# Presentation: 300816

## Pandemic Influenza & The Local Response in Kansas City, Missouri

-  Bonnie Martin
- Emergency Response Planner
- Kansas City, Mo. Health Department

## The Pandemic Influenza Preparedness Plan for Kansas City, Mo.

- A Brief Overview

## The Traditional Planning Methodology

- The majority of Pandemic Influenza Plans throughout the nation utilize the WHO Pandemic Phases (next slide) as indicators of needed planning and response activities.
- The WHO Phases act like a “threat advisory system” similar to the one developed by Department of Homeland Security.

## WHO Pandemic Phases

| Period | Phase | Description |
| --- | --- | --- |
| Interpandemic | 1 | No new influenza virus subtypes. |
|  | 2 | A circulating animal influenza virus subtype poses a substantial risk. |
| Pandemic Alert | 3 | Rare cases of human-to-human infection. |
|  | 4 | Small cluster(s) with limited human-to-human transmission. |
|  | 5 | Larger cluster(s) but human-to-human spread still localized. |
| Pandemic  | 6 | Increased and sustained transmission in the general population. |
| Postpandemic |  | Return to Interpandemic. |

## Currently...

- The WORLD is in:

| Period | Phase | Description |
| --- | --- | --- |
| Pandemic Alert | 3 | Rare cases of human-to-human infection. |

- _Numbers & Statistics for H5N1 (since 2003): _
- Total Human Cases: 	256
- Total Human Deaths: 	151
- Mortality Rate: 		58.5%

## The Key Question

- How does the world being in Phase 3 affect Kansas City, Mo. when there have been _**NO**_ cases of *highly-pathogenic* H5N1 in North, South, and Central America?
- The reality is that it does affect us ***minimally***, but not enough to dictate local planning endeavors.

## The Joint Pandemic Status System (JPSS)

- A two-fold indicator designed to provide focus for local activities in response to a global condition.
- Replicates the WHO Pandemic Phases and localizes their use.
- Kansas City, Mo. Health Department (KCHD) will determine its own Local Pandemic Status and plan accordingly.
- While still acknowledging the WHO Phases.

## The JPSS in Action

**The JPSS in Action**

- Currently the WORLD is in Pandemic Alert Phase 3.
- LOCALLY, Kansas City, Mo. is only in Interpandemic Phase 1.
- _JPSS = LOCAL-1 / WHO-3_
- Once determined, the JPSS dictates which sections of the Plan are activated.

## The Plan for Kansas City, Mo.

- Broken down into 3 sections:
- Plan Overview
- Local Actions
- What KCHD **may** do in response to the Local Pandemic Status.
- Global Actions
- What KCHD **may** do in response to the WHO Pandemic Phase.

## How the Plan will be Activated

- Utilizing the JPSS, only those sections of the Plan will be activated.
- Example:
- JPSS = LOCAL-1 / WHO-3
- KCHD will then activate only Section 2, Phase 1 **and** Section 3, Phase 3.

- Section 2
- Local Actions
- Phase 1

- Section 3
- Global Actions
- Phase 3

## Plan Maintenance

- Periodically, a KCHD committee will determine the Local Pandemic Status based on:
- Information from recognized sources (WHO, CDC, HHS, FAA) as well as local expertise and understanding.
- As the Local Pandemic Status increases to match the WHO Pandemic Status, local actions will also increase.

## Additional Thoughts

- The new structure allows for KCHD to ‘localize’ its planning efforts.
- Only those sections of the plan indicated by the JPSS will be activated at any given time.
- Can be found on the Web at: _[http://](http://www.kcmo.org/health.nsf/web/fluplan)__[www.kcmo.org/health.nsf/web/fluplan](http://www.kcmo.org/health.nsf/web/fluplan)_

## The Local Response: A More In-Depth Look

## Current Actions

- Currently, KCHD is encouraging all residents and planning partners to practice ‘sound’ preparedness measures.  These include:
- Proper Hand/Cough Hygiene
- Getting a Seasonal Flu Shot
- Developing a Business Continuity Plan (addressing Pandemic Influenza)
- Developing a strong relationship with Public Health
- Individual Preparedness – Emergency Kits, etc.

## Current Actions (Cont’d)

- Ways in which the KCHD is encouraging pandemic preparedness:
***Learn to Live***TM Campaign – reaching out to businesses, individuals, and community groups
- Media Placement – Public Service Announcement, Flyers, Posters, etc.
- Newly Launched Website – Influenza Information Gateway: _[http://www.kcmo.org/health.nsf/web/flu](http://www.kcmo.org/health.nsf/web/flu)_

## Possible Local Response Actions During a Pandemic

- Antivirals
- It is foreseeable that antivirals will be limited in availability and *possibly *ineffective.
- KCHD will abide by the Department of Health and Human Services (HHS) established priority schedule for antiviral distribution/dispensing.

## Possible Local Response Actions During a Pandemic

- Vaccine
- Vaccine production is expected to take anywhere from 3 to 6 months once the pandemic has already begun.
- Because of this limited availability, KCHD must abide by the HHS priority schedule for vaccine distribution/dispensing.
- KCHD will activate (as necessary) Points of Dispensing (POD) sites throughout the community to provide the vaccine as it becomes available for mass dispensing.

## Possible Local Response Actions During a Pandemic

- Community-Level Containment
- KCHD may recommend certain community-level containment or social distancing measures to slow the spread of the disease.
- These may include:
- Encouraging residents to stay home from work if sick
- Encouraging businesses to practice telecommuting
- Possibly closing/deterring public gatherings
- Limiting mass transit

## Community-Level Containment

- Closing of Schools
- The decision of whether or not to close schools will no doubt be a complicated one.
- KCHD must consider the outcry of the business community as well.
- Such a decision will also have to be made with a regional focus in mind.

## Public Information Will Be KEY

- Throughout a local response to a pandemic, public information will be vital.
- KCHD will constantly encourage good hygiene and healthy habits.
- Information as to antiviral and vaccine distribution will be disseminated.
- KCHD will be looking to state and federal partners for information as well.

## Challenges To Remember

- Volunteers:
- Currently there are fewer than 200 registered volunteers for the Kansas City Region (Medical Reserve Corps).
- Emergent Volunteers will require training.
- Private Businesses
- Must begin planning **now** to address key questions of liability, insurance coverage, etc.

## Things to Consider

- Work closely with KCHD to ‘iron out’ planning details
- Become part of the ***Learn to Live***TM Campaign
- Consider becoming a CLOSED Dispensing Site for Mass Prophylaxis

## Questions, Comments, or Concerns?

**Thank you for your time and attention.**
- Bonnie Martin
- _[Bonnie_Martin@kcmo.org](mailto:Bonnie_Martin@kcmo.org)__ / 816-513-6130_