# 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.

## 

## Introduction

One of the greatest and most likely threats to the public's health is a
naturally occurring event -- an influenza pandemic. Influenza epidemics
happen nearly every year (often called seasonal influenza), and cause an
average of 36,000 deaths annually in the United States. Influenza
epidemics are caused by a few known virus strains that circulate around
the world. Over time, people develop immunities to these strains, and
vaccines are developed to protect people from serious illness.

Influenza viruses experience frequent, slight changes to their genetic
structure. Occasionally, however, they undergo a major change in genetic
composition. It is this major genetic shift that creates a "novel" virus
and the potential for a pandemic -- a global epidemic. The creation of a
novel virus means that most, if not all, people in the world will have
never been exposed to the new strain and have no immunities to the
disease. It also means that new vaccines must be developed and therefore
are not likely to be available for months, during which time many people
could become infected and seriously ill.

During the 20^th^ century, three pandemics occurred that spread
worldwide within a year. The influenza pandemic of 1918 was especially
virulent, killing a large number of young, otherwise healthy adults. The
pandemic caused more than 500,000 deaths in the United States and more
than 40 million deaths around the world Subsequent pandemics in 1957--58
and 1968-69 caused far fewer fatalities in the U.S., 70,000 and 34,000
deaths respectively, but caused significant illness and death around the
world.

The Centers for Disease Control and Prevention (CDC) estimates that in
the U.S. alone, an influenza pandemic could infect up to 200 million
people and cause between 100,000 and 200,000 deaths. Scientists and
health officials throughout the world believe that it is inevitable that
more influenza pandemics will occur in the 21^st^ century. Recent cases
of human disease caused by a widespread and growing avian influenza
outbreak suggest that a new pandemic could be developing at this time.

Table 1. Estimated number of Episodes of Illness, Healthcare Utilization
and Deaths Associated with Pandemic Influenza Scenarios for US
population and King County (from SKPHD Pandemic Plan, 2006)

  --------------------- ------------------ -------------- -------------- --------------
  **Characteristic**    **Moderate                        **Severe (1918 
                        (1959/68-like)**                  -- like)**     

                        **US**             **King         **US**         **King
                                           County**                      County**

  **Illness**           90 Million         540,000        90 Million     540,000

  **Outpatient Care**   45 Million         270,000        45 Million     270,000

  **Hospitalization**   865,000            5,190          9,900,000      8,910

  **Deaths**            209,000            1,254          1,903,000      11,418
  --------------------- ------------------ -------------- -------------- --------------

There are several characteristics of influenza pandemic that
differentiate it from other public health emergencies. First, it has the
potential to suddenly cause illness in a very large number of people,
who could easily overwhelm the health care system throughout the nation.
A pandemic outbreak could also jeopardize essential community services
by causing high levels of absenteeism in critical positions in every
workforce. It is likely that vaccines against the new virus will not be
available for six to eight months following the emergence of the virus.
Basic services, such as health care, law enforcement, fire, emergency
response, communications, transportation, public schools and utilities,
could be disrupted during a pandemic. The increased stress from a
potential pandemic or actual pandemic will also increase the mental
health service needs throughout the schools and community. Finally, the
pandemic, unlike many other emergency events, could last for many weeks,
if not months. The City of Seattle Emergency Operations Center has asked
agencies to prepare for school closures that may last up to 2 months.

Schools tend to be affected by outbreaks more than other settings
because their occupants---primarily children---easily transmit illnesses
to one another as a result of their close proximity and their
inefficiency at containing the droplets issued by their coughs and
sneezes. High susceptibility of students and staff to exposure to a
mutated virus as result of proximity and a longer duration of the
outbreak due to lack of immunity and vaccines could result in lengthy
and widespread absenteeism. In a worse-case scenario, the pandemic could
force schools to close, potentially prompting administration to extend
the academic year and expend additional resources for staff sick leave
and substitute teachers.

