Prepare to Care Pandemic Planning at Fraser Health Pandemic - PowerPoint PPT Presentation

Prepare to Care Pandemic Planning at Fraser Health Pandemic Influenza Planning December 10, 2009 Facilitator: Lisa Zetes-Zanatta 7

Pr Prepare to Ca Care: Introductions  FHA Pandemic Lady – Lisa Zetes-Zanatta  Roundtable introductions  Name  Service 8 8

What is the flu anyway?? 9 9

Influenza Virus  Influenza A is subtyped by surface proteins  Hemagglutinin (H)  16 different types  Helps virus enter cells  Neuraminidase (N)  9 different types  Helps virus leave cell to infect others 10 10

Influenza Virus Types  Type A : Infects humans and other animals  More severe illness  Causes regular epidemics; can cause pandemics  Type B : Infectious only to humans  Causes epidemics, but less severe illness 11 11

Influenza Prevention  Yearly influenza shot  Avoid those who are ill  Wash your hands  Antivirals (in special circumstances) If you are ill--don’t come to work, cover coughs and sneezes. 12 12

Vaccine Development Inactivated trivalent vaccine (killed vaccine)  2 A, 1 B  Effectiveness of vaccine depends on “match” between circulating  strains and those in vaccine A/New Caledonia/20/99-like A/California/7/2004-like (H1N1) (H3N2) Influenza Protection B/Shanghai/361/2002-like 13 13

Surveillance on Surveillance on circulating strains circulating strains Selection of Selection of specific strains specific strains Preparation Preparation and distribution and distribution of virus stock to of virus stock to manufacturers manufacturers Seed pools Seed pools inoculated into inoculated into eggs eggs 14 14

May Harvest and concentration of fluids June July Vaccine inactivated and purified August Vaccine blended, content verified September Packaging, labeling, delivery October 15 15

Influenza Pandemic  What is a Pandemic?  Outbreak in wide geographic area (global)  Effects large # of people with serious illness  Usually a new virus or one which population has not had exposure in a long time  May have rapid spread  May occur in waves 16 16

Seasonal VS Pandemic Influenza  Pandemic  Seasonal  Occurs infrequently  Occurs every year (3 per century)  Occurs during winter  Occurs any time of (usually Dec-Mar) year  Most recover in 1-2  Some may not weeks without tx recover, even with  Very young, very tx old, ill most at risk  People of all ages of serious illness may be at risk 17 17

Recent Pandemics  Past Pandemics:  1968 Hong Kong Flu (H3N2)  1957 Asian Flu (H2N2)  1918 Spanish Flu (H1N1) 18 18

1918 Pandemic  Worst of past century  Estimated 20-40% of world population ill  40-50 million people died worldwide  600,000 or more deaths in US  High mortality in young adults 19 19

There are severe pandemics and mild pandemics 20 20

Infectious Disease Deaths 1900-1996 21 21

H1N1 Human Swine Virus  Swine influenza is caused by type A of the virus  Transmission can be found through contact with infected pigs and more recently through human to human contact.  This virus began human to human transmission in March and Early April in Mexico. By late April the spread of the novel strain was worldwide.  This virus is a novel subtype not previously detected in swine or humans 22 22

Are we more or less at risk today compared to 1918? 23 23

Pandemic Planning – Why Plan  Closing of borders, shutting down trade  Closing of schools, events, and businesses where large numbers of people congregate  Supply Chain disruption  Health Surges to point of total congestion 24 24

Pr Prepare to Ca Care: Ongoing Pandemic Threat: 2008/09 Update  As of December 8, 2009: o 1001 hospitalized human H1N1 cases, 47 deaths o Approx. 90% of cases under 40 years old o Lull in H1N1 activity over summer, however presence of virus did not disappear like the routine influenza virus 25 25

Pr Prepare to Ca Care: Anticipated Impacts – Acute Care Sites and Community Programs  System to be extremely taxed  Current service delivery levels will not be available  Sites and programs will defer a number of activities on a priority basis  Assessment centres and alternative care sites to operate  Interoperability btw. acute & cmty programs will be essential 26 26

Supply Issues Discussion  Syringes  Surgical Masks / Visors  Laundry  N95’s 27 27

Pr Prepare to Ca Care: Q & A Period Lisa: lisa.zeteszanatta@fraserhealth.ca 28 28

Pandemic ic Tabletop Exerc rcis ise November 19, 2009

Organizational Background Business Continuity and Emergency Management are prescribed by Government mandate to the LDB There has been a Pandemic Plan in place at the LDB since October 2008 The LDB has been proactive with other types / levels of emergency management exercises before Recently two pandemic scenarios were part of the LDB’s Emergency Operations Centre (EOC) exercise Pandemic Tabletop Exercise

Approach to this Presentation Follow the “natural phases” of the exercise Explain lessons learned Field questions – interactive Pandemic Tabletop Exercise

Preparing the Exercise Refresh the Pandemic Plans (+ “lessons learned” from 1st) “Selling” the exercise to the organization (2 nd exercise was requested) Deciding on the exercise format Preparing a good scenario Have a knowledgable facilitator Pandemic Tabletop Exercise

Kicking off the Exercise Have enough time (2 nd exercise was full eight hour day) Make sure that the EOC team is complete & prepared Secure undivided attention Explain the purpose and method Introduce the scenario Pandemic Tabletop Exercise

Overcome Hesitation to “Go First” Good scenario will have a clear “first actor” Use direct questions to facilitate Simulate information flow Avoid speculation / reduce discussion – follow procedure (TOUGH!) Pandemic Tabletop Exercise

In the thick of the scenario Keep the communication channels open Gating criteria / triggers for decision making Emergency Team members may be missing Where is your workforce? External dependencies Use as much visuals in the plan as possible (flow-charts / diagrams) It can be overwhelming! Pandemic Tabletop Exercise

Wind-down Gauge understanding of “De-escalation” and “Stand-down” Solicit input on what would represent a “Normalization” of the situation Solicit input on “What have we learned today?” (evaluation) Pandemic Tabletop Exercise

Capture it all Transfer the scribed notes into electronic format if necessary Facilitator to review scribed notes and prepare “Lessons Learned” document Conduct a de-brief with the exercise team and/or have an “Evaluation Form” to understand how useful the exercise was Pandemic Tabletop Exercise

Evaluation Results EOC EXERCISE EVALUATION SCORECARD (Nov 19, 2009) Evaluation Element Dominant Opinion Status Exactly right 67% 1. Duration Of Exercise Comprehensive and easy to understand 75% 2. Quality of Instructions Realistic 67% 3. Realism of Exercise Above 6 75% 4. Number of Issues Needing Explanations Good 83% 5. Effectiveness of the Scenario Partially 59% 6. Did the EOC Procedures Work Very realistic + Satisfactory 50% + 50% 7. Realism of Environment and Conditions Good + Satisfactory 58% + 42% 8. Overall Rating Pandemic Tabletop Exercise

Top 5 “Lessons Learned” 1. Prepare / publish clear decision making (go / no-go) criteria for EOC activation – speed up activation 2. Clearly spell out the chain of command 3. Clearly assign skill-sets to EOC command structure (NOT seniority or Organizational Hierarchy) 4. Use flow-charts for each EOC section – works better than checklists 5. Simplify EOC forms; clarify sign-off responsibilities Pandemic Tabletop Exercise

Questions? QUESTIONS? Pandemic Tabletop Exercise