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LLIS Lesson Learned: Infectious Disease Outbreaks: Creating Hospital Staffing Surge Plans. February-July 2003
"Between February and July 2003, Severe Acute Respiratory Syndrome (SARS) caused 812 deaths and affected people in 29 countries. Processes for containing the disease also produced significant consequences for individuals employed in the healthcare system. In Canada, approximately 40 percent of all probable SARS cases and quarantined individuals were healthcare workers. The Canadian government placed quarantine restrictions on at least 10 medical facilities, which subsequently depleted the supply of medical professionals available to support response operations. At the time of the outbreak, part-time staff filled approximately 44 percent of the nursing positions in the Toronto metropolitan area. Many of these part-time nurses worked in multiple medical facilities and were therefore simultaneously included in staffing surge plans at several hospitals. As facilities were quarantined, the staff members, including part-time nurses, were placed into working quarantine, which restricted their place of work to a single medical facility. This restriction to one facility significantly reduced the floating resource pool of part-time nurses. To fill the staffing shortfall, some hospitals offered double or triple pay to nurses who were not already under quarantine orders at another facility. This strategy allowed some hospitals to meet their short-term staffing needs but left others without a sufficient staff to support the region's medical response. After the outbreak, hospital officials recommended that all healthcare facility administrators create contingency plans for ensuring a staffing surge even if the face of a depleted pool of part-time nurses."
Lessons Learned Information Sharing (LLIS)
2006-05-08
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Press Briefing by Scott McClellan and Homeland Security Advisor Fran Townsend regarding Pandemic Flu [May 3, 2006]
In this press briefing held on May 3, 2006 by Scott McClellan and Homeland Security Advisor Fran Townsend is in regards to an implementation plan for the pandemic influenza.
United States. Office of the White House Press Secretary
McClellan, Scott; Townsend, Frances Fragos
2006-05-03
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Template Policy on Healthcare Facility Patient Evacuation and Shelter-In-Place
"It is the policy of the healthcare facility to have defined procedures to protect the life and safety of both patients and staff should there be a hazard that causes the healthcare facility to decide either to shelter-in-place or to evacuate."
Wisconsin. Department of Health and Social Services
2006-05-02?
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Pandemic Influenza Infection Control Guidelines for Home Healthcare Services
This brochure provides information for home health agencies regarding guidelines for pandemic influenza in the healthcare setting.
West Virginia. Department of Health & Human Resources
2006-05
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Pandemic Influenza Infection Control Guidelines for Emergency Medical Services
This brochure provides information for emergency medical services personnel on how to protect themselves during patient transport.
West Virginia. Department of Health & Human Resources
2006-05
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Assessing the Effectiveness of Shelter-in-Place as an Emergency Response to Large-Scale Outdoor Chemical Releases
"Large-scale outdoor chemical releases can cause severe harm to people in nearby communities. Sheltering in buildings may be used as a temporary measure to reduce health risk from exposure to the toxic materials. Shelter-in-place (SIP) is relatively straightforward to implement because most people are already in buildings most of the time, and so exercising the emergency response simply means closing windows and doors, and turning off ventilation fans. However, air leakage variability in the building stock can lead to considerable differences in the effectiveness of buildings in protecting occupants against outdoor releases. The effectiveness of SIP for the community can also vary for different release conditions. This dissertation identifies and assesses the key factors that affect community-scale SIP effectiveness. Large-scale airborne toxic chemical releases are simulated to assess the potential acute health effects for the exposed population. Modeling of the distribution of indoor concentrations is accomplished through detailed analysis of the air leakage of 2 residential and non-residential buildings and simulation of their air infiltration rates. The expected outcome for a population that shelter indoors is quantified by a community-based metric that captures the variability among buildings. Sensitivity of SIP effectiveness to model parameters is evaluated under different release scenarios by comparing changes in the casualty reduction estimates."
Lawrence Berkeley National Laboratory
Chan, Wanyu R.
