# Presentation: 212822

## Pan Flu II Tabletop Exercise

- Pandemic Influenza strikes Minnesota
- Federal Executive Board of Minnesota
- October 3, 2006

## Objectives for Today’s Program

- Explore the major consequences of a highly pathogenic pandemic influenza outbreak on your agency/business
- Review your current preparations
- Explore the HR concerns that will affect your agency/business as a result
- Understand the potential outcomes

## Objectives, continued

- Assess your leadership’s role and function
- Explore the impact of the permanent loss of key personnel
- Impact of the employees family concerns on your agency/business
- What long term concerns will follow the pandemic that will challenge your agency/business

## Agenda

- 07:30 – 08:00 	Registration
- 07:15 – 07:30 	Facilitator Meeting
- 08:00 – 08:25 	Session Opening (Auditorium - All)
- 08:35 – 09:00	Scenario I (Groups)
- 09:00 – 09:30	Scenario II (Groups)
- 09:30 – 10:00	Scenario III (Groups)
- 10:00 – 10:30 	Scenario IV (Groups)
- 10:30 – 11:00	Scenario V (Groups)
- 11:00 – 11:30	Scenario VI and VII (Groups)
- 11:30 		Small Group Reporting and Closure 				(Auditorium - All)

## Expectations

- Active engagement to the exercise and each other
- Not all participants in each group will have the same knowledge/experience
- Find out your organization’s current strengths and weaknesses
- Report out findings to large group at conclusion
- _A strict non-attribution clause in effect for all conversations today_

## Scenario I

***Increased Human-To-Human Transmission of H5N1 Influenza in Southeast Asia***
- November 3, 2006
-   The World Health Organization (WHO) reports a strain of avian influenza H5N1.
-   It is allowing easy human-to-human transmission in China.
-   WHO has upgraded the Pandemic Influenza Alert to Phase 4.
-   WHO officials have been working to stem the outbreak.
-   Health workers are administering anti-viral drugs.
-   There are currently no reports of influenza H5N1 cases outside the city where the outbreak began.

## Discussion and Exploration

***Question Set #1***
- Does your agency/business have complete and up-to-date orders of succession and delegation?

## Discussion and Exploration

***Question Set #1***
- Does your agency/business have complete and up-to-date orders of succession and delegation?
- What are the essential functions of your agency/business?

## Discussion and Exploration

***Question Set #1***
- Does your agency/business have complete and up-to-date orders of succession and delegation?
- What are the essential functions of your agency/business?
- Have you identified the corresponding vital records and databases to sustain your essential functions?
- How will they be safeguarded, accessed, and maintained?
- If your agency/business plans to rely on telework during a pandemic, how will you ensure access to important data, and how will you ensure the security of that data?

## Discussion and Exploration

***Question Set #1***
- Does your agency/business have complete and up-to-date orders of succession and delegation?
- What are the essential functions of your agency/business?
- Have you identified the corresponding vital records and databases to sustain your essential functions?
- How will they be safeguarded, accessed, and maintained?
- If your agency/business plans to rely on telework during a pandemic, how will you ensure access to important data, and how will you ensure the security of that data?
- Who are the personnel critical to the performance of your essential functions? Have you trained additional personnel to perform these functions, if necessary?

## Discussion and Exploration

***Question Set #1, continued***
- What are the physical and information systems necessary for the performance of your essential functions? Do these systems required human interaction? If so, how long, if at all, can these systems function without human intervention and maintenance?

## Discussion and Exploration

***Question Set #1, continued***
- What are the physical and information systems necessary for the performance of your essential functions? Do these systems required human interaction? If so, how long, if at all, can these systems function without human intervention and maintenance?
- Who are the supplies and contractors whose services are necessary for the performance of your essential functions? Have you conducted planning sessions to determine actions that will be taken during a pandemic?