**Summary of Emergency Management Principles**

The Public Health Department of Seattle-King County (PHSKC), the Seattle
Emergency Operations Center (EOC), and Seattle Public Schools (SPS) will
utilize their pandemic Influenza plan for their agencies to achieve the
following goals:

-   Limit the number of illnesses and deaths

-   Preserve continuity of essential school functions

-   Minimize educational and social disruption

-   Minimize economic and academic losses

The plan will be coordinated with other PHSKC, EOC, and SPS Emergency
Management plans and activities, and will be coordinated with the plans
of our community, state and federal partners.

I.  Planning Assumptions

The U.S. Health and Human Services Pandemic Influenza Plan contains the
following information about pandemics, how they might affect school aged
children, and how states and local agencies should plan for them:

 

1.  The clinical attack rate (the percentage of people who will become
    so sick they won\'t be able to go to work or school)
    will be 30% in the overall population.  Illness rates will be
    highest among school-aged children (about 40%) and decline with age.

2.  Children will shed the greatest amount of virus (they are more
    contagious than adults) and therefore are likely to pose the
    greatest risk for transmission.

3.  On average about 2 secondary infections will occur as a result of
    transmission from someone who is ill.

4.  In an average community, a pandemic outbreak will last 6 to 8
    weeks.  At least two pandemic disease waves are likely.

5.  It is anticipated that the school district will need to plan to
    function with a total of 30% work force absentee rate for the entire
    pandemic outbreak. If staff absenteeism is sufficient to warrant the
    administrative closure of the school or district, the administrative
    procedures for temporary school closures (See SPSEMP-Base Plan) are
    to be followed.

 Whether or not schools will be closed or for how long is impossible to
say in advance, since all pandemics are different in their scope and
severity.  However, it is well established that infectious disease
outbreaks most often start in schools and so the SKPHD may close schools
early in an event. The duration of school closings can only be
determined at the time of the event based on the characteristics of the
pandemic, but it is unlikely that schools will be closed for less than 2
weeks (based on the incubation period of the disease and the length of
time people are contagious) and could be as long as 8 weeks, as
mentioned above. Other planning assumptions that are being used by the
community include:

6.  Working closely with the PHSKC and the EOC will maximize the health
    and safety of the school community. Understanding the roles of each
    agency and their responsibilities will promote coordination and
    communications (See Base Plan).

7.  An influenza pandemic will result in the rapid spread of the
    infection with outbreaks throughout the world. Communities across
    the state and the country may be impacted simultaneously.

8.  There will be a need for heightened global and local surveillance of
    flu symptoms and infection rates.

9.  King County will not be able to rely on mutual aid resources, State
    or Federal assistance to support local response efforts.

10. Antiviral medications will be in extremely short supply. Local
    supplies of antiviral medications may be prioritized by PHSKC for
    hospitalized influenza patients, close contacts of patients, health
    care workers providing care for patients, or other groups.

11. Due to vaccine production and distribution constraints, a vaccine
    for the pandemic influenza strain will likely not be available for 6
    to 8 months following the emergence of a novel virus.

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a.  As vaccine becomes available, it will be administered to eligible
    persons and ultimately to the entire population.

b.  Insufficient supplies of vaccines and antiviral medicines will place
    greater emphasis on social distancing strategies to control the
    spread of the disease in the county.

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12. There could be significant disruption of public and privately owned
    critical infrastructure including transportation, commerce,
    utilities, public safety and communications.

13. Social distancing strategies aimed at reducing the spread of
    infection such as closing schools, community centers, and other
    public gather points and canceling public events may be implemented
    during a pandemic.

14. It will be especially important to coordinate disease control
    strategies throughout counties in the Puget Sound area and the State
    due to the regional mobility of the population.

15. The general public, health care partners, response agencies, elected
    leaders and schools will need continuous updates on the status of
    the pandemic outbreak, the steps PHSKC and the school district is
    taking to address the incident, and steps the public can take to
    protect themselves.