2006-05
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National Communicable Disease Surveillance Manual of Saint Lucia
"The purpose of surveillance is not just to detect communicable diseases but rather to respond to any communicable diseases with the appropriate disease control measure. The potential for rapid spread of a communicable disease has demanded that our surveillance system provides information as close to real time as possible. It is probably more appropriate to think of our national communicable disease surveillance and control system as a health security system. The system demands accurate and rapid intelligence. This intelligence must be available in a system that can see and respond rapidly at the country borders as well as within each community and within every sector e.g. trade, health, agriculture, education or tourism. We live in a global environment within which an emerging infectious disease from anywhere in the world can arrive in Saint Lucia within 24 hours of emerging. Infectious diseases can arrive via people or through agricultural and goods imports. Therefore the scope of our disease surveillance and response systems must be competent to manage this."
Saint Lucia
2006-05
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Maryland Prepares: Pandemic Influenza and Avian Influenza Status Report
"Maryland was one of the first states to develop its own pandemic influenza response plan. The Department of Health and Mental Hygiene (DHMH) began work on this plan in 1999. The current pandemic influenza response plan is available at the website flu.Maryland.gov. This informative new influenza Web site was launched by the Governor's Office last fall. DHMH has conducted several pandemic influenza conferences and tabletop exercises to raise awareness among the public health community, healthcare providers, schools, businesses, industries, and other public and private stakeholders."
Maryland; Maryland. Department of Health and Mental Hygiene
2006-05
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National Strategy for Pandemic Influenza: Implementation Plan
"A new influenza strain, influenza A (H5N1), is spreading through bird populations across Asia, Africa, and Europe, infecting domesticated birds, including ducks and chickens, and long-range migratory birds. In response to this threat, the President issued the National Strategy for Pandemic Influenza on November 1, 2005. The Strategy outlines the coordinated Federal Government effort to prepare for pandemic influenza. This Implementation Plan for the National Strategy for Pandemic Influenza further clarifies the roles and responsibilities of governmental and non-governmental entities, including Federal, State, local, and tribal authorities and regional, national, and international stakeholders, and provides preparedness guidance for all segments of society. It also provides guidance for families and individuals to ensure appropriate personal protection. The Implementation Plan represents a comprehensive effort by the Federal Government to identify the critical steps that must be taken immediately and over the coming months and years to address the threat of an influenza pandemic. It assigns specific responsibilities to Departments and Agencies across the Federal Government, and includes measures of progress and timelines for implementation to ensure that we meet our preparedness objectives. This Plan will be revised over time. The pandemic threat is constantly evolving, as is our level of preparedness."
United States. White House Office
United States. Homeland Security Council
2006-05
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Continuity of Operations: Selected Agencies Could Improve Planning for Use of Alternate Facilities and Telework during Disruptions, Report to the Chairman, Committee on Government Reform, House of Representatives
"To ensure that essential government services are available in emergencies, federal agencies are required to develop continuity of operations (COOP) plans. The Federal Emergency Management Agency (FEMA), within the Department of Homeland Security (DHS), is responsible for overseeing and assessing the status of COOP capabilities of federal executive branch agencies. It has developed guidance stating that agency COOP plans must designate alternate facilities and prepare personnel for unannounced relocation to these facilities. The guidance also states that agencies should consider the use of telework in their continuity plans. GAO was asked to follow up on its previous work on COOP planning and determine, among other things, to what extent (1) 6 selected agencies prepared their alternate facilities and (2) 23 major agencies made preparations necessary to effectively use telework in emergency situations."
United States. Government Accountability Office
2006-05
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School District Pandemic Influenza Planning Guidelines
"One of the most important public health issues our Nation and the world faces is the threat of a global disease outbreak called a pandemic. It is therefore important that adequate planning take place before any pandemic occurs. The ubiquitous nature of an influenza pandemic compels Federal, State and local governments, communities (including schools), corporations, families and individuals to learn about, prevent, prepare for, and collaborate in efforts to slow, respond to, mitigate, and recover from a potential pandemic. The development, refinement, and exercise of pandemic influenza plans by all stakeholders are critical components of preparedness."
