Pandemic Emergency Toolkit

Are you ready?

Getting Started

All residents have a role in preparing for a public health emergency – like pandemic influenza

The community Tool Kit provides information on how to prepare for public health emergencies.

Getting started

Goals of community Tool Kit: Increase knowledge about pandemic

influenza Provide information on how to prepare

for a pandemic Start discussions how communities can

work to prepare for a pandemic

Agenda

Influenza overview Historical recount of pandemic influenza Future view of a pandemic Individual, Family, and Community

emergency preparedness.

What is Influenza?

Influenza is a respiratory infection caused by the influenza virus

In Canada, the flu season runs from November to April and up to 25% of Canadians may be infected with influenza

Influenza can kill, particularly people who are older and people with other serious medical conditions

The Influenza (Flu) viruses

3 types : A, B, C (mild) A or B cause epidemics almost every

winter 10-20% of people affected, 3 500 deaths Influenza A divided in subtypes : 15

different H subtypes, 9 N subtypes Vaccines : current A sub-types + B strains Animal reservoirs : birds, pigs susceptible

to swine, bird and human influenza viruses

What does Pandemic Mean?

Pandemic: occurring over a wide geographic area and affecting an exceptionally high proportion of the population

By affecting many people, pandemic influenza could well overwhelm health services

In addition, other aspects of society could be affected, simply because of a lack of staff due to illness

How the Flu Virus can change

Two different ways : Antigenic « drift » (A and B) : small

changes in the virus that happen continually over time. This is why we can catch the flu more than one time in a lifetime, why vaccine composition is constantly modified

Antigenic « shift » (A only) : abrupt, major change in the Influenza A viruses. Most people have little or no protection against the new virus.

What happens in a pandemic?

If this new virus (with an H and/or an N component from the avian virus) is able to infect humans AND spread from person to person, an influenza pandemic can occur.

It is possible for the genes of two influenza viruses to mix and create a new virus.

PANDEMIC = everywhere on earth, limited in time.

How does virus get transmitted?

Contact with feces, blood, sputum and tears from infected animals and birds.

History of Pandemic Influenza

Previous pandemics in the 20th century occurred in 1918-19 (“Spanish”), 1957-58 and 1968-69 (“Hong-Kong”)

In 1918-1919, an estimated 30-50,000 Canadians died, part of 20-40 million deaths around the world

While most deaths from influenza occur among the elderly, the highest number of deaths in the 1918-19 epidemic occurred among people aged 20-40

The 1968-1969 pandemic caused less deaths than observed in a “regular” flu season.

The estimated impact of a pandemic in Canada

“Normal” flu season affects 10-20% of people

pandemic influenza could affect 30-50% and be more severe

Between 4.5-10.6 million Canadians infected

Between 11,000-58,000 deaths (vs 160,000 in 1918)

Economic impact $10-24 Billion Heath care system overwhelmed…

Pandemic Planning Components

7 Components of the Pandemic Influenza Plan

Surveillance Public health measures Use of antivirals Vaccination Emergency services Health services Communications

Planning for Influenza

Planning for pandemic influenza involves federal, provincial, territorial and community officials

Planning is dynamic – the plan is not completed and put on a shelf but must be regularly tested (annually before September) and updated in light of new information or interventions to prevent and treat influenza

Pandemic Influenza – How will we know it is coming?

Novel (new) virus likely cause of pandemic Novel/new virus likely to arise in Asia due to

crowded living conditions and people living close to livestock animals (e.g. pigs & chickens)

Surveillance systems detect novel/new viruses

Health Canada supports these activities and receives information from World Health Organization (WHO) and others

Pandemic Influenza – How will we know it is coming?