##  III. AUTHORITIES 

In King County, various public officials have overlapping authorities
with regard to protecting public health and safety. The Governor, the
State Secretary of Health, the King County Executive, City of Seattle
Mayor, and the Local Health Officer (LHO) each can implement authorities
within the scope of their jurisdiction aimed at protecting public
health, including increasing social distancing by closing public or
private facilities. During a pandemic, the presence of overlapping
authorities will necessitate close communication and coordination
between elected leaders, the EOC, the Local Health Officer and schools
to ensure decisions and response actions are clear and consistent. The
Director of Public Health -- Seattle & King County is the Local Health
Officer for Seattle and may direct the isolation and quarantine of
individuals or groups. The Local law enforcement officials, the Seattle
Police Department, have the authority to enforce the orders issued by
PHSKC or Superior Court Judges within their jurisdiction.

A school district has the authority to close schools for emergency
reasons. 335.030*.* A school district may close school for emergency
reasons, as set forth in RCW 28A.150.290(2)(a) and (b), without
complying with the requirements of RCW 28A.335.020 (a policy and citizen
involvement prior to closing a school).

The Superintendent of Public Instruction has established the following
definitions related to emergency school closures:

> 1\) A "district-wide emergency closure" means "that all school
> buildings in the school district are unsafe, unhealthy, inaccessible,
> or inoperable due to one or more unforeseen natural events, mechanical
> failures, or action or inactions by one or more persons." WAC
> 392-129-090.
>
> 2\) A "school emergency closure" means "a school in the school
> district comprised of more than one school that is unsafe, unhealthy,
> inaccessible, or inoperable due to one or more unforeseen natural
> events, mechanical failures, or actions or inactions by one or more
> persons." WAC 392-129-100.

The Superintendent of Public Instruction has established regulations for
school district to follow to request continued financial support from
the State during a district-wide emergency closure and a school
emergency closure. WAC 392-129. For example, a school district may apply
to the Office of the Superintendent of Public Instruction for
continuation of state support during a school emergency closure under
WAC 392-129-145. Under WAC 392-129-150, the Superintendent of Public
Instruction has the authority to determine if the district has
conclusively demonstrated that unforeseen natural events prevented the
operation of the school. For a school closure, it appears that the
Superintendent of Public Instruction can only excuse the school district
for up to two scheduled days per incident.

####  VI. Phases of a Pandemic 

The World Health Organization (WHO), the medical arm of the United
Nations, has developed a global influenza preparedness plan that
includes a classification system for guiding planning and response
activities for an influenza pandemic. This classification system is
comprised of six phases of increasing public health risk associated with
the emergence and spread of a new influenza virus subtype that may lead
to a pandemic. The Director General of WHO formally declares the current
global pandemic phase and adjusts the phase level to correspond with
pandemic conditions around the world. For each phase, the global
influenza preparedness plan identifies response measures WHO will take,
and recommends actions that countries around the world should implement.

