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Gaps in Respiratory PPE for Infectious Disease Response
"Federal agencies continue to implement equipment cache programs to assist communities with the response to disaster situations. Equipment contained within federally funded caches should meet national standards where appropriate. This paper will focus on recommendations to increase the availability of respiratory protection for first responders (first receivers) using cache programs that relate to infectious disease response. Appropriate protective ensemble will also include disposable protective clothing to include caps, gowns, boots, gloves and eye/face splash protection. For respirators, caches should include materials that support training, use and proper fit. Sufficient quantities of fit test kits should be included in the caches for each type of respiratory equipment contained within. Appropriate medical assessment(s) and training must be considered for the use, selection and care of the materials contained within as well as the fit testing, doffing, donning and re-use procedures. Based on a review of available sources, it is the opinion of the IAB [InterAgency Board] that respiratory PPE [Personal Protective Equipment] supplies of N95 respirators are not sufficient to meet the potential demands of an Infectious Disease Response. In the event of a large scale-incident, there are demonstrated concerns about how long it will take for cache replenishments to occur as most of the respiratory protective equipment is not manufactured domestically. Many responder organizations have used DHS [Department of Homeland Security] grant funds to purchase enhanced PPE ensembles, however, until recently, grant funds could not be leveraged to maintain and sustain these products resulting in a degradation of preparedness and response levels."
InterAgency Board
2009-12-07
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Recommended Actions for EMS Providers To Prepare For and Respond to Pandemic Influenza
This guide contains recommended actions to prepare Emergency Medical Service (EMS) providers for pandemic influenza. Sections in the document include the following: "Community Wide Coordination and Control," "Key Contact Information," "Planning Assumptions," "Quick Reference Charts," and "Recommended Actions." Additional resources are provided to supplement the information. This document includes charts and tables.
Los Angeles County (Calif.). Emergency Medical Services Agency
2009-12
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North Carolina Emergency Guidelines for Schools, 2009 Edition
From the document: "The North Carolina Department of Health and Human Services, Division of Health Service Regulation, Office of Emergency Medical Services, Emergency Medical Services for Children Program has produced this first North Carolina edition of the Emergency Guidelines for Schools (EGS). [...] These guidelines are designed to assist school staff in responding to pediatric emergencies when the school nurse is not available. They were created with the input of EMS [Emergency Medical Services], emergency medicine, and pediatric specialists to assist in the development of school based emergency guidelines. The purpose of the manual is to provide general guidance based on generally accepted courses of action when confronted with medical emergencies. The guidelines for managing various illnesses and injuries are listed in alphabetical order to assist in locating them in what may be stressful circumstances. In addition, toward the end of the manual, there is a section on disaster preparedness planning based on the type of threat. This also includes information to assist schools with pandemic flu planning." This document downloaded based on the following statement from the North Carolina Department of Health and Human Services [NC DHHS] site: "Unless otherwise noted on an individual document, N.C. DHHS grants permission to copy and distribute files, documents, and information for non-commercial use, provided they are copied and distributed without alteration."
North Carolina. Office of Emergency Medical Services
2009-11-23
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2009 Influenza Pandemic: An Overview [November 16, 2009]
"This report provides a synopsis of key events in the H1N1 pandemic response, followed by information about selected federal emergency management authorities and actions taken by [the Department of Homeland Security] DHS, [Health and Human Services] HHS, and state and local authorities. It then lists congressional hearings held to date; discusses appropriations and funding for pandemic flu preparedness and response activities; summarizes U.S. government pandemic flu planning documents; and lists sources for additional information. An Appendix describes the [World Health Organization] WHO process to determine the phase of an emerging flu pandemic."
Library of Congress. Congressional Research Service
Redhead, C. Stephen; Lister, Sarah A.
