic Influenza Center - http://pandemicflu.gov/ U.S. Department of State Avian Influenza Fact Sheet (3/21/06) - http://travel.state.gov/travel/tips/health/health_1181.html 25
Pandemic Flu Thank You 26