+--------------------------+--------------------+---------------------+
| **Pandemic Phases**      | **Public Health    | **Seattle Public    |
|                          | Goals**            | Schools Goals**     |
+--------------------------+--------------------+---------------------+
| Interpandemic Period     | Strengthen         | Ensure that staff   |
|                          | influenza pandemic | members and         |
| ***Phase 1*** -- No new  | preparedness at    | students are        |
| influenza virus subtypes | all levels.        | trained in          |
| detected in humans. An   | Closely monitor    | preventative        |
| influenza virus subtype  | human and animal   | measures such as    |
| that has caused human    | surveillance data. | respiratory         |
| infection may be present |                    | etiquette and       |
| in animals. If present   | Minimize the risk  | universal           |
| in animals, the risk of  | of transmission to | precautions.        |
| human infection or       | humans; detect and |                     |
| disease is considered    | report such        | Minimize the risk   |
| low.                     | transmission       | of transmission to  |
|                          | rapidly if it      | humans; ensure that |
| ***Phase 2*** -- No new  | occurs.            | staff members       |
| influenza virus subtypes |                    | understand          |
| detected in humans.      |                    | detection and       |
| However, a circulating   |                    | reporting           |
| animal influenza virus   |                    | guidelines and      |
| subtype poses            |                    | report rapidly as   |
| substantial risk of      |                    | required.           |
| human disease.           |                    |                     |
+--------------------------+--------------------+---------------------+
| Pandemic Alert Period    | Ensure rapid       | Ensure all          |
|                          | characterization   | personnel are       |
| ***Phase 3*** -- Human   | of the new virus   | knowledgeable about |
| infection(s) are         | subtype and early  | the latest          |
| occurring with a new     | detection,         | epidemiological     |
| subtype, but no          | notification and   | information.        |
| human-to-human spread,   | response to        |                     |
| or at most rare          | additional cases.  | Review and update   |
| instances of spread to a |                    | business continuity |
| close contact.           | Contain the new    | plans per Base      |
|                          | virus within       | Plan.               |
| ***Phase 4*** -- Small   | limited foci or    |                     |
| cluster(s) of human      | delay spread to    | Ensure that best    |
| infection with limited   | gain time to       | practices for       |
| human-to-human           | implement          | infection detection |
| transmission but spread  | preparedness       | and control         |
| is highly localized      | measures,          | measures are        |
| suggesting that the      | including vaccine  | followed.           |
| virus is not well        | development.       |                     |
| adapted to humans.       |                    | Ensure adequate     |
|                          | Maximize efforts   | resources for       |
| ***Phase 5*** -- Larger  | to contain or      | staff/student       |
| cluster(s) of human      | delay spread to    | protection.         |
| infection but            | possibly avert a   |                     |
| human-to-human spread is | pandemic, and to   | Ensure that SPS is  |
| localized, suggesting    | gain time to       | implementing best   |
| that the virus is        | implement response | practice for social |
| becoming increasingly    | measures.          | distancing          |
| better adapted to        |                    | techniques per LHO  |
| humans, but may not yet  |                    | guidelines,         |
| be fully transmissible   |                    | including reducing  |
| (substantial pandemic    |                    | the school activity |
| risk).                   |                    | calendar.           |
|                          |                    |                     |
|                          |                    | Maximize            |
|                          |                    | communications with |
|                          |                    | parents related to  |
|                          |                    | health and safety.  |
+--------------------------+--------------------+---------------------+
| Pandemic Period          | Implement response | Increase            |
|                          | measures including | surveillance of     |
| ***Phase 6*** --         | social distancing  | staff/student       |
| Pandemic is declared.    | to minimize        | health and          |
| Increased and sustained  | pandemic impacts.  | attendance and      |
| transmission in the      |                    | implement           |
| general population.      |                    | administrative      |
|                          |                    | procedures to       |
|                          |                    | ensure adequate     |
|                          |                    | staffing for        |
|                          |                    | essential business  |
|                          |                    | and school          |
|                          |                    | functions.          |
|                          |                    |                     |
|                          |                    | Follow LHO and EOC, |
|                          |                    | social distancing,  |
|                          |                    | isolation and       |
|                          |                    | quarantine          |
|                          |                    | measures.           |
|                          |                    |                     |
|                          |                    | Ensure maximum      |
|                          |                    | support and         |
|                          |                    | education for ill   |
|                          |                    | and affected        |
|                          |                    | students.           |
+--------------------------+--------------------+---------------------+

###### V. Concept of Operations

A.  **Overview**

    1.  PHSKC will be the lead agency in coordinating the local health
        and medical response to a pandemic with State, Federal, and
        local agencies and officials.

    2.  PHSKC will respond under the auspices of the PHSKC Pandemic
        Influenza plan as well as the Department Emergency Operations
        Plan, Emergency Support Function 8 (Health and Medical Services)
        and the Regional Disaster Plan.

    3.  PHSKC's response actions will emphasize disease surveillance and
        investigation, social distancing measures to reduce the spread
        of infection, and continually informing and educating the public
        about the pandemic, the public health response, and steps the
        public can take to reduce the risks of infection.

    4.  SPS will maintain increased communications with the city's
        Emergency Operation Center (EOC) and the PHSKC and will
        implement those procedures that increase the health and safety
        of the school community.

