Prepared or Scared? Pandemic Preparedness Makes the Difference

1. Prepared or Scared? Pandemic Preparedness Makes the Difference • Mary Furnari, Director, Office of International Students and Scholars, Washington State University, Pullman • Chris Andresen, Associate Director, Office of International Education, Willamette University • Liz West, Assistant Director of Student Affairs, Washington State University Spokane

2. Objectives • Identify the community, institutional and individual issues surrounding pandemic planning • Discuss how institutions can prepare for a pandemic influenza outbreak • Explore implications for the international office • Provide practical tips for assisting the international /study abroad students on your campus

3. Seasonal or Pandemic? • Seasonal influenza • Usually peaks December through March in North America • 36,000 deaths and 200,000 hospitalizations per year • Typical victim is frail, elderly or very young. • Pandemic influenza • Rapid, global spread among humans • No seasonal preference • Comes in waves • Total duration a year or more • Millions of deaths

4. Why the concern now? • Pandemics have occurred every 10-49 years over the last 300 years (3 in last century) • Most deadly was 1918 pandemic • Avian influenza has similar characteristics to 1918 flu • Evidence of human to human transmission

5. World Health Organization (WHO) Pandemic Response Alert Phases Currently at Phase 3 with 253 human cases in Asia and Europe

6. Confirmed Cases By Location

7. Cumulative Number of Confirmed Human Cases of Avian Influenza (H5N1) As reported to the World Health Organization Total number of cases includes number of deaths. WHO reports only laboratory-confirmed cases.

8. Most susceptible population 15-35 year olds 25% of Americans infected 50 million deaths world-wide, 675,000 in US over a 9 month period Patients were contagious for two days before symptoms began Once symptomatic, illness was fatal within 4-6 days Worldwide threat within 4 weeks of first cases 1918 Flu Pandemic

9. Clinical Features of H5N1 • Most cases have occurred in previously healthy children and young adults. • Droplet infection acquired primarily from domestic poultry secretions • Incubation period typically 2 days • Most contagious one day before onset of illness and two days after

10. Symptoms • Typical human influenza-like symptoms (e.g., fever, cough, sore throat, and muscle aches) • Diarrhea, vomiting and abdominal pain in some cases • Respiratory distress within 4-13 days, usually leading to pneumonia • Multi-organ failure • More than 50% of those infected have died.

11. Public Health Goals Focused on controlling the spread • Isolation of the sick • Quarantine of the exposed • Protective sequestration • Social distancing • Public education

12. Community Control ofPandemic Influenza Less Restrictive Isolation of Ill Management of contacts Quarantine of small groups Cancellation of specific events Closure of specific facilities Closure of facilities and transportation Widespread community quarantine More Restrictive

13. Planning Assumptions • Pandemics can last 18 months with first 3-4 months most deadly period • In an affected community • outbreaks may last 6-8 weeks • may be several waves of outbreaks • Absenteeism in workforce may be as high as 40% • 25% ill • 15% caring for others or afraid to come to work • Essential services may be disrupted

14. University Preparedness • Who should be on the preparedness committee or task force? • How is preparedness different for residential versus non-residential campuses? • What can/must be done for off campus students?

15. University-Community Planning • Directed by Spokane Regional Health District • College/university work group meets monthly for two hours • Bring concerns to health district • Share best practices for education, resources, hygiene, preparation, stockpiles, emergency response plans, determination of essential personnel and functions, etc.

16. University/Community Planning • Explore new and existing community partnerships (university and local hospital, city and county health departments, and unconventional partners) • At Willamette University, campus will provide services (triage, housing, food, etc.) for nearby hospital in exchange for access to resources

17. University/Community Planning • Participate in local tabletop exercises with city and county organizations • Look for creative partnerships (State Fairgrounds, other campuses/schools in area, etc.) • Individual units should participate in tabletop exercise

18. University Preparedness • Ideally, this process has already begun on your campus and includes personnel across divisions and departments • Like all successful university charges, must have higher level administrative support and involvement • Determine how information will be disseminated across campus

19. University Preparedness • Personnel policy • Payroll issues • Cross-training (40% absenteeism) • Cancellation of classes • Refund policies • Evacuate vs. quarantine

