Category Archives: Pandemics & Infectious Diseases

Preparing for an Influenza Pandemic: Personal Protective Equipment for Healthcare Workers

Source: Institute of Medicine/National Academies Press

From press release:
During an influenza pandemic, healthcare workers will be on the front lines delivering care to patients and preventing further spread of the disease. Protecting the more than 13 million healthcare workers in the United States from illness or from infecting their families or the patients in their care is critical to limiting morbidity and mortality and preventing progression of a pandemic. The National Personal Protective Technology Laboratory asked the Institute of Medicine (IOM) to conduct a study on the personal protective equipment (PPE) (respirators, gloves, gowns, eye protection, and other equipment) needed by healthcare workers in the event of an influenza pandemic.

The IOM committee determined that there is an urgent need to address the lack of preparedness regarding effective PPE for use in an influenza pandemic. Three critical areas were identified that require expeditious research and policy action: (1) Influenza transmission research should become an immediate and short-term research priority so that effective prevention and control strategies can be developed and refined. The current paucity of knowledge significantly hinders prevention efforts. (2) Employer and employee commitment to worker safety and appropriate use of PPE should be strengthened. Healthcare facilities should establish and promote a culture of safety. (3) An integrated effort is needed to understand the PPE requirements of the worker and to develop and utilize innovative materials and technologies to create the next generation of PPE capable of meeting these needs. Increasing the use of field testing in the pre-market phase and conducting thorough postmarketing evaluations are vital to producing effective equipment, as is the creation of rigorous federal regulatory and testing requirements. The committee believes that improvements can be made so that healthcare workers will have PPE that provides protection against influenza transmission based on a rigorous risk assessment with solid scientific evidence. The recommendations provided in this report are intended to serve as a framework and catalyst for a national PPE action plan that is an integral part of the overall national plan for an influenza pandemic.

Read online.

Vaccine Prioritization During an Influenza Pandemic

Source: Critical Infrastructure Protection Program, George Mason University School of Law

Preparing for an influenza pandemic is a monumental challenge and requires participation from federal, state and local governments as well as the private sector. It is with great pleasure that the George Mason University School of Law’s Critical Infrastructure Protection (CIP) Program publishes a collection of essays (PDF; 737 KB) on vaccine prioritization during an influenza pandemic. The United States government is spending a significant amount of time and resources examining and preparing for the possible threat of an influenza pandemic. A major challenge in preparing for an influenza pandemic encompasses vaccine prioritization. Specifically, if a pandemic were to occur and vaccines needed to be distributed, who should be first to receive vaccines? Should first responders or critical infrastructure employees have priority to receive the vaccines?

The CIP Program invited leading scholars to address this important issue. The essays focus on different concerns about vaccine prioritization. The first essay, submitted by Dr. Colleen Hardy, of the George Mason University School of Law’s Critical Infrastructure Protection Program, provides an overview of current federal response plans to an influenza pandemic. Specifically, it summarizes the Department of Health and Human Services’ (HHS) influenza plan concerning vaccine prioritization. In addition, the essay describes the National Infrastructure Advisory Council’s (NIAC) Working Group on Pandemics’ recommendations to the Department of Homeland Security and HHS.

Pandemic Planning and Response for State IT: Where’s My Staff?

Source: National Association of State Chief Information Officers

Without the flow of electronic information, government comes to a standstill. When a state’s data systems and communication networks are disrupted, the problem can be serious and the impact far-reaching. The consequences can be much more than an inconvenience. Serious disruptions to a state’s IT systems can lead to public distrust, chaos, fear and potential loss of life. Traditionally, IT disruptions are planned for based on anticipated disasters both natural and man-made that can physically damage facilities and equipment. However, we live in a time that holds the potential for a pandemic outbreak in your city, state or possibly the nation. What would you do as state chief information officer (CIO) if one day your staff did not come to the office because of a pandemic outbreak?

Full report (PDF: 185 KB)

Pandemic Influenza: Warning, Children At-Risk

Source: Trust for America’s Health and American Academy of Pediatrics, Issue Brief, October 2007

From the summary:
The American Academy of Pediatrics (AAP) and Trust for America’s Health (TFAH) issued a report in October 2007, Pandemic Influenza: Warning, Children At-Risk, which finds that children and teens between the ages of 0-19 account for nearly 46 percent of all H5N1 “bird” flu deaths. The report also identifies gaps in U.S. preparedness for treating and caring for children during a possible pandemic flu outbreak.

Influenza Pandemic: Further Efforts Are Needed to Ensure Clearer Federal Leadership Roles and an Effective National Strategy, August 14, 2007

Source: Report to Congressional Requesters, United States Government Accountability Office, GAO-07-781, August 2007

An influenza pandemic is a real and significant potential threat facing the United States and the world. Pandemics occur when a novel virus emerges that can easily be transmitted among humans who have little immunity. In 2005, the Homeland Security Council (HSC) issued a National Strategy for Pandemic Influenza and, in 2006, an Implementation Plan. Congress and others are concerned about the federal government’s preparedness to lead a response to an influenza pandemic. This report assesses how clearly federal leadership roles and responsibilities are defined and the extent to which the Strategy and Plan address six characteristics of an effective national strategy. To do this, GAO analyzed key emergency and pandemic-specific plans, interviewed agency officials, and compared the Strategy and Plan with the six characteristics GAO identified.