    5.  The Seattle Public Schools assumes the following
        responsibilities:

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a.  Develop capabilities to implement non-medical measures to decrease
    the spread of disease throughout the school community as guided by
    the epidemiology of the pandemic and the LHO.

b.  Develop and implement pandemic preparedness activities and a
    business continuity plan aimed at maintaining the provision of
    educational services and limiting the spread of disease throughout
    the duration of a pandemic.

c.  Communicate with and educate the school community about approved
    public health practices and what each person can do to prepare or
    respond to minimize health risks.

d.  Develop and implement educational support plans for students who are
    isolated or quarantined and coordinate these plans with the social
    support plans developed by the PHSKC and the EOC.

e.  Develop and implement support plans for Teen Health Clinics
    designated to be used as "immunization clinics" or "flu clinics" to
    triage/evaluate and/or treat influenza patients not requiring
    hospital care.

    1.  Each Seattle Public School assumes the following
        responsibilities:

f.  Develop a response plan that will:

    -   Identify chain of command in case of illness with a minimum of 2
        back ups.

    -   Review and best practices for respiratory hygiene and universal
        precautions. Train all school staff, volunteers and students.
        Identify and procure needed resources.

    -   Review procedures for sending ill individuals home and make
        adjustments if necessary.

    -   Report the number of staff and students daily absent with
        pandemic flu to the PHSKC and Incident Commander.

    -   Document actions taken.

    -   Update staff and provide information on extent of infection at
        school site and potential changes that might take place at
        school.

g.  Develop a recovery plan that provides for education support and
    emotional support for staff and students. If there is loss of life,
    implement procedures located in the Quick Reference Guide.

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B.  **Direction and Control**

    1.  PHSKC and all response partners will operate under the Incident
        Command System throughout the duration of the pandemic response
        as outlined in the SPSEMP.

    2.  PHSKC may activate the Public Health Emergency Operations Center
        (PHEOC) to coordinate the county-wide public health and medical
        response during a pandemic.

    3.  The City of Seattle and SPS may activate their EOCs during a
        pandemic to coordinate consequence response.

    4.  During Pandemic Phases 1, 2 and 3 where King County is not
        directly affected, PHSKC will lead countywide preparedness and
        education efforts for pandemic response.

    5.  During Pandemic Phases 4, 5 and 6 PHSKC will communicate with
        health system partners through the Health Care Coalition to
        coordinate and manage health care system resources and
        information.

    6.  PHSKC will assess the viability of community containment options
        and establish criteria for recommending their implementation to
        local elected officials.

    7.  Upon reaching Pandemic Phase 4 (if local area is not affected;
        Phase 3 if local area is affected)

        a.  PHSKC will provide regular briefings to the King County
            Executive, the Mayor of Seattle, other local elected
            officials, and regional response partners. Briefings will
            address the nature of the disease, its communicability and
            virulence, availability of vaccines and antivirals, actions
            that are being taken to minimize the impact, and health
            information being shared with the public and health care
            providers.

        b.  SPS will attend PHSKC briefings and provide information to
            staff and students. SPS will take appropriate measures
            including social distancing and increased respiratory
            hygiene in order to reduce transmission.

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C.  **Communications**

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1.  Communications with the public and health care providers will be one
    of the most critical strategies for containing the spread of the
    influenza and for managing the utilization of health care services.
    This plan's communications goals are to:

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a.  Provide accurate, consistent, and comprehensive information about
    pandemic influenza including case definitions, treatment options,
    infection control measures, and reporting requirements.

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a.  Instill and maintain public confidence in the schools and the
    County's public health care systems and their ability to respond to
    and manage an influenza pandemic.

b.  Ensure an efficient mechanism for managing information between
    PHSKC, health system partners and the schools.

c.  Contribute to maintaining order, minimizing public panic and fear,
    and facilitating public compliance by providing accurate, rapid, and
    complete information.

d.  Address rumors, inaccuracies, and misperceptions as quickly as
    possible, and prevent the stigmatization of affected groups.

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2.  Communications During Pandemic Phases 1, 2, 3

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a.  The PHSKC Communicable Disease, Preparedness and Community Based
    Public Health Practice Sections will educate providers, public
    officials, schools and emergency responders about influenza
    pandemics and steps they should take to plan for pandemic outbreaks.

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a.  Under the direction of the Chief Academic Officer, the central
    administration will assess the needs of the schools.

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i.  Assess the information needs of the school community.

