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Planning for Pandemic 2009 H1N1 Key Interagency Points COOP / COG CI/KR Interact with the Public / Business Community 1st Responder Support Social Distancing School Closure Higher Ed Cancelling Public Events Behavioral Health Ongoing Initiatives Operationalized (for H1N1) State PanFlu Plan, recently reviewed by Feds and updated. Monitor stock levels. Provide daily Situation Reports to state leadership. Coordinate with partners for deployment of state antiviral stockpile Posting H1N1 info on WebEOC Coordinating with DOE and DMHMRSAS DOE working closely w/ PUBLIC Schools DMHMRSAS w/ CSBs Ongoing Initiatives Develop Guidance Documents / Outreach: DOE/ Higher Ed, Healthcare, Responders, Pharmacies, etc. Received SNS material and operationalizing distribution plan. Active Public Communications Campaign Updating Website, Press Releases, FAQs, talking points daily+. Daily Thematic Press Teleconferences, Interviews Talking Point Virtual Library SWINE FLU ICS DR. KAREN REMLEY, COMMISSIONER Incident Commander Dr. Mark Levine Deputy Commissioner Deputy Incident Commander Rob Oldham, MD PIO Phil Giaramita Planning Chief Bob Mauskapf Technical Advisors Safety Officer Joanne Wakeham, PhD Logistics/Administration/ Financial Chief Stacey Ferrer Operations Chief Dr. Diane Helentjaris 35 District Health Planning Units District Planners Situation Unit Leader Steve Harrison Liaison Officer Joe Hilbert CHS Branch Director Jeff Lake Epi Branch Director Diane Woolard, PhD HR Becky Bynum 35 Local Health Dept. Units District Directors Education Branch Director Suzi Silverstein Hospital/Medical Community Branch Director Bill Berthrong EMS Unit Leader Jim Nogle Lab Branch Director Dr. Jim Pearson Fatality Mgmt Director Dr. Leah Bush Behavioral Health Branch Director Beth Nelson, DMHMRSAS DCLS Laboratory Testing Initially performed validated seasonal flu assay for A/H1, A/H3, and influenza B; forwarding “untypeable” (probable swine flu) specimens to CDC Modified test algorithms and performed Swine flu testing on specimens when the patient met the VDH/DCLS case criteria Implemented electronic system to pre-accession and track swine flu samples; VDH Regional epidemiologists approved sample submission and assigned numbers based on criteria prior to file transfer to DCLS Prepositioned specimen collection kits in OCME regional sites and all District HD for redistribution to medical facilities statewide Expanded courier schedule to 7 day pickup at District HD locations DCLS Laboratory Testing Verified the CDC-Emergency Use Approval (EUA) Swine flu assay in 3 days; CDC certified to report confirmed (positive) influenza A/H1 (swine) results Continued to test respiratory viruses and sub-type seasonal influenza A for H1 and H3 to meet obligation as a WHO reference laboratory Updated website information, established a laboratory call center, emailed and blast-faxed laboratory safety, specimen collection and shipping information to Sentinel physicians, sentinel laboratories, and District HDs. Modified LIMS applications; implemented reports and queries; Enhanced electronic messaging to provide results to VDH and CDC using HL7 reporting standards Diverted and trained additional staff from other parts of DCLS to support accessioning, testing and reporting Pandemic Influenza Planning: Health Risk communications Community containment Antiviral distribution plan Mass vaccination Medical surge, healthcare coalitions Surveillance and investigation Laboratory services Fatality management Altered standards of care due to resource limitations Issue: Antivirals Federal stockpile of antivirals growing VA has 770 K courses on-hand Rec’d 280K add’l courses from SNS For Treatment only: Distribution Through Pharmacies+++, in accordance with VDH SNS / Medical Countermeasure Distribution plan Increasing supply and production capacity Discussion of increased prophylaxis use AV Prescription Abuse; Stockpile implications: Avg. Day: AB Co. receives orders for 6k courses 5/3: 600k courses; Allocations established. Vaccines No H1N1 Vaccine yet developed; Working. VDH has a robust and frequently tested Statewide Mass Vaccination Plan an element of VDH Strategic National Stockpile / Medical Countermeasure Distribution Plan Pandemic Influenza Planning: Non-Health Command and Control Public Safety Sustainability Community containment measures Continuity of Operations: Economic impact School closure / Event cancellation Isolation Voluntary quarantine Government entities Critical infrastructure: Courts, economy, trade, business Agriculture, water and food chain safety Human resource issues, policies (public and private) Extended Pandemic Influenza Planning Include involvement of: DOD Installations Courts Schools/Colleges and Universities First responders – fire, EMS/Public safety, Law enforcement Business community/Private sector Media Assisted living and other social services programs Volunteer, non-profit groups/Faith community Coordinated planning of federal, state, local governments and agencies Public Information Issues Integrity of media lists Importance of setting clear guidelines and sticking to them Control messages by maintaining consistent news flow Value of networking to dispel contradictory or false information Partnership support on staffing needs Timely approval process Lessons Learned Refine human resource, purchasing, and financial management guidelines for statewide application. Improve State Agency familiarity on Continuity of Government plans and policies, and develop additional measures where gaps were identified. Define and determine “essential personnel” in consideration of a protracted event and assure measures are in place to provide for augmentation personnel and cross-training. Lessons Learned (cont’d) Identify state, local government and private sector essential infrastructure and services. Consider Enforcement and Inspection waivers if needed due to staff shortages and to assure business continuity. Evaluate legality of suspending FOIA laws pertaining to electronic meetings, quorums and public meeting requirements at the state and local levels, and determining if meeting requirements can be suspended, waived or modified so that state boards can meet on the telephone or electronically. Develop social distancing messages/protocols and public countermeasures. Lessons Learned (cont’d) Prioritize supply chain services and resources to ensure essential needs are met. Consider stockpiling of essential supplies where appropriate. Resolve misconceptions on responsibilities for fatality management. Work with the media in delivering educational information to the public. Vigorously pursue improvements to telework policies and capabilities. PanFlu COOP Discuss expectations with staff early Communications will be key Need reliable, credible sources of information Need coordinated communication channels Rely on both internal/external channels May need to consider relief for regulatory requirements Coordinate vertically and horizontally. Cross-train Succession is a two-way street. Questions? http://www.cdc.gov/swineflu http://www.vdh.virginia.gov http://www.vdh.virginia.gov/pandemicflu