Webcast Outline: April 2, 2008

The following is an outline of the visual presentation made during the April 2 live webcast of discussions to help state planners in the next round of pandemic influenza planning.

Pandemic Intervals, Triggers, and Actions

Approaches to Planning and Response

Índice de Gravedad de la Pandemia

• Determined using:
• • Case-Fatality Ratio
  • Excess Mortality
• PSI characterized as categories
• • For instance, for categories 4 and 5 (CFRs 1-2% and = 2%) all community measures are recommended
• Complete information available at Pandemicflu.gov, “Community Strategy for Pandemic Influenza Mitigation in the US ”

Community Mitigation Interventions

• Home: Cases and Contacts
• • Voluntary Isolation of Cases
  • Voluntary Quarantine of household members in homes with ill persons, use antivirals if feasible
• School: Child Social Distancing
• • Dismissal of students, closure of child care programs
  • Reduce out-of-school contacts & community mixing
• Workplace / Community: Adult Social Distancing
• • Decrease number of social contacts
  • Increase distance between persons
  • Minimize public gatherings
  • Modify workplace schedules

When to Initiate Actions?

• WHO Phases identify global progression of pandemic
• US Government Stages provide more framework for national actions
• Pandemic Intervals
• • New approach to planning to account for:
  • • Asynchrony of pandemic transmission
    • Need for different responses to occur in different places based on local transmission of influenza
  • Identified time intervals that follow an idealized pandemic curve

Intervals, Triggers, Actions

• Pandemic Intervals
• • Initiation
  • Acceleration
  • Peak Transmission
  • Deceleration
  • Resolution
• Definitions and triggers for actions such as implementing CMI are provided

Preguntas

• intervals@cdc.gov
• • For questions regarding Intervals, Triggers, and Actions approach
• Pandemicflu.gov
• • Community Mitigation Guidance

Uniformed Military Services

The National Guard

• The National Guard is the organized militia reserved to the states by the Constitution of the United States* .
• • It is a Constitutionally unique “dual hatted” organization
  • Since 1636, the Guard has served America as both a wartime force and the first military responders in times of domestic crisis.
  • • Under Command of the Governor thru The Adjutant General
    • May be Federalized by the President to fight wars or quell insurrections
    • Currently there are over 450,000 National Guardsmen
  • Can provide essential domestic support services to the States during disasters
  • • Today there over 7000 guardsmen nationwide providing disaster relief support to the States
    • The National Guard “Essential 10”:
    • • Aviation and Airlift, Communications, Command and Control, Engineering, Logistics, Medical, CBRNE Response, Maintenance, Security,  Transportation

Uniformed Military Services: Specific Considerations during a Pandemic

• Encourage State Emergency Managers and Public Health Officials to:
• • Understand how to efficiently utilize the National Guard (NG) capabilities during all phases of PI planning and response
  • • Clearly codify the responsibilities of the NG in the State plan
    • Establish solid lines of communications in a pre-event environment
    • Cross walk the “NG Essential 10” to the NRF ESF’s
    • Identify critical shortfalls and develop solutions
    • Understand constraints and limitations of the NG response
  • Ensure that All DoD (Active Duty and Reserve), NG members and their beneficiaries, living in the state are accounted for in all phases of planning for:
  • • Antiviral medications, PPE, Healthcare, Social Services, etc.
  • Encourage local public health officials to establish contact with adjacent Federal military base/post Public Health Emergency Officer
  • • Coordinate with the Federal Regional PI Planning Office

National Guard Domestic Support to State: “The Essential 10”

Sustain Transportation Systems:  Operating Objective A.6

Sustain Transportation Systems

3 Goals

1. Keep Goods and People Moving
2. Protect Transportation Workers
3. Protect the Public while using Transportation Systems

Goal 1. Keep Goods and People Moving

• Keep state transportation systems moving
• Keep goods and cargo moving within states and from state to state
• Identify and prioritize essential transportation systems and cargo

Goal 2.  Protect Transportation Workers

• Measures to ensure the safety of transportation workers
• Training and instruction on personal protective equipment, cleaning/sanitizing operations and protocol for potentially sick passengers

Goal 3.  Protect the Public while using Transportation Systems

• Public awareness and education
• Travel advisories
• Public Safety Campaigns

Additional Reference Material

• Transportation Sub-Sector annexes from “Pandemic Influenza Preparedness, Response, and Recovery”           
• • Aviation
  • Highway and Motor Carrier
  • Maritime                      
  • Mass Transit
  • Railroad
• Now available in final draft:   http://www.dot.gov/pandemicflu/

Provide Healthcare and Manage Mass Fatalities

At-Risk Populations

• Definition- Functional Needs
• Planificación
• • Locating populations in the community
  • Relationships with advocates
  • Messages from trusted sources

Bed Surge Capacity

• Hospital Available Beds for Emergencies and Disasters (HAvBED)
• • Standard Definitions; Seven types
  • • Available in 24 hours; Available in 72 hours
  • ED Status: Open / Closed / NA
  • Available ventilators
  • http://www.ahrq.gov/prep/havbed/havbed2.htm

Alternate Care Sites

• Expand into Non-Hospital Settings
• • Identify locations
  • Scope of care
  • Dotación de personal
  • Equipment, Supplies, Pharmaceuticals

Personnel Surge Capacity

• Volunteer Registry (ESAR-VHP)
• • Procedures for deploying and tracking
  • • Databases with credentialed personnel
    • Mission definition - Resource types
    • Notification & Fitness for duty
    • Human resources; Legal protections
    • Logistics support
    • Reporting procedures

Scarce Resources

• Ethical Distribution
• • Spectrum of adaptations
  • • Administrative / Clinical changes
  • Maximize resources
  • Clinical care committee
  • Ethical principles and Community norms
  • Transparent decision making
  • http://www.ahrq.gov/research/mce

Manejo de fatalidades

• Web-based death certificates
• Procedures for deaths at home
• Public messages for stress management

Healthcare Recovery

• Mechanisms to restore
• • Staffing, equipment, supplies, pharmaceuticals
  • Mental health, substance abuse and other services
• After action reviews and corrective action plans

Departamento de Asuntos de Veteranos

• Primary function is to provide services to eligible veterans
• Serves as a back up for the Department of Defense
• Has expanded responsibilities under the National Response Framework
• States/territories should include their local VA facilities in the PI planning process

Los webinarios sobre planificación para la influenza pandémica se hacen posibles gracias al Departamento de Salud y Servicios Humanos en los EE. UU.