Pandemic Preparedness

1. Pandemic Preparedness Business Continuity Planning Issues Kathleen Criss, CBCP Emergency Management Coordinator University of Pittsburgh Medical Center

2. Historic pandemics • 1918-19 Spanish Flu: A (H1N1) • 20-50 million deaths worldwide • 500,000 deaths in the United States • Nearly half were young, healthy adults • 1957-1958 Asian Flu: A (H2N2) • 1st identified in China February 1957 • Spread to U.S. by June 1957 • 70,000 deaths in the United States • 1968-1969 Hong Kong Flu: A (H3N2) • Detected early 1968; spread to U.S. later that year • Approx 34,000 deaths in the U.S. • Virus still circulating today

3. Why planning is necessary? • Economies are negatively impacted during public health outbreaks: effect on transportation, tourism, GDP, and increased healthcare costs • Major economic losses due to absenteeism • Potential 30% of global workforce unavailable due to sickness or fear • Pandemic could be single most devastating event for transportation industry • Interruptions to the critical infrastructure and effect on business and everyday life

4. Organizational structure Source: Continuity Central - http://www.continuitycentral.com/feature0265.htm On-line survey conducted from 10/6 – 11/10/05; 221 responses received.

5. Potential effect on industry* *Sikich, Geary W., A new planning paradigm: Economic Consequences of a Pandemic

6. Business responsibility • Protect staff, customers, visitors, vendors and suppliers • Responsibility to key stakeholders such as shareholders, institutional investors • Develop a succession plan for key management • Create guidelines to support mission-critical areas and functions • Develop a pandemic outbreak plan

7. External dependencies: vendors, products, public safety, transportation Work with facilities management to plan building access and HVAC considerations Create ‘swat teams’ to support mission-critical functions Support arrangements for swat team members, i.e., housing, food, water, transportation Remote work arrangements; increased IT needs Health and security measures for employees Child/elder care issues Pandemic plan considerations

8. Identify 2nd and 3rd line support teams; provide cross training Upgrade key facilities: HVAC for filters and isolation, electronic locks Develop HR policy for pay/sick time, altered job responsibilities, housing, transportation, food and water, return to work procedures Purchase spare parts for mission critical equipment Upgrade infrastructure to support remote access, conferencing capabilities Stockpile gloves, masks, antiseptic wipes/hand sanitizers for employees and public areas Provide education on infection control procedures Promote family emergency planning for staff Mitigation

9. Develop a list of required resources, people, and equipment Train back-up management team Prepare general support procedures for loss of key individuals Create security lockdown procedure and exercise Test remote work arrangements regularly Conduct exercises of plan components Plan for secondary data center operations to avoid cross-contamination of teams Provide alternate work arrangements; split critical depts into 2 teams and vary work arrangements Quick establishment of a disaster cost center Planning

10. Response • Announce HR policy requirements, i.e., travel restrictions • Activate crisis communication plan and provide regular updates to staff, customers, shareholders and vendors • Implement security containment and check-in procedures • Run concurrent shifts alternating between sites; bring in staff on a rolling basis; avoid cross contamination of teams • Use alternate meeting methods: tele/video conferencing • Freeze changes to data systems/applications for at least 6-12 weeks • Implement manual procedures, when necessary • Increase levels of cleaning in public areas, bathrooms, help desks, call centers, shared workspaces (1 part bleach to 8 parts water on all surfaces)

11. Recovery • Work with Human Resources to assess management team and finalize job positions • Conduct leadership meetings, if necessary, to define or redefine company structure • Assess employee situation and needs, especially for key areas • Conduct internal/external communications on any company changes • Implement return to normal operations plan • Restart change requests and system upgrades • Be prepared for second wave of illness

12. Promote staff preparedness • Family emergency planning see SWPA Red Cross site at: http://www.swpa.redcross.org • Individuals should be prepared to be self-sufficient for about 3 months* • Learn simple medical skills • Put financial matters in order: bank records, life insurance, will, etc. • Get a flu shot and pneumovax vaccination to prevent multiple illnesses and reduced immunity *3 months was recommended because of potential JIT delivery chains, transportation, and shelf restocking issues.

13. Regional preparedness • Ongoing MMRS ESF #8 operational planning • MMRS hospital tabletop exercise conducted Sept ‘05 • Region 13 Risk Communications is developing materials for communicating to the public; a website will be available shortly • ACHD surge capacity planning meetings underway • PaDOH will be conducting pandemic exercises in each CTTF; Region 13 Sept ’06 • Note: PaDOH pandemic plan has not yet been released

14. Where to get more information • CDC – http://www.cdc.gov/flu/pandemic.htm • WHO - http://www.who.int/csr/disease/avian_influenza/pandemic/en/index.html • DHHS - http://www.pandemicflu.gov/ • U.S. pandemic plan - http://www.whitehouse.gov/homeland/pandemic-influenza.html • Continuity Central – http://www.continuitycentral.com/feature0261.htm • Center for Biosecurity of UPMC – http://www.upmc-biosecurity.org/

15. Additional resources • Bloom, E., V. deWit, and M. Carangal-San Jose. 2005. Potential Economic Impact of an Avian Flu Pandemic on Asia. ERD Policy Brief No. 42. • Carey, J. Bird Flu: Shoring Up Corporate Defenses. BusinessWeek online, November 7, 2005. • Haworth, J. Communicable diseases: business continuity issues. • Sikich, G. A new planning paradigm: Economic Consequences of a Pandemic. 2005. • Woodson, G. Preparing for the Coming Influenza Pandemic. • And many more…

16. Questions and open discussion House Bill No. 2069, Session of 2005 – Proposed Critical Infrastructure Tax Credit – Referred to Committee on Finance, October 17, 2005.

17. Thank you. Kathleen Criss University of Pittsburgh Medical Center 412-647-5826 criskx@upmc.edu Happy Thanksgiving!