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i.  Intensify public education efforts about influenza pandemics and
    steps that can be taken to reduce exposure to infection. Information
    may be disseminated via web site postings, parent letters, or school
    newsletters, television and radio broadcasts.

ii. SPS will identify hard to reach families and ensure communications
    in the home language.

iii. Coordinate with PHSKC to develop common health messages and
     education materials in multiple languages. Coordinate with PHSKC to
     ensure that bilingual staff can serve as information conduits to
     vulnerable school families and build sustainable preparedness
     capabilities.

iv. Develop template pandemic informational letters, including
    translations, for parents/guardians.

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3.  Communications During Phases 4, 5, 6

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a.  PHSKC Public Information Officer (PIO) will evaluate the need to
    establish a Joint Information Center (JIC) in conjunction with
    appropriate health system and response partners. A JIC will be
    activated when the PHSKC PIO deems it necessary based on specific
    characteristics of the pandemic. If school closures are considered,
    the SPS PIO will work with the JIC.

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a.  The PHSKC PIO will develop a communications strategy including
    identifying appropriate community partners for reaching and
    educating diverse communities such as limited English speaking and
    homeless students and their families. SPS will assist in
    translations for the school community.

b.  As the pandemic expands, the PHSKC PIO will provide daily updates on
    the pandemic and will organize regular media briefings.

c.  The PHSKC PIO will keep the public informed about steps that should
    be taken to protect against infection, treatment options for
    individuals who are infected, the status of the spread of the
    outbreak in the community, and the disease control and containment
    strategies that are being implemented.

d.  The SPS PIO will evaluate the need to establish a school information
    call center to respond to public inquiries. The SPS PIO will
    disseminate web alerts per JIC guidelines and as necessary. Pandemic
    letters will be sent out to parent/guardians per JIC and SPS
    communication strategy.

#### 

D.  **Mitigation**

> Mitigation activities are taken in advance of an influenza pandemic to
> prevent or temper its impact. Mitigation efforts will occur primarily
> during the early pandemic phases (Phases 1-3).
>
> The SPS pre-event mitigation activities include:

1.  Planning, exercising, evaluating and revising the Pandemic Influenza
    Management Plan.

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1.  Training and equipping SPS staff to assure competencies and
    capacities needed to respond to a pandemic outbreak.

2.  Developing strategic partnerships with local community health care
    institutions and providers, and local, state and federal response
    agencies and their staff.

3.  Educating schools and parents about an influenza pandemic and
    recommend preparedness measures.

4.  Informing and updating schools about the potential impacts of an
    influenza pandemic on essential services and city, county, and
    school infrastructure. Reviewing and updating district-wide business
    continuity plans and assuring essential business functions are
    adequately staffed per Base Plan.

5.  Stockpiling necessary equipment and supplies that will be needed to
    respond to an influenza pandemic.

6.  Establish ventilation (HVAC) standards to be used during each phase
    of the pandemic.

######## Surveillance

### The Influenza Surveillance Program by Public Health - Seattle & King County provides information on influenza activity in King County for health care providers and the public. Because influenza is not a mandated notifiable disease under the Washington Administrative Code, PHKSC uses several methods to understand when influenza has arrived, is most active, and subsides in our community. One method is the sentinel reporting system. The Public Health Department has identified schools as sentinel reporters and monitors school absenteeism. All schools within King County are asked to report absenteeism of 10% or more of the school population each week from approximately November through April on a voluntary basis. School absenteeism in the winter months generally correlates with the level of influenza in the community. Further, SPS will electronically send daily aggregate attendance data to the SKCPHD Epidemiology Department to analyze trends that might augment the data from the sentinel reporting system.

### During a pandemic flu response, the Disease Control Officer in the Communicable Disease Section may declare the circulating strain of influenza causing the pandemic a Disease of Public Health Significance, requiring health care providers, schools, and labs to report patients meeting a case definition. 

### Surveillance During Pandemic Phases 1, 2, 3

a.  The Communicable Disease Section will maintain daily influenza
    tracking activities \[reports regarding school absenteeism,
    pneumonia and influenza deaths submitted by Vital Statistics,
    nursing home reports and sentinel providers\]. []{.mark}

b.  As a sentinel reporter, each school will report attendance data when
    student absentee rates rise above 10% for one week during the months
    of November-April. The report should be sent to the PHSKC per
    current standards and a secondary report sent to the SPS Incident
    Commander.

