Planning for a Crisis -- Pandemic Influenza


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  • Overview of spread via migration routes (southeast asia  turkey)
  • Planning for a Crisis -- Pandemic Influenza

    1. 1. PLANNING FOR A CRISIS PANDEMIC INFLUENZA A REAL LIFE EXAMPLE Presented By Gary Ades, Ph.D. Senior Vice President EHA Consulting Group, Inc. To Risk & Safety Managers Executive Study Group National Restaurant Association Providence, RI July 17, 2006
    2. 2. WHAT IS A CRISIS? <ul><li>An unplanned event which triggers a real or perceived threat to the safety, health or environment of our customers and/or employees </li></ul>
    3. 3. TYPES OF CRISES <ul><li>Food Safety- Product is recalled or a customer becomes ill </li></ul><ul><li>Bioterrorism </li></ul><ul><li>Biosecurity </li></ul><ul><li>Workplace Violence </li></ul><ul><li>Robbery </li></ul><ul><li>Act of God – Hurricanes, earthquakes, etc </li></ul><ul><li>Worker Illness </li></ul><ul><ul><li>Hepatitis, tuberculosis, Salmonella, Norovirus, etc. </li></ul></ul><ul><ul><li>PLANNING FOR A PANDEMIC INFLUENZA </li></ul></ul>
    4. 4. SOME DEFINITIONS <ul><li>PRODUCT RECALL- a firm’s voluntary removal or correction of a marketed product that violates the laws enforced by the FDA and USDA. </li></ul><ul><li>BIOSECURITY- is the series of management steps taken to prevent the introduction of infectious agents into a herd or flock, e.g., Avian Influenza, Foot and Mouth Disease </li></ul><ul><li>BIOTERRORISM- is the intentional contamination of plants, animals, or humans with infectious agents (viruses, bacteria, protozoa, insects, or fungi) or toxins (nuclear, chemical, bacterial or fungal) with the express intent to cause disease or economic hardship in animals, agricultural systems, or humans. </li></ul>
    5. 5. CYCLES OF CRISIS MANAGEMENT <ul><li>Crisis Management is a cyclical process involving: </li></ul><ul><li>Initial action and fact gathering </li></ul><ul><li>Containment </li></ul><ul><li>Assessment and Analysis </li></ul><ul><li>Response </li></ul><ul><li>Control </li></ul><ul><li>Communication to all affected/interested publics </li></ul><ul><li>Evaluation </li></ul>
    6. 6. PRINCIPLES OF CRISIS MANAGEMENT <ul><li>Make as many preparations as possible in advance </li></ul><ul><li>Minimize the number of people involved </li></ul><ul><li>Communications will be accurate, efficient, secure and appropriate </li></ul><ul><li>Decision-making will be allocated to appropriate levels </li></ul><ul><li>Threats and/or crises will be carefully analyzed and risks and/or threats to the Company , its interests and employees evaluated </li></ul><ul><li>Assume a worst-case scenario and prepare accordingly </li></ul><ul><li>Actions should be consistent with the Company’s values and legal requirements </li></ul><ul><li>The Company's actions will be properly documented </li></ul><ul><li>The cause of any crisis will be thoroughly investigated </li></ul><ul><li>The Company will assess its effectiveness in responding to any crisis </li></ul>
    7. 7. KEYS TO SUCCESSFULLY ADDRESSING A CRISIS <ul><li>Plan ahead. Develop the plan before your need it. </li></ul><ul><li>Identify appropriate team members </li></ul><ul><li>Develop and use a checklist to guide and monitor your preparedness planning activities </li></ul><ul><li>Prepare a written document of the plan </li></ul><ul><li>Keep the Plan current- especially regarding contact information (at several levels) and training </li></ul><ul><li>Test the program. A written document whose activities have not been tested is just a feel good dust collector. </li></ul>
