# Presentation: 512731

## Infectious Disease Planning: Incorporating Pandemic Planning into School Crisis Plans Emergency Management for Schools TrainingSanta Monica, California September 26, 2006

**Dana Carr**
- Program Specialist, Office of Safe and Drug-Free Schools

## Why Address Pandemic Influenza?

- Is a unique crisis situation, different than other emergencies
- Has potential to cause serious social disruption
- Is part of continuum of emergency management planning

## Seasonal Influenza

- Serious public health problem
- 36,000 deaths in the US per year
- 120,000-200,000 hospitalizations per year
- Usually poses respiratory symptoms
- "Flu season" typically lasts from November-March in the US
- "Flu shots" help protect against circulating influenza viruses predicted for each particular flu season

## What is a Pandemic?

- New strain of influenza virus
- Universal susceptibility
- Affects large portion of the world and population
- Unpredictable

## Historic Pandemics

**1918**: Spanish Flu (~50 million deaths worldwide, 500,000-675,000 in the US)
**1957**: Asian Flu (1-2 million deaths worldwide, 70,000 in the US)
**1968-69**: Hong Kong Flu (700,000 deaths worldwide, 34,000 in the US)
**??**  Scientists believe that it is a matter of time before the next pandemic (when, not if)

## Potential Cause of Pandemic: H5N1?

- Scientists are watching H5N1 carefully
- Spreads quickly in bird population
- Has existed in current form for many years
- Has high fatality rate (about 50%) and ability to cause serious disease in humans
- Strain is similar (and maybe identical) to the virus that caused the 1918 pandemic
- Has the potential to shift in a way that makes it easier to spread between people

## Potential Source of Spread

## Confirmed Cases of H5N1 as of July, 2006

- Source: _[www.pandemicflu.gov](http://www.pandemicflu.gov/)__, accessed September 15, 2006_

## However...

- There is no sustained human-to-human transmission
- Those who have gotten sick have had direct contact with infected birds
- H5N1 is a concern but may or may not cause the next pandemic
**There is no influenza pandemic at this time**

## Planning Assumptions

- Worst case scenario assumed:1918-like pandemic, little preparation
- Spread will likely be rapid and unpredictable
- Each wave of the virus may affect a community for 6-8 weeks at a time
- Absentee rates may be as high as 40%
- 20% of adults will be sick (40% of children)
- Some will stay home as a protective step
- Others will need to tend to children or sick family members

## Challenges Unique to an Influenza Pandemic

- Will cause a major social disruption
- Will affect multiple locations simultaneously so resources will not be able to be shifted geographically
- Will overwhelm the health care sector
- Health care facilities
- Medical staff
- Will not be enough vaccine or anti-viral medication for the entire population

## Pandemic Challenges, continued

- May have more advance warning than other emergencies so will need to be careful with communication messages (share vs. scare)

## Implications for Schools

- Children expected to have high rates of infection
- Schools may face closures or release of students
- Policy and logistical challenges
- School feeding
- Continuation of learning
- Need for comprehensive approach
- Schools may be used as emergency facilities

## Government's Response

- Federal Government
- National Strategy (November 2005)
- Implementation Plan (May 2006)
- Additional sector-specific guidance (Forthcoming)
- Department of Education's Pandemic Influenza Plan
- State Governments (_[www.pandemicflu.gov](http://www.pandemicflu.gov/)__) _

## Local Government's Response

- Local planning efforts will be key
- Local authorities will have significant responsibility for response
- Collaboration is paramount

## Schools Can Start Planning Now...Prevention-Mitigation

**Identify and talk** to a contact in your local health department
**Identify** other key stakeholders, such as school nurses
**Identify** legal authorities for school closures and delegations of authority

## Prevention-Mitigation, Continued

- Review **management and other policies** and identify gaps
- Business Continuity Plans
- Incident Command Structure
- Succession Plans
**Educate** staff, parents, and students
- Good health and hygiene habits (i.e. flu shots, effective hand washing, covering coughs and sneezes, etc.)
- Risks of infectious disease and prevention

## Schools Can Start Planning Now...Preparedness

- Generate and review **communication** plans
- Consider need for messages to different audiences
- Identify and trusted spokesperson, such as Public Information Officer
- Need for clear messages to help assuage fears
- Evaluate **supply policies** and order supplies if needed (i.e. tissues, soap, alcohol gel, etc.)
**Train** teachers and staff on the risks and implications of a pandemic, as well as on contingency plans

## Preparedness, Continued

- Create a **surveillance** system to help track student and staff absences
- Consider different mechanisms for delivering **educational content** if schools are closed for extended period of time
**Test** your plan and conduct tabletop exercises that include a pandemic influenza situation

## Schools Can Start Planning Now...Response

**Activate** your ICS
**Communicate** with teachers, staff, and parents
- Messages MUST be clear, accurate, and honest
**Track** absences in collaboration with local health department

## Response, Continued

- Promote **infection control **measures among and between students and staff
- Make **necessary changes **through the process

## Schools Can Start Planning Now...Recovery

- Assess the physical AND mental **health** needs of students and staff
- Ongoing health assessments and referrals (if necessary)
- Provide materials on grieving, loss, maybe PTSD
- Ensure support for staff, such as through an Employee Assistance Program (EAP)
- Ensure appropriate **environmental remediation **of school facility if school was used as health care site or if there were sick children in school building

## Recovery, Continued

**Assess** ongoing policies and practices, including regular "debriefing"
- Return to **learning** environment

## Additional Resources

- Federal government's pandemic influenza website: _[www.pandemicflu.gov](http://www.pandemicflu.gov/)_
- Centers for Disease Control and Prevention: _[www.cdc.gov](http://www.cdc.gov/)__ _
- Department of Homeland Security: _[www.dhs.gov](http://www.dhs.gov/)__ _
- World Health Organization: _[www.who.int](http://www.who.int/)_
- Association of Sate and Territorial Health Officials: _[www.astho.org](http://www.astho.org/)__ _

## Frequently Asked Questions

- Can I still eat chicken?
- What does "effective hand washing" mean?
- Should I use antibacterial products?
- How will I know if I have the virus?
- What can I do to prepare myself and family?
- Can and should I buy Tamiflu today?

## Contact Information

- Dana Carr
- (202) 260-0823
- _[Dana.Carr@ed.gov](mailto:Dana.Carr@ed.gov)__ _