2009-11-16
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State EMS System Pandemic Influenza Preparedness: A Report of the FICEMS
"An influenza pandemic could seriously impact the Nation -- its health care delivery system, its transportation system, its economy and its social structure. As the Nation's health care 'safety net,' emergency medical services (EMS) will be faced with higher demands for services while experiencing problems similar to the rest of the Nation -- increased employee absenteeism, disruption of supply chains and increased rates of illness and death. 911 Public Safety Answering Points (PSAPs) serve as the public's single point of access to EMS, law enforcement and fire services -- as well as an avenue for requesting many other services. Ensuring both 911 and EMS are well-integrated into the Nation's pandemic influenza planning and response is essential to the Nation's health and safety in the event of a pandemic. On January 15, 2009, HHS [Department of Health & Human Services] Secretary Leavitt and DHS Secretary Chertoff submitted a report to the HSC [Homeland Security Council] that summarized the status of States' operating plans with respect to preparedness for, response to, and recovery from an influenza pandemic. This report, Assessment of States' Operating Plans to Combat Pandemic Influenza: Report to Homeland Security Council (HSC Report), found that integration of EMS systems into pandemic influenza preparedness generally is inadequate. The FICEMS' [Federal Interagency Committee on Emergency Medical Services] Preparedness Committee presented a summary of these findings to the FICEMS at a June 3, 2009 meeting. The FICEMS directed its Preparedness Committee to conduct a more detailed analysis of State EMS and 9-1-1 pandemic influenza preparedness and to present its findings and recommendations to FICEMS prior to December of 2009."
Federal Interagency Committee on EMS
2009-11-12
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Pandemic Influenza and the Globalization of Public Health
"When one can circle the globe in less than the time of incubation of most infectious pathogens, it is clear every country relies to some extent on the health systems of other countries to prevent and protect their citizens from global health threats. Therefore, creating and maintaining a good health system in one country requires attention to interregional and international cooperation. Domestic and international spheres of public health policies are becoming more intertwined and inseparable."
Walter H. Shorenstein Asia-Pacific Research Center
Barry, Michele; Zhang, Qiong, 1969-; Eggleston, Karen
2009-11
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Drive-Through Medicine: Drive-Through Triage Template
From the Introduction: "During the peak of a pandemic flu event, hospitals and clinics may be overwhelmed with patients seeking medical care. If this occurs, the goal of patient triage is to identify persons who have pandemic influenza and separate those patients from others. This reduces the risk of disease transmission and helps identify the specific care and disposition for each patient (i.e., home care, Intermediate Care Center [ICC] or hospitalization). The Drive-Through Triage Template is intended as an alternative model for administration of patient triage and treatment outside the hospital setting. However, the template could be modified to serve as a plan for a drive-through prophylaxis Point of Dispensing or POD."
Santa Clara County (Calif.). Public Health Department
Cameron Bruce Associates
2009-11
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Infection Prevention for Alternate Care Sites
From the Introduction: "During a disaster, large numbers of individuals may require medical care in a community. Many hospitals and healthcare agencies are currently operating at or near capacity for routine provision of care and lack the resources necessary to accommodate patient surge generated by a disaster. When hospitals and healthcare agencies cannot absorb patient flux or when the physical structure has been damaged, alternate care sites (ACS) may need to be established to meet medical care needs and permit existing healthcare systems to continue operations. ACSs are temporary healthcare facilities only, however, disasters can have a brief or long-term impact on the community's healthcare system; ACSs will need to remain operational for as long as the situation requires. Disease transmission is possible in ACSs as it is in any setting where medical care is provided. In addition, some ACSs may provide health care services outside the controlled environment of an existing healthcare facility or in sub-optimal environments, such as warehouses, schools, or other buildings that were not originally intended to function as healthcare facilities. This can increase the risk of infection transmission."
