Pandemic Influenza:
What YOU Need To Know
Katherine M. Williams, RN
Masters of Nursing and Healthcare Practices
Affiliated...
What is Pandemic Influenza?
 Pandemic influenza in humans occurs
naturally several times a century, on average.
 Pandemi...
What is Pandemic Influenza?
 Pandemic flu affects the entire world,
not just a country or a continent.
Where Does it Come From?
 Pandemic influenza is a virus to which humans have
no natural immunity.
 It originates in wild...
Recent Pandemics
 1918-19 - H1N1, "Spanish flu”
Severe: Humans had no immunity to any of
the 8 gene sequences
 1957-58 “...
Why Should We Be Concerned?
 The 1918 “Spanish flu” had a mortality rate of
approximately 3% and caused widespread social...
Where is it Now?
Blue: A/H1N1 Red: H5N1 Purple: Both A/H1N1 & H5N1
Current Situation
Reported deaths
3,969 deaths as of Sept 17, 2009:
 Brazil: 899
 United States: 694
 Argentina: 514
 ...
Deaths in the U.S.
First reported death:
April, 2009
Current total: 693
Last week alone: 102
United States Cumulative Deat...
Severity
 This is now considered a “moderate” pandemic by
the CDC (Category 2).
 Expect at least 100,000,000 Americans t...
A/H1N1 Fatalities
 Average age of death: 38 years old.
 Affecting children and young adults, very
different from seasona...
Who’s Most at Risk?
 Ages 5-50
 Pre-existing conditions:
 Asthma
 Diabetes
 Pregnancy
 Heart disease
 Obesity
But I’m not hearing much
on the news!
 Complacency and Apathy: our two worst
enemies.
 Media censorship: don’t want to c...
What about that “36,000” number?
 Only around 1,300 people die
each year directly from
seasonal influenza, according
to t...
Under-reporting Issues:
 No longer testing all suspected
cases
 Only the severely ill and/or
hospitalized
 Shortage of ...
What about a vaccine?
 Won’t be available until at least mid-October
 Just finishing first clinical trials
 First to re...
Potential Problems with a vaccine
Major questions:
 Safety?
 Number of shots needed?
 How well will it work?
 How many...
What does this flu look like?
 Fever (but up to 25% have no fever!)
 Respiratory symptoms: cough, congestion,
respirator...
What if you catch it?
 Most cases are “mild,” requiring no medical
intervention.
 Some cases are NOT mild!
 If you have...
So What Can YOU Do?
 Be aware of the people around you – is anyone
coughing or looking sick?
 If you have increased risk...
So What Can YOU Do?
 If you feel sick, STAY HOME until you have
been symptom-free for at least 48 hours.
 Relapse is com...
Prepare? For What?
 Increased virulence in Second Wave?
 Vaccine production and distribution issues
 Tamiflu resistance...
H1N1 + H5N1:
The Worst Case Scenario
 H5N1 (“bird flu”) has a 60% mortality rate.
 If the two combine, we may have a vir...
Mike Leavitt
Former Secretary, U.S. Dept of Health and Human Services
 “Local preparedness is the foundation of
pandemic ...
Former Secretary Leavitt, again:
 "Anything we say in advance of a
pandemic seems alarmist. Anything
you've done to prepa...
Who Should Prepare?
 The U.S. Department of Health and Human Services
recommends the following entities should begin
prep...
Thoughts on Preparedness
 We CANNOT depend on governmental help.
 Most states and local governments are
woefully behind ...
Individual Preparations
“You are on your own.”
What does this mean
to the average family?
It means we must PREPARE.
Why Prepare?
 40-50% of the workforce will be absent:
 Some will be sick.
 Some will need to take care of
families.
 S...
Why Prepare?
 Medical services will be overwhelmed:
 Our health care system has no real “surge capacity” to
deal with a ...
Why Prepare?
 Basic services may be interrupted:
 Utility workers will be affected, too, resulting in
electricity, water...
Why Prepare?
 International commerce will be drastically
reduced:
 About 80% of the raw materials for our
medications co...
Why Prepare?
 “Just in time” thinking will backfire:
 Most businesses and services have very little
on hand for day-to-d...
Why Prepare?
 Schools may be
closed:
 Schools are prime
locations for disease
transmission.
 Other places people
congre...
Why Prepare?