Peer-Reviewed, Online Database Showcases Local, County and State Pandemic Planning – Downloadable Tools Can Help Communities Protect Citizens by Enhancing Their Own Plans

Source: Center for Infectious Disease Research & Policy, and the Pew Center on the States, 2007

From the press release:
Public health planners have a new tool to help them prepare for an influenza pandemic. Pew and the Center for Infectious Disease Research & Policy are announcing the launch of www.PandemicPractices.org, a new online resource that highlights promising ways communities are preparing for a flu pandemic.

PandemicPractices.org brings together more than 130 peer-reviewed practices from four countries, 22 states and 33 counties. Compiled as a tool to save communities and states time and resources, the database enables public health professionals to learn from one another and to build on their own pandemic plans. Using PandemicPractices.org, they can examine and download pandemic flu planning materials and use or adapt them to fit local needs.

Utah Pandemic Influenza Response Plan

Source: David N. Sundwall, Robert T. Rolfs, Utah Department of Health, August 28, 2007

An influenza pandemic as severe as the 1918 pandemic could cause nearly a million Utahns to become ill and result in over 350,000 outpatient doctor visits, 80,000 hospitalizations, and 16,000 deaths over the course of a year. Critical assumptions used in developing this plan included: 1) outbreaks would probably occur widely across the state and nation, limiting the ability to share resources among jurisdictions; 2) vaccine would not be available until several months had elapsed; 3) shortages of critical medicines (including antiviral medications) and other supplies would occur; 4) capacity to provide medical care would be severely stressed or exceeded; and 5) absenteeism rates and fear would stress the abilities to maintain business continuity and to provide for essential community services including police, fire, water, food, transportation and sanitation.

The goals of this plan are, first, to minimize serious illness and death, and second, to limit societal disruption and economic losses. The plan is intended to coordinate with global and national plans developed by the World Health Organization (WHO) and the U.S. Department of Health and Human Services (DHHS). It outlines responsibilities and activities in six areas (Planning and Coordination; Public and Risk Communications; Surveillance, Investigation and Containment; Vaccine Management and Administration, Antiviral Medication Stockpiling and Use; Laboratory Testing, and Health Care and Emergency Response). It uses the three pandemic planning phases outlined by WHO (Inter-Pandemic, Pandemic Alert, and Pandemic Periods), the U.S. Federal Stages, and introduces Utah Pandemic Response Levels.

This plan outlines activities and responsibilities for government public health agencies and builds upon preparedness assets developed at federal, state, and local levels of government and in the private sector. The Plan incorporates work by several advisory bodies, including a Pandemic Influenza Planning Committee (2005-2006), the Pandemic Influenza Workgroup (2006-ongoing), and the Governor’s Pandemic Influenza Taskforce, which met in 2006-2007 and developed recommendations that are included in and will set the stage for the next phase of this planning process.

See also:
Utah Department of Health’s Pandemic Influenza Web site

Financial Services Firms Face Flu Pandemic — On Paper

Source: Patrick Thibodeau, Computerworld, August 28, 2007

Massive planning exercise will assess impact on staffing, telecommunications

What may be the largest pandemic planning exercise ever conducted in the U.S. is set to begin next month. The dry run will force financial services firms to operate with shrinking numbers of employees — on paper, at least.

More than 1,800 organizations have signed up to participate in the three-week simulation, which is being sponsored by the U.S. Department of the Treasury and the Securities Industry and Financial Markets Association.

See also:
• U.S. Department of the Treasury press release
FBIIC / FSSCC Pandemic Flu Exercise of 2007

Interim Pre-pandemic Planning Guidance: Community Strategy for Pandemic Influenza Mitigation in the United States—Early, Targeted, Layered Use of Nonpharmaceutical Interventions

Source: Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, CS108488, February 2007

From press release:
Community Measures Prevent Deaths During Pandemic, New Study Finds –
School closures and other community strategies designed to reduce the possibility of spreading disease between people during an epidemic can save lives, particularly when the measures are used in combination and implemented soon after an outbreak begins in a community, according to a new study based on public records from the 1918-1919 influenza pandemic.

The findings (subscription required), which are published in the Aug. 8 issue of the Journal of the American Medical Association, provide vital clues to help public officials planning for the next influenza pandemic and highlight the importance of community strategies. These strategies are particularly important because the intervention most likely to provide the best protection against pandemic influenza — a vaccine — is unlikely to be available at the outset of a pandemic. Community strategies that delay or reduce the impact of a pandemic (also called non-pharmaceutical interventions) may help reduce the spread of disease until a vaccine that is well-matched to the virus is available.

Scientists from the Centers for Disease Control and Prevention (CDC) and the University of Michigan Medical School′s Center for the History of Medicine completed an exhaustive review of public records such as health department reports, U.S. Census mortality data and newspaper archives.
See also:
Early Warning Infectious Disease Program (EWIDS)
Pandemic Planning Update IV
Department of Health and Human Services’ Pandemic Flu Website