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1.  Surveillance During Pandemic Phases 4, 5, 6

    a.  As a sentinel reporter, each school will closely monitor and
        report attendance and data trends when student absentee rates
        rise above 10%. During these phases, daily reports will be sent
        to the Chief Academic Officer.

    b.  The SPS Human Resources Department will activate tracking of
        absenteeism for school and central staff and report trends to
        the SPS Incident Commander. This data will be used to identify
        staffing needs and inform school closure discussions.

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    a.  The PHSKC will collaborate with SPS to identify essential
        personnel to be included in priority groups for vaccinations.

######## Vaccine Management 

a.  In consultation with Washington State DOH, the Communicable Disease
    Section will finalize recommendations to the Local Health Officer
    regarding priority groups to receive vaccination based on CDC
    guidelines.

b.  The PHSKC will finalize mass vaccination plans with regional
    partners, including schools.

##### 

##### G. Social Distancing Strategies

## Social distancing strategies are non-medical measures intended to reduce the spread of disease from person-to-person by discouraging or preventing people from coming in close contact with each other. These strategies could include closing schools; closing non-essential agency functions; implementing emergency staffing plans; to increase telecommuting, flex scheduling and other options; and closing all public assemblies or after school activities.

## PHSKC Director will review social distancing strategies and current epidemiological data during each phase and recommend to key elected officials, including the King County Executive, the Mayor of Seattle, suburban city Mayors and superintendents of public school districts social distancing actions that should be implemented to limit the spread of the disease.

## Decisions regarding the closing of all public and private schools, community colleges and universities in King County will be made by the Local Health Officer after consultation with local school superintendents, school presidents and elected officials. 

## Decisions regarding the implementation of social distancing measures including suspending large public gatherings and closing stadiums, theaters, churches, community centers, and other facilities where large numbers of people gather will be made jointly and concurrently by the Local Health Officer and the King County Executive and coordinated with all executive heads of cities and towns in King County. 

## Social Distancing Strategies During Phases 1, 2, 3

## The PHSKC will

## educate elected officials, government leaders, school officials, response partners, businesses, the media and the public about influenza pandemics and their consequences.

## coordinate with elected officials, government leaders, school officials, response partners, and businesses regarding the use of using social distancing strategies, the associated impacts they cause and the process for implementing these measures.

## 

## confirm the decision making process and criteria for recommending social distancing strategies with key public officials.

## SPS schools will

## 

## increase respiratory hygiene education for staff, students and parents.

## increase symptom monitoring and attendance 

##  monitoring to ensure accurate reporting to PHSKC.

##  Social Distancing Strategies During Phases 4, 5, 6

## PHSKC will 

## 

## The Local Health Officer will coordinate with elected officials regarding decision making and implementation of social distancing strategies that are commensurate with the severity of illness and societal impact of the pandemic.

## Implement specific, county-wide social distancing strategies that may include

## 

## Encourage government agencies and the private sector to implement pandemic emergency staffing plans to maintain critical business functions while maximizing the use of telecommuting, flex schedules, and alternate work site options.

## Encourage the public to use public transit only for essential travel; therefore transportation to schools may be interrupted.

## Advise King County residents to defer non-essential travel to areas of the world affected by pandemic influenza outbreaks.

## Suspend all public events where large numbers of people congregate including sporting events, concerts, and parades.

## Close all public and private schools and colleges. 

## Suspend all government functions not dedicated to addressing the impacts of the pandemic or maintaining critical continuity functions.

## 

## Monitor the effectiveness of social distancing strategies in controlling the spread of disease and will advise appropriate decision-makers when social distancing strategies should be relaxed or ended.