 Interstate commerce may break down:
 The people who deliver our
food, supplies and fuel will be
vulnerable...
So Why Aren’t People
Preparing?
I’m not preparing because…
 I HAVEN’T HEARD OF IT
 There are some folks out of touch with
world events and the news -
th...
I’m not preparing because…
 I BELIEVE THE WHOLE
THING IS JUST HYPE
 “News organizations produce
scary stories to get rat...
I’m not preparing because…
 I DON’T HAVE THE FUNDS TO PREPARE
 “It’s hard enough just paying the regular
bills and you w...
I’m not preparing because…
 MAGICAL THINKING
 “The threat is real but if I don’t prepare it
won’t happen. Preparation wi...
I’m not preparing because…
 I’LL WAIT AND SEE WHAT
HAPPENS
 “Yeah, I know bad things
could happen, but there will
be ple...
I’m not preparing because…
 IT’S NOT HAPPENING IN MY TOWN
“Why should I be concerned
because a bunch of people
somewhere ...
I’m not preparing because…
 I HAVE NO FEAR
 “So what if it happens,
I’ll just take my chances –
Nothing can hurt me!”
I’m not preparing because…
 THERE’S NO HOPE
 “Preparation is an illusion.
The pandemic will last so long
and be so bad t...
So you feel the need to start preparing…
 What exactly do I need to do?
 And for how long?
Take the First Steps:
 Start THINKING about how you will react to a
disaster – ANY disaster.
 Stay INFORMED.
 TELL OTHE...
How Do We Prepare?
 Begin to stockpile:
 Food and water supplies
 Medications
 Alternative heating and cooking
methods...
A Kernel of Truth?
Things to Consider:
 Food
 For how long?
 How much per person?
 What to buy?
 How to store it?
Things to Consider:
 Water
 How much?
 How to store it?
 Alternative sources?
Things to Consider:
 Heating, lighting and cooking
 Wood
 Propane
 Solar
 Candles and lamps
Things to Consider:
 Sanitation
 Sewage waste
 Toilet paper!
 Feminine products
 Garbage disposal
Things to Consider:
 Medications and First Aid
 Talk to your doctor about prescriptions
 Buy a good first aid kit
 Bas...
Also Consider:
Home schooling for children
Security
Money
Providing for Pets
Entertainment
For How Long?
 U.S. Dept of Health and Human
Services recommends that
families have AT LEAST TWO
WEEKS of supplies ready....
THREE MONTHS?!?!?!
 The best models we have indicate that
pandemics will travel in waves.
 Each wave may be in your comm...
Plan Ahead
 What happens if you get sick or
get stuck at work?
 Who will take care of your
children?
 Who will take on ...
Some good advice:
 “In your pandemic flu prep plans, don’t
forget mental health. You’ll need a hefty
supply of strength, ...
Why I am Preparing:
“Prepare for the worst,
hope for the best.”
For More Information…
 U.S. Department of Health & Human Services
www.pandemicflu.gov
 Centers for Disease Control & Pre...
For More Information…
 The Flu Wiki: the original site for preparation and up-
to-the-minute news forum.
www.fluwiki.info...
Any Questions?
Thank you for coming!
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Pandemic Influenza H1 N1 & H5 N1 V2[1]

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Katherine M. Williams, RN Masters of Nursing & Health care Practices Slide Presentation on Pandemic Flu

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  • Assign key staff with the authority to develop, maintain and act upon an influenza pandemic preparedness and response plan.
    Determine the potential impact of a pandemic on your organization’s usual activities and services. Plan for situations likely to require increasing, decreasing or altering the services your organization delivers.
    Determine the potential impact of a pandemic on outside resources that your organization depends on to deliver its services (e.g., supplies, travel, etc.)
    Outline what the organizational structure will be during an emergency and revise periodically. The outline should identify key contacts with multiple back-ups, role and responsibilities, and who is supposed to report to whom.
    Identify and train essential staff (including full-time, part-time and unpaid or volunteer staff) needed to carry on your organization’s work during a pandemic. Include back up plans, cross-train staff in other jobs so that if staff are sick, others are ready to come in to carry on the work.
    Test your response and preparedness plan using an exercise or drill, and review and revise your plan as needed.