20. Upper Administration support • What can an international office do independent of administration if they don’t take it seriously? • Promote avian flu preparedness in context of general emergency (flood, fire, earthquake, tsunami, etc.) preparedness

21. Continuity of Operations Plan (COOP) What are the primary, essential functions of office? Who provides service + back up? What support (i.e. technical) needed for staff to accomplish? Int’l Office Strategies

22. Internal Preparedness Cross-training of staff Set up technology for working from off campus (when possible) Encourage personal preparedness for family, home Int’l Office Strategies

23. Int’l Office Strategies • Inform students about pandemic • Develop communication plan • Monitor travel • Develop Emergency Information website • Develop guidelines for suspension of classes/evacuation • Provide for students who might not be allowed to go home • Develop procedures for student death

24. Informing students and scholars Use orientations for outbound and inbound students/scholars Newsletters, listservs, student groups, etc. to keep people informed Online travel form, emergency contact info Monitor/inform students coming from affected areas Int’l Office Strategies

25. Int’l Office Strategies Communication Plan: International Students • Explain terms: Social distancing, quarantine, isolation, etc. • Encourage individual preparedness plan • Encourage seasonal flu vaccine • Develop Travel Notification Form • Prepare/translate alert messages in advance • Encourage students to have 1-20/DS-2019 travel endorsement current at all times

26. Int’l Office Strategies Emergency Websitefor International Students • Helpful links: major airlines, bus service, Embassy/Consulate sites • Centers for Disease Control, WHO, Public Health Department, etc. • Information in foreign languages • Emergency contact numbers (Student Health, hospital, police, etc.)

27. Int’l Office Strategies Communication Plan: Parents of International Students • Request parents name, address, and email • Send letter to parents of new undergraduate students (*with unrestricted access) • Prepare alert messages for parents in advance (translate for largest groups)

28. Int’l Office Strategies Communication Plan: Concerned Public Work with University Relations to develop plan for dealing with potential backlash toward international students, faculty perceived as “bringing the flu” to campus.

29. Guidelines forEvacuation Order • Assist students to return home/find transportation • Assist students to identify family/friends within U.S. with whom they can stay • Work with Housing/Residence Life for care of students who stay • Communicate with parents about University plan, student’s whereabouts, etc. • Develop alternate procedures for travel endorsements • Remind students of address notification requirement & travel notification form • Obtain direction from SEVP regarding SEVIS procedures under pandemic emergency closure

30. In Case of Death of Student • Notify student’s embassy/consulate • Ensure parents are notified • Determine appropriate means regarding disposition of remains • Ensure support/counseling to friends of student

31. Communicate with partners abroad Keep updated contact info on both ends Inform each other about special preparations, procedures Pre-negotiate closure and refund policies Int’l Office Strategies

32. Study Abroad Considerations • General Emergency Preparedness • Avian Flu Preparedness Don’t forget NAFSA resources!

33. Monitor student travelers Develop communication plan Develop guidelines for temporary closure of programs Make plans with program leaders/providers for shelter-in-place, closure decisions, and resources for students who might not be allowed to go home Study Abroad Considerations

34. Study Abroad Preparedness • For an excellent example of stage-by-stage preparedness refer to University of Maryland site • Also available in French, Spanish, German, and Chinese • http://www.umd.edu/emergencypreparedness/pandemic_flu/appendices/appendix_ l.cfm

35. Maintain student roster Collect emergency contact info (incl. health issues, passport numbers) Verify health insurance Maintain housing & itinerary info Register students with local embassy Train RD on emergency plans Disseminate basic emergency info to students pre-departure Assess risk in areas Study Abroad Office (SAO)

36. Host on-site orientation Send SAO student housing info Know local emergency numbers/contacts Establish/maintain contact with U.S. consulate Collect & update student whereabouts Determine assembly points, sharing with SAO and students Disseminate health an safety info to students (orientation + over course of program) Resident Directors/Program Providers

37. Purchase insurance and emergency evacuation/ repatriation coverage Provide emergency contact info Inform RD of whereabouts Understand emergency plan and assembly points Assemble an emergency/medical pack Carry emergency contact info at all times Monitor own health abroad (and upon return) Practice good hygiene and minimize risk Students

38. Thank you for your attention. Good luck with your planning!