    8. 8. PANDEMIC INFLUENZA PLANNING - IS YOUR COMPANY READY?- <ul><li>According to a recently release study by the Thompson Publishing Group: </li></ul><ul><li>76% of the 468 business respondents have no contingency plan for an avian flu (pandemic influenza) outbreak </li></ul><ul><li>47% of senior managers consider this to be an important issue </li></ul><ul><li>Of the 63% of the respondents who reported having a business continuity plan only 25% had contingencies for pandemic influenza </li></ul><ul><li>What are employers worried about? </li></ul><ul><ul><li>Human resource-related issues (72%) </li></ul></ul><ul><ul><li>Remote work agreements (48%) </li></ul></ul><ul><ul><li>IT/data processing (41%) </li></ul></ul><ul><ul><li>Coordination with state and local governments (35%) </li></ul></ul>
    9. 9. BACKGROUND <ul><li>Avian Influenza (AI) is a virus that causes disease in various types of birds, thus the common name “bird flu”. AI viruses can infect chickens, turkeys, pheasants, quail, duck, geese and guinea fowl as well as a wide variety of other birds, including migratory waterfowl. </li></ul><ul><li>AI viruses are classified by a combination of two groups of proteins found on the surface of the virus: hemagglutinin proteins (H), of which there are 16 (H1-H16), and neuraminidase proteins (N), of which there are 9 (N1-N9). AI strains also are divided into two groups based on the pathogenicity of the virus--the ability of the virus to produce disease. </li></ul>
    10. 10. BACKGROUND <ul><li>Low Pathogenicity Avian Influenza (LPAI ) </li></ul><ul><li>Most AI strains are classified as low pathogenicity and cause few clinical signs in infected birds. LPAI generally does not pose a significant health threat to humans. However, LPAI is monitored because two strains of LPAI—the H5 and H7 strains–can mutate into highly pathogenic forms. </li></ul><ul><li>High Pathogenicity Avian Influenza (HPAI) </li></ul><ul><li>This is a more pathogenic type of avian influenza that is frequently fatal to birds and easily transmissible between susceptible species. The strain that is currently of concern in East Asia & the Pacific, Africa, Europe & Eurasia, Near East and South Asia is the H5N1 HPAI virus. </li></ul>
    11. 11. BACKGROUND <ul><li>TRANSMISSIBILITY </li></ul><ul><li>AI is primarily spread by direct contact between healthy and infected birds through respiratory secretions and feces. The disease also can be spread through indirect contact if healthy birds are exposed to contaminated equipment or materials. </li></ul><ul><li>The HPAI H5N1 virus can be spread from birds to people as a result of extensive direct contact with infected birds. Broad concerns about public health relate to the potential for the virus to mutate, or change into a form that could spread from person to person. </li></ul>
    12. 12. World Health Organization’s Current AI Pandemic Status
    13. 13. BACKGROUND <ul><li>TRANSMISSABILITY </li></ul><ul><li>According to the World Health Organization (WHO) domestic ducks and some migratory waterfowl have acquired the ability to resist the disease caused by these strains and are now capable of excreting large quantities of highly pathogenic virus without showing the warning signs of the illness. In endemic countries, this altered role of domestic ducks and migratory waterfowl is now thought to contribute to the perpetuation of the transmission cycle. </li></ul><ul><li>The H5N1 virus can survive in feces for at least 35 days at low temperature (4°C); while at 37°C, viruses could survive for 6 days in stability tests on fecal samples. AI viruses can also survive on surfaces, such as within the poultry house environment, for several weeks </li></ul>
