Transcript Office of Safe and Drug-Free Schools National Conference 2007 Pandemic Influenza Tabletop Exercise

Office of Safe and Drug-Free Schools
National Conference 2007
Pandemic Influenza
Tabletop Exercise
Facilitators:
Pegi McEvoy, Seattle Public Schools
Larry Borland, Douglas County School District
August 4, 2007
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DRAFT
Content
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Exercise Rules
Exercise Objectives
Exercise Schedule
Pandemic Influenza Background Information
Scenario Briefings
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DRAFT
Exercise Rules
• This exercise is conducted in a “non-attributable”
environment
• Scenario depicts a plausible pandemic influenza event
• No trick questions or “hidden” agendas
• Players have no previous knowledge of the scenario,
and will receive information at the same time
• Players will respond using existing plans, procedures
and other response resources
• Decisions are not precedent-setting and may not reflect
your organization’s final position on a given issue
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DRAFT
Exercise Objectives
• Assess school district hazard prevention measures,
specifically those addressing infectious threats such as
pandemic influenza
• Assess school district preparedness
– Faculty & staff training in pandemic flu awareness
• Coordinate and assess communication plans as an
emergency response activity among school districts and
emergency response partners
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Exercise Objectives Con't.
•Assess school district’s ability to recover from a
pandemic influenza outbreak in order to resume normal
activities
•Coordinate and assess psychological support services for
students and staff
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DRAFT
Sample Exercise Schedule
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1:00 P.M.
1:30 P.M.
1:40 P.M.
2:00 P.M.
2:10 P.M
2:30 P.M.
2:40 P.M.
3:20 P.M.
3:30 P.M.
3:40 P.M.
3:50 P.M.
4:00 P.M.
4:20 P.M.
5:00 P.M.
Participant Sign-In
Introduction
Exercise Overview
Read Module 1
Module 1 Discussion
Read Module 2
Module 2 Discussion
Break
Read Module 3
Module 3 Discussion
Read Module 4
Module 4 Discussion
Debriefing about Lessons Learned
End of Exercise
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DRAFT
Pandemic Influenza
• Of the few avian influenza viruses that have
crossed the species barrier to infect humans
– H5N1 has caused the largest number of detected
cases of severe disease and death in humans;
– H5N1 has potential to cause a pandemic influenza
outbreak;
– Half of those infected with the virus have died;
– Most cases have occurred in previously healthy
children and young adults
FROM PARTICIPANT MANUAL APPENDIX A – CDC H5N1 FACT SHEET
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Pandemic Influenza
• Symptoms
– Typical human influenza-like symptoms
• Fever, cough, sore throat and muscle aches
• Eye infections, pneumonia and severe respiratory
diseases
• Severity of symptoms depends on which virus
caused the infection
FROM PARTICIPANT MANUAL APPENDIX A – CDC H5N1 FACT SHEET
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Pandemic Influenza
• The H5N1 virus is resistant to two antiviral medications
commonly used for influenza (amantadine and
rimantadine)
• Two other antiviral medications, oseltamavir (Tamiflu™)
and zanamavir, would probably work to treat influenza
caused by H5N1 virus
• In April 2007, the Federal Government purchased from
Sanofi Pasteur Inc. an H5N1 vaccine for inclusion in the
Strategic National Stockpile (SNS) and to be distributed
only by public health officials if needed
• Other vaccines are being researched and developed
FROM PARTICIPANT MANUAL APPENDIX A – CDC H5N1 FACT SHEET
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DRAFT
World Health Organization (WHO) Phases and
Federal Government Response Stages (USG)
Participant Manual Appendix D, CDC “Pandemic Influenza Community Mitigation Interim
Planning Guide”
DRAFT
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WHO Phases,
United States Government Response Stages
(USG) and
Pandemic Severity Index (PSI)
Participant Manual Appendix D, CDC “Pandemic Influenza Community
Mitigation Interim Planning Guide”
DRAFT
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WHO, USG and PSI
• WHO and USG are reporting mechanisms
describing the events (i.e., animal cases, human
cases, deaths, etc.)
