# Presentation: 616260

## Using Live Satellite Broadcast to Prepare for Pandemic Influenza 

- Norman Jackson, M.S. and Lisa D. Benton, M.D., M.P.H.
- Bioterrorism Planning and Preparedness Section
- Immunization Branch
- Division of Communicable Disease Control
- (510) 620-7989/3787
- (510) 620-3774(fax)
- njackson@dhs.ca.gov or lbenton@dhs.ca.gov

**Notes:**
Self explanatory

## Disclosures

- The speaker has no financial conflict with the manufacturer of any product named in this presentation
- The use of trade names and commercial sources during this presentation is for identification only, and does not imply endorsement by the Immunization Branch, CDHS, CDC, or any other public, private or commercial entity

## Estimated impact of a future influenza pandemic in the U.S.

- 15-35 % of the U.S. population (~290 million persons will be affected; 5.4-12.7 million in CA)
- Deaths: 89,000- 207,000
- Hospitalizations: 314,000 – 734,000
- Outpatient Visits: 18-34 million
- Additional illnesses: 24-74 million
- Economic Impact: $71.3- $166.5 billion
**Meltzer M, Emerging Inf Dis 1999 5:659-71**

**Notes:**
A pandemic is defined as a new influenza virus that has ability to replicate, spread person to person, and cause disease in humans, and to which there is little or no immunity against it in the population . We are hearing almost daily how devastating a pandemic will be in terms of monetary and societal costs. This study cited here for example, lists...(data on slide)

## Risk Communication and Public Protective Actions during 1918 

- "Wear a Mask and Save Your Life! A Mask is 99% Proof Against Influenza.“
- "Obey the laws, And wear the gauze. Protect your jaws from septic paws."

**Notes:**
We also know from the experience of the last great pandemic influenza of this century in 1918, it was important to reach the public and health care providers with effective messages. 

## Avian H5N1 Influenza

- 12/03-present: human cases in 4 countries
- A greater than 50% mortality
- Variability of reporting outbreaks and containment presents risk communication, education, and training challenges

**Notes:**
We have been hearing of the ongoing spread of avian influenza A H5N1 across Asia, and the concern that it can possibly be carried to the US by migratory birds. We know that it has a greater than 50% mortality rate and that we do not have enough vaccine or anti-viral medication to protect everyone if large numbers of people become infected. It is a race against time as a pandemic is unfolding before our eyes.

## Slide 6

**Notes:**
Today, due to many advances such as globalization and rapid international travel, growing diversity, new occupations, expanding media markets, we have an obvious need to communicate health information and health education quickly and clearly to large audiences.

## Definition of a Pandemic

- Isolation from humans of a novel  influenza A virus
- Little or no immunity in the population
- Demonstrated ability of the virus to replicate and cause disease
- Efficient person-to-person transmission

**Notes:**
An extra slide.

## Slide 8

**Notes:**
In California, because of our need to cover a wide geographic area (rural, suburban, urban), areas bordering neighboring states and countries, and large diverse population, satellite technology allows us to meet all these different needs for training and education. Currently for this broadcast, there are almost 960 satellite downlink sites registered for a registered audience of almost 5000 persons. We are using the live broadcast as an opportunity to test/exercise our ability at CDHS to respond to an emergency in real time.

## Broadcast Content Outline

- Influenza pandemic overview
- National, state & local updates
- How a pandemic unfolds...
- Notification of initial suspected cases
- Surveillance and Laboratory Response
- Medical and non-medical containment
- Risk communication
- Live Q & A segment
- Tabletop Exercise “in a box”

**Notes:**
While the content of our broadcast could be tailored to an advanced audience, we recognized the need to cover the basics. We envisioned launching this satellite training as the first in a series on public health preparedness. We agreed it was important to make the content understandable to front line staff that would have a role in response as well as the technical experts. We hope that we can provide future broadcasts that are more specific—for example a training specifically for laboratory scientists, nurses, etc.

## Learning Objectives

- 1.  Describe how to prevent the spread of
-      influenza to prevent pandemics.
- 2. List two issues related to the availability
-     of pandemic influenza vaccine or anti-
-     virals.
- 3. Identify at least one way that the
-     laboratory is involved in responding to a
-     pandemic influenza emergency.
** **

**Notes:**
We agreed upon learning objectives that a wide audience could appreciate, so that everyone can get a little something out of this. Some counties are further along in their planning but others are just beginning. We kept this in mind when we designed the tabletop in a box to accompany the broadcast.