Estimated lead-time for pandemic strain to reach Canada : 3 months (surveillance)

WHO declares pandemic phases 4, 5, 6…Novel/new virus likely to arise in Asia due to crowded living conditions and people living close to livestock animals (e.g. pigs & chickens)

WHO Pandemic Phases - 2006

The initial reaction :quarantine and isolation

A naturel reaction, but ineffective High contagiousness No acquired immunity High number of infected individuals Potential for discrimination and harm Lose sight of effective components of

pandemic planning to reduce spread

Public Health Measures

Increasing awareness in individuals and communities: personal hygiene, personal protection, avoiding unnecessary personal contacts (educational material)

Infection control measures in health care settings (educational material, supplies)

Infection control measures include immunization, hand hygiene, barrier control (masks, gloves, gowns), patient isolation/accommodation, restriction of visitors, staff, cohorting, environmental cleaning, and education for staff, patients and visitors.

Public Health advisories to reduce congregation : schools, public gatherings… (MOH, Head Nurse, C & C)

Self Care

Pandemic Flu Vaccine

Challenge : mass immunization when vaccine becomes available

Likely to proceed by priority groups Canada self-sufficient and capacity well

maintained Vaccines can be mass-produced,

distributed, and administered

Use of Antivirals

Treatment : documented effectiveness in reducing complications, hospitalizations, and mortality.

Prophylaxis : may have protectective effect against clinical disease or severe disease, dose not prevent infection and antibody development.

Business Continuity

Pandemic influenza could create a general state of emergency

At least 33% absenteeism in workplaces Business continuity : identifying

essential services and contingency measures

Governance continuity : who makes the decisions (at all times) ?

Issues with infrastructures, transportation, food supply, communications, etc.

Health Services

Medical supplies may be inadequate Hospitals and medical clinics may be

overwhelmed. Significant numbers of illness and death

may occur. Significant number of people may not

have anyone to take care of.

Health Services (2)

Self Care Education

Infection control measures

Think about a place for Flu/Alternate Care Centre

Communications

Two key roles in communities (Health Care Workers (HCW) and Chief and Council (C&C)

HCW and C&C will receive information and make decisions and will transmit information to the public and local decision-makers (school principal, other health professionals, Northern store, etc.).

HCW and C&C will report back information to the zone / regional / provincial / national level

Participate

Surveillance activity

Early detection / diagnosis period : ILI surveillance in communities ; identification of pandemic strain

Does your community participate in ILI surveillance?

Participate(School Curriculum)

Public Education – Crucial to integrate ‘Infection Control’ in school curriculum

Goal – To form habits to control spread of infection.

Teaching and Learning Strategies – must be theory and practice base Hand hygiene Coughing precautions Germ education Self Care Environmental Cleanliness – control of

spitting, garbage, body hygiene, homes, school, community

Prepare

Believe that the preparation for an emergency is necessary

Disasters do happen where you live and work Disasters do impact you, your family and your

community You can significantly lessen the impact by being

prepared Plan for all hazards Consider infrastructure disruption (i.e., power outage,

water/sewer treatment, communication, etc.)

Prepare

Community plans

Community planning – addresses the 7 components of the Pandemic Influenza Plan in each community.

The objectives Pandemic plan

1) to reduce the morbidity and mortality by influenza

2) to minimize social disruption

Your Community Plan

Do you know what is in your community plan?

Prepare

Personal responsibility: Create a family communication plan:

Work/school/cell numbers, addresses and e-mail

Meeting place for your family if separated – local/distant

Personal information on all family members

Gather emergency supplies Talk about emergency planning in your

community.

Prepare

Emergency Supplies

Water & food Cash funds

Battery /crank radio Maps

Spare batteries Communication plan

Flash lights Medical histories

ID and credentials Infant needs

Medications Pet needs

First aid kit Copy of legal/financial papers

Etc………

Practice

Self care measures (self isolation, taking measures to self treat until medical intervention is necessary)

Infection control measures

First aid

Are you ready?

In an emergency the best way to ensure the safety your family and your community is to prepare

Websites

The Ontario Pandemic Plan (hard to find on the MOHLTC site) http://www.health.gov.on.ca/english/

providers/program/emu/pan_flu/pan_flu_plan.html

World Health Organization for an international perspective www.who.int

Centers for Disease Control (US, this is science) http://www.cdc.gov/flu/pandemic/

FluWatch : influenza surveillance in Canada http://www.hc-sc.gc.ca/pphb-dgspsp/fluwatch

Thanks !