Association for Professionals in Infection Control and Epidemiology (APIC)
Rebmann, Terri; Russell, Jacie
2009-11
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Statewide Concept of Operations for Pandemic Influenza
"The Statewide Concept of Operations discusses communication and coordination at the local state and federal government levels. At the local level, checklists are included in the Statewide Concept of Operations to assist with local government pandemic influenza preparedness, including alert and warning considerations and suggested response actions. At the state level, the Statewide Concept of Operations includes a discussion of how public health and medical information should flow and how resources should be ordered among the levels of government. At the federal level, the Statewide Concept of Operation describes the established federal role in managing the Strategic National Stockpile, which is vital to pandemic influenza response planning and State Operations Center coordination. The Statewide Concept of Operations emphasizes that all events begin at the local level and recommends that each local agency prepare a pandemic influenza operations plan. At the state level, the plan outlines 27 preparedness, response and recovery objectives under three strategic goals as established by the CDC and outlines the agencies that have plans and procedures for each objective. The plan also includes a State Agency Responsibilities Matrix that lists the state agencies that have lead and support roles for each CDC [Centers for Disease Control and Prevention] objective."
California Emergency Management Agency
2009-11
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Pandemic Influenza Plan: Module 1: Surveillance and Infection Control (November 2009)
This Federal Bureau of Prisons (BOP) offers updated information from the Centers for Disease Control and Prevention regarding pandemic H1N1 influenza.
United States. Bureau of Prisons
2009-11
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Pandemic Influenza Planning Guide for State of Arizona Agencies
"The objective of this Planning Guide is to assist state agencies in developing and implementing their own pandemic influenza plans. The Pandemic Influenza Planning Guide focuses on educating and protecting employees. We recognize that employee protection and continued service delivery can be achieved through a combination of infection control methods and the use of personal protective measures; therefore, this guide focuses on communication, education, and employee engagement. This Pandemic Influenza Planning Guide provides practical occupational safety and health information as well as some important Human Resources-related policies that will assist agencies in developing their own pandemic preparedness plans. While pandemic planning focuses on employees and communications, best practices suggest that pandemic planning be part of each agency's all hazards continuity plan."
Arizona. Department of Administration
2009-11
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Coordinating Call Centers for Responding to Pandemic Influenza: A Workbook for State and Local Planners
"The universal emergency number 9-1-1 is just one of many numbers that ties into what is termed a call center. Briefly, a call center is an interface (both human resource and technological) between an operator (either human or technological) and a caller seeking assistance or information. 9-1-1 and 4-1-1 are probably the more 'traditional' call centers you recognize, but there are many more types of call centers operating within and outside of your community. For example, you may have a poison center or a crisis hotline or a nurse advice line operating in your community. These same call centers may be operating at a regional or state level. It is these additional call centers that you want to tap into to manage non-emergency calls (and perhaps some emergency calls) during an influenza pandemic or other major public health emergency in order to reserve your 9-1-1 and healthcare systems for those in critical need of medical services. Tapping into these additional resources for call management is how you develop a coordinated call center system. This workbook will lead you through a step-by-step process for developing this system."
Centers for Disease Control and Prevention (U.S.)
2009-11
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Pandemic Influenza Disaster Declaration Fact Sheet
"The Department of Homeland Security (DHS), including the Federal Emergency Management Agency (FEMA), in cooperation and coordination with various State and Federal agencies, is prepared to take appropriate and authorized action in response to requests for Federal assistance through the Stafford Act as a result of a pandemic influenza. In order to assist States in assessing impacts and evaluating the need for Federal assistance in a pandemic influenza, FEMA has developed these guidelines for requesting Stafford Act assistance from the Federal Government."
United States. Federal Emergency Management Agency
2009-10-22
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British Columbia's H1N1 Pandemic Influenza Response Plan (2009): Guidelines for Pandemic Influenza-Related Infection Control for Community Pharmacies
From the Document: "This document is meant to be a practical 'how to' guide for community pharmacists who wish to improve their infection control practices for pandemic influenza. First addressed are engineering and administrative approaches, followed by personal protection and traditional disinfection procedures. Office management issues such as sick leave policies and continuing education are also considered. Multiple examples of scripts, messages, signs, checklists and handouts are offered throughout."