Connecticut Association of Public School Superintendents
2006-05
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Long-Term Care and Other Residential Facilities Pandemic Influenza Planning Checklist
"Planning for pandemic influenza is critical for ensuring a sustainable healthcare response. The Department of Health and Human Services (HHS) and the Centers for Disease Control and Prevention (CDC) have developed this checklist to help long-term care and other residential facilities assess and improve their preparedness for responding to pandemic influenza. Based on differences among facilities (e.g., patient/resident characteristics, facility size, scope of services, hospital affiliation), each facility will need to adapt this checklist to meet its unique needs and circumstances. This checklist should be used as one tool in developing a comprehensive pandemic influenza plan. Additional information can be found at www.pandemicflu.gov. Information from state, regional, and local health departments, emergency management agencies/authorities, and trade organizations should be incorporated into the facility's pandemic influenza plan. Comprehensive pandemic influenza planning can also help facilities plan for other emergency situations."
Centers for Disease Control and Prevention (U.S.); United States. Department of Health and Human Services
2006-05-01
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Pandemic Influenza Infection Control Guidelines for Hospitals
Occupational health guidelines for healthcare facilities in West Virgina to follow in case of pandemic influenza.
West Virginia. Department of Health & Human Resources
2006-05
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Pandemic Influenza Infection Control Guidelines for Schools and Workplaces
Brochure providing guidelines for citizens of West Virginia on how to identify influenza and what to do to prevent its spread.
West Virginia. Department of Health & Human Resources
2006-05
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Pandemic Influenza Infection Control Guidelines for Communities
This brochure provides information for West Virginia citizens on how to stay healthy and keep others healthy during a pandemic.
West Virginia. Department of Health & Human Resources
2006-05
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Pandemic Influenza Planning: A Guide for Individuals and Families
"This guide is designed to help [individuals] understand the threat of a pandemic influenza outbreak […] It describes commonsense actions […] in preparing for a pandemic." The guide provides information on pandemic influenza, on planning for the disruption of essential services in the event of an outbreak, on being prepared for the disruption of food and water supplies, and on the disruption of medical care. The guide also provides information on vaccinations and antivirals as well as preparedness checklists and forms and resources for further information.
United States. Department of Health and Human Services
2006-05
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Mandatory Vaccination: Why We Still Got to Get Folks to Take Their Shots
From the Abstract: "Vaccination is widely considered one of the greatest medical achievements of modern civilization. Childhood diseases that were commonplace less than a generation ago are now increasingly rare because of vaccines. In order to be effective at eliminating communicable diseases, vaccines must be administered to sufficient levels of persons in the community. Because of this, public health officials have mandated vaccination for certain diseases as a condition to school attendance. The overwhelming effectiveness of vaccination programs may lead individuals to ignore the benefits of vaccination and focus more on the risk of side effects. Moreover, some have criticized the coercive nature of these programs. These objections may lead to an unacceptably high number of exemptions, which can compromise vaccination programs and leave the population susceptible to outbreaks. This paper explores vaccination programs with an eye toward greater public safety without ignoring the reality of a small but committed group of vaccine critics. The paper begins with a discussion of the historical development of mandatory vaccination policies and the issues posed by exemptions. It then addresses some of these issues in the context of vaccine safety. It also seeks solution by framing the discussion in economic terms. It concludes by recommending stricter enforcement of mandatory requirements for most vaccines and greater dissemination of information on the continued importance of vaccination."
Digital Access to Scholarship at Harvard; Harvard Library. Office for Scholarly Communication
Balding, Ben
2006-04-27
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Strengthening Pandemic-Influenza Preparedness and Response, Including Application of the International Health Regulations (2005): Report by the Secretariat
"Beginning in mid-2003, eight countries in south-east Asia experienced the largest and most severe outbreaks of highly pathogenic avian influenza in poultry on record. The causative agent, the H5N1 strain of Influenzavirus A, has since become endemic in domestic birds in several of the initially affected countries. 2. From July 2005 to the end of the year, the virus expanded its geographical presence in birds beyond the initial focus in Asia. Countries reporting their first outbreaks, in both wild and domestic birds, included (in order of reporting) the Russian Federation, Kazakhstan, Turkey, Romania and Ukraine. Croatia and Mongolia reported detection of the virus in wild birds only. 3. Beginning in February 2006, the geographical presence of the virus in birds expanded again, this time dramatically: between then and early April 2006, 32 countries, located in Africa, Asia, Europe and the Middle East, had reported their first cases of infection in wild or domestic birds, or both. This development marks the fastest and most extensive geographical spread of any highly pathogenic avian influenza virus recorded since the disease was first described in 1878. The virus has now affected poultry in some of the world's most densely populated and impoverished areas poorly served by systems for health care and disease surveillance. This situation increases the likelihood that human cases may not be detected promptly or at all, thus weakening the early warning system that signals the need to intensify pandemic preparedness or launch an effort to contain an emerging pandemic virus."