  • Pandemic Influenza H1 N1 & H5 N1 V2[1]

    1. 1. Pandemic Influenza: What YOU Need To Know Katherine M. Williams, RN Masters of Nursing and Healthcare Practices Affiliated with: The American Red Cross Service Employees International Union, Local 199
    2. 2. What is Pandemic Influenza?  Pandemic influenza in humans occurs naturally several times a century, on average.  Pandemic flu is usually more severe than “seasonal” flu (the kind you get your annual flu shot for), with a higher death rate.
    3. 3. What is Pandemic Influenza?  Pandemic flu affects the entire world, not just a country or a continent.
    4. 4. Where Does it Come From?  Pandemic influenza is a virus to which humans have no natural immunity.  It originates in wild birds and then jumps to other species, including pigs and humans.  “Swine flu” has bird, pig and human genes, a very unusual occurrence.
    5. 5. Recent Pandemics  1918-19 - H1N1, "Spanish flu” Severe: Humans had no immunity to any of the 8 gene sequences  1957-58 “Asian flu” Mild: We had immunity to 5 of 8 gene sequences  1968-69 "Hong Kong flu” Milder: We had immunity to 6 of 8 gene sequences  1997- ? H5N1, “Bird Flu” Severe: Humans have no immunity  2009 - ? A/H1N1, “Swine Flu” Moderate: We have no immunity to any of the 8 gene sequences, but have modern medicine to help us this time.
    6. 6. Why Should We Be Concerned?  The 1918 “Spanish flu” had a mortality rate of approximately 3% and caused widespread social disruption.  H1N1 currently has a mortality rate of around 0.5%, or 5 times the death rate of seasonal influenza, with prompt, first-rate medical care.  It has spread rapidly around the globe.  It is a new, unstable, unpredictable virus that has the capability to mutate soon and often.
    7. 7. Where is it Now? Blue: A/H1N1 Red: H5N1 Purple: Both A/H1N1 & H5N1
    8. 8. Current Situation Reported deaths 3,969 deaths as of Sept 17, 2009:  Brazil: 899  United States: 694  Argentina: 514  India: 220  Mexico: 217  Australia: 172  Thailand: 153  Chile: 132  Peru: 121  Great Britain: 79  Canada: 76  Malaysia: 76 Cases have been confirmed on all continents and in nearly every country. WORLD CUMULATIVEDEATHS 0 500 1000 1500 2000 2500 3000 3500 4000 4500 5/1/2009 5/15/20095/29/20096/12/20096/26/20097/10/20097/24/20098/7/2009 8/21/20099/4/2009 Series1
    9. 9. Deaths in the U.S. First reported death: April, 2009 Current total: 693 Last week alone: 102 United States Cumulative Deaths 0 100 200 300 400 500 600 700 800 4/1/2009 4/15/2009 4/29/2009 5/13/2009 5/27/2009 6/10/2009 6/24/2009 7/8/2009 7/22/2009 8/5/2009 8/19/2009 9/2/2009 9/16/2009 Series1
    10. 10. Severity  This is now considered a “moderate” pandemic by the CDC (Category 2).  Expect at least 100,000,000 Americans to become ill at some point in the next 6-18 months.  Category 2 = between 90,000 and 450,000 deaths, mostly children and young adults.
    11. 11. A/H1N1 Fatalities  Average age of death: 38 years old.  Affecting children and young adults, very different from seasonal flu.  About 1/3 have NO pre-existing medical conditions.  Most on ventilators for at least 7 days.
    12. 12. Who’s Most at Risk?  Ages 5-50  Pre-existing conditions:  Asthma  Diabetes  Pregnancy  Heart disease  Obesity
    13. 13. But I’m not hearing much on the news!  Complacency and Apathy: our two worst enemies.  Media censorship: don’t want to cause “panic.”  There’s more “important” news out there!
    14. 14. What about that “36,000” number?  Only around 1,300 people die each year directly from seasonal influenza, according to the American Lung Assoc.  The “36,000” number is an estimated number from a 2003 study, based on pneumonia death rates.  Most at risk of death from seasonal flu: >65 or <2 years old
    15. 15. Under-reporting Issues:  No longer testing all suspected cases  Only the severely ill and/or hospitalized  Shortage of testing kits  Highly unreliable results  Need specialized test for definitive diagnosis (PCR)
    16. 16. What about a vaccine?  Won’t be available until at least mid-October  Just finishing first clinical trials  First to receive vaccines:  Healthcare workers  Pregnant women  Emergency services  “High risk” people
    17. 17. Potential Problems with a vaccine Major questions:  Safety?  Number of shots needed?  How well will it work?  How many available?  How to distribute?  80% of U.S. vaccines are made overseas.