British Columbia
Foggin, Timothy; Daniels, Sandra
2009-10-21
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2009 Influenza Pandemic: An Overview [October 15, 2009]
"This report first provides a synopsis of key events, actions taken, and authorities invoked by [World Health Organization (WHO)], the U.S. federal government, and state and local governments. It then discusses the WHO process to determine the phase of a flu pandemic, and selected actions taken by the Departments of Homeland Security and Health and Human Services, and by state and local authorities. Next, it lists congressional hearings held to date, and provides information about appropriations and funding for pandemic flu activities. Finally, it summarizes U.S. government pandemic flu planning documents and lists sources for additional information about the situation as it unfolds. This report will be continually updated to reflect unfolding events."
Library of Congress. Congressional Research Service
Redhead, C. Stephen; Lister, Sarah A.
2009-10-15
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Pandemic Flu School Action Kit
This webpage is designed to help parents and schools prepare for a pandemic flu outbreak.
Contra Costa County (Calif.). Health Services Department
2009-10-12
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Utah Emergency Medical Services: Pandemic Influenza Guidelines
This document provides preparedness and response guidelines for pandemic influenza. These guidelines are meant for emergency response, public health, and emergency medical service personnel.
Utah. Department of Health
2009-10-07
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City of Corvallis Pandemic Influenza Plan: 2009-2010 Flu Season
"This Plan describes unique challenges posed by an influenza pandemic that may necessitate specific leadership decisions, response actions, and communications mechanisms."
Corvallis (Or.)
2009-10-06?
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British Columbia's H1N1 Pandemic Influenza Response Plan (2009): Guidelines for Pandemic Influenza-Related Office Management and Infection Control for Private Physicians
From the Introduction: "This document is meant to be a practical 'how to' guide for family physicians who wish to improve their infection control practices for pandemic influenza. First addressed are engineering and administrative approaches, followed by personal protection and traditional disinfection procedures. Office management issues such as sick leave policies and continuing education are also considered. Multiple examples of scripts, messages, signs, checklists and handouts are offered throughout."
British Columbia
Foggin, Timothy; Daniels, Sandra
2009-10-02
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Louisiana Pandemic Influenza Guidance (October 2009)
"The Louisiana Department of Health and Hospitals (DHH) Office of Public Health (OPH) has created this Pandemic Influenza Guidance as a comprehensive containment and treatment plan to assist in the control of an outbreak of a novel influenza virus, such as the 2009 H1N1 influenza virus ("swine flu") or avian influenza."
Louisiana. Department of Health and Hospitals. Office of Public Health
2009-10
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Laboratory Guidance: Pandemic Influenza Response
"The Louisiana Department of Health and Hospitals (DHH) Office of Public Health (OPH) has created this Pandemic Influenza Guidance as a comprehensive containment and treatment plan to assist in the control of an outbreak of a novel influenza virus, such as the 2009 H1N1 influenza virus ('swine flu') or avian influenza. DHH OPH has followed, and will continue to follow, the international and national recommendations for identification, prophylaxis, and treatment of disease as well as considered the frameworks provided by the Centers for Disease Control and Prevention (CDC) for pandemic planning purposes as well as those recommended by the Occupational Safety and Health Association (OSHA). This Laboratory Plan also serves as an Annex to the Louisiana Pandemic Influenza Guidance, which describes the overall response for the Department of Health and Hospitals."
Louisiana. Department of Health and Hospitals
2009-10
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Mass Vaccination Guidance for Pandemic Influenza Response
"The Pandemic Influenza Mass Vaccination Annex describes the system that will be used to order, store, distribute, track and administer influenza vaccine during a pandemic. The Pandemic Influenza Mass Vaccination Plan is an annex to several other plans and guidance documents, including the Louisiana Point of Dispensing (POD) Plan, in which the State of Louisiana has planned for an 'all-hazards' mass distribution system for the receipt, storage, distribution, and dispensing of vaccinations/medications to the general public."