## Discussion and Exploration

***Question Set #1, continued***
- What are the physical and information systems necessary for the performance of your essential functions? Do these systems required human interaction? If so, how long, if at all, can these systems function without human intervention and maintenance?
- Who are the supplies and contractors whose services are necessary for the performance of your essential functions? Have you conducted planning sessions to determine actions that will be taken during a pandemic?
- What organizations does your agency/business work closely with? What plans are in place to ensure effective communication and coordination with them during a pandemic?

## Discussion and Exploration

***Question Set #1, continued***
- What are the physical and information systems necessary for the performance of your essential functions? Do these systems required human interaction? If so, how long, if at all, can these systems function without human intervention and maintenance?
- Who are the supplies and contractors whose services are necessary for the performance of your essential functions? Have you conducted planning sessions to determine actions that will be taken during a pandemic?
- What organizations does your agency/business work closely with? What plans are in place to ensure effective communication and coordination with them during a pandemic?
- Does your agency/business have a pandemic coordinator? If so, what are their specific responsibilities?

## Scenario II

***Phase 5 Pandemic Alert Declared***
- December 10, 2006
-   The mutated influenza H5N1 virus is spreading outside the control area in China.
-   Pandemic Influenza Alert raised to Phase 5.
-   Flights from China and Southeast Asia may be limited in the future.
-   Colleges and universities are recommending that students studying in China and Southeast Asia return home immediately.
-   Flights to Southeast Asia have declined steeply.
-   Minnesota and the rest of the U.S. experiencing flu strain A/Wisconsin.
-   CDC issues a statement warning that the annual flu vaccine may not be effective against the A/Wisconsin strain and will not work against H5N1 strain.
-   A pandemic flu vaccine is six months away from distribution.

## Discussion and Exploration

***Question Set #2***
- What critical positions in your agency/business will receive priority prophylaxis anti-viral medications if they become available? If they are not made available, what will be your course of action?

## Discussion and Exploration

***Question Set #2***
- What critical positions in your agency/business will receive priority prophylaxis anti-viral medications if they become available? If they are not made available, what will be your course of action?
- Does your agency/business have a pandemic response plan? If so, what are the triggers which activate your pandemic response plan? What is your concept of operations? What are the procedures involved in activating the response plan?

## Discussion and Exploration

***Question Set #2, continued***
- Does your agency/business have a Pandemic Influenza Communication Plan?
- How will your agency/business ensure that employees have timely and accurate information during a pandemic? Who will be in charge of such communications, and what are the key messages you will send?
- What key messages does your agency/business need to send to the public and what plans are in place to get the word out?
- How will your agency/business help to calm the fears of your employees as it becomes apparent that a pandemic is developing?  What information is necessary to make available?

## Scenario III

***The Pandemic Hits Minnesota***
- January 15, 2007
-   Thousands have contracted pandemic influenza in China.
-   Several hundred deaths reported.
-   St. Paul Regions Hospital and Hennepin County Medical Center are reporting suspected cases of pandemic influenza in young adults.
-   Other North American cities have confirmed cases of the virulent H5N2 strain.
-   Early symptoms make initial diagnosis difficult.
-   There is a 2-3 day period where individuals are most infectious, but do not yet show symptoms.

## Discussion and Exploration

***Question Set #3***
- What policies does your agency/business have in place for reducing the spread of influenza among your employees?

## Discussion and Exploration

***Question Set #3***
- What policies does your agency/business have in place for reducing the spread of influenza among your employees?
- What policies does your agency/business have in place for dealing with employees who come to work while ill, or who become ill while at work?

## Discussion and Exploration

***Question Set #3***
- What policies does your agency/business have in place for reducing the spread of influenza among your employees?
- What policies does your agency/business have in place for dealing with employees who come to work while ill, or who become ill while at work?
- What measures will your agency/business take to protect employees who are required to have frequent contact with the public?

## Discussion and Exploration

***Question Set #3, continued***
- Who will be in charge of keeping track of who among your workforce is ill, is absent, or has died?
- How will your agency/business assist their families who are suffering from illness or grief?
- How will your agency/business assist your transitioning workforce with health, grief, and trauma issues?