    18. 18. What does this flu look like?  Fever (but up to 25% have no fever!)  Respiratory symptoms: cough, congestion, respiratory distress  Nausea and vomiting  Body aches and pains  Severe headache & mental status changes  Conjunctivitis
    19. 19. What if you catch it?  Most cases are “mild,” requiring no medical intervention.  Some cases are NOT mild!  If you have increased risk factors DEMAND Tamiflu from your doctor.  Pay careful attention to disease progression – if you experience respiratory distress, high fever, gray skin, or extreme lethargy: GO TO THE EMERGENCY ROOM ASAP!
    20. 20. So What Can YOU Do?  Be aware of the people around you – is anyone coughing or looking sick?  If you have increased risk factors, consider avoiding crowded areas like malls, airplanes, churches, and movie theaters.  BE AWARE: People can spread the flu for the first 24-48 hours they are infected and not show any symptoms.
    21. 21. So What Can YOU Do?  If you feel sick, STAY HOME until you have been symptom-free for at least 48 hours.  Relapse is common – watch for this.  PREPARE for the second wave starting now.
    22. 22. Prepare? For What?  Increased virulence in Second Wave?  Vaccine production and distribution issues  Tamiflu resistance?  Possible shortages of food and fuel  Combination with H5N1?
    23. 23. H1N1 + H5N1: The Worst Case Scenario  H5N1 (“bird flu”) has a 60% mortality rate.  If the two combine, we may have a virus that is easily transmissible and highly lethal.  The World Health Organization is VERY worried about this recombination.  Widespread civilization collapse is possible.
    24. 24. Mike Leavitt Former Secretary, U.S. Dept of Health and Human Services  “Local preparedness is the foundation of pandemic readiness. Any community that fails to prepare with the expectation that the federal government will, at the last moment, be able to come to the rescue will be tragically wrong.” - Interview, March 21, 2006
    25. 25. Former Secretary Leavitt, again:  "Anything we say in advance of a pandemic seems alarmist. Anything you've done to prepare after it begins is inadequate." - March 2006, California Pandemic Planning Summit
    26. 26. Who Should Prepare?  The U.S. Department of Health and Human Services recommends the following entities should begin preparations:  Individuals  Businesses  Faith-Based Organizations  Schools  Healthcare Agencies  Non-profit agencies  State and local Governments
    27. 27. Thoughts on Preparedness  We CANNOT depend on governmental help.  Most states and local governments are woefully behind on their pandemic preparedness plans.  Does your city have a plan?  How do these top-down plans affect you?
    28. 28. Individual Preparations “You are on your own.” What does this mean to the average family? It means we must PREPARE.
    29. 29. Why Prepare?  40-50% of the workforce will be absent:  Some will be sick.  Some will need to take care of families.  Some will be afraid to come to work.  Most businesses do not have a pandemic plan.
    30. 30. Why Prepare?  Medical services will be overwhelmed:  Our health care system has no real “surge capacity” to deal with a huge increase in patients.  Most hospitals do not have adequate supplies of personal protective equipment on hand to protect healthcare workers.
    31. 31. Why Prepare?  Basic services may be interrupted:  Utility workers will be affected, too, resulting in electricity, water and natural gas outages.  Most communities have only a week’s worth of chlorine on hand to treat water supplies.  Police and other emergency services may be overwhelmed.
    32. 32. Why Prepare?  International commerce will be drastically reduced:  About 80% of the raw materials for our medications come from overseas.
    33. 33. Why Prepare?  “Just in time” thinking will backfire:  Most businesses and services have very little on hand for day-to-day operations.  Think of what local grocery stores look like the day before a blizzard is predicted.
    34. 34. Why Prepare?  Schools may be closed:  Schools are prime locations for disease transmission.  Other places people congregate may also close, such as malls, churches, etc.
    35. 35. Why Prepare?  Interstate commerce may break down:  The people who deliver our food, supplies and fuel will be vulnerable, too.  Interstate travel may be restricted.
    36. 36. So Why Aren’t People Preparing?
    37. 37. I’m not preparing because…  I HAVEN’T HEARD OF IT  There are some folks out of touch with world events and the news - they don’t want to know what’s really going on around them.