    14. 14. BACKGROUND
    15. 15. GIVENS <ul><li>Based on the results of a Think Tank Session held at the 2006 International Livestock Congress and subsequent white paper: </li></ul><ul><li>It is speculated that H5N1 will arrive in North America water fowl in near future. </li></ul><ul><li>If it invades commercial poultry systems, it will be quickly identified and contained and controlled locally with effective bio-security in production systems and through testing of commercial flocks. </li></ul><ul><li>Consumer paranoia will occur and industry will suffer. </li></ul>
    16. 16. CONCERNS <ul><li>Impact from recreational fowl and back yard [free-range, live/wet markets] flocks will be the primary factor in failure of containment-control strategies. </li></ul><ul><li>Much information is available, but planning strategies of constituencies [industry, government, research] are not unified, consistent or effectively communicated and focused. </li></ul><ul><li>Industry lacks credibility as viewed by consumer. </li></ul><ul><li>Media spins may be biased. </li></ul>
    17. 17. Pandemics Do Happen! H1 H1 H3 H2 H7 * H5 * H9 * 1918 Spanish Influenza H1N1 1957 Asian Influenza H2N2 1968 Hong Kong Influenza H3N2 1980 1997 1915 * Avian Flu 2003 2004 1977 1996 2002 1925 1935 1945 1955 1965 1975 1985 1995 2005 2003-2006 1998 1999 2003
    18. 18. Pandemic Strain Emergence: Reassortment of Influenza A Viruses Avian Reservoir Avian virus Human virus other mammals? New reassorted virus
    19. 19. Planning Assumptions: Health Care <ul><li>50% or more of those who become ill will seek medical care </li></ul><ul><li>Number of hospitalizations and deaths will depend on the virulence of the pandemic virus </li></ul>Severe (1918-like) Moderate (1957-like) 1,903,000 209,000 Deaths 745,500 64,875 Mechanical ventilation 1,485,000 128,750 ICU care 9, 900,000 865,000 Hospitalization 45 million (50%) 45 million (50%) Outpatient medical care 90 million (30%) 90 million (30%) Illness
    20. 20. Our Health Protection Preparedness System A NETWORK of Shared Responsibility! <ul><li>Local - state - federal </li></ul><ul><li>Domestic – international </li></ul><ul><li>Public – private </li></ul><ul><li>Multi-sector </li></ul><ul><li>Non-partisan </li></ul><ul><li>Animal – human </li></ul><ul><li>Health protection – homeland security – economic protection </li></ul>Healthcare Delivery System Federal Partners Education System Business & Workers Local /State / Federal Public Health System
    21. 21. Pandemic Influenza Checklists <ul><li>State and Local </li></ul><ul><li>BUSINESS </li></ul><ul><li>Preschool </li></ul><ul><li>Schools (K-12) </li></ul><ul><li>Colleges & Universities </li></ul><ul><li>Faith-based & Community Organizations </li></ul><ul><li>Physician Offices and Ambulatory Care </li></ul><ul><li>Home Health </li></ul><ul><li>Emergency Medical Services </li></ul><ul><li>Travel Industry </li></ul><ul><li>Correctional Facilities </li></ul>
    22. 22. Protecting Your Business <ul><li>Plan for impact on business </li></ul><ul><li>Protect employees and customers </li></ul><ul><li>Establish policies </li></ul><ul><li>Allocate resources </li></ul><ul><li>Engage employees </li></ul><ul><li>Coordinate with external organizations </li></ul>
    23. 23.
