Lessons from Operation Panflu

1. Lessons from Operation Panflu Higher Education Pandemic Symposium November 2, 2007 • University of Vermont

2. Review Emergency Operations Plan • Keep operational plans complete, up-to-date • Incomplete plan = difficult to form plan of action for situation RECOMMEND: • Draft annexes for pandemic flu, isolation & quarantine • FLAG areas that need development

3. Review EOC Roles & Responsibilities • Use Incident Command System (ICS) • Failure to use ICS = hard to coordinate response RECOMMENDS: • Set ICS roles for campus staff in EOP • Get ICS training for staff … • … and for campus response groups • Write MOUs for coordinating agencies

4. Plan for EOC Infrastructure • Consider: visual and IT aids - headphones - conference calling - disaster mgmt. software - PIO - media center - security • Go without = hard to manage emergency RECOMMEND: • ID infrastructure needs & fill them • Drill EOC often • Visit experienced EOCs to learn best practices

5. Know Who is Who • Keep current contact info for all critical personnel • Integrate external agencies into college/U operations RECOMMENDS: • Diagram resources for local staff at state, federal levels • Establish college/U, health department working relationships • Recognize by sight, name, function • ID vests for all command personnel • Clarify command & control for health dept. and college/U personnel

6. Take Action to Control Infection • Plan to take immediate infection control actions • Swift isolation = decreases potential for spread of illness RECOMMEND: • Specify infection control measures, procedures in plan

7. Allow Access to Patient Info • Clinic staff need access to patient medical information, authority to release • Without info = can’t know medical status, compromises medical judgment RECOMMEND: • Allow access to patient medical information for clinic staff ONLY

8. Give Medical Attention FAST • Provide for immediate medical attention for infected students • Delay = lack of cooperation; potential to spread illness RECOMMENDS: • Practice health department/behavioral health coordination • Go-kit with response checklist for any infectious disease– intake forms, fact sheets, info handouts, contact lists, etc. • IDEA: health care worker on call (cell) to answer medical ?s

9. Understand Isolation & Quarantine • Know/ understand definitions, purpose, plans and protocols • Lack of understanding = hard to implement RECOMMEND: • Review Vermont legislation - ensure legal counsel refer to current EOC plans • Train all campus staff for their roles • Outreach campaign = students, families, community • Public information (e.g. laminated cards in dorms, welcome packs)

10. Plan for Quarantine Site • ID adequate facility for quarantine (bathrooms, fire safety, enough beds, etc.) • Safe, comfortable facility = reduce stress, increase cooperation RECOMMEND: • Create checklist of necessaries for location & facility • Tour potential facilities to make sure they will work

11. Plan for Quarantine Support • Food service, laundry, supplies, biohazard bags, communication needs • Logistical supports = reduce stress, increase cooperation, free staff time RECOMMEND: • Plan for all logistical needs to support patients and staff • Create Job Action Sheet for Quarantine Site Liaison • Assign Liaison when quarantine is activated • Drill quarantine sites and coordination with EOC

12. Plan for Security • Maintain isolation or quarantine with security, PPEs • Lack of security = isolation or quarantine breaks, potential spread of illness RECOMMEND: • Create Job Action Sheet for Security • Assign Security when isolation or quarantine is activated

13. Communicate Safety Measures • All info about quarantine must be communicated to all • If not = staff respond without personal protection RECOMMEND: • Provide complete info about active quarantines to all personnel • Train health and college/U staff in ICS, unified command, PPE use

14. Clarify Authority to Release • ONLY the person with authority to do so can release patients from quarantine. • Premature release = potential for spread of illness RECOMMEND: • Lab results should be forwarded promptly to those in clinical setting who are authorized to do the testing – and act on the results • Others should be cautioned that this is part of a specialized role

15. Consider Behavioral Health Effects • Quarantine decisions must be based on science/protocols, NOT empathy • Premature release = potential for spread of illness RECOMMEND: • Consider behavioral health in quarantine planning • Train staff regarding mental/emotional rigors

16. Communicate about Quarantine • If quarantine is voluntary, enforcement is by information-sharing, risk communication • Without enough info = students go home, to dorm, to hospitals RECOMMENDS: • Coordinate health and college/U quarantine plans • Station security officers trained in use of PPE • (Develop college/U panflu communication plans with health)

17. Communicate with Students • Provide full, accurate, consistent, credible information throughout event • Without info = more stress, fear; less trust, cooperation RECOMMEND: • Develop list of commonly asked Qs & As, fact sheets • (Train in Crisis & Emergency Risk Communication)

18. Communicate with Families • Family Assistance Center = means to communicate with, provide psychological support to families • In pandemic flu situation = physical or virtual? RECOMMEND: • Write plan to establish FAC for emergencies, including activation, support features, staffing • Investigate staff resources with health or mental health department

19. The Internet & Public Info • Use of internet by quarantined students can affect media relations and coordinated public information efforts • Blogs or video posts by students = potential to spread rumors, mis-info RECOMMEND: • Restrict web access to secure, password-protected website for students and their families • Update plans to reflect internet use; include adequate IT support

20. Nancy Erickson Communication Director nericks@vdh.state.vt.us pandemicflu.gov healthvermont.gov