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As you know, health professionals are concerned the continued spread of H5N1 avian (bird) flu virus across many parts of the world presents a significant threat to human health. Since 2003, more than half the people who contracted the H5N1 virus from contact with infected birds have died. At this time the H5N1 virus has not mutated into a form easily transmitted between people. But the current situation serves as a good reminder to begin planning for a pandemic, because pandemics do happen.
As part of Ohio's pandemic influenza planning efforts, we will publish quarterly newsletters for you, our planning partners. Begininning with the Fall issue, the newsletters will be directed to four key areas: businesses, schools, faith-based and nonprofit community organizations. Each of these areas will be impacted differently in the event of a pandemic. For example, how could a pandemic impact the supply or demand for Ohio products and services and what needs to be done to ensure business continuity? How will community organizations continue to provide critical services in a time of need and shortages? And how can schools help stop the spread of illness without closing their doors? These and many other issues specific to societal roles will be addressed.
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A primer on pandemic influenza
A pandemic is a global disease outbreak. An influenza pandemic occurs when a new influenza virus emerges for which people have little or no immunity. The disease spreads easily from person to person; causes serious illness or death; and can move across the country and around the world in a very short time.
Certain strains of influenza occur annually worldwide and should not be confused with pandemic flu. These “seasonal” viruses cause the high fevers, coughs and chills familiar to all Ohioans, especially between November and mid-March, which is the state’s peak period of seasonal flu activity.
Pandemic influenza is much more serious than seasonal influenza and occurred three times in the last century. Pandemics can occur any time; symptoms may be more severe and complications more frequent. Recent pandemics occurred in 1957-58 and 1968-69 but the most serious was the 1918 Spanish flu pandemic that killed as many as 30 million to 50 million people worldwide. Local, state and federal governments are preparing for the worst-case scenario that would be similar to the 1918 pandemic.
Whether the H5N1 virus or another virus will be the next source of pandemic influenza is unknown. The H5N1 virus will inevitably strike birds in North America, likely entering the continent via one of the transcontinental flyways. While this may cause some alarm for the human population, this eventuality is not a cause to panic. H5N1 is still primarily a bird disease.
History tells us we will eventually have another influenza pandemic. When an influenza pandemic occurs, it is certain our everyday lives will drastically change. These changes may include temporary closing of schools or cancellation of events, disruption of normal services such as electricity and water and some shortages. Planning for an influenza pandemic is similar to preparing for any emergency. Take time to understand your needs and take action to help lessen the impact of an influenza pandemic.
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Exercising Ohio's plan
While medical experts agree a flu pandemic cannot be prevented, planning and training are key to preparing for when one does occur. The Ohio Department of Health (ODH) and its response partners including local health departments, hospitals and other state agencies regularly meet, train and prepare to conduct exercises to test their readiness.
One such recent exercise involved ODH, Indiana State Department of Health, several Ohio local health departments and Ohio Emergency Management Agency. The group participated in a tabletop exercise detailing the initial days of a flu outbreak in the state. A tabletop exercise involves a group of experts discussing the actions they would take as a result of the information they are given during the exercise scenario.
These tabletop exercises are valuable, enabling ODH and its partners to fine-tune details of individual plans and efficiently discover how those plans mesh together.
A more detailed tabletop exercise was held in June when representatives from state agencies, local health departments, businesses and community organizations participated in a planning exercise facilitated by the Naval Postgraduate Academy. Hosted by Governor Bob Taft at the Ohio Emergency Operations Center, the day-long exercise revealed some gaps that need filling, but for the most part revealed a state ahead of others in preparing for a potential influenza pandemic.
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Web site highlights
- Beginning this month, we will highlight planning processes of Ohio partners. Currently we are highlighting The Goodyear Tire and Rubber Company and the American Red Cross of Greater Columbus. Visit http://www.ohiopandemicflu.gov for best practices in local health districts as well.
- In June we added a publication library for all pandemic-related documents created by the State of Ohio. You'll find a link on the bottom of every Web page. Be sure to check out some of the fact sheets and posters. This week we added Ten Things You Need to Know About Pandemic Influenza and Seasonal Flu vs. Pandemic Flu.