    24. 24. 1.1 PLAN FOR THE IMPACT OF A PANDEMIC ON YOUR BUSINESS <ul><li>Identify a pandemic coordinator and/or team with defined roles and responsibilities for preparedness and response planning. The planning process should include input from labor representatives. </li></ul><ul><li>Identify essential employees and other critical inputs (e.g. raw materials, suppliers, sub-contractor services/ products, and logistics) required to maintain business operations by location and function during a pandemic. </li></ul><ul><li>Train and prepare ancillary workforce (e.g. contractors, employees in other job titles/descriptions, retirees). </li></ul><ul><li>Develop and plan for scenarios likely to result in an increase or decrease in demand for your products and/or services during a pandemic (e.g. effect of restriction on mass gatherings, need for hygiene supplies). </li></ul><ul><li>Determine potential impact of a pandemic on company business financials using multiple possible scenarios that affect different product lines and/or production sites. </li></ul><ul><li>Determine potential impact of a pandemic on business-related domestic and international travel (e.g. quarantines, border closures). </li></ul>
    25. 25. 1.1 PLAN FOR THE IMPACT OF A PANDEMIC ON YOUR BUSINESS (Con’t) <ul><li>Find up-to-date, reliable pandemic information from community public health, emergency management, and other sources and make sustainable links. </li></ul><ul><li>Establish an emergency communications plan and revise periodically. This plan includes identification of key contacts (with back-ups), chain of communications (including suppliers and customers), and processes for tracking and communicating business and employee status. </li></ul><ul><li>Implement an exercise/drill to test your plan, and revise periodically. </li></ul>
    26. 26. 1.2 PLAN FOR THE IMPACT OF A PANDEMIC ON YOUR EMPLOYEES AND CUSTOMERS <ul><li>Forecast and allow for employee absences during a pandemic due to factors such as personal illness, family member illness, community containment measures and quarantines, school and/or business closures, and public transportation closures. </li></ul><ul><li>Implement guidelines to modify the frequency and type of face-to-face contact (e.g. hand-shaking, seating in meetings, office layout, shared workstations) among employees and between employees and customers (refer to CDC recommendations). </li></ul><ul><li>Encourage and track annual influenza vaccination for employees. </li></ul><ul><li>Evaluate employee access to and availability of healthcare services during a pandemic, and improve services as needed. </li></ul><ul><li>Evaluate employee access to and availability of mental health and social services during a pandemic, including corporate, community, and faith-based resources, and improve services as needed. </li></ul><ul><li>Identify employees and key customers with special needs, and incorporate the requirements of such persons into your preparedness plan. </li></ul>
    27. 27. 1.3 ESTABLISH POLICIES TO BE IMPLEMENTED DURING A PANDEMIC <ul><li>Establish policies for employee compensation and sick-leave absences unique to a pandemic (e.g. non-punitive, liberal leave), including policies on when a previously ill person is no longer infectious and can return to work after illness. </li></ul><ul><li>Establish policies for flexible worksite (e.g. telecommuting) and flexible work hours (e.g. staggered shifts). </li></ul><ul><li>Establish policies for preventing influenza spread at the worksite (e.g. promoting respiratory hygiene/ cough etiquette, and prompt exclusion of people with influenza symptoms). </li></ul><ul><li>Establish policies for employees who have been exposed to pandemic influenza, are suspected to be ill, or become ill at the worksite (e.g. infection control response, immediate mandatory sick leave). </li></ul><ul><li>Establish policies for restricting travel to affected geographic areas (consider both domestic and international sites), evacuating employees working in or near an affected area when an outbreak begins, and guidance for employees returning from affected areas (refer to CDC travel recommendations). </li></ul><ul><li>Set up authorities, triggers, and procedures for activating and terminating the company’s response plan, altering business operations (e.g. shutting down operations in affected areas), and transferring business knowledge to key employees. </li></ul>
    28. 28. 1.4 ALLOCATE RESOURCES TO PROTECT YOUR EMPLOYEES AND CUSTOMERS DURING A PANDEMIC <ul><li>Provide sufficient and accessible infection control supplies (e.g. hand-hygiene products, tissues and receptacles for their disposal) in all business locations. </li></ul><ul><li>Enhance communications and information technology infrastructures as needed to support employee telecommuting and remote customer access. </li></ul><ul><li>Ensure availability of medical consultation and advice for emergency response. </li></ul>
