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									                 Pandemic Influenza
               Business Continuity Plan




Prepared by:
Mark Pankhurst,
Assistant Fire Chief,
Community Emergency Management Coordinator




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                             City of Kawartha Lakes
                    Pandemic Influenza Business Continuity Plan


Purpose

This Pandemic Influenza Business Continuity Plan has been developed as a guide for
City Departments to facilitate the maintenance of essential services and or functions
during a Pandemic emergency. This plan will be included as an appendix of the City’s
Emergency Response Plan.

By preparing for and managing outbreaks of Influenza, the City can ensure continuity
and maintain essential community services. The City can play an extensive role in
controlling risks by taking practical actions to manage pandemic influenza.

This plan is aligned with the OHPIP (Ontario Health Plan for an Influenza Pandemic), the
CPIP (Canadian Pandemic Influenza Plan) and the Haliburton, Kawartha, Pine Ridge
District Health Unit Pandemic Influenza Plan.

A well managed plan and partnership with the Haliburton, Kawartha, Pine Ridge District
Health Unit and the Ross Memorial Hospital, will reduce the likelihood of widespread
infection and the consequences of a pandemic emergency.

Pandemic Plan Steering Committee

A Pandemic Plan Steering Committee has been established from the Manager and
Supervisor levels within the City. The goal and objective of the committee will be to
identify the priority services that the City must continue to deliver during a Pandemic
outbreak. The members of the committee will also assist each other in the development
of departmental plans on how they will deliver these services.

Background of Influenza

Influenza outbreaks have occurred for centuries and there have been three pandemics
in the previous century alone; the Spanish (1918), Asian (1957) and Hong Kong (1968).
Experts predict that another pandemic is overdue although the timing and the pattern are
unpredictable. When a pandemic flu outbreak occurs, the impact could be devastating.

Estimates suggest that in Ontario 8 million people will be infected; of those 4 million will
be clinically ill and 1200 will die. It has been projected that workforces will have absentee
rates of 30 - 35 % due to the viral effects on employees and their families.

Based on the above projections, the City could experience massive staff shortages.
Since pandemic flu spreads the same way as seasonal flu - through droplets contained
in sneezes and coughs and by hand contact, basic precautions can greatly reduce the
spread.




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For both the public and employees there is an expectation that services will continue as
usual and uninterrupted. In this context the disruptions created by the 2003 Power
Outage and the SARS outbreak emphasize the need for and the benefits of an overall
Emergency Plan and in this case a Pandemic Influenza Business Continuity Plan.


Definitions

Influenza

Influenza is a contagious respiratory illness caused by a group of viruses including
Influenza Types A, B and C.

Most seasonal influenza epidemics are caused by Influenza Types A and B. Type C
rarely causes human illness. Influenza can cause mild to severe illness.

Influenza usually starts suddenly. Common symptoms include:

   1.   Fever (usually high, lasting 3 to 4 days)
   2.   Headache (often severe),
   3.   Aches and pains (often severe),
   4.   Fatigue and weakness (can last 2 to 3 weeks),
   5.   Extreme exhaustion (very common at the start)
   6.   Stuffy nose, sneezing, sore throat,
   7.   Chest discomfort and cough
   8.   Nausea, vomiting and diarrhea (in children).

Many different illnesses, including the common cold, can have similar symptoms.

While most healthy people recover from influenza without complications. Older people,
young children, and people with certain health conditions are at high risk for serious
complications from influenza.

Some of the complications caused by influenza include:

   1. Bacterial pneumonia
   2. Dehydration
   3. Worsening of chronic medical conditions, such as congestive heart failure,
      asthma or diabetes
   4. Children and adults may develop sinus problems and ear infections

The incubation period for influenza is from 1 to 3 days. People with influenza are
infectious and able to transmit the virus for up to 24 hours before symptoms appear.




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Adults are infectious for 3 to 5 days after symptoms appear while children are infectious
for up to 7 days after symptoms appear.

People with influenza tend to shed more virus in their respiratory secretions in the early
stages of the illness. Viral shedding tends to last longer in infants, young children and
people with weak or compromised immune systems.

The importance of influenza viruses as a major human health threat is due to a number
of factors, including a high degree of transmissibility, the presence of a vast reservoir
(primarily infected birds) of novel (new) variants, and the unusual properties of the
influenza virus genome.

Influenza A viruses are composed of two major antigenic structures essential to vaccines
and immunity: hem agglutinin (H) and neuraminidase (N). The structure of these two
components defines the virus subtype.

Pandemic Influenza

Pandemic influenza refers to the occurrence of a new strain of influenza that circulates
worldwide.

The new strain, which usually occurs due to “antigenic shift”, will not have been
previously seen in humans and so there will be no past immunity to provide protection.

