Planning for Pandemic Flu. pandemic flu table-top exercise



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Planning for Pandemic Flu Lawrence Dickson - University of Edinburgh

Background Previous phase of health and safety management audit programme raised topic of Business Continuity Management Limited ability to continue full range of University work activities due to loss of staff or facilities Definition of essential activities and key staff Flu pandemic is a good example of such a situation

Definitions Epidemic: serious outbreak in a single community, population or region Pandemic: epidemic spreading around the world affecting hundreds of thousands of people, across many countries

What causes pandemic flu? Emergence of a new highly virulent flu viral strain New virus passes easily from person to person Few, if any, people have any immunity No vaccine available

Influenza pandemics in last century Year Strain Name Number of confirmed human deaths (UK) 1918-19 H1N1 Spanish Flu Global Deaths 250,000 20-40 million 1957-58 H2N2 Asian Flu 33,000 1 million 1968-69 H3N2 Hong Kong Flu 33,000 1 million

Guidance available e.g. at: http://www.dh.gov.uk

Foreseeable risks to the University Loss of key individuals due to illness or death Disruption to teaching/examinations/research Reduction in student numbers Critical supplies - e.g. catering in residencies, research reagents Central support IT network, building maintenance, security Sick students unable to travel home, and difficulty in monitoring, assuming 25% affected Inability to handle enquiries from relatives and friends Reliance on external providers, e.g. WebCT, BT, whose service may also be disrupted

Policy and Approach The University will endeavour to continue to operate throughout a pandemic The University will take guidance from the government and will comply with instructions issued by the government The health and well being of staff and students is paramount Students will not be disadvantaged as a result of the incidence of pandemic flu The University will provide communication and advice that aims to inform and calm fears, and will avoid creating concerns or worries in people, or attract unhelpful Press interest The University will adopt both containment strategies and continuity strategies to manage the impact of an outbreak

UoE Information available Corporate Action Plan at current alert level Communication, infection control, student accommodation issues Minimise the risk of spread of flu and recognising the symptoms of flu Pandemic flu planning checklist for individuals and families

Information available from many different web sites, e.g.

http://www.ed.ac.uk/staff-students/staff/pandemic-flu

http://www.safety.ed.ac.uk/resources/general/pandemic.shtm

http://www.safety.ed.ac.uk/resources/general/pandemic_flu_plan.shtm

http://www.dh.gov.uk/en/index.htm

http://www.who.int/csr/disease/swineflu/en/index.html

http://www.scotland.gov.uk/topics/health/health/avianinfluenza/mexicanswiuneflu

Current WHO phase of pandemic alert Inter pandemic phase New virus in animals, no human cases Low risk of human cases 1 Higher risk of human cases 2 Pandemic alert New virus causes human cases No or very limited human-human transmission 3 Evidence of increased human-human transmission 4 Evidence of significant human-human transmission 5 Pandemic Efficient and sustained human-human transmission 6 Updated 27 11 29 th June April 2009

WHO PANDEMIC INFLUENZA PHASES PHASES 5-6 / PANDEMIC PHASE 4 POST PEAK PHASES 1-3 POST PANDEMIC TIME PREDOMINANTLY ANIMAL INFECTIONS; FEW HUMAN INFECTIONS SUSTAINED HUMAN TO HUMAN INFECTION WIDESPREAD HUMAN INFECTION POSSIBILITY OF RECURRENT EVENTS DISEASE ACTIVITY AT SEASONAL LEVELS

How the desktop exercise will work Five parts: Part 1 Significant human-to-human transmission of a new virus Part 2 Outbreak in the UK Part 3 Suspension of teaching/research Part 4 Business Continuity and Recovery Each of these sections will be followed by a short question and discussion session Part 5 Debriefing Questions Parts 1 4 will be driven by a series of interjects, introduced at ~ one minute intervals

Part 1 Significant human-to-human transmission Dec 2005 Jan 2009 April 2 nd April 22 nd April 24 th April 26 th April 28 th April 29 th The US Centres for Disease Control and Prevention receive reports of twelve cases of human infection with swine flu. Five of these twelve cases occurred in patients who had direct exposure to pigs and six reported being near pigs. A 4-year-old boy contracts the swine flu virus in Veracruz state, Mexico. A community in Veracruz has been protesting pollution from a large pig farm. CDC confirms three cases of swine flu in California and two in Texas, near San Antonio. Mexico's Minister of Health confirms 20 deaths from swine flu, but 40 other fatalities are being investigated and at least 943 nationwide are sick from suspected flu. Mexico City shuts down schools, museums, libraries, and theatres across the capital. Authorities begin to screen for signs of infection at some international airports. The United States Government reports 20 laboratory confirmed human cases of swine influenza A/H1N1 (8 in New York, 7 in California, 2 in Texas, 2 in Kansas and 1 in Ohio). The WHO raises the level of influenza pandemic alert phase 3 to phase 4. Two suspected cases of swine flu in Scotland affecting individuals who have recently returned from Mexico are been confirmed as positive. Both individuals are recovering at Monklands Hospital in Lanarkshire. A University employee returning from Mexico City plans to return to work as normal. The Health and Safety Department receives a request for Tamiflu from a member of staff planning to visit China on business. Map showing global confirmed cases 29 th April, 16:30 GMT Further confirmed cases in the UK are reported from London, Birmingham and Devon.

Part 2 Outbreak in the UK April 29 th May 4 th May 10 th June 11 th June 14 th June 29 th The WHO Director-General raises the level of influenza pandemic alert phase 4 to phase 5, and announces that a pandemic is imminent. Over the next few days additional cases are reported from around the world, but the adverse health effects of the disease appear to be mild. The media are playing down the severity of the outbreak, with fewer and fewer reports being detailed in news bulletins. The WHO Director-General raises the level of influenza pandemic alert phase 5 to phase 6, indicating that the world is now at the start of the 2009 influenza pandemic. The first UK swine flu death is reported in Paisley a 38 year old woman with underlying health conditions. A second UK swine flu death is reported. The man, a 73 year old from the Inverclyde area, had "serious underlying health conditions". The first death in England is reported the next day, a young girl in Birmingham. One Scottish Institution has already experienced an outbreak of swine flu which has affected 200 individuals