## Discussion and Exploration

***Question Set #3, continued***
- Who will be in charge of keeping track of who among your workforce is ill, is absent, or has died?
- How will your agency/business assist their families who are suffering from illness or grief?
- How will your agency/business assist your transitioning workforce with health, grief, and trauma issues?
- What policy is in place to address employees who have exhausted their sick time and/or vacation time?

## Scenario IV – Part 1

***The Virus Spreads Throughout Minnesota***
- February 14, 2007
-   The virus is spreading quickly.
-   People are stocking up on food, batteries, OTC’s, and other supplies leading to a growing shortage.
-   Others have moved to small towns and cabins resulting in cases being reported in these areas.
-   Approximately 200,000 cases of H5N1 in Minnesota, with roughly 4,000 deaths, and additional cases are being diagnosed every day.
-   The virus is attacking seemingly healthy people and especially lethal to those between the ages of 15 and 39.
-   Local hospitals are reporting that 25-35% of their staff is absent.
-   Hospitals do not have enough ventilators and beds, and more and more influenza patients are now being cared for in their homes. There are reports of many such people dying in their homes.

## Scenario IV – Part 2

***The Virus Spreads Throughout Minnesota, continued***
- February 14, 2007
-   The Governor has officially declared a State of Emergency in Minnesota.
-   The National Guard has been activated and are assigned to priority services throughout the state.
-   Medical assistance supplies are available from the Federal Government at this time.
-   U.S. DHS has elevated the Homeland Security Advisory System nationwide to Orange (High Risk of Terrorist Attacks).
-   Schools and daycare facilities have been closed in an attempt to slow the spread of the virus compounding staffing issues for businesses and government agencies.
-   Colleges and universities students without family in the area requiring healthcare overwhelm campus services.
-   Local stores have run very low on food and other essential supplies.

## Discussion and Exploration

***Question Set #4***
- How will your agency/business handle the potential shortage of basic supplies such as batteries, office supplies, and hygiene products?

## Discussion and Exploration

***Question Set #4***
- How will your agency/business handle the potential shortage of basic supplies such as batteries, office supplies, and hygiene products?
- Will your agency/business assist in providing supplies for your employees (e.g. water?)

## Discussion and Exploration

***Question Set #4***
- How will your agency/business handle the potential shortage of basic supplies such as batteries, office supplies, and hygiene products?
- Will your agency/business assist in providing supplies for your employees (e.g. water?)
- What policies does your agency/business have in place for handling the needs of employees with small children, in the event of a closure of schools and daycare centers?

## Discussion and Exploration

***Question Set #4***
- How will your agency/business handle the potential shortage of basic supplies such as batteries, office supplies, and hygiene products?
- Will your agency/business assist in providing supplies for your employees (e.g. water?)
- What policies does your agency/business have in place for handling the needs of employees with small children, in the event of a closure of schools and daycare centers?
- What policies does your agency/business have in place for handling the needs of employees who stay home during a pandemic to care for ill family members?

## Scenario V – Part 1

***The Virus Continues In Minnesota***
- March 18, 2007
-   The H5N1 has spread to all areas of the United States.
-   Virus has spread throughout the US and businesses are experiencing high absenteeism.
-   Public gatherings are discouraged and public transportation is sustained to a basic level; commuting has become difficult.
-   Local gas stations are now beginning to run out of gasoline.
-   Police and fire departments and emergency services are overwhelmed and understaffed and responding to prioritized calls.

## Scenario V – Part 2

***The Virus Continues In Minnesota, continued***
- March 18, 2007
-   Hospitals and pharmacies have run out of antiviral medications and are running low on prescription medications.
-   Federal officials announce a pandemic vaccine may be ready in June.
-   A growing number of deaths are due to serious chronic medical conditions.
-   Periodic interruptions of services have become common.
-   Internet services are no longer reliable.
-   Cemeteries are overwhelmed and experiencing delays; the number of deaths continues to rise.
-   The sudden influx of orphans is putting stress on the Minnesota Department of Human Services.
-   There have been substantial deaths among the elderly.
-   Local charities and volunteers are providing basic supplies to the elderly mental health services to families, first responders and health care workers.

