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Pandemic Flu Preparedness and Response Plan: Phase 1

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A pandemic is an epidemic which affects the entire world. Influenza pandemics have occurred regularly throughout human history. Is the threat of pandemic flu real? Yes, it is. Will a pandemic be caused by the current circulating strain (H5N1) of avian influenza? There is no way of knowing. Because of the possibility of severe adverse impacts to our community, the Health Department has made preparation for pandemic flu one of its highest priorities.   In October, 2005, Dr Scott Morrow, Health Officer, presented to John Maltbie, County Manager and elected and appointed Department Heads the potential dangers of pandemic flu. As a result of this potential pandemic, and with the support of the County Manager, the Health Department convened a group of representatives from various County Departments and the Hospital Consortium to begin developing a Pandemic Flu Preparedness and Response Plan. Below are the contents of Phase 1 of this Plan. All documents are in PDF format. COVER PAGE EXECUTIVE SUMMARY INTRODUCTION TITLE PAGE SECTION ONE: INTRODUCTION SECTION TWO: CONCEPT OF OPERATIONS SECTION THREE: CONTINUITY OF GOVERNMENT AND BUSINESS SECTION FOUR: SURVEILLANCE SECTION FIVE: LABORATORY DIAGNOSTICS SECTION SIX: HEALTHCARE PLANNING SECTION SEVEN: INFECTION CONTROL STRATEGIES SECTION EIGHT: CLINICAL GUIDELINES AND THE ROLE OF PUBLIC HEALTH SECTION NINE: VACCINE AND ANTIVIRAL DISTRIBUTION AND USE SECTION TEN: COMMUNITY DISEASE AND PREVENTION - LEGAL ASPECTS SECTION ELEVEN: TRAVEL-RELATED RISK OF DISEASE TRANSMISSION SECTION TWELVE: PUBLIC HEALTH COMMUNICATION SECTION THIRTEEN: PSYCHOSOCIAL WORKFORCE SUPPORT SERVICES SECTION FOURTEEN: CORONER'S OFFICE COMPLETE PHASE 1 PLAN IN ONE DOCUMENT (249 PAGES) COVER PAGES AND EXECUTIVE SUMMARY Cover Sheet Executive Summary Introduction Title Page back to top SECTION ONE: INTRODUCTION I. Introduction      Overview      The Need for Planning      Purpose      Pandemic Planning Assumptions      Plan Maintenance      Acknowledgements back to top SECTION TWO: CONCEPT OF OPERATIONS II. Concept of Operations       Rationale      Goals      Overview      Participating Agencies and Response Roles      Planning and Response Phases      Pandemic Phase Matrix back to top SECTION THREE: CONTINUITY OF GOVERNMENT AND BUSINESS III. Continuity of Government and Business      Rationale      Goals      Overview      Specific Communication Strategies back to top SECTION FOUR: SURVEILLANCE IV. Surveillance      Outpatient Surveillance           CMR/AVSS           Nurses’ Database           Sentinel Provider Network/Flu Surveillance           Syndromic Surveillance           Emergency Department Surveillance           ED Census           First Watch      Hospital Surveillance           Hospital/Infection Control Site Visit           CMR/AVSS           ED Census           Nurses’ Database           Syndromic Surveillance      Mortality Surveillance           CMR/AVSS           Nurses’ Database           Pediatric Death Reporting           122 Cities Death Reporting      Community Surveillance           School Absenteeism           Outbreak Reporting           Pharmaceutical/Over-the-Counter Medication Sales           Laboratory Staff Surveillance           Veterinary Surveillance           CD/DCP Unit Communications      Airport-Based Surveillance Appendix 1: Ed Census Appendix 2: First Watch Appendix 3: 122 City Death Reporting Appendix 4: School Absenteeism Appendix 5: National Retail Data Monitor Appendix 6: Veterinary Surveillance back to top SECTION FIVE: LABORATORY DIAGNOSTICS V. Laboratory Diagnostics      Interpandemic and Pandemic Alert Periods           Role of Public Health Laboratory      Pandemic Period           Role of Public Health Laboratory      Rationale      Overview           Laboratory Testing for Novel Influenza Subtypes           Testing for Human Cases of Avian Influenza           Recommendations on Laboratory Testing for Human Cases of Avian Influenza           Testing for Human Influenza Strains with Pandemic Potential      Recommendations for the Pandemic Period      Use of Diagnostic Assays During an Influenza Pandemic           Virus Isolation           RT-PCR Subtyping      Status of San Mateo County Public Health Laboratory Appendix 1: Influenza Diagnostic Assays Appendix 2: Reference Testing Guidelines for Potential Pandemic Strains of Influenza Appendix 3: Laboratory Biosafety Guidelines for Handling and Processing Specimens or Isolates of Novel Influenza Strains Appendix 4: Guidelines for Collecting and Shipping Specimens for Influenza Diagnostics back to top SECTION SIX: HEALTHCARE PLANNING VI. Healthcare Planning      Overview      Essential Hospital Surge Strategies      Alert Levels      Trigger for the Standardized Emergency Management System/National Incident        Management System           Element 1. Staffing — “Umbrella Plan”                Considerations                Strategies           Element 2. Bed Capacity                Considerations                 Strategies           Element 3. Consumable and Durable Supplies                Considerations           Element 4. Continuation of Essential Medical Services back to top SECTION SEVEN: INFECTION CONTROL STRATEGIES VII. Infection Control Strategies back to top SECTION EIGHT: CLINICAL GUIDELINES AND THE ROLE OF PUBLIC HEALTH VIII. Clinical Guidelines and the Role of Public Health      Rationale      Overview      Summary of Public Health Roles           Interpandemic and Pandemic Alert Periods           Pandemic Periods      Clinical Guidelines for the Interpandemic and Pandemic Alert Periods      Clinical Guidelines for the Pandemic Period Appendix 1: Clinical Presentation and Complications to Seasonal Influenza Appendix 2: Clinical Presentation and Complications of Illnesses Associated with Avian Influenza A (H5N1) and Previous Pandemic Influenza Viruses Appendix 3: Guidelines for Management of Community-Acquired