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Best Practices - The Goodyear Tire & Rubber Company
In March 2005, Goodyear's manager of global business continuity and fire protection, Mike Janko, listened to a presentation about pandemic influenza at a conference. This spurred a discussion upon his return to corporate headquarters in Akron about what Goodyear would do should the H5N1 virus circulating in Asia spark this century's first pandemic influenza. Company leaders agreed this was an important aspect of business continuity and began planning Goodyear's response to an influenza pandemic.
Goodyear operates more than 100 plants in 29 countries with about 80,000 employees. They employee about 5,000 people in Ohio, from the 3,000 working in their Akron offices and technical center in Summit County to the factories in Marysville and St. Marys to its retail outlets across the state.
Identify Key Players
Goodyear's first step in planning for a pandemic was identifying regional leaders around the world who could assist with messages and goals throughout their region and could identify key players in the planning process. Those key players were provided background materials and planning templates with established timelines and deliverables. They participated in regular conference calls and developed tactical teams in their regions to address all aspects of business continuity in the face of a pandemic.The tactical teams consisted of a key member and an alternate for each functional business role. Within two months of forming a global leadership team, Goodyear had detailed plans for 15 countries in Asia.
Key Elements of Goodyear's Pandemic Flu Plan
1) Communications - Ensure the business has the means to reach associates, customers, suppliers and shareholders and that communications are accurate. Communication channels need to be redundant (e.g., having a process for communicating if telephone lines are inoperable). Another aspect of communication is developing relationships within the community before a pandemic. Regular communications with medical experts and local emergency operations centers is suggested.
2) Medical knowledge - It is essential to address medical preparedness, risk reduction and hygiene practices for associates in the workplace and at home with their families. Goodyear follows World Health Organization and Centers for Disease Control and Prevention advice on social distancing, hand washing and staying home when sick. Goodyear also elected to participate in International SOS, a fee-based service that helps organizations manage the health and safety risks facing their travelers, and follow the International SOS protocols for disinfection. Click here for more information on pandemic preparedness by International SOS.
3) Business resiliency - Strategies to address include ensuring business resiliency models to address both customer needs and supplier raw material sourcing. For Goodyear, each region and facility assessed its operations for responding to a pandemic, identified critical customers and suppliers and established triggers for altering production schedules during a pandemic.
4) Essential functions - Each facility has identified critical functions. For a highly critical function they have focused on critical jobs and tasks and ensured cross training has been provided where redundancy is not yet in place.
Test Your Plans
Once plans were complete, Goodyear's strategy included conducting tabletop exercises to validate the plan and systems. About 170 Goodyear employees from 15 countries participated in a three-hour tabletop exercise to practice implementation of plans for Asia. Shortly afterward, plans from facilities in Africa, Europe and the Middle East faced the same tests.
Goodyear's exercises were facilitated on an Internet meeting space and posed escalating scenarios to the various locations for offline discussion and online report-back. The goal of the exercises was to locate any deficiencies in the response plans and identify other critical incidents that could impact operations, such as volcanoes and earthquakes that threaten some of their plants in Asia. Teams utilize a formal incident command system and have established timelines for correcting plans based on lessons learned in exercises.
Manage Your Plans
The plans for all of Goodyear's tactical teams are centrally coordinated to help facilitate sharing of best practices and ensure the plans do not overlap or conflict with one another. As in any emergency plan, feedback systems should be built in to allow for continuous improvement and updates as situations shift.
"The key is preparation, preparation, preparation," says Janko. "You need to be able to easily answer these questions - What do you do beforehand? How do you address it during the pandemic? Then you have to maintain your focus on recovery, which for a pandemic, could be a long time."
Document Sharing
Read a sample letter to Goodyear's customers and a planning presenation.
Best Practices - American Red Cross of Greater Columbus
Nonprofit and community service organizations assist those in need in many ways. During an influenza pandemic, the need for services will likely outweigh the number of volunteers who may be at home sick or caring for sick family members. That is why preparing for a pandemic is crucial.
Nonprofit and community service organizations should consider how a pandemic could affect their work. Health care professionals and emergency responders are determining answers to these and other questions:
* People may be asked to avoid large gatherings or remain in their homes as a way to slow the spread of disease. How will essential services continue while keeping volunteers and those in need safe?