## Discussion and Exploration

***Question Set #5***
- What plans does your agency/business have in place for ensuring the continuation of essential services in the event of interruptions in gas, water, telephone, and electrical services?

## Discussion and Exploration

***Question Set #5***
- What plans does your agency/business have in place for ensuring the continuation of essential services in the event of interruptions in gas, water, telephone, and electrical services?
- If your agency/business plans to rely on telework during the pandemic, how will you respond to a disruption of internet service?

## Discussion and Exploration

***Question Set #5***
- What plans does your agency/business have in place for ensuring the continuation of essential services in the event of interruptions in gas, water, telephone, and electrical services?
- If your agency/business plans to rely on telework during the pandemic, how will you respond to a disruption of internet service?
- What policies does your agency/business have for handling employees who have difficulty getting to work during a pandemic due to their dependence on public transit or carpooling?

## Discussion and Exploration

***Question Set #5, continued***
- If your regular suppliers are unable to deliver services, what plans does your agency/business have in place for procuring those supplies from another source?

## Discussion and Exploration

***Question Set #5, continued***
- If your regular suppliers are unable to deliver services, what plans does your agency/business have in place for procuring those supplies from another source?
- What plans does your agency/business have in place for supporting the mental and emotional health of your employees as the pandemic continues and deaths of friends and family members occur?

## Scenario VI

***First Wave of Pandemic Begins To Wane***
- April 20, 2007
-   Weeks after the initial outbreak, the pandemic is showing signs of waning.
-   Roughly 20,000 Minnesotans have died to date.
-   Shipments of food, gasoline, and other supplies have resumed.
-   Many survivors are well enough to return to work.
-   Government agencies and businesses are starting to assess recovery steps and prepare for the next pandemic wave.
-   Some smaller businesses are finding it difficult to recover from the economic losses.
-   Financial losses have been especially devastating for airlines and for businesses like professional sport teams, theaters, and malls.
-   Schools and daycare facilities have reopened.

## Discussion and Exploration

***Question Set #6***
- What plans does your agency/business have in place for replacing employees who die or who are permanently disabled from pandemic influenza?

## Discussion and Exploration

***Question Set #6***
- What plans does your agency/business have in place for replacing employees who die or who are permanently disabled from pandemic influenza?
- What plans does your agency/business for dealing with the press and the public, regarding your performance during the pandemic?

## Discussion and Exploration

***Question Set #6***
- What plans does your agency/business have in place for replacing employees who die or who are permanently disabled from pandemic influenza?
- What plans does your agency/business for dealing with the press and the public, regarding your performance during the pandemic?
- What steps will your agency/business take to prepare for the next wave of the pandemic?

## Scenario VII - Rhetorical

***Second wave of Pandemic Begins***
- August 26, 2007
-   Several suspected H5N1 cases were reported early last week.
-   More cases have been diagnosed in MN; a similar resurgence appears to be occurring throughout the United States.
-   The highest infection rate is among young adults between 15 and 39.
-   This second wave of the pandemic has so far caused very few deaths but high rates of absenteeism.
-   This milder second wave is still causing high rates of employee absence.
-   A much milder third wave of pandemic is also predicted.
-   The new vaccine should be available, but supplies could be limited.
-   The rates of employee absenteeism for businesses and government agencies will likely be manageable during a third wave, and schools and stores may remain open.
-   It is anticipated that the H5N1 vaccine will be part of the coming winter’s annual influenza vaccine.

## If Time Permits...

***Question Set #7***
- How will your agency/business continue recovery efforts during this second wave of the pandemic?

## End of the Scenario

- Return promptly to the main auditorium for group reports and concluding remarks