• PSI is a planning tool and is based on
epidemiologic measurements
• Beginning at USG 3, USG & PSI are used
together
• PSI uses projections to gauge the potential
impact and prompts specific community actions
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Summary of the Community Mitigation
Strategy by Pandemic Severity
Participant Manual Appendix D, CDC “Pandemic Influenza
Community Mitigation Interim Planning Guide”
DRAFT
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Scenario Briefing – Module 1
May 2010 – July 2010
• Limited number of H5N1 cases in Asia, no human
cases in United States
– Increasing number of animal cases, very few human cases in
Asian countries
– Most H5N1 human cases attributed to contact with diseased
animals
– WHO issues Phase 3 pandemic alert indicating “no or very
limited human-human transmission”
DRAFT
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Scenario Briefing – Module 1
May 2010 – July 2010
• Limited number of H5N1 cases in Asia, no human cases
in the United States
– No cases of infection (in humans and animals) have been
identified within the United States
– Health and Human Services (HHS) developed Pandemic
Influenza Plan
– Centers for Disease Control (CDC) developed infection
prevention and control measures for the public, school systems,
hospitals, etc
– United States allocated funding for additional vaccine research
and development
– Increasing media coverage raises public awareness on the
threat of pandemic influenza
DRAFT
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Module 1
Key Discussion Questions
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What kind of educational material is available to
faculty, staff, students and parents about pandemic
influenza?
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Does the plan outline the decision-making process,
key personnel, and criteria for cancelling classes or
closing schools? For example, are decisions made by
the education or health agency? At the State or local
level? Or, collaboratively?
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Has faculty, staff, community and emergency response
partners been involved in providing input and feedback
for crisis planning for schools?
DRAFT
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Module 1
Key Discussion Questions
(cont.)
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Will faculty and staff play a role in the incident
command structure once the Incident Command
System (ICS) is activated during an emergency? If so,
what is the role?
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Does the school have plans to acquire and maintain
essential supplies, such as disinfectants, face masks,
gloves, in the event of a pandemic influenza outbreak?
DRAFT
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Module 1
Additional Discussion Questions
(as time allows)
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Is the school district’s current emergency response
plan suited for a pandemic influenza outbreak?
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Has the State legislature drafted policy providing
considerations and accommodations to local school
districts in the event of a pandemic flu (i.e., reducing
the number of required school days and allowing for
additional leave for staff).
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Is there a communication plan for keeping the district
and schools informed of decisions regarding school
scheduling and closures?
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Module 1 Questions
DRAFT
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Scenario Briefing – Module 2
July 2010 – September 2010 (USG 4)
• H5N1 human cases on the rise in Asia, few isolated
human cases found in the United States
– WHO issues Phase 6 pandemic alert, indicating efficient and
sustained human-to-human transmission
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Few cases in the United States
Isolated human cases in United States, some fatalities, USG 4
PSI Standby activities are activated
CDC alerted hospitals, physicians and other healthcare and
public health entities to prepare for a potential outbreak within
the United States
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Scenario Briefing – Module 2
July 2010 – September 2010
• H5N1 human cases on the rise in Asia, few isolated
human cases found in the United States (cont.)
– US hospitals see an increase in human cases over the next two
months
– Most severe cases seen in children and young adults
– Virus spread by close-contact
– H5N1 threatens school, because students are in close-contact
and use the same equipment and facilities
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DRAFT
Scenario Briefing – Module 2
July 2010 – September 2010
• H5N1 human cases on the rise in Asia, few
isolated human cases found in the United States
(cont.)
