Many
organizations have planned for disasters, some
with an impressive array of activities including
practice drills, tabletop exercises, and extensive
implementation plans. While all of these activities
are essential to minimizing the impact and costs
of natural disasters for terrorist activities,
they will prove inadequate for pandemic events
such as an outbreak of a new strain of influenza.
Experts say a pandemic will feel more like
a war or a severe economic crisis than an earthquake,
hurricane, or act of terrorism. As a result,
a pandemic threat requires a unique approach
to planning and a different set of skills and
preparation than traditional disaster preparedness
activities. |
This article was published
in the
Fall
2006 issue of Perspectives.
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 “Organizations that depend upon existing, on-the-shelf
disaster plans will pay a heavy price during a pandemic
event,” said Bob
Blitzer, an ICF International
vice president in emergency management. “Within
a few days, the organization will realize that it is
unprepared to respond to the needs of its employees,
its customers, and its community.”
U.S. federal
officials who have been planning for potential pandemic
events have made it very clear that this is a unique
threat, unlike any natural or man-made disaster.
"The pandemic threat is different...the
significant mobility of human populations means that
every corner of the globe and every element of society
are likely to be touched. This widespread effect has
ramifications not only for the health and well being
of populations, but for the national and economic security
of the nations, and the functioning of society. Once
this fundamental premise is recognized, the scope and
scale of the measures necessary to prepare for a pandemic
become apparent."1
It also is apparent to the experts involved in planning
for a pandemic event that relying solely on the health
and medical communities to respond to this kind of
a crisis is unrealistic and potentially dangerous.
Officials point out that the vast majority of the
actions that will be taken will occur from nontraditional
sources. Federal support will be substantially less
than in the case of traditional disasters, and because
of the scope of the problem, traditional “mutual
assistance” agreements
with neighboring communities and states will be virtually
useless.
"They all think the cavalry is going to arrive
and do all the ‘heavy lifting,’" said
Anita Tallarico, an ICF senior vice president describing
state and local agencies and the business community. “However,
government officials emphasize that local communities
must prepare to be able to help themselves for at
least three days.”
The President’s Implementation Plan clearly
states that the primary burden of responding will fall
on nongovernmental institutions. “More than 85
percent of critical infrastructure is owned and operated
by the private sector. Therefore, sustaining the operations
of critical infrastructure under conditions of
pandemic influenza will depend largely on each organization’s
development and implementation of plans for business
continuity while facing staffing shortages and
the need to protect the health of its workforce.”2
This
will require a major “shift in thinking” for
businesses that are not accustomed to taking care
of health needs for employees while simultaneously
trying to sustain business operations with limited
staff and absence of other normal support services
for an extended period of time.
"When we go in
and work with a client on a training exercise and help
with planning,” said Blitzer—who
formerly headed up the Weapons of Mass Destruction
response operations at the Federal Bureau of Investigation—“the
client quickly realizes that its traditional way
of thinking about disaster planning is completely
inadequate. Once stakeholders realize how quickly
a pandemic outbreak occurs, and the fact that it
is inevitable that another one will occur in our
lifetime, their thinking changes."
Here are
just a few of the assumptions federal officials make
as they plan for a pandemic event. These assumptions
also must be incorporated into planning efforts
in the private sector and by state and local agencies.
- Susceptibility
will be universal.
- Civil disturbances and breakdowns
in the public order may occur.
- Typically, illness rates
will be highest among school-aged children (about
40 percent) and decline with age. Among working adults,
an average of 20 percent will become ill during
a community outbreak. Actual illness rates by age,
however, will depend on the characteristics of the
new virus and may vary from these rates.
- Risk groups for severe and
fatal infection cannot be predicted with certainty,
but are likely to include infants, the elderly,
pregnant women, and persons with chronic or immunosuppressive
medical conditions.
- In a severe
pandemic, absenteeism rates of 40 percent or higher
may result from individual illness, the need to
care for ill family members, and fear of infection.
- Typically,
the risk of transmission (viral shedding) will
be greatest during the first two days of illness.
