Influenza Response Plan

Ashtabula County Pandemic Influenza Response Plan
Lead Agency : The Health Departments of Ashtabula County (HDAC)
Ashtabula County, Ashtabula City and Conneaut City Health Departments
County Agencies that would be Likely to Carry Out Missions in Support of Pandemic Influenza Response:
Ashtabula County Emergency Management Agency
Ashtabula County Chapter of Red Cross

I         Introduction

A.       Purpose

1.      This Ashtabula County Influenza Response Plan addresses public health and emergency management responsibilities for county level organizations in the event of a pandemic influenza outbreak. An influenza pandemic may require response actions that are beyond the capabilities of local government, local health departments, and the Ohio Department of Health (ODH), and may require a Governor’s declaration of emergency and/or federal disaster declaration. The primary goal of this Plan is to coordinate county level efforts to prepare for, delay the onset, and mitigate the impact of a highly contagious and potentially highly fatal influenza pandemic, and to initiate a long-term recovery plan in response to a potentially devastating pandemic.

2.      Influenza (flu) is a highly contagious disease that can pose a threat to humans. In the event of a pandemic, influenza can pose a very serious threat to human life, with potentially severe economic impacts that could result from even a moderate outbreak. During a Pandemic Flu incident, the Disease Surveillance Specialist of the Ashtabula County Health Department will monitor the disease outbreak worldwide and in Ohio. Through use of Incident Command System (ICS) based structure at the Ashtabula County Health Department and through the Ashtabula County Emergency Management Agency (EMA), the Ohio Department of Health director will issue protective orders to mitigate the serious effects of a contagious outbreak of a novel influenza strain for which humans have no natural or acquired immunity and for which no vaccine currently exists.

3.      Strategies to limit transmission such as social distancing, isolation, staying at home, hand washing and respiratory etiquette (e.g. covering your cough) are measures that can be taken to mitigate the diseases spread and impact. For preparations to have maximum impact, they need to be made before a pandemic occurs. In that context, the purpose of this plan and its supporting procedures are to:
a.  Reduce morbidity
b. Reduce mortality
c. Minimize social disruption
d. Facilitate planning for recovery
4.      This Ashtabula County Pandemic Influenza Response Plan serves as a strategic plan for Ashtabula County. The Ohio Department of Health will serve as the Lead Agency for the State’s overall response to an influenza pandemic. The purpose of this plan is to prepare for, identify, respond to, and attempt to control an influenza pandemic and to mobilize resources to support local emergency response. Local preparedness is the foundation of pandemic readiness and response because of the potential extent of an outbreak and potential depth of the impact of an influenza pandemic.
To meet this challenge, the strategic plan includes significant communication and education components. These components include changing the concepts of mass care, medical surge, level of care, fatality management, and the approach to urgent care.
5.      The Health Departments of Ashtabula County (HDAC) will coordinate its level of response according to the World Health Organization (WHO) pandemic influenza phases, with preparedness activities identified for phase 1 through 4 and response activities for phase 5 and 6. Although WHO phase 5 (“large clusters but human to human spread still localized”) is a pandemic alert phase and phase 6 signifies the pandemic period, these two phases are both considered response phases for the State of Ohio, since a designation of pandemic influenza would lead to the initiation of activities at the Ohio Department of Health, and possible activation of Assessment and Monitoring activities on the part of Ohio Emergency Management Agency or the activation of the Ohio Emergency Operations Center.
B. Scope
This Ashtabula County Pandemic Influenza Response Plan provides guidance for identifying the health
and medical needs of victims of pandemic influenza emergency.
II.            Situation
A. General Condition.
1.  Influenza (flu) like other human infectious disease continually occurs in Ohio.
2. The emergence of novel strains of influenza and the re-emergence of “older” influenza strains can occur
 at any time in Ohio.
3. Influenza is a highly contagious human infectious disease that is transmissible from person to person and
requires an immediate response to control the spread of disease. The spread of influenza cannot be prevented. Initial actions in early phases of an outbreak will serve to contain the spread of the disease to allow time for production and distribution of vaccine and antiviral. However for a novel influenza virus strain that lead to a pandemic, there is little that can be done to stop the disease until immunities are developed in the population, and vaccines are created. The extent of the pandemic will rest on the morbidity and mortality rate of the influenza strain.
4 . ODH provides statewide coordination for public health issues with the Health Departments of Ashtabula County
(HDAC) as the local authority.
B. Emergency Condition
1. An outbreak of a novel influenza strain that transmits from human to human is an emergency condition that may rapidly exhaust public health, local and state resources and capabilities.
2. Medical care facilities may quickly become overwhelmed with ill patients infected with influenza as well as with individuals who worry about being infected (the “worried well”).
3. Due to a massive increase in demand, medical supplies and pharmaceuticals may be in short supply for the immediate treatment of the victims. Because a pandemic represents a “new” viral strain, there may be no effective vaccine available to combat the onset of disease. At worst, Ohio may expect one-third of its residents to fall ill. Worldwide, millions of deaths may be expected.
4. Disruptions in communications and transportation may result from a pandemic, adversely affecting the supply of pharmaceutical and medical equipment
5. Public utilities may be affected because of insufficient staff to keep systems operating.
C. Assumptions
1. An influenza vaccine specific to the pandemic strain will not be available at the beginning of a pandemic.
2. Once a novel virus is identified, it may take as long as 6 to 8 months, or even longer, before vaccine is available for distribution.
III.          Lead Agency
A.            Pandemic Influenza Emergencies in Ashtabula County