World Health Organization
2006-04-24
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Pandemic Flu and Medical Biodefense Countermeasure Liability Legislation: P.L. 109-148, Division C (2005) [April 12, 2006]
"Division C of P.L. 109-148 (2005) limits liability with respect to pandemic flu and other public health countermeasures. Specifically, upon a declaration by the Secretary of Health and Human Services of a public health emergency or the credible risk of such emergency, Division C would, with respect to a 'covered countermeasure,' eliminate liability, with one exception, for the United States, and for manufacturers, distributors, program planners, persons who prescribe, administer or dispense the countermeasure, and employees of any of the above. The exception is that a defendant who engaged in willful misconduct would be subject to liability under a new federal cause of action, though not under state tort law. Division C's limitation on liability is a more severe restriction on victims' ability to recover than exists in most federal tort reform statutes. However, victims could, in lieu of suing, accept payment under a new 'Covered Countermeasure Process Fund,' if Congress appropriates money for this fund."
Library of Congress. Congressional Research Service
Cohen, Henry, 1949-
2006-04-12
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University of Cincinnati, Ohio Emergency Operations Plan: Hazard-Specific Annexes: Pandemic Response
"The purpose of this annex is to establish procedures for taking the proper emergency preparedness and response actions for a pandemic involving a novel flu strain"
University of Cincinnati
2006-04-10?
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Getting Ready for the Pandemic Flu Checklist
"It's time to prepare for a pandemic flu or emergency. Pandemic flu virus can be highly contagious so you may be asked to limit your time with others or remain at home for several days to prevent it from spreading easily form person to person. Schools, daycares, community centers and other places where people will be in close contact may be closed. The following are simple steps you can take to prepare for a pandemic flu or any emergency. Remember, essential services (such as transportation, garbage, schools, stores) may be limited or postponed during a pandemic flu."
Adams County (Wash.). Health Department
2006-04-05?
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U.S. and International Responses to the Global Spread of Avian Flu: Issues for Congress [Updated April 4, 2006]
"Influenza A/H5N1 is the strain of influenza currently spreading throughout the world. Although it is a bird flu, it has infected a relatively small number of people - killing more than half of those infected. Some scientists are concerned that H5N1 may cause the next influenza pandemic. Flu pandemics have occurred cyclically, between every 30 and 50 years. Since 1997, when the first human contracted H5N1 in Hong Kong, the virus has resurfaced and spread to nearly fifty countries in Asia, Europe, the Middle East, and Africa - infecting more than 190 people. In February 2006, the virus spread from Asia and central Europe to western Europe. In March 2006, health experts confirmed new bird flu cases among more than 20 countries across Europe, Asia, and Africa. Most of the countries were experiencing their first H5N1 cases. The first human H5N1 fatalities outside of Asia occurred in 2006 when Turkey and Iraq announced their first human deaths related to H5N1 infection in January 2006 and February 2006, followed by Azerbaijan and Egypt in March 2006."
Library of Congress. Congressional Research Service
Salaam-Blyther, Tiaji
2006-04-04
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Computer Model Examines Strategies to Mitigate Potential U.S. Flu Pandemic
"If pandemic flu were to emerge in the United States, what interventions might slow its spread and minimize the impact? With support from the National Institutes of Health (NIH), researchers from the Fred Hutchinson Cancer Research Center in Seattle, Wash., and the Los Alamos National Laboratory have used computer models to suggest possible answers. The findings appear in the April 11, 2006, issue of the 'Proceedings of the National Academy of Sciences' and will be available in the online edition the week of April 3."
United States. Department of Health and Human Services; National Institutes of Health (U.S.)
