ࡱ> BDAM (bjbj== "@WW$ltttt }$   :} } <V@} ХZt }0x} County Briefing for Hospital Avian Flu Good Afternoon. Id like to thank Dr Tsai for inviting me to speak to you today about Avian Flu and a possible pandemic. First, I need to clarify what my office does and what it doesnt do. The Dukes County Emergency Management Agencys mission statement has both an Internal and an External component. The internal component is to contribute to the continuity of the County Government, before during, and after an emergency or disaster. This means that it is my responsibility to help create plans for the various County departments and to help them to implement these plans in the mitigation, preparation, response, and recovery phases of an emergency or disaster. Also in this Internal part of the mission statement is my responsibility to contribute to the ability of County employees to be better able to prepare themselves and their families for emergencies and disasters. This is a new program by my office that is to begin at the department heads meeting on the 30th of Dec. This is designed to be a cooperative process between the employees and their Emergency Management department. In addition to the run of the mill weather emergencies that we face here on the island, my office will provide answers to individual questions from County employees regarding personal and family disaster prevention, preparation, response and recovery, by email. In regards to Avian Flu / Flu Pandemic, this question and answer process will become very important when it comes time to help the employees protect themselves and their families. The external part of my mission statement, and this is more important to the hospital, is to collect disaster related information and disseminate the information to interested governmental bodies and interested non-governmental bodies. This information, which could include information that has come down through the Emergency Management channels, or planning templates that others have successfully used (Im thinking of the Portable Isolation Units, or perhaps flash alerts of an emergency nature, or just information of a technical nature from an Emergency Management perspective, is available to you from the County Emergency Management office or the County Emergency Management Library, if you desire it. Another example of this is any change in the Pandemic Alert levels, which are checked daily, by my office. The second part of my mission statement is to facilitate multi-departmental and multi-jurisdictional cooperation between Island governmental bodies and between Island governmental bodies and non-governmental bodies. This part of the mission statement was added because it is becoming increasingly evident that the crisiss that the Island faces, be they natural, man-made, or in the Public Health sector, are becoming more regional in nature and require resources that are located in one town but are needed by all the other towns. The second reason why this was added was because of the growing threats of Public Health Emergencies. For example, in a pre-pandemic or pandemic situation, you would need help from a variety of disciplines. Just imagine the challenges that you would face if you had 200 people clamoring at you doors. Then imagine if you didnt know which ones were contagious. Then, imagine that they all brought their kids. Then imagine if 30% of your workforce didnt show up because they were too ill to come to work. Then imagine that youre already full. Then imagine that you have many deceased patients to prepare, arrange transportation and storage for. As you can see, in a situation like this, you had better have a lot of partnerships already established within your community, or you will quickly be overwhelmed. Now, what we dont do is to usurp control from any of the Town Emergency Managers. By Law, they are your Emergency Managers and they have jurisdiction over certain emergency management matters within their jurisdictional boundaries. The County has absolutely no controlling authority over any property or person outside the County Department or County Property and my mission statement is very careful about this matter. That said , common sense dictates that if you need resources or planning help from outside of the jurisdiction, you should be free to arrange for them. Now, Avian Flu. The current situation is that the world has passed the interpandemic period and has entered the Quote Pandemic Alert Period. The Pandemic Alert Period (as defined by the World Health Organization) is composed of 3 phases - Phase 3, Phase 4, and Phase 5. We are currently at Phase 3, which is characterized as Human infections with a new subtype but no human to human spread or rare spread to close contacts. We have not yet entered Phase 4, which is Small clusters, human-to-human transmission and the spread is highly localized, and the virus not well adapted to humans Phase 5 is characterized by large clusters, human to human spread is still localized, but the virus has mutated to be increasingly better adapted to humans, although it is still not fully transmissible, nor does it pose a substantial pandemic risk. If the virus was to mutate further, we would all pass out of the Interpandemic period and enter the quote Pandemic Period The pandemic period is really Phase 6 and it is characterized by increased and sustained transmission in the general populations. To recap, we are currently in the Pandemic Alert Period. We are at Phase 3 Phase 3 is that there are human infections with a new subtype but no human spread or rare spread to close contacts. We, the Emergency Managers, are watching for the next Phase Phase 4, which is that the virus has now mutated in such a manner that human-to-human transmission is possible but is confined to small clusters and that the spread is highly localized and the virus has not yet mutated to adapt well to humans The Hand-out that Ive given you comes from a Regional plan from Vancouver Coastal Health. It was the best regional plan that I could find. What surprised me was that I couldnt find any regional plans from the U.S. This may be because Canada had that SARS scare and had to become more proactive in the planning for Public Health disasters. Youll see over on the right side that there is a column for Action required, that is keyed to the various Phase levels on the left side. I thought this might be useful to you for your strategic planning purposes. One of the things that really jumped out at me was how many times that coordinating planning with local private and public partners, Emergency managers, etc was mentioned. But if we go back to those questions I asked you earlier about: imagine this and then imagine that, you will see how vital it will be that you do your planning with all the different jurisdictions that you serve, and not just the jurisdiction where you are located. This is because you will need resources from all these jurisdictions. One jurisdiction will not be able to handle all the tasks that you will need to have performed. Situation assessment: This assessment was taken from the W.H.O. document Responding to the Avian Influenza Pandemic Threat 2005 The risk of a pandemic is great.. All prerequisites for the start of a pandemic have now been met, save one: the establishment of efficient human to human transmission. Human cases are continuing to occur, and the virus has expanded its geographic cal range to include new countries, this increasing the size of the population at risk. Each new human case gives the virus an opportunity to evolve towards a fully transmissible pandemic strain. The risk is persist . The virus has established a and ecological niche in poultry and is now endemic in parts of Asia. Outbreaks have recurred, despite aggressive control measures. Wild migratory birds have just in the last year, spread the virus 4000 miles from Asia to Russia and the Ukraine to Romania. The virus is expected to now turn south as the birds fly south for the winter. Evolution of the threat cannot be predicted. Virus mutation to human to human transmission can take the form of reassortment event which would yield explosive spread of the virus or the slower Adaptive mutation. The early warning system is weak. Preventative intervention is possible, but untested Reduction of morbidity and mortality during a pandemic will be impeded by inadequate medical supplies Situation assessment on a local level is precarious. Some of the factors which affect us are: Inablility to plan regionally Planning for the event is in its infancy Our supply lines are very vulnerable Our storage of supplies are only adequate for a very short time Other anecdotal factors: A viable vaccine will not be able to be developed for 6 months after the virus makes it to the human to human transmission stage. 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