– During the month of September 2010, the local hospital is
treating more and more H5N1 patients
• Most patients are children and young adults
– On September 20, 2010, CDC confirmed several local media
reports that the most recent human H5N1 outbreak occurred
inside a high-rise apartment building in (City / District)
– PSI moves to Activate
– On September 26, 2010 the district cancels all classes and
implements alternative teaching and learning activities
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Module 2
Key Discussion Questions
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Does the school system have a surveillance system for
absences? If so, is this system linked to the local
health department or other health-related entity?
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Does the school plan adequately address the
maintenance of educational operations in the case of
pandemic? If so, what plan is in place for maintaining
continuity of instruction (tele-schooling,
individual/group mentoring) for students?
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What is the school procedure for school closure when
a public health emergency has been declared?
DRAFT
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Module 2
Additional Discussion Questions
(as time allows)
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To address the fear of a pandemic influenza outbreak,
does the school district have the capabilities to provide
psychological support for student and faculty/staff when
needed?
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Does the school have established communication
protocols with community and emergency response
partners, such as local health departments and media,
before and during a public health emergency?
DRAFT
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Module 2
Additional Discussion Questions (cont.)
(as time allows)
• What is the school’s plan to communicate with media for
latest information dissemination?
• What is the school’s plan to communicate with
emergency response partners (e.g., public health) during
pandemic influenza outbreak during a public health
emergency?
DRAFT
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Module 2 Questions
DRAFT
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Scenario Briefing – Module 3
October 2010 – December 2010
• Significant H5N1 human-to-human transmission in
the United States
– Surge in people seeking care for influenza-like illness
– Epidemiological studies reveal schools and daycare centers are
most vulnerable to outbreaks because people are in close quarters
to one another and susceptible to the influenza virus
– A pre-established partnership agreement between the district and
the local public health agency provides vaccines to educators after
the most vulnerable populations are treated. However, the supply is
very limited. (It is possible that schools will not be provided any
vaccines)
– The Federal Government is working with foreign manufacturers to
produce more vaccinations
– USG 5 and PSI Level 5 moves to Activate
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Scenario Briefing – Module 3
October 2010 – December 2010
• Significant H5N1 human-to-human transmission in
the United States (cont.)
– Schools in the district remain closed
– USG 5 and PSI Level 5 -Activate
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Module 3
Key Discussion Questions
What key procedures are in place to support the
continuity of essential school operations, during a long
term school closure? The following items should be
considered during discussion
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Air quality/HVAC system functions
Decontamination
Safe learning environment and alternative teaching and
learning methods
Payroll
Line of Succession for all key staff
Collective Bargaining Agreements
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Module 3 Questions
DRAFT
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Scenario Briefing – Module 4
January 2011
• Human H5N1 cases on a steady decline…for now
– Human H5N1 cases here in the United States and around the world
have leveled off and begin to decline
– The vaccine only offers limited protection from and immunity to the
H5N1 virus
– The Federal Government secured additional vaccinations and began
to provide the vaccine to district personnel
– Federal Government Response Stage at USG 6-PSI Level moved to
Activate
– After several months of closure, schools are back in session
• Elevated rates of staff and student absenteeism (approximately
1/3)
• Alternative learning activities are provided to affected students
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Scenario Briefing – Module 4
January 2011
• Human H5N1 cases on a steady decline… for now…
– Seasonal Flu Impact: concurrent epidemic of seasonal flu
– Not over: Past experiences with pandemic flu outbreaks show
outbreaks can occur in waves
– H5N1 resurgence is a realistic threat
– Recovery phase with standby community activities in place
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Module 4
Key Discussion Questions
1. How much time/school days does the district need to
prepare to reopen individual schools within the district? For
example, how many days are needed to:
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Replenish cleaning and hygiene supplies;
Assess, identify and prioritize the order of individual schools to
reopen;
Assess staff capacity, including substitutes (remember, nearby
school district will also be recruiting substitutes);
Inform and train staff on health and prevention issues;
Inform parents of school reopening plans and procedures; and
Inform, train and modify learning environment to meet the
needs of available staff and healthy students at school
alongside alternative strategies addressing those at home.
