AMA Citizen Ready Pandemic

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Influenza Pandemic:CitizenReady Training

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This project was supported by Cooperative Agreement Number 2007-GT-T7-K002 administered by the U.S. Department of Homeland Security, Office of Grants and Training. Points of view or opinions in this document are those of the author and do not represent the official position or policies of the U.S. Department of Homeland Security.

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Introductions

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Housekeeping
Turn off mobile phones
Coat closet
Restrooms
Food and refreshments
Session length

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CitizenReady Program
Designed to help the American public prepare
Provides basic life-saving and support information for public health emergencies
Helps build physical and mental health resilience in the community

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Potential for Pandemic
Click below to launch the animation

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Program Objectives
The difference between seasonal and pandemic influenza
The role of the public health system during an influenza pandemic
What actions you and your community can take to prepare for a pandemic
The importance of developing and exercising personal, workplace, school and community emergency plans
What public health directives may be issued in a pandemic and why they should be followed
What actions you can take to limit the spread of influenza

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Problem Overview

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What Is Seasonal Influenza?
Seasonal Influenza
Caused by a virus; commonly called “flu”
Symptoms: fever, headaches, sore throat, body aches, congestion
200,000 hospitalized and 36,000 deaths annually
Virus is spread through respiratory droplets (coughing/sneezing)
Most Vulnerable (elderly, pregnant, children, chronic disease

Preventing Seasonal Flu

Get Seasonal Flu Vaccine
Hand-washing
Practice cough etiquette

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What Is Pandemic Influenza?
Affects wide geographic area, high proportion of population

New virus to which the population has limited to no immunity
Can spread across US in 5 weeks
Will infect communities for 6-8 weeks before receding
No vaccine will be present in the early stages
The effectiveness of antivirals are unknown

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Emergence and Spread of a Pandemic Virus

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Can a Pandemic Happen Again?

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Progression to a Pandemic

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Possible Pandemic Toll in U.S.
>50% who become ill will seek medical care

Illness: 90 million (30%)
Outpatient medical care: 45 million
Hospitalization: 9.9 million
Intensive care: 1.5 million
Mechanical ventilation: 750,000
Deaths: 1.9 million

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Shift in Healthcare Priorities
With so many people sick, health care authorities will identify three categories in the community:
Susceptible, but not yet exposed to the virus
Exposed but do not have symptoms yet
Sick and contagious
Of the sick and contagious, which ones are likely to survive?
Resource allocation based on that answer
Susceptible
Exposed
Sick and Contagious

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By taking action
Delay
Reduce
1. Delay the spread of the virus and peak of the outbreak:
2. Reduce number of cases at peak
3. Control virus and health impacts
Pandemic outbreak:No intervention
Daily Cases
Pandemic outbreak:
With intervention
Control
Days since First Case

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Community Preparedness
Enforce social distancing
E.g., close/dismiss schools, cancel sports events
Establish a community hotline
Set up local alternatives to conventional hospital care
E.g., Flu clinics
Encourage employers to ensure that exposed and sick workers stay home

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Hospitals will be Overwhelmed
Hospitals will be overwhelmed with flu patients
Going to hospital could make you sick
And you could contribute to spread of infection
Alternative Sites:
Primary care clinics,
Designated flu clinics,
Point of Distribution sites

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Breaking News

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Community Responsibilities

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Community Response Part A
Assume assigned roles in the community
Head of household
Businessperson
Children’s sports coach
Divide into groups
Determine actions your group will take
Share your decisions with the group

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Community Response Part B
In your group, discuss:
Who will care for the children?
How can families plan ahead for school dismissal?
What steps should employers take to plan for absenteeism?
How will children be entertained and taught at home?
How will needed school services be replaced?
Are there concerns about unsupervised children?

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Why Social Distancing?

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This Approach Works
Excess mortality over 1913-1917 baseline in Philadelphia and St. Louis
300
250
200
150
100
50
0
Philadelphia
St. Louis
Death Rate/100,000 Population
9-Nov
16-Nov
23-Nov
30-Nov
7-Dec
14-Dec
21-Dec
28-Dec
21-Sep
28-Sep
5-Oct
12-Oct
19-Oct
26-Oct
2-Nov
Date
Source: Hatchett, Mecher, & Lipsitch. Public health interventions and epidemic intensity during the 1918 influenza pandemic. PNAS Early Edition. April 6, 2007

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Individual Responsibilities

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Taking Action As Individuals
Get Seasonal Flu Vaccine
Contact community hotline if:
You think you are sick
A family member is sick
Wash hands well
Practice cough etiquette
Identify vulnerable individuals in your community
Establish social networking for local updates (facebooks, twitters)
Get trustworthy information and follow directions from public heath authorities
Stay home if you are sick

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Gaining Resilience

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Summary

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Become CitizenReady
Take early, quick action as:
Individuals
Communities
Taking action:
Makes you feel more in control
Can dramatically decrease transmission of the virus
Allows you to be helpful to others
All community groups need to work together
Community citizens need to be ready and willing to act
Learn about local agencies and organizations involved in pandemic preparedness