## Learning Objectives

- 4. Identify at least one non-medical
-     intervention to decrease the spread
-     of a pandemic influenza emergency.
- 5. Explain why it is essential to
-     collaborate with outside agencies
-     during a pandemic influenza
-     emergency.

**Notes:**
Again, the goal is to get people thinking about who needs to come to the table for pandemic planning and emergency response. We’re clearly learning a lot of lessons about this from response to Katrina.

## Broadcast Planning Tips

**Form Committees and Teams**
**Pandemic Influenza Executive Advisory Committee (EAC)**
**Designate subcommittees**
**Identify and coordinate stakeholders**
**Graphics **
**Technical production (satellite tests, etc.)**
**Promotion team**
**Continuing Education**
**Evaluation team- start design early**

**Notes:**
Now, I’d like to summarize some of the tips or actually lessons learned throughout this production process. ( I think the next few slides are self explanatory.)

## Broadcast Planning Tips

**Keep adequate administrative support**
- Follow current events daily
- Logistics (room reservations, meetings, teleconference calls)
- Tracks spending, budgets, schedules
- Meeting minutes, mailings, other communications

## Broadcast Planning Tips

- Outline project goals and objectives
- Update Project timeline frequently
- Identify point persons for communications flow

## Broadcast Planning Tips

- Make bold executive decisions
- Audition, cut, and replace talent as needed but use discretion and diplomacy
- Know what is negotiable and when less is more (e.g. background colors for slides...)
- Acknowledge teamwork and small contributions
- Check in with everyone on the project and persons in the intended audience

**Notes:**
Feel free to share some of your stories as well, since there was something happening almost daily. Emphasize the help that came from the support people (Kerdlyn, Liz)

## Broadcast Planning Tips

- Stay on target
- The only constant is change
- Stay flexible and look for opportunities
- Embrace new technology and ideas
- You should have started earlier than you thought

**Notes:**
In conclusion, you’ll probably have a few more stories.

## Slide 17

**Notes:**
May also want to again give people the contact information. Invite them to view register and view the broadcast and also invite them to participate in the follow up calls, especially if they have interest in doing a broadcast for their state.

## Tabletop Exercise

- The purpose of the 2-hour tabletop exercise is to _practice_ response activities related to an influenza pandemic.
- The ideal participants for this tabletop exercise are staff and managers in: public health, public health laboratories, clinical health care, veterinary medicine, environmental health, public information, public safety, emergency management, and transportation.

## Tabletop Exercise

- Objectives:
- To familiarize LHD staff with their local jurisdiction’s pandemic influenza plan
- To practice 2 of the 10 deliverables that should be included in a pandemic influenza plan.

## Tabletop Deliverables

_**Deliverable #1**_: Draft a Health Advisory intended for your local health department staff on what your county is doing to prepare for pandemic influenza.
_**Deliverable #2**_: Create a Public Information Fact Sheet for one of the activities listed.
_**Deliverable #3**_: Draft possible key messages and use them to draft a press release about pandemic influenza in general *before *a local outbreak has occurred.
_**Deliverable #4**_: Identify agency partners, as well as other stakeholders, who would be involved in two of the listed response activities, and list their respective roles and responsibilities.
_**Deliverable #5**_: List issues to be included in an MOU (Memorandum of Understanding) with one partner agency (on any of the issues listed in Deliverable #4, among others) and then draft a sample MOU.

## Tabletop Deliverables (continued)

_**Deliverable #6**_: Draft possible key messages and use them to draft a press release to alert the public about the first case of pandemic influenza.
_**Deliverable #7**_: Identify agency partners, as well as other stakeholders, who would be involved in two of the listed response activities, and list their respective roles and responsibilities.
_**Deliverable #8**_: Draft the key messages to include in a press release to alert the public about any of the issues listed in Deliverable #7.
_**Deliverable #9**_: Test your organization’s existing emergency response command and communication structure by drawing a schematic of the response structure and information flow, or a call-down tree to activate an emergency response plan.
_**Deliverable #10**_: Draft a checklist, step-by-step plan, or flowchart on the type of communication channels that will be used, how they will be used (e.g., updating Web sites daily), and the populations that the communication channels will reach.

## Acknowledgments

- Chris Chase, MPH
- Everly Mercario, Sc.D., M.S., Ed.M.
- Janet Yuen, MPH
- Elizabeth Han
- Kerdlyn Henry
- CDLHN Staff
- Members of the EAC
- CDHS, Emergency Preparedness Office
- Thank you!!