    29. 29. 1.5 COMMUNICATE TO AND EDUCATE YOUR EMPLOYEES <ul><li>Develop and disseminate programs and materials covering pandemic fundamentals (e.g. signs and symptoms of influenza, modes of transmission), personal and family protection and response strategies (e.g. hand hygiene, coughing/sneezing etiquette, contingency plans). </li></ul><ul><li>Anticipate employee fear and anxiety, rumors and misinformation and plan communications accordingly. </li></ul><ul><li>Ensure that communications are culturally and linguistically appropriate. </li></ul><ul><li>Disseminate information to employees about your pandemic preparedness and response plan. </li></ul><ul><li>Provide information for the at-home care of ill employees and family members. </li></ul><ul><li>Develop platforms (e.g. hotlines, dedicated websites) for communicating pandemic status and actions to employees, vendors, suppliers, and customers inside and outside the worksite in a consistent and timely way, including redundancies in the emergency contact system. </li></ul><ul><li>Identify community sources for timely and accurate pandemic information (domestic and international) and resources for obtaining counter-measures (e.g. vaccines and antivirals). </li></ul>
    30. 30. 1.6 COORDINATE WITH EXTERNAL ORGANIZATIONS AND HELP YOUR COMMUNITY <ul><li>Collaborate with insurers, health plans, and major local healthcare facilities to share your pandemic plans and understand their capabilities and plans. </li></ul><ul><li>Collaborate with federal, state, and local public health agencies and/or emergency responders to participate in their planning processes, share your pandemic plans, and understand their capabilities and plans. </li></ul><ul><li>Communicate with local and/or state public health agencies and/or emergency responders about the assets and/or services your business could contribute to the community. </li></ul><ul><li>Share best practices with other businesses in your communities, chambers of commerce, and associations to improve community response efforts. </li></ul>
    31. 31. SOME QUESTIONS TO ASK YOURSELF <ul><li>What would happen to your business if 40% of your work force didn’t show up for two weeks straight? </li></ul><ul><li>If an outbreak hits one location, can you switch to another location? </li></ul><ul><li>Can you operate if a majority of your workforce works from home? </li></ul><ul><li>Can you modify your sick leave policy to discourage sick workers from coming in? </li></ul><ul><li>What will you do if the local or state government quarantines your area? </li></ul>
    32. 32. PLANNING SUGGESTIONS <ul><li>From government officials, corporate contingency planners and executives at a recent summit of New England-based businesses on pandemic preparedness. The Summit was sponsored by the U.S. Chamber of Commerce and the New England Council. </li></ul><ul><ul><li>Establish a pandemic planning team early </li></ul></ul><ul><ul><li>Analyze your supply chain </li></ul></ul><ul><ul><li>Draft a communicable diseases policy </li></ul></ul><ul><ul><li>Look into expanding your leave policy </li></ul></ul><ul><ul><li>Put up a pandemic flu section on your intranet </li></ul></ul><ul><ul><li>Establish a phone network to keep employees informed </li></ul></ul><ul><ul><li>Start enhancing your workplace hygiene now </li></ul></ul>
    33. 33. TABLE TOP DRILLS <ul><li>As with any crisis management program, the program should be tested before its used or needed. </li></ul><ul><li>A Tabletop Drill is the method of choice for this testing. It allows key players, from participating groups within a company or organization to gather in face-to-face, round-table settings and talk through expected actions for an pandemic influenza emergency scenario. </li></ul><ul><li>This allows for evaluation of the plans and procedures and resolves questions of coordination and responsibility. </li></ul><ul><li>Tabletop Drills are typically informal, and the moderator will facilitate discussion among participants. </li></ul>
    34. 34. WILL IT HAPPEN? <ul><li>No one knows </li></ul><ul><li>Will this crisis or something similar happen in the future? YES </li></ul><ul><li>Preparing for this situation NOW will not only be needed if the pandemic influenza occurs but provides an excellent template for crisis management planning </li></ul>
    35. 35. FOR MORE INFORMATION OR TO CONTACT US <ul><li>Gary Ades </li></ul><ul><li>[email_address] </li></ul><ul><li>479.254.9026 </li></ul><ul><li>Visit our web site at </li></ul>