* Supply chains may break down. Are there goods you can procure in advance to help respond to community needs during an influenza pandemic?
* Hospitals may quickly reach surge capacities. Do your services involve caring for people who may turn to your organization if hospitals overflow?
Public health experts are using the 1918 outbreak of influenza as a worst-case scenario for planning purposes. Planning for a worst-case emergency can help an organization better prepare for any emergency.
Historic Activities of the Red Cross
The Red Cross is well known for its role in emergency services. It urges individuals to prepare for emergency situations; and during a disaster its members and volunteers provide shelter, food and recovery services for victims.
During the 1918 “Spanish flu” pandemic, the Red Cross distributed gowns and masks to families visiting ill soldiers. Soldiers were one of the most affected populations during the 1918 pandemic because the virus spread quickly in the close quarters of military bases.
This excerpt from The Great Influenza by John M. Barry details some of the work of the Red Cross:
The Red Cross did not get government funds or direction, although it was working in close concert with the government. Nor was its charge to care for the public health. Yet, it had already allocated money to fight the epidemic and had begun organizing its own effort to do so-and do so on a massive scale. Its nursing department had already begun mobilizing “Home Defense Nurses.” The Red Cross had divided the country into thirteen divisions, and the nursing committee chief of each one had already been told to find all people with any nursing training. It had already instructed each division to form at least one mobile strike force of nurses to be ready to go to areas most in need. And before anyone within the government sought aid, the War Council of the Red Cross had designated a “contingent fund for the purpose of meeting the present needs in coping with the epidemic of Spanish influenza.”
The Red Cross was in its early years during the 1918 influenza pandemic. Its leaders focused on recruiting nurses and distributing supplies. The organization’s duties have grown greatly since then. The Red Cross is a prime example of an organization that may see an increase in need and a decrease in volunteers during a pandemic. With many scientists warning of the eventuality of another influenza pandemic, the Red Cross is looking at its services in a different way.
Current Planning Process
As during the 1918 pandemic, the Red Cross of Greater Columbus is in the process of identifying funding sources. Determining funding sources ahead of time allows nonprofit organizations to better focus on caring for members of the community during a potential pandemic.
The Red Cross often serves large numbers of people in close quarters by providing shelter during an emergency situation. During a pandemic, people may be urged to avoid large gatherings. The Red Cross is determining alternatives to the mass sheltering used in other emergency situations.
Providing food to victims of disaster is another critical Red Cross service. In a pandemic, bringing people together for meals will not be recommended. The Red Cross is determining the feasibility of house-by-house delivery. It is also considering taking food to distribution points at churches recommended by their partners at Voluntary Organizations Active in Disasters (VOAD).
Distribution locations that can be monitored to keep people a safe distance from one another is another way the Red Cross may distribute needed supplies during a pandemic. The Red Cross recognizes the importance of communicating critical information with state and local health departments.
Planning Partners
The Red Cross of Greater Columbus has begun meeting with many organizations in the community to aid in the planning process. Key partners in this planning process include VOAD, the Columbus Health Department, Franklin County Board of Health, Ohio Department of Health as well as local emergency management agencies.
Call for Community Organization Highlights
If your organization is planning for a potential pandemic and would like to share activities, send submissions to Sara Morman or call her at (614) 644-8562.
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Pandemic Flu Expert Speakers Bureau
On July 20, an infectious disease control consultant for the Ohio Department of Health spoke at the Ohio Municipal League annual meeting and discussed what lawyers need to know and have prepared for a potential pandemic. If you would like to request an influenza pandemic expert to speak at an upcoming statewide meeting, convention or event, send us an e-mail with an overview of your needs. Your local health department is an excellent resource for your planning events as well. Click here for a list of Ohio's local health departments.
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Upcoming Events
- Ohio State Fair 2006, August 2 - 13 : Come visit the Ohio Department of Health booth in the Marketplace to receive your pandemic flu kit. We will be distributing activity cards, coloring calendars and emergency preparedness DVDs as well as other helpful information and materials on pandemic influenza. Of course the Wheel of Health will also be waiting for your spin.
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Last Updated July 24, 2006
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