2006-04-03
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H7N7 Dutch Avian Flu Outbreak (2003) Associated with Human Conjunctivitis and Fatal Case of Acute Respiratory Distress Syndrome in Exposed Veterinarian Who Did Not Take Tamiflu or Receive Vaccination
"At about the same time the SARS novel virus outbreak was swirling in Canada and the Far East (March-June 2003), a highly lethal disease subsequently identified as avian influenza virus subtype H7N7 was devastating commercial chicken flocks on (initially) six farms in Gelderland Province, the Netherlands, an area with a high density of poultry farms. Eventually the infection spread to 255 farms, and on March 1, 2003 the Dutch Ministry of Agriculture announced a ban on the export of all poultry and poultry-related products. In addition, the Ministry ordered the culling of all infected flocks, which led to the killing of around 30 million chickens-about 28% of the total chicken population in the Netherlands. The human population in the Netherlands is 16 million people."
Suburban Emergency Management Project (U.S.)
2006-04-02
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Evacuation and Quarantine Annex to the Madison County Disaster and Emergency Plan
"The purpose of this annex is to provide for the orderly and expeditious evacuation of all or any part of the population of Madison County when such action has been determined by competent authority to be the most effective available means to protect the people from the effects of a disaster or major emergency, regardless of its cause. It also addresses the related problem of exclusion of people from an area through quarantine. The Evacuation Annex is to be used in coordination with applicable hazard-specific and functional annexes as well as with the main body of the Madison County Disaster and Emergency Plan of which all of these annexes are a part."
Madison County (Mont.)
2006-04
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Seattle Public Schools Emergency Management Plan: Biological Incident Annex: Pandemic Influenza Management Plan
"The Seattle Public Schools Emergency Management Plan (SPSEMP) consists of several components including the Base Plan, Appendixes, Emergency Support Functions, Support Annexes and Incident Annexes. The Pandemic Influenza Management Plan is one of several Incident Annexes and therefore serves to augment the Base Plan and other components. In order to ensure efficient and effective emergency management, the SPSEMP document must be implemented in its entirety."
Seattle Public Schools
2006-04
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Pandemic Influenza Planning Guidance for Medical Reserve Corps Units
"Planning for pandemic influenza is critical for Medical Reserve Corps (MRC) units. The following guidance identifies important, specific activities MRC units can do now to prepare for such an event. Many activities are specific to pandemic influenza, but a number also pertain to any public health or other emergency. This guidance is adapted from the State and Local Pandemic Influenza Planning Checklist developed by HHS [Department of Health and Human Services] and found on the federal government's pandemic influenza website (www.pandemicflu.gov). It also includes relevant elements from the Business Pandemic Influenza Planning Checklist and Faith-Based & Community Organizations Pandemic Influenza Preparedness Checklist, also from HHS and available at the aforementioned website. This guidance is not intended to set forth mandatory requirements for MRC units. Rather, each MRC unit should determine for itself whether it is adequately prepared for disease outbreaks in accordance with the laws, plans and procedures of its local jurisdiction and state."
Northwest Tribal Emergency Management Council
2006-04
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Santa Rosa County Pandemic Flu Plan
"Santa Rosa County will implement a comprehensive Pandemic Flu Plan in order to facilitate the continuity of governmental operations so as to provide necessary services to the citizens of the County in the event that a Pandemic strikes the Gulf Coast of Florida."
Santa Rosa County (Fla.). Division of Emergency Management
Hahn, Daniel
2006-04
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How Prepared is Europe for Pandemic Influenza? An Analysis of National Plans
This report surveyed all countries in the European Union (25 member states), in addition to Bulgaria, Romania Norway and Switzerland. Each plan was scrutinised according to a checklist based on the World Health Organization checklist1 -- a total of 169 criteria were identified and were either fulfilled or not fulfilled, thus giving an indication of the plan's completeness."
London School of Hygiene and Tropical Medicine
Mounier-Jack, Sandra; Coker, Richard, 1960-
2006-04-01?
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Arkansas Influenza Pandemic Response Plan
Arkansas's Influenza Pandemic Response Plan provides guidance to state agencies and departments to counter the anticipated impact of a pandemic influenza outbreak.
Arkansas. Department of Health
2006-04
