1. Influenza Damage AssesmentMexico April 2009

3. Rare but recurrent event (every 10-42 years). Associated with increased morbidity & mortality

4. Last 3 pandemics in last 100 yrs – 1968 (3m deaths), 1957 (2m deaths and 1918 (50m deaths)

5. Past 3 pandemics - avian viruses became a human virus

6. Human viral respiratory infection

7. Self-limiting, but can be serious & fatal in elderly & very young ~ 500,000 deaths globally each yr.

8. Occurs seasonally

9. Routine vaccination available

10. 20,000 death in Mexico last year

11. Bird virus - different from human influenza virus

12. Spreads from birds to birds

13. Can sometimes infect humans

15. Suspected in swine not deadly among them

16. Spreading from Mexico to the United States, Europe, Middle East, Asia and Africa

17. More than 2,500 infected humans in rare instances – source of outbreak is unknown

18. 15 certified with virus but at least 160 suspected

19. Deadly if not treated in the beginning

20. If A(H1N1) evolves into a human virus it could cause a human influenza pandemic

21. There is a cure but not a vaccine

24. GDP will decline 4.5%

26. overstretched health facilities

28. higher public anxiety

29. reduced capacity due to illness & death

31. interruption in public services

33. The cruise ships cancelled all ports of call (10 million passengers)

34. reduced availability of key persons

35. interruption of regular supply systemseconomic systems

37. Mexico City has a high informal sector

38. overstretched health facilities

40. loss of government credibility (45% think gov is withholding information)

42. food supply for urban centers is fixed on a weekly basis and daily on some staples

44. travel advisories for executives

45. migration of qualified human capital

46. loss of employmenteconomic systems

47. What went wrong – chain of mistakes

48. ¿What should city authorities do in the next hours? Verify the chain of command in actions and in the delivery of information Establish two press conferences a day, on the same hour (9:00 am and 6:00 pm) to inform to the media and the general population, of the situation and deliver quarantine requirements. Reinforce the message that this is not a deadly disease it can be cured if treated on time and repeat preventive measures (hand washing). Assure that medical supplies and treatment will be available and free (if treated in a private hospital the City will give a tax credit to the health care providers). Asses the availability of staples for the City on a daily basis. Acquire temperature scanners to be deployed in bus terminals (intra - national), subway and public markets. Inmates that can be transferred or have complied a reduced sentence should be freed to reduce overpopulation in jails ASAP. Involve the private sector in actions that will help prevent contagion – distribution of health kits etc.. Announce that a tax credit package is being designed for local businesses

49. ¿What should city authorities do in the next days? Normalize activities Continue the prevention campaign Announce the tax credit package (salary tax, property tax extensions) Call all the leaders of the cities different communities to personally inform the situation Same with the judicial and local party leaders

50. ¿What should city authorities do in the next weeks? Announce the creation of a metropolitan crisis response team with the Federal government and the state of Mexico Upgrade the Protección Civil unit (local FEMA) to a Cabinet level post Create a Central Crisis Command center for the city Create a color-coded threat condition indicator to correspond to the current situation. An agency-specific protective measures associated with each threat condition will allow a flexible, graduated and appropriate response to a change in the nation’s level of risk. Roadshow in the international community to reassure investors that the City is back to normal

51. North America status

52. A Bio terrorism scenariocan be ruled out Characteristics of BT Agents Chotani, 2003