## SPS schools will

## Follow LHO guidelines as appropriate including following 

## social distancing guidelines and emergency pandemic staffing plans.

## 

##  Cancel extracurricular activities or close schools as directed by LHO.

### H. Isolation and Quarantine 

1.  Isolation and Quarantine

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a.  The PHSKC will

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i)  coordinate planning efforts for isolation and quarantine with State
    DOH, neighboring county health departments, community based
    organizations, SPS, and local law enforcement.

ii) follow CDC guidelines in developing isolation and quarantine
    procedures for individuals traveling from areas in which a novel
    influenza virus is present.

####  [VI. Maintenance of Essential Services]{.smallcaps}

1.  One of the critical needs during a flu pandemic will be to maintain
    essential community and business services.

    a.  With the possibility that 25-35% of the workforce could be
        absent due to illness, it may be difficult to maintain adequate
        staffing for certain critical functions.

    b.  There is the possibility that services could be disrupted if
        significant numbers of public health, law enforcement, fire and
        emergency response, medical care, transportation,
        communications, and public utility personnel are unable to carry
        out critical functions due to illness. Individual SPS schools or
        the entire district may be adversely disrupted.

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1.  SPS will update and maintain continuity of operations plans and
    protocols that address the unique consequences of a pandemic.

2.  SPS will follow best practice guidelines for return to work after an
    influenza illness. Current recommendations are based upon seasonal
    influenza recommendations. Because experts do not know whether the
    mode of transmission, incubation period, or contagious period of
    pandemic strains of the influenza virus will be similar to those of
    seasonal influenza (recurring yearly), SPS will update and follow
    specific recommendations from the SKCPHD during a pandemic) Current
    influenza recommendations include employees/volunteers who have
    become ill with influenza should stay at home until all of the
    following criteria are met

-   At least 5 days have passed since the symptoms of illness began; AND

-   Fever has resolved and has not been present for at least 24 hours;
    AND

-   Cough is improving (decreasing in frequency and amount of secretions
    with no associated chest discomfort or shortness of breath)

> Upon returning to the work environment, employees should continue to
> follow cough etiquette and hand washing protocols.

3.  The SPSEMP- Base Plan will be updated and maintained. The Base Plan
    includes a continuity of operations and business recovery plans
    detailing

    a.  Line of Succession

    b.  Identification of mission essential services and priorities.

    c.  Continuity of operations and business recovery plans, including

        -   Business Impact Analysis

        -   Critical "daily" functions that need to be provided even
            during an event, although at a reduced level

        -   Standard Operating Procedures for critical
            functions/processes including clearly documented protocols
            for adjusting staffing to maintain essential functions

        -   Human Resource policies including

            1.  Staff policies for personal illness or care of family

            2.  Policies for flexible work hours and working from home.

            3.  Procedures for the reassignment of employees to support
                mission essential services.

4.  Maintenance of Essential Services During Phases 1, 2, 3

    a.  The Seattle Public Schools will work with the PHSKC and the EOC
        to update plans for maintaining essential departmental services
        during a pandemic.

    b.  In conjunction with the PHSKC, the District will educate central
        administration and the school community that provide essential
        services about the need for continuity of operations planning in
        advance of a pandemic.

5.  Maintenance of Essential Services During Phases 4, 5, 6

    a.  The Seattle Public Schools will update its continuity of
        operations plans and will request that its schools update their
        plans.

    b.  The SPS Incident Commander, in conjunction with the PHKSC, will
        determine the appropriate time to implement the continuity of
        operations plans and protocols.

#### [Recovery]{.smallcaps}

1.  School recovery from an influenza pandemic will begin when school
    officials determine that normal supplies, resources and response
    systems can manage ongoing school activities.

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1.  The Seattle Public School will assess the economic and educational
    impact of the pandemic.

2.  Recovery plans will depend on the severity and duration of the
    pandemic but will include business recovery plans to mitigate
    education and financial losses, as well as emotional recovery plans
    as outlined in the Base Plan.

3.  In consultation with the PHSKC and SPS will recommend specific
    actions to be taken to return schools and district offices to
    pre-event status including environmental sanitation.

4.  The SPS Safety and Security Department will conduct an after-action
    evaluation of the pandemic response. The evaluation will include
    recommendations for amendments to the SPSEMP including the Pandemic
    Influenza Management Plan.