Comprehensive Planning for Pandemic Influenza Response in Schools

1. Planning for Pandemic Influenza Pegi McEvoy, MN, ARNP Safety and Security Department Seattle Public Schools

2. Critical Incident Management Prevent Prepare Respond Recover 2

3. Critical Incident Management Pandemic 101 Pandemic Vs. Plan-demics School and District Planning 3

4. A Pandemic Occurs..... When 3 criteria are met: • Novel Subtype where people do not have immunities AND • Humans are infected and severe illness is caused AND • Virus spreads easily • H5N1 meets criteria 1 and 2 4

5. Potential Source of Spread

6. Confirmed Cases of H5N1 as of July, 2006 Source: www.pandemicflu.gov, accessed September 15, 2006

7. Scientists cannot predict the severity and impact of an influenza pandemic, ... The associated economic impact in our country alone could range between $71.3 and $166.5 billion.Julie L. Gerberding, M.D., M.P.H.Director, Centers for Disease Controland Prevention 7

8. World Health Organization Phases of an Influenza Pandemic 8

9. World Health Organization Phases of an Influenza Pandemic 9

10. The World Health Organization (WHO) defines six pandemic alert phasesWe are currently at Phase 3 10

11. 2 1 3 Goals of Community Measures Delay onset of outbreak Delay onset of outbreak Reduce the peak burden on hospitals/infrastructure Reduce the peak burden on hospitals/infrastructure Pandemic Outbreak: No Community Measures Used Pandemic Outbreak: No CommunityMeasures Used Decrease a) number of cases of death and illness and b) overall health impact Decrease a) number of cases of death and illness and b) overall health impact Number of Daily Cases Pandemic Outbreak: With Measures Taken Days Since First Case 11

12. 12

13. Community Strategies by Pandemic Flu Severity 13

14. Community Strategiesby Pandemic Flu Severity 14

15. Goals in a PandemicFrom Seattle's Public Health Department • Limit death and illness • Preserve continuity of essential government and business functions • Minimize social disruption • Minimize economic losses 15

16. Planning Assumptions • Some believe that the early closure of schools is essential to mitigate pandemic • Modeling Data • Historical Data • All pandemics start out local....each Local Health Officer (LHO) determines the distribution of pharmacological agents and non-pharmacological interventions 16

17. Planning Assumptions • Each state has slightly different laws about jurisdictions, however, the LHO usually has authority to close schools • Schools should plan for closures of • 1 week, • 1 month and • 3 months for health and safety reasons, with educational plans for each length • State and Federal entities are still working through funding and No Child Left Behind (NCLB) issues for schools and pandemics 17

18. Goals in a Pandemic - Schools The 4 Continuities • Health • Business • Education • Community 18

19. Potential Impact of Pandemic Flu in the US and Locally 19

20. Computer Simulation: Unfolding of an Influenza OutbreakSevere Pandemic Projection: 828,950 Infected Source: Los Alamos National Laboratory and University of Washington, 2006 20

21. Local Impact: Health Status (from Seattle's Public Health Department) • In the first 6 weeks of a pandemic: • 1.2 million people infected • 245,000 - 612,000 clinically ill • 180,000 - 470,000 outpatient visits • 24,436 - 57,216 people hospitalized • Up to 11,500 dead 21

22. Estimated School District Impact • In the first 6 weeks of a pandemic: • 10,000 staff/students infected • 2042 - 5100 clinically ill • 1500 - 3917 outpatient medical visits • 204 - 479 people hospitalized • Up to 96 dead 22

23. Leadership in Pandemic Planning • It is different than other types of planning • Get ready for lots of questions • Have the answers or ... talk about where the community is in the process 23

24. Glossary of Terms • Isolation • Quarantine • Voluntary Quarantine • Shielding • Community Containment 24

25. Integrating NIMS and School All-Hazard Plans 25

26. Integrating NIMS and Pandemic Plans 26

27. Basic Plan Mission, authorities, &responsibilities Emergency Support Function Annexes Incident Appendices Broad Functional Tasks Update Pandemic Appendix Functional Addenda The Details: SOPs, maps & Checklists Update Plans 27

28. Pandemic Influenza: Prevent-Mitigate Authorities • Social Distancing • District Closures • Classes cancelled • Libraries, Malls, After School Day Cares • Transportation • Public • Private/Contractors • School Owned • Isolation and Quarantine • Union Contracts 28

29. Pandemic Influenza: Prevent-Mitigate Continuity of Health 29

30. Pandemic Influenza: Prevent-Mitigate Surveillance • Sentinel Program - Absences beyond 10% with respiratory symptoms • Monitored by IT/Safety & Security & schools • Student Absences • Staff Absences 30

31. Pandemic Influenza: Prevent-Mitigate Influenza-like Illness (ILI) Surveillance • Temperatures above 100.4º F AND • One or more of the following: cough, sore throat, or shortness of breath AND • History of contact with domestic poultry or known or suspected case of H5N1 in an H5N1 affected county within 10 days of symptoms 31

32. Pandemic Influenza: Prepare Education • Staff • Students • Parents/Volunteers • Vendors/Agencies 32

33. Pandemic Influenza : Prepare Education • Staff • Students • Posters • Curricula 33

34. Pandemic Influenza: Respond Continuity of Business 34

35. Pandemic Influenza: Respond Continuity of Business • Maintenance of Essential Services • Information Technology Capacity • Telecommuting 35

36. Pandemic Influenza: Respond Resource Management • Human Resources • Flex Time • Telecommuting • Reassignment of staff to essential services • Retraining • Union Contracts • Personal Protective Equipment • Vaccination Priority List 36

37. Goals for Schools in a Pandemic - Respond and Recover Continuity of Education 37

38. What is your State discussing? Edu-tainment Vs. Education & Meeting Standards Vs. NCLB Proficiencies 38

39. Pandemic Planning to Respond and Recover Continuity of Education Planning for: • class cancellation • 1 week • 1 month • 3 months • Testing/Graduating 39

40. Pandemic Planning to Respond and Recover Continuity of Community 40

41. Estimated Seattle School District Status • In the first 6 weeks of a pandemic: • 10,000 million people infected • 2042 - 5100 clinically ill • 1500 - 3917 outpatient medical visits • 204 - 479 people hospitalized • Up to 96 dead 41

42. Caretaking Issues: Respond and Recover • The majority of our families are on free and reduced lunch. • If we expect about 100 deaths per 50,000 (approximately), that would also mean 100 parents deceased. ` In Seattle the number of students not living with both parents is 38.3% If their parents are hospitalized or die, do we have the resources to take care of our students until reunited with other family members? 42

43. Pandemic Influenza:Respond & Recover If schools and day cares are closed, who will take care of our responder's children? Develop a volunteer roster to help support their families. 43

44. Additional Resources • Federal government's pandemic influenza website: www.pandemicflu.gov • Centers for Disease Control and Prevention: www.cdc.gov • Department of Homeland Security: www.dhs.gov • World Health Organization: www.who.int • Association of Sate and Territorial Health Officials: www.astho.org 44

45. ...a newly emerging influenza virus can wreak catastrophic damage worldwide in a matter of months.Anthony S. Fauci, M.D.Director, National Institute of Allergy and Infectious Diseases 45

46. But we can get through this together.......if we get prepared. 46