Pandemic Influenza Plan - Questar III BOCES Pandemic influenza occurs when a novel influenza virus appears

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  • Plan

    Pandemic

    New York State Department of Health

    February 2006

  • New York State Department of Health Pandemic Influenza Plan

    February 7, 2006

    TABLE OF CONTENTS Introduction............................................................................................................................ ii List of Acronyms.................................................................................................................... v Section 1: Command and Control .................................................................................... 1-1 Section 2: Surveillance and Laboratory Testing............................................................. 2-1 Section 3: Healthcare Planning......................................................................................... 3-1 Section 4: Infection Control .............................................................................................. 4-1 Section 5: Clinical Guidelines ........................................................................................... 5-1 Section 6: Vaccine Procurement, Distribution, and Use ................................................ 6-1 Section 7: Antiviral Medication Procurement, Distribution, and Use.......................... 7-1 Section 8: Travel-Related Disease Control and Community Prevention ..................... 8-1 Section 9: Communications.............................................................................................. 9-1 Section 10: Training and Education............................................................................... 10-1 Section 11: Workforce Support ...................................................................................... 11-1 Section 12: Highly Pathogenic H5N1 Avian Influenza in Non-Human Animals ....... 12-1 Section 13: Public Health Preparedness Informatics ................................................... 13-1

  • Introduction Pandemic influenza occurs when a novel influenza virus appears that causes readily transmissible human illness against which most of the population lacks immunity. Several features set pandemic influenza apart from other public health emergencies or community disasters:

    • Influenza pandemics are expected but arrive with very little warning. • Outbreaks can be expected to occur simultaneously throughout much of the U.S.,

    preventing sharing of human and material resources that usually occur in the response to other disasters. Localities should be prepared to rely on their own resources to respond. The effect of pandemic influenza on individual communities will be relatively prolonged (weeks to months) in comparison to disasters of shorter duration.

    • Because of widespread susceptibility to a pandemic influenza strain, the number of persons affected will be high.

    • Health care workers and other first responders will be at higher risk of exposure and illness than the general population, further straining the health care system.

    • Effective preventive and therapeutic measures, including vaccine and antiviral agents, are likely to be delayed and in short supply.

    • Widespread illness in the community could result in sudden and potentially significant shortages of personnel in other sectors that provide critical public safety services.

    The purpose of the New York State Department of Health Pandemic Influenza Plan is to assist public health officials and health care providers in preparing for and responding rapidly and effectively to an influenza pandemic, consistent with national guidance. The New York State guidance document was developed using the U.S. Department of Health and Human Services’ Pandemic Influenza Plan, issued November 2005 (http://www.dhhs.gov/nvpo/pandemicplan/). Part two of the federal plan, Public Health Guidance for State and Local Partners, outlined the key planning and preparedness issues to be considered by state and local public health officials. The New York State plan is divided into 13 sections:

    1) Command and Control, 2) Surveillance and Laboratory Testing, 3) Healthcare Planning, 4) Infection Control, 5) Clinical Guidelines, 6) Vaccine Procurement, Distribution and Use, 7) Antiviral Medication Procurement, Distribution and Use, 8) Travel-Related Disease Control and Community Prevention, 9) Communications, 10) Training and Education, 11) Workforce Support, 12) Highly Pathogenic H5N1 Avian Influenza in Non-Human Animals, and 13) Public Health Preparedness and Informatics.

    February 7, 2006 ii

  • Each section includes a description of the activities to be undertaken by pandemic period, using the World Health Organization’s classification system (Table below). Activities are designated as to whether they are the role of the state health department, local health department and/or providers and public health partners.

    World Health Organization Pandemic Periods/Phases

    Interpandemic Period

    Phase 1 No new influenza virus subtypes in humans. An influenza virus subtype that has caused human infection may be present in animals. If present in animals, the risk of human infection or disease is considered to be low.

    Phase 2 No new influenza virus subtypes have been detected in humans. However, a circulating animal influenza virus subtype poses a substantial risk of human disease.

    Pandemic Alert Period

    Phase 3 Human infection(s) with a new subtype, but no human-to-human spread, or at most rare instances of spread to a close contact.

    Phase 4 Small clusters(s) with limited human-to-human transmission but spread is highly localized, suggesting that the virus is not well adapted to humans.

    Phase 5 Larger cluster(s) but human-to-human spread is still localized, suggesting that the virus is becoming increasingly better adapted to humans, but may not yet be fully transmissible (substantial pandemic risk).

    Pandemic Period

    Phase 6 Pandemic phase: increased and sustained transmission in general population.

    Pandemic influenza planning and preparedness activities should build upon response planning efforts for other emergencies, such as a smallpox recurrence, chemical spills, and natural disasters. In addition, efforts to prepare for an influenza pandemic will significantly enhance New York State’s ability to respond to other emergencies and disasters. This version of the New York State Department of Health’s Pandemic Influenza Plan reflects currently available scientific knowledge regarding the potential for an influenza pandemic, the expected ramifications on New Yorkers, and the most effective strategies and tactics to support our response. It is important to understand that this plan will be updated and revised regularly as additional information and guidance become available. Also, during a pandemic, guidance in this document may change. For

    February 7, 2006 iii

  • example, at this time, it is realistic to expect that there will be limits on availability of vaccine and antiviral medications, and most people will not have access to these resources. This fact may change and result in modifications to the current plan. Other revisions to the plan may cover imposition of alternate standards of patient care in response to problems of surge capacity or depletion of essential medical supplies during a pandemic. The document and any revisions will be available on the public website of the New York State Department of Health at www.nyhealth.gov. It is our intention to encourage all New Yorkers to fully familiarize themselves with the contents of the plan. Redactions, if any, will apply only to information that must be kept confidential to protect public security.

    February 7, 2006 iv

  • Acronyms

    AE Adverse Events ACIP Advisory Committee on Immunization Practices AIIR Airborne Infection Isolation Room ARDS Acute Respiratory Distress Syndrome BCDC NYSDOH Bureau of Communicable Disease Control BHNSM NYSDOH Bureau of Healthcom Network Systems Management BHAE NYSDOH Bureau of HIV/AIDS Epidemiology BNE NYSDOH Bureau of Narcotics Enforcement BSTDC NYSDOH Bureau of Sexually Transmitted Disease Control BTBC NYSDOH Bureau of Tuberculosis Control CDC Centers for Disease Control and Prevention CDESS Communicable Disease Electronic Surveillance System CDMS Clinic Data Management System CERC Crisis Emergency Risk Communication CLIMS Clinical Laboratory Information Management System CMRTS Counter Measure Resource Tracking Systems DAV Data Analysis and Visualization EAS Emergency Alert System ED Emergency Department EDB Executive DashBoard ECLRS NYSDOH Electronic Clinical Laboratory Reporting System EIP Emerging Infections Program EMS Emergency Medical Services EPA Environmental Protection Agency ESAR-VHP Emergency System for the Advance Registration of Volunteer Health

    Professionals FDA Food and Drug Administration FEMA Federal Emergency Management Agency GIS Geographical Information System HAN Health Alert Network HERDS Healthcare Emergency Response Data System HHA Home Health Agency HHS U.S. Department of Health and Human Services HIN Health Information Network HOC Health Operations Center HPAI Highly Pathogenic Avian Influenza HPN Health Provider Network HSB NYSDOH Healthcom Services Bureau IATA International Air Transport Association ICP Infection Control Professional ICS Incident Command System ILI Influenza-like illness IMS Public Health and Heal