    38. 38. I’m not preparing because…  I BELIEVE THE WHOLE THING IS JUST HYPE  “News organizations produce scary stories to get ratings.”  “Politicians and leaders want to cover their butts no matter how small the threat.”  “Big Pharmaceutical companies are encouraging fear to get business for their drugs.”
    39. 39. I’m not preparing because…  I DON’T HAVE THE FUNDS TO PREPARE  “It’s hard enough just paying the regular bills and you want me to spend money on something that probably won’t affect me?”
    40. 40. I’m not preparing because…  MAGICAL THINKING  “The threat is real but if I don’t prepare it won’t happen. Preparation will just cause it to happen.”
    41. 41. I’m not preparing because…  I’LL WAIT AND SEE WHAT HAPPENS  “Yeah, I know bad things could happen, but there will be plenty of time to take steps if it gets worse.”
    42. 42. I’m not preparing because…  IT’S NOT HAPPENING IN MY TOWN “Why should I be concerned because a bunch of people somewhere else are getting sick?”
    43. 43. I’m not preparing because…  I HAVE NO FEAR  “So what if it happens, I’ll just take my chances – Nothing can hurt me!”
    44. 44. I’m not preparing because…  THERE’S NO HOPE  “Preparation is an illusion. The pandemic will last so long and be so bad that I can’t avoid it. Everyone will die, so I might as well give up hope now.”
    45. 45. So you feel the need to start preparing…  What exactly do I need to do?  And for how long?
    46. 46. Take the First Steps:  Start THINKING about how you will react to a disaster – ANY disaster.  Stay INFORMED.  TELL OTHERS what you know and learn. … AND THE BIG ONE:  Be ready to “make it on your own” if things take a turn for the worse.
    47. 47. How Do We Prepare?  Begin to stockpile:  Food and water supplies  Medications  Alternative heating and cooking methods  Emergency radio / communications  Alternative sanitation / hygiene
    48. 48. A Kernel of Truth?
    49. 49. Things to Consider:  Food  For how long?  How much per person?  What to buy?  How to store it?
    50. 50. Things to Consider:  Water  How much?  How to store it?  Alternative sources?
    51. 51. Things to Consider:  Heating, lighting and cooking  Wood  Propane  Solar  Candles and lamps
    52. 52. Things to Consider:  Sanitation  Sewage waste  Toilet paper!  Feminine products  Garbage disposal
    53. 53. Things to Consider:  Medications and First Aid  Talk to your doctor about prescriptions  Buy a good first aid kit  Basic OTC medications  Take a First Aid course from your local American Red Cross chapter  Get the flu shot!
    54. 54. Also Consider: Home schooling for children Security Money Providing for Pets Entertainment
    55. 55. For How Long?  U.S. Dept of Health and Human Services recommends that families have AT LEAST TWO WEEKS of supplies ready.  The U.S. State Dept. has recommended that all U.S. residents overseas stockpile up to THREE MONTHS of supplies.
    56. 56. THREE MONTHS?!?!?!  The best models we have indicate that pandemics will travel in waves.  Each wave may be in your community for several weeks to a month.  The waves may contain slightly different versions of the virus, so you might get it more than once.
    57. 57. Plan Ahead  What happens if you get sick or get stuck at work?  Who will take care of your children?  Who will take on the role of “nurse?” or caregiver?  Do you have family or neighbors who need extra help?
    58. 58. Some good advice:  “In your pandemic flu prep plans, don’t forget mental health. You’ll need a hefty supply of strength, resolve and useful ways to manage stress and maintain resilience as much as you will need water and food.” - excellent advice from the Fluwiki
    59. 59. Why I am Preparing: “Prepare for the worst, hope for the best.”
    60. 60. For More Information…  U.S. Department of Health & Human Services www.pandemicflu.gov  Centers for Disease Control & Prevention (CDC) www.cdc.gov/flu/pandemic/  World Health Organization www.who.int/csr/disease/influenza/pandemic
    61. 61. For More Information…  The Flu Wiki: the original site for preparation and up- to-the-minute news forum. www.fluwiki.info  Pandemic Flu Information Forum: excellent source for current news and preparation. www.singtomeohmuse.com  Get Pandemic Ready: all the basics on preparation for families and individuals, easy to use. http://66.236.6.202/
    62. 62. Any Questions? Thank you for coming!
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