1. In this role, HDAC will coordinate public health surveillance, epidemiologic investigation, laboratory, mass prophylaxis/vaccination, public health surge capacity, public health information and education activities and guidance on infection control practices, including isolation and quarantine.

2. The HDAC will be in communication with the Ashtabula County Emergency Management Agency on public health surveillance and response activities.
B. Notification and Communications
1. ODH will learn of novel influenza outbreaks from one of many sources, including the Centers for Disease Control and Prevention (CDC), the World Health Organization, or possibly one of Ohio’s own public health laboratories
2. Upon learning of novel influenza outbreak that could possibly affect Ashtabula County, the HDAC will notify the Ashtabula County EMA.
3. HDAC will employ available communications methods to report a confirmed case or outbreak of novel influenza strain. These methods include, telephone, fax, and e-mail.
4.  There will not be a specific “incident” site for a pandemic influenza public health emergency however; County EOC’s will be activated under NIMS because the outbreak will, in a very short time, be widespread. Incident command will be activated in specific area(s) where the emergency is occurring to support local operations.
a. Local governments will activate incident command structures.
C. Response Actions
1.Infection Control Practices
a. The organizations that have responsibilities for guidance on human  infectious disease infectioncontrol practices for HDAC is the Ohio Department of Health
b.  Coordination of infection control practices to include specific containment, prevention and treatment guidance for the infectious disease that causes the emergency; provide guidance on any type of disinfection that may be required; and  provide guidance on limitation on movement (e.g. quarantine orders) to limit the spread of the infectious disease to other areas within the state, for governing the receipt and conveyance of remains of the deceased, and for other sanitary matters  (ORC 3701.13 and 3701.14).
2. Mass Prophylaxis/Vaccination
a. HDAC has the responsibility for mass prophylaxis and/or vaccination in Ashtabula County
   ODH will coordinate activities related to the Strategic National Stock (SNS).
b. Coordination of mass prophylaxis/vaccination to include determining priority guidelines
    for chemoprophylaxis/vaccination administration and ensuring access to pharmaceuticals
    to identified populations.
3. Public Health Information
    HDAC will maintain a joint information center (JIC) in the HDAC EOC throughout the emergency. The
    JIC will be lead by the public information officer and supported by PIO’s all other agencies having
    responsibilities to address human infectious disease emergency. Organizations on this team will ensure
    that maps, guidance, alerts and warnings concerning the human disease emergency in Ashtabula County
    and will be available to the public.
4. Vector Control
    HDAC will coordinate vector control activities including assessing the threat of vector-borne diseases related to the human infection disease emergency; providing technical assistance and consultation on protective actions regarding those diseases; and providing technical assistance and consultation on medical treatment of victims of vector borne diseases.
5.Victim Identification/Mortuary Services
a. HDAC will assist in providing temporary morgue facilities and processing,preparation and disposition of remains
b. HDAC will maintain the vital statistics for each person.
6. Mental Health
a. HDAC in collaboration with local behavioral health authorities and community providers will assess mental health needs of first responders, emergency workers, victims, families and community. Implement the Ashtabula County Special Needs Plan.
D. Supporting Agencies 
a.   Ashtabula County EMA
1. Support HDAC by providing statewide coordination during human infectious disease response and recovery emergencies.

2. Facilitate public information and rumor control efforts throughout the emergency through the JIC.

3. Provide personnel to assist in response recovery operations as needed.

4. Implement the Ohio Emergency Operations Center Standard Operating Procedures.

b   Ashtabula County Chapter American Red Cross

 1. Provide emergency first aid, supportive counseling, health care for minor illnesses and injuries to human infectious disease emergency victims in mass shelters and other sites deemed necessary by the HDAC.
2. Assist community health personnel subject to the availability of staff.
3. Provide supportive counseling for the family members of the dead and injured.