Children will play a major role in spreading the
disease.
- On average,
infected persons will transmit infection to approximately
two other people.
- Isolation and quarantine measures
are likely, as are mandatory restrictions on domestic
and international travel.
- Epidemics will last six to
eight weeks in affected communities.
- Multiple waves
of illness are likely to occur, with each wave
lasting two to three months.
National Strategy for Pandemic Influenza President Bush released
the National Strategy for
Pandemic Influenza
in May 2006.
The Implementation Plan
outlined
in the report identifies four federal priority
actions: |
1. Advance International Capacity
for
Early Warning and Response. |
- Advance International
Cooperation: Secure
international commitment to transparency, scientific
cooperation, rapid reporting of human and animal
cases, and sharing of data and viral isolates—in
collaboration with the U.S.-initiated International
Partnership on Avian and Pandemic Influenza.
- Build International
Capacity: Provide technical assistance to
build veterinary and public health capacity in
at-risk countries and to detect and contain animal
and human outbreaks of avian influenza, including
development and exercise of preparedness
plans.
- Ensure Rapid Response: Develop the federal
government’s
capability
to respond rapidly to animal or human outbreaks
of influenza with
pandemic potential for purposes of assessment
and containment, either independently or
in support of an international response.
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2. Limit the Arrival and Spread of a Pandemic. |
- Ensure Early Warning
and Situational Awareness: Enhance domestic avian influenza surveillance
in humans, wild birds, and poultry.
- Establish
a Border and Transportation Strategy: Develop
a comprehensive border and transportation
strategy that strikes a balance between efficacy
of interventions to delay and limit the spread
of disease and the economic and societal
consequences, international implications,
and operational feasibility of these interventions.
- Establish Screening Protocols
and Implementation Agreements: Establish
alliances with international partners to
voluntarily limit travel and establish
screening for travelers from affected areas.
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3. Provide Clear Guidance to All Stakeholders. |
- Ensure Effective Risk
Communication: Implement educational and risk communications
programs to increase national and international
awareness of the risks of avian influenza and
appropriate behaviors to reduce these risks.
Ensure that timely, accurate, and credible information
is provided by spokespeople at all levels of
government during an outbreak.
- Provide Guidance
on Distributing Urgent Resources: Develop
and share with state, local, and tribal public
health officials and the medical community
strategies for optimizing the allocation
of scarce medical resources during periods
of sharp surges in the need for medical services
and mechanisms for incorporating additional
health care providers within defined settings.
- Provide Comprehensive
Guidance to Limit the Spread of Disease: Develop
a containment template for state, local, and tribal partners that builds
upon data available from state-of-the art
modeling and scientific understanding of
influenza biology and patterns of transmission.
- Provide Clear Guidance
for the Public and Private Sectors: Develop
pandemic planning guidance for private
sector, and federal, state, local, and
tribal entities.
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4. Accelerate the Development of Countermeasures. |
- Develop Rapid Diagnostics: Support
development of rapid, sensitive,
and accurate diagnostic tests, to be used in the clinical setting and for screening.
- Establish Stockpiles of
Vaccine and Antiviral Medications: Build
stockpiles of pre-pandemic vaccine and
antiviral medications and define strategies
for use.
- Advance Technology and
Production Capacity for Influenza Vaccine: Develop
cell-based, vaccine-manufacturing methods;
increase domestic vaccine production capacity;
and advance the development of next-generation
influenza diagnostics and countermeasures,
including the most effective methods of
preparing for and responding to a surge
in demand for medical services.
|
SOURCE: Fact
Sheet: Advancing the Nation’s Preparedness
for Pandemic Influenza
(May 3, 2006) |
For more information on how you can help your organization
meet the federal guidelines for preparing an effective
pandemic event implementation plan, contact info@icfi.com or 1.703.934.3603, or visit icfi.com/pandemic.
1National Strategy for Pandemic Influenza:
Implementation Plan. May 2006, p. 18.
2National Strategy for Pandemic Influenza:
Implementation Plan. May 2006, p. 13.
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