Louisiana. Department of Health and Hospitals. Office of Public Health
2009-10
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Bureau of EMS Guidance for Pandemic Influenza Response
"The Louisiana Department of Health and Hospitals (DHH) Office of Public Health (OPH) has created this Pandemic Influenza Guidance as a comprehensive containment and treatment plan to assist in the control of an outbreak of a novel influenza virus, such as the 2009 H1N1 influenza virus ('swine flu') or avian influenza. DHH OPH has followed, and will continue to follow, the international and national recommendations for identification, prophylaxis, and treatment of disease as well as considered the frameworks provided by the Centers for Disease Control and Prevention (CDC) for pandemic planning purposes, and those recommended by the Occupational Safety and Health Administration (OSHA). As there is little natural immunity to any new virus, it is recognized by DHH OPH that ongoing communications and updates to the health care community as well as the public are critical to the health of Louisiana. The recommendations that identify vulnerable populations and guidelines for treatment are also adopted by Louisiana, and the State remains in compliance with recommendations from such authorities as the Centers for Disease Control and Prevention (CDC)."
Louisiana. Department of Health and Hospitals. Office of Public Health
2009-10
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Geographic Information Systems and Pandemic Influenza Planning and Response
This document explains how geographic information systems (GIS) can support public health business practices and how to learn more about specific ESRI technology solutions. Additionally, the document contains an appendix that features model GIS practices and solutions.
Environmental Systems Research Institute (Redlands, Calif.)
2009-10
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Community Containment and Mitigation Guidance for Pandemic Influenza Response
This guide recommends preparedness and response strategies to mitigate the impact of pandemic influenza in Louisiana.
Louisiana. Department of Health and Hospitals
2009-10
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Alberta's Plan for Pandemic Influenza - a Summary
"Alberta's Plan for Pandemic Influenza has been developed by Alberta Health and Wellness (AHW) and the Alberta Emergency Management Agency (AEMA) to guide and support the pandemic planning and response of the Government of Alberta, the health sector, the municipalities, and other key stakeholders. It has been developed to align with the Canadian Pandemic Influenza Plan for the Health Sector (CPIP) as well as the Alberta Health Services pandemic response plan. The Plan provides a coordinated and phased response to Pandemic (H1N1) 2009 influenza. It is based on a scenario in which pandemic influenza is of moderate severity, but is scalable to address additional responses that may be required should pandemic influenza cause more severe disease or affect a larger proportion of the population. The Plan remains an evergreen document and will therefore be revised to incorporate lessons learned from the Pandemic (H1N1) 2009 influenza response and other pandemic scenarios as required. This document provides an overview of the detailed plan."
Government of Alberta. Health and Wellness
2009-10
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Pandemic Influenza Guidance for Homeless Shelters & Homeless Service Providers
"Homeless shelters and other homeless service sites continue to play an important part in protecting the health of the people they serve. People using homeless services depend on providers to maintain healthy living environments and to take measures to decrease the risk of influenza transmission. Homeless persons may bear particular risk of contracting influenza because of crowded and unsanitary living conditions, stressed immune systems, and close contact with highly transient persons. This is also the case for other communicable diseases, but the rapidly developing H1N1 epidemic calls for increased precautions and vigilance. Maintaining the health of an entire population who are at higher risk of influenza transmission is a significant task for organizations with limited resources and staff capacity. For this reason, pandemic influenza planning and response requires that homeless service providers collaborate with local, state, national, tribal, and territorial efforts. The purpose of this manual is to provide guidance for homeless shelters and other homeless service providers to plan for and to respond to the special needs of homeless individuals during the influenza season. Different facilities will need to tailor the guidance to meet the needs of their staff and the people they serve."