DRAFT
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Module 4
Key Discussion Questions
• What is the school’s plan to provide psychological
support to faculty, staff, students and parents who have
been in isolation for three months and are having
difficulty re-adjusting to “regular life?”
• What is the school’s plan to maintain monitoring for
possible resurgence of the virus?
DRAFT
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Module 4
Additional Discussion Questions
(as time allows)
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Does the emergency management plan provide protocols
standards for decontaminating the buildings and standards
providing for a safe and healthy environment?
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What kind of resources does a district need in order to rehabilitate the
learning environment (i.e., what supplies and tool, how many staff,
how many days.) For example, if the school was used as a
community facility, such as a makeshift hospital or clinic or vaccine
distribution site, what are the procedures for sanitizing the facilities?
Does the district have agreements in place with local and/or State
emergency response entities regarding decontamination processes
and determinations of safety?
DRAFT
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Module 4
Additional Discussion Questions (cont.)
(as time allows)
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Does the plan provide criteria for students and
staff re-entering the school community and
recontamination prevention programs? For
example, those who have been exposed in the
last seven days are not permitted to attend
school. For those attending school, are there
sufficient hand-washing supplies and
information awareness campaigns preventing
the spread of germs? Are social distancing
programs in place?
DRAFT
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Module 4
Additional Discussion Questions (cont.)
(as time allows)
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What are the school’s procedures to maintain
communication with community and
emergency response partners in case H5N1
resurfaces?
What are the school’s efforts to communicate
with parents, students and staff about the
possibility of H5N1 resurfacing?
What is the school’s plan to provide
psychological support for faculty, staff, and
students due to influenza related fatalities?
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Module 4 Questions
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Exercise Debriefing Questions
• Does the school emergency response plan adequately address
key issues, such as school faculty and staff training in pandemic
flu knowledge and handling high morbidity and/or mortality in
schools, in dealing with a mass influenza outbreak?
• What issues did you identify in the emergency management
procedures that could hinder emergency management efforts?
• Does the school and district emergency response plan
adequately address key issues faced during a long-term school
closure, including continuity of instruction, feasibility of feeding
students in school meal programs, continuity of business
operations (e.g., payroll) and leave policies for teachers?
DRAFT
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Exercise Debriefing Questions Con't.
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Do the school emergency management procedures properly coordinate
communication as an emergency response activity among schools, school
districts, community and emergency response partners during a pandemic
influenza event? In your opinion, what can be done to maintain and
coordinate communication during an emergency situation such as the
pandemic influenza scenario presented in the exercise?
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Does the plan provide adequate resources to the district and schools?
Does the plan take into account those resources available regionally?
Does the plan outline a process for requesting assisting and resources
from local and state partners?
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What are the roles and responsibilities of parents throughout the district’s
pandemic influenza plan? Do they participate in prevention-mitigation
activities? Preparedness? Response? Recovery? Are parents involved in
the decision to cancel classes? At what level are they engaged?
DRAFT
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Exercise Debriefing Questions Con't.
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Does the plan provide for adequate psychological support
for students, faculty and staff before, during and after a
mass influenza outbreak event? If not, what activities and
partnerships can the team identify to enhance the mental
health of faculty, staff and students?
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Overall, is the school capable of effectively and efficiently
recovering from a mass influenza outbreak in order to
resume a safe learning environment? Can the team identify
methods for hastening the disinfectant process? What
social distancing strategies can be added?
DRAFT
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END OF EXERCISE
Your input, feedback, questions and other issues
identified during the exercise that can help improve
school crisis planning. Currently, all events depicted
in this exercise are fictional as there is no pandemic
influenza outbreak in the United States. The ultimate
goal of this exercise is to provide school districts as
well as their respective community and emergency
response partners an opportunity, through
discussion of possible events, to better prepare for a
pandemic flu outbreak.
DRAFT
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