Pandemic Planning A country, state and city concern

1. Pandemic PlanningA country, state and city concern Dr. Gregory N. Larkin Director Corporate Health Services

2. YIPES! Or YAWN?

3. Treatment and supply availability • In a pandemic, most businesses and health care facilities will be impacted • Medical care/supplies will be harder to obtain • Home supplies will be harder to obtain • Medication (Tamiflu) to potentially treat influenza is currently in short supply and may not be readily available in your area • It is not yet known for sure if this medication will be effective • Antibiotics to treat secondary infections, such as pneumonia, may also be in short supply

4. Key points (worst case) • When the first human to human case presents, it will take 3 months to encircle the globe • A community will go through 3-4 cycles each lasting 4-6 weeks causing 20-30% population infection • Unknown effectiveness of present antiviral agents • Effective vaccine will take 3-6 months to produce • Employers need to prepare to: • Continue critical processes with a reduced work force (e.g. insulin) • Reduce potential infectious opportunities • Socialization and contact reduction • Employees should consider a modest stockpile of home supplies

5. WHO Pandemic Phases

6. What can we expect? • Lessons learned from epidemiology and the current situation in Asia • maximum recorded interval between pandemics is 39 years – it could be soon (but it remains unpredictable) • the likely origin will be SE Asia, but we can’t say for sure • global spread will be rapid – we either prepare now, or risk being caught by surprise • several epidemic waves; first may be ‘milder’ than subsequent ones – sustainability and resilience will be key issues

7. What can we expect? • 4. excess mortality and morbidity difficult to predict but may be high (but it doesn’t follow that the next pandemic will be like 1918) • 5. overall population clinical attack rate is likely to be 25-33% • 6. there may be a shift from the current pattern of disease, towards younger age groups in terms of severity and mortality – with obvious implications for the business workforce • 7. impacts on health services and business continuity are likely to be very considerable

8. What do we know and need to do TODAY? • Known: • WHO Phase three • Potential of community being 40% absence • Adverse impact on both community and business operations • Need to do: • Prevention, Response, Business Continuity and Communication

9. Prevention Overview • Medically sound and consistent education • What methods in place for world and community tracking • Influenza characteristics (prevention, spread, treatment) • Personal planning elements • Worksite planning

10. Prevention- Personal Planning • Due to possible community service breakdown; • Consider stockpiling those domestic items of importance (e.g. medications, water, food (include pets, etc.), cleaning supplies) • Understand the importance of ‘social distancing’ • Travel, shopping, social gatherings • Understand the importance of containment • Hard surface cleaning, disposal of tissue, etc.

11. Prevention- Work Site Planning • Reduce the spread of infection by: • Encourage ill employees to remain at home • Consider ‘screening’ protocols employees/visitors at the door • Facility promotion of frequent hand washing and proper disposal of tissues. Stockpile supplies. • Alternative methods for face to face meetings- Work with IT • Ascertain critical vendors pandemic preparation

12. Response • Engage prevention protocols • Entrance screening (ear thermometers, masks) • Close cafeterias (box lunches) • Hand washing stations/supplies • Isolation protocols (on site medical facilities) • Disinfectant procedures (cleaning/disposal) • Telecommunication where possible • Limit travel of all kinds

13. Social distancing at home and at work • Social distancing refers to methods to reduce the frequency and closeness of contact between people • Generally, social distancing refers to mass gatherings of people, but the same methods can be applied to the home setting

14. Social distancing at home and work • When around people who are coughing or sneezing, keep your distance by at least 3 feet • Avoid meeting people face to face: use the telephone or have web conferences • Avoid any unnecessary travel • Avoid crowded places • Avoid public transportation • Avoid crowded restaurants

15. Social distancing at home and work • Stock up on basic items to minimize exposure to public places • Shop at smaller stores with smaller lines and fewer people • Shop at off hours to avoid large crowds • Arrange to pay bills by mail, online or over the phone • Cancel or postpone family gatherings, outings or trips • If you cannot avoid crowds, minimize the amount of time you spend around people

16. Business Continuity • Expect 40-50% temporary reduction in work force • Ill or caring for ill or guardianship of children • Identify Business Critical Processes • Core business needs including vendors • Materials to be stockpiled or expanded inventory • Identify non critical processes • Employees encouraged to remain home • Identify what, if any, critical business can be telecommuned • Tasks and resources needed • Develop Human Resource benefit policies for absence • Create redundant personnel and resource support

17. Communication • Prepare now: • Resources to provide credible education regarding • Influenza tracking • Work site protocols (screening, hand washing, etc.) • Business critical/non critical criteria and application • Benefit implications for related absences • Recommended work place and home supplies

18. Summary • Pandemic or other broad disaster merits planning • The current viral threat is real although when, not if, a global spread is unknown • The worst case will impact 40% to 50% of the population directly or indirectly • All community and business services could be severely challenged • Today- Start actions for Prevention, Response, Business Continuity and Communication.