National Health Care for the Homeless Council (U.S.)
Scott, Marion
2009-10
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Economic Cost and Health Care Workforce Effects of School Closures in the U.S.
"School closure is an important component of U.S. pandemic flu mitigation strategy. The benefit is a reduction in epidemic severity through reduction in school-age contacts. However, school closure involves two types of cost. First is the direct economic impact of the worker absenteeism generated by school closures. Second, many of the relevant absentees will be health care workers themselves, which will adversely affect the delivery of vaccine and other emergency services. Neither of these costs has been estimated in detail for the United States. We offer detailed estimates, and improve on the methodologies thus far employed in the non-U.S. literature. We give estimates of both the direct economic and health care impacts for school closure durations of 2, 4, 8, and 12 weeks under a range of assumptions. We find that closing all schools in the U.S. for four weeks could cost between $10 and $47 billion dollars (0.1-0.3% of GDP) and lead to a reduction of 6% to 19% in key health care personnel. These should be considered conservative (i.e., low) economic estimates in that earnings rather than total compensation are used to calculate costs. We also provide per student costs, so regionally heterogeneous policies can be evaluated. These estimates permit the epidemiological benefits of school closure to be compared to the costs at multiple scales and over many durations."
Brookings Institution
Epstein, Joshua M., 1951-; Lempel, Howard; Hammond, Ross A.
2009-09-30
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Benchmarks for Developing a Law Enforcement Pandemic Flu Plan
"While state and local public health departments will lead the response to a public health emergency, community members look to their local law enforcement executives to be the voice of authority, calm, and guidance during any type of crisis. Law enforcement officials are now being tasked with understanding and planning for public health risks - to ensure that the law enforcement agency can sustain its critical functions, while helping ensure a resilient, healthy, and safe workforce and community. This guide was designed to help law enforcement personnel from departments of all sizes and at all stages of the pandemic influenza planning process ensure their plans are as comprehensive, adaptable, and current as possible. It is also designed to help agencies comply with National Incident Management System (NIMS) guidelines. First and foremost, planning for a flu pandemic or other public health emergency is similar to planning for any other type of critical incident. The primary difference between public health emergencies and other critical incidents is that in the latter, continuity of operations plans typically focus on replacing physical structures and resources. Planning for public health emergencies requires departments to focus more on employee wellness and the ability to sustain human resources as well as the ability to maintain critical operations with a reduction in staff. And, as previously mentioned, a pandemic influenza - likely the worst-case scenario of public health emergencies - would be accompanied by a significant reduction in human resources and other non-typical challenges to a law enforcement agency's ability to operate."
Police Executive Research Forum; United States. Office of Justice Programs
Brito, Corina Sole; Luna, Andrea Morrozoff; Sanberg, Elizabeth Lang
2009-10
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Physical Interventions to Interrupt or Reduce the Spread of Respiratory Viruses: Systematic Review
From the Introduction: "Epidemic and pandemic new viral infections pose a serious threat worldwide. Several have occurred recently, including the current H1N1 pandemic influenza and the coronavirus outbreak that caused severe acute respiratory syndrome (SARS). Even non-epidemic acute respiratory tract infections place a serious burden on health and healthcare systems. Overall, epidemics account for most of the 7% of total deaths from respiratory tract infections in the world. Our 2007 Cochrane review showed that physical interventions (personal hygiene, barriers, and distancing) are highly effective. However, the current mainstay of pandemic interventions still seems to be vaccines and antiviral drugs, with no evidence supporting their widespread use, especially against a seemingly mild threat such as the novel H1N1 virus. For example, in the most recent guidance document on planning for pandemic influenza from the World Health Organization, handwashing and masks were mentioned only twice and gloves and gowns once each, but vaccines and antivirals were cited 24 and 18 times, respectively."
BMJ Publishing Group
Jefferson, Tom; Del Mar, Chris; Dooley, Liz . . .
2009-09-22