Pneumonia, Including Post-Influenza Community-Acquired Pneumonia back to top SECTION NINE: VACCINE AND ANTIVIRAL DISTRIBUTION AND USE IX. Vaccine and Antiviral Distribution and Use      Purpose      Overview      Health Department Organization During Mass Prophylaxis      NETVAC ICS Structure      NETVAC Patient Flow Chart      NETVAC Position Description           Job Action Checklist: Operations Section Chief           Job Action Checklist: NETVAC Zone Director           Job Action Checklist: NETVAC Area Supervisor           Job Action Checklist: NETCVAC Unit Leader           Job Action Checklist: NETVAC Administrative Assistant           Job Action Checklist: Facility Liaison           Job Action Checklist: Mental Health Specialist           Job Action Checklist: NETVAC Logistics Lead           Job Action Checklist: NETVAC Generic Function      Personnel Phone Tree      Physical Requirements and Logistical Considerations      NETVAC Sites           Enteric Go Kit Contents           Respiratory Go Kit Contents           Minimal Clinic Equipment/Supplies           Children’s Antiviral Medication Dosages           Assumptions to Set Up a NETVAC back to top SECTION TEN: COMMUNITY DISEASE AND PREVENTION - LEGAL ASPECTS X. Community Disease Control and Prevention—Legal Aspects      Introduction      General Authority of the Health Officer           Health Officer Defined           Sources of Health Officer Authority           Health Officer Authority to Investigate and Report Disease           Health Officer Authority to Prevent and Control Communicable Disease           Health Officer’s Jurisdictional Territory and Enforcement of Health Officer Orders           Health Officer Powers, Duties and Responsibilities are Circumscribed by Constitutional             Limitations           Health Officer Authority to Declare a Local Emergency      Constitutional Parameters impacting the Authority of the Health Officer           Protecting Public Health is an Exercise of Police Power           Health Officer Actions Must Be Consistent with Constitutional Requirements           Other Constitutional Considerations      Enforcement of Health Officer Authority           The Authority to Enforce Health Officer Orders Derives from the Statutory           Duties and Powers of the Health Officer           Enforcement of Health Officer Orders Must Meet Constitutional Due             Process Requirements           Preliminary Steps to Enforcement           Enforcement Methods in the Event of Non-Compliance with Health Officer Orders           Enforcement of Court Orders           Preparedness Points      Interjurisdictional Coordination and Cooperation           State Department of Health Services           United States Public Health Service           Director of Centers for Disease Control and Prevention           Health Officer Jurisdiction within Federal Enclaves           Law Enforcement           Other Local Jurisdictions           Native American Tribes           University of California Facilities           Preparedness Pointers     Confidentiality of Health Information           The Release of Patient Information is Restricted by Both Federal and California Law           Using Health Information for Public Health Activities           Responding to Public Records Requests      Media Resources and Management           Releasing General Non-Medical Information to the Media           Release of Patient Health Information to the Media           Preparedness Points      Limiting the Movement of Individuals and Groups           Isolation and Quarantine in Non-Tuberculosis Context           Temporary Closures of Public Gatherings           Evacuation           Curfews           Preparedness Points      Involuntary Investigation, Examination, Decontamination, Treatment, and Vaccination           Involuntary Investigation, Examination, and Diagnostic Testing           Involuntary Decontamination, Disinfection, and Treatment           Vaccination and Immunization           Preparedness Points      Inspection, Seizure, Decontamination, Disinfection, and Destruction of Real         and Personal Property           Inspection and Seizure           Decontamination, Disinfection, and Destruction           Owner Compensation      Rationing of Resources           Authority for Health Officers to Order Rationing           Content of Rationing Orders           Preparedness Points      Commandeering           Commandeering Real or personal Property           Authority to Commandeer Real or Personal Property           Content of Commandeering Orders           Preparedness Points      Conscription           Conscription           Authority to Conscript           Preparedness Points      Table of Authorities back to top SECTION ELEVEN: TRAVEL-RELATED RISK OF DISEASE TRANSMISSION XI. Travel-Related Risk of Disease Transmission back to top SECTION TWELVE: PUBLIC HEALTH COMMUNICATION XII. Public Health Communication       Influenza Pandemic Preparedness Activities       Interpandemic and Pandemic Alert Periods       Pandemic Period             Messages and Audience back to top SECTION THIRTEEN: PSYCHOSOCIAL WORKFORCE SUPPORT SERVICES XIII. Psychosocial Workforce Support Services       Rationale      Responsibilities in Workforce Support      Interpandemic and Pandemic Alert Periods           Institutionalizing Psychosocial Support Services           Preparing Workforce Support Materials           Developing Workforce Resilience Programs      Pandemic Period           Delivering Psychosocial Support Services           Services for Families           Implementing Workforce Resilience Programs  Appendix 1: San Mateo County Mental Health Interventions in Flu Pandemic back to top SECTION FOURTEEN: CORONER'S OFFICE XIV. Coroner’s Office      Rationale      Goals      Overview      Mitigation of Surge      Investigation      Storage      Transportation      Equipment      Statistics and Reporting      Safety back to top COMPLETE PLAN IN ONE DOCUMENT View/Download Complete Phase I plan - 249 pages back to top