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Challenges in Planning for An Effective Pandemic Flu Response

Challenges in Planning for An Effective Pandemic Flu Response. Dr. P.J. Maddox Professor and Chair Department of Health Administration and Policy College of Health and Human Services George Mason University. How Ready Are We?. Used with permission of the Minneapolis Star-Tribune.

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Challenges in Planning for An Effective Pandemic Flu Response

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  1. Challenges in Planning for An Effective Pandemic Flu Response Dr. P.J. Maddox Professor and Chair Department of Health Administration and Policy College of Health and Human Services George Mason University

  2. How Ready Are We? Used with permission of the Minneapolis Star-Tribune

  3. Acknowledgements/References • www.ahrq.gov • http://www.ahrq.gov/downloads/pub/evidence/pdf/bioreg/bioreg.pdf • http://www.ahrq.gov/research/mce/mceguide.pdf • www.pandemicflu.gov • http://www.pandemicflu.gov/plan/pdf/panflureport3.pdf • http://www.pandemicflu.gov/plan/federal/index.html • http://www.pandemicflu.gov/plan/states/index.html • http://www.nga.org/Files/pdf/0607PANDEMICPRIMER.PDF • http://www.cdc.gov/ncidod/eid/vol12no09/06-0369.htm

  4. “Localities should be prepared to rely on their own resources to respond.” U.S. Pandemic Flu Plan, 2006 www.pandemicflu.gov/plan accessed 11/1/06

  5. A Pandemic Virus Will • Cause a large number of disease incidents and deaths • Cause anxiety and possibly panic among citizens • Cost the nation significant resources and effort to respond effectively

  6. Pandemic May… • Pandemic may be severe or mild • Can last for months and come in waves ( 2 or more)

  7. Potential Impact of Next Pandemic • Outbreaks will occur simultaneously throughout the US • High levels of absenteeism in all sectors at all levels • Order and security disrupted for several months, not just hours or days

  8. If a Pandemic Occurs Soon • There will be little or no vaccine until 6 - 9 months after the outbreak begins • There will be very limited supplies of antiviral medicines for treatment • All communities hit at about the same time • Plan for the short-term should assume no effective Rx

  9. In a Pandemic What Might Occur? • Health systems will likely be overwhelmed • Essential services could be at risk (fuel, power, water, food, etc.) • “Just-in-time” supply lines could be disrupted

  10. Impact Cont’d • High mortality rates could occur • Social disruption could occur • Public transportation cut back • Delivery of goods curtailed or ceases

  11. Government Officials, Public Health Entities, Health Professionals and Businesses • Must consider how to manage the outbreak itself and maintain critical operations (four key areas) • The challenges of planning and effectiveness of the response/recovery dictated by: • complexities of uncertainty • harnessing the cooperation of many entities & getting them to work well together

  12. Planning and Response Challenges: Nature of Pandemic • Pandemic effects will be broad, deep and simultaneous and states must focus resources to ensure continuation of essential services • Ability to function and deliver services throughout public and private sectors will be compromised • Delivery of products (US, global) will be interrupted and essential services strained • Excess medical and other personnel will not be available to fill gaps • States/local communities must be prepared to set priorities on service delivery and facilitate self-reliance

  13. Planning and Response Challenges: Medical Response • Medical response capability in a pandemic will be limited, strained and potentially depleted during a pandemic so atypical measures will be needed to control the spread of the disease • Anti-viral drugs may/may not be available for the entire population • Vaccines will be developed but not in sufficient quantities or time to inoculate the population before pandemic starts • Medical treatment will be limited (lack of equipment and trained personnel) • In addition to coordinating care, states/communities/businesses need to focus on curbing disease spread

  14. To Curb Disease Spread • Restrict public gathering • Limit travel • Close schools • Stress personal hygiene Measures such as isolation and quarantine may be effective only in earliest stages

  15. Planning and Response Challenges: Cross-Sector Cooperation • Government must work closely with private sector to ensure critical operations and services are maintained • Many individual will be sick and incapacitated, affecting a wide range of key services such as food, energy and health care • Economic activity will be disrupted severely, but basic services must still be maintained • US Gov plan recommends advisory councils with industry to sustain such functions • States need to define and communicate the leadership roles, responsibilities and line so authority needed to maintain government operations Continuity of operations plans (COOP) are needed for both public and private entities (including Government and businesses)

  16. Planning and Response Challenges: Uncertainty, Change and Flexibility • Pandemic will force many key decisions be made in a dynamic environment of shifting events; will require partnerships that are developed and tested in advance • Responses should consider disease impact, areas affected, capacities available and stages of recovery • Testing of plans via periodic exercises among all partners to anticipate/improve response Ability to make good decisions on the fly will be as important as good advance planning

  17. Key Issues for Effective Pandemic Plans/Response Operations • Recognition of the potential human, social and economic impact within state & region • Public and private sectors committed (plan development) • Broad community involvement in plan development • Have ethical aspects of policy decisions been considered? • Legal framework for state pandemic plan is in place: • Includes contingencies for health-case delivery and maintenance of essential services and for implementation of public health measures? • Localities/states have prioritized countermeasure allocations (in advance of an outbreak) • Can state update prioritization after outbreak begins based on at-risk populations, available supplies and characteristics of the virus? • Locality/states has an effective communications plan and strategy • Personnel aware of roles and responsibilities in communication plan • State has back-up plan in case functions fail due to infrastructure or manpower losses

  18. Pandemic Plan Must stress communication, intergovernmental coordination, public education, health resources, curbing economic impacts, maintaining essential services, using appropriate legal authority to stop disease spread and training

  19. Pandemic Plan • Must encompass horizontal and vertical domains • Horizontal includes assets, government and private-sector capabilities • Vertical includes linking national efforts with local requirements • As the chief executive, the governor is positioned to serve as the nexus for horizontal and vertical integration http://www.nga.org/Files/pdf/0607PANDEMICPRIMER.PDF

  20. Pandemic Plan • Develop strategies to engage and educate the public • The planned response must provide effective communication to the public to minimize negative behaviors, accentuate positive actions and limit psychosocial and psychological impact of imposing public health measure that may include restricting movement

  21. Pandemic Plan • Establish pandemic preparedness coordinating committee that represents all relevant stakeholders in the region • Include: Public safety, public health, homeland security, agriculture, emergency management and education, private sector representatives from all critical service industries (including healthcare) and volunteer organizations • Purpose: review and coordinate procedures for delivering health resources, backfilling personnel and equipment and continuing operations of critical services

  22. Pandemic Plan • Coordination of health care assets will be especially critical since they exist in the public, private, volunteer and faith-based domains: Assess what is available and taking care not to double-count assets Caution: Some personnel counted in multiple asset categories (i.e. National Guardsmen)

  23. Wide-Array of Considerations Must be Managed Effectively to Ensure Adequate Preparation and Response/Recovery

  24. Take home messages You don’t know if the pandemic will start tomorrow, a year from now, or ten years from now, or how severe it will be. • Don’t assume it’s tomorrow and distort your life unbearably. • Don’t imagine it’s never and postpone your preparations indefinitely. from Peter Sandman, Risk Communications Specialist

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