In past influenza pandemics, emergence of new strains has caused significant
hospitalizations and deaths, and has spread rapidly around the world.

The 20th century pandemics were caused by the H1N1, H2N2 and H3N2 strains. H1N1
and H3N2 viruses continue to circulate and cause yearly epidemics of influenza today.

Certain conditions make an influenza pandemic more likely:

   1. A new influenza Type A virus arising from a major genetic change i.e., an
      antigenic shift
   2. A susceptible population with little or no immunity
   3. A virus that is transmitted efficiently from person to person
   4. A virulent virus with the capacity to cause serious illness and death
   5. Pandemic History and Timeline
H1
Guiding Principles

Understanding the Risk:

Decisions should be based on a good understanding of the science underlying and
influenza outbreak and the risks involved. The factors contributing to the presence and
spread of the disease must be understood. The City's leaders must have a clear




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perception of the likelihood and consequences of a pandemic influenza.

Focus on Actions:

Knowledge is important but only actions can help manage pandemic risks. The City
needs to take steps to prevent the spread and severity of the disease. We need to plan
now to protect employees

Internal Protection First:

The City's first responsibility is to its employees and the services that we provide.
Protecting the workforce will help avoid interruptions to our essential services.

Protection of Employees:

Employees will look to the City's leaders for leadership and protection including revising
the workplace procedures to minimize exposure to the virus both from internal and
external contacts; work from home policies; care giving for affected family members.

Ensure the Delivery of Essential Services:

Reduction in our workforce will place the delivery of essential services at risk.
Interruption of critical public services will compound the effects caused by the influenza.

Support of Health Authorities:

The City will be expected to assist health care officials in delivering health services
through non-medical means. We may be asked to provide access to our facilities, to
provide assistance with mass immunization clinics and flu assessment centers.

Minimizing Net Financial Impacts:

The City's expenses are likely to increase and revenues may drop through decreased
activity and use of the City's services

Collaboration:

Pandemic influenza and its consequences can be managed more effectively through
collaborative efforts of many stakeholders including the Haliburton, Kawartha, Pine
Ridge District Health Unit (HKPR), the Provincial Government and the Federal
Government.




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HKPR:

The HKPR works in partnership with local residents and agencies to promote health,
prevent illness and protect against disease.

Since being created in 1945, the goal of the Health Unit has been to encourage healthy
lifestyles and a safe environment for residents of Northumberland County, Haliburton
County and the City of Kawartha Lakes. The Health Unit also monitors health trends in
our communities and keeps track of local disease statistics.

Provincial Government:

The Ontario Government implements national recommendations for surveillance and
immunization programs; coordinates the investigation of outbreaks; provides guidelines
and direction to local Health Units.

Federal Government:

Health Canada is the primary federal agency with the authority to oversee the federal
response to pandemic influenza. The National Pandemic Influenza Committee will
coordinate national influenza response, communication with the World Health
Organization (WHO) and other nations, distribution of vaccine and anti-viral medications
and allocation of the National Emergency Stockpile System (NESS) of emergency
Hospitals.


Strategic Approach

Emergency Management in Ontario and Canada is organized into five stages:

   1. Prevention – involves activities taken to prevent or avoid an emergency

   2. Mitigation – involves actions that can reduce the impact of an emergency.

      Immunization, social distancing and infection prevention are examples.

   3. Preparedness – involves measures that are put in place before an emergency
      occurs that will enhance the effectiveness of response and recovery activities.
      Developing plans, tools and protocols are examples.

   4. Response – involves the coordinated actions that would be undertaken to an
      emergency.

   5. Recovery – recovery involves activities that are conducted to help recover from
      the emergency and return to a state of normalcy. The ongoing care and treatment
      of the sick would be an example.




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This Pandemic Influenza Business Continuity Plan is based on a four part strategic
approach:

   1. Be Ready – Departments will identify those services that are critical to our
      Customers. They will also identify those that are less critical and that can be
      curtailed to free up resources for the critical services. A process will be developed
      to redistribute those resources.

   2. Be Watchful – The Ontario Government through the Haliburton, Kawartha, Pine
      Ridge District Health Unit is charged with communicating the information to the
      City on influenza activity.

       The provincial Ministry of Health and Long Term Care has an active screening
       and surveillance program established. The department's function will be to watch
       for warning signs of infection.

       The province in collaboration with local health units will provide stakeholders
       information on identification and prevention of the disease.

   3. Be Decisive – The City can act decisively to manage and contain the spread of
      the disease by taking precautionary steps at the prevention phase; by educating
      employees to prevention methods and by reviewing services offered that gather
      the public in public places.

   4. Be Transparent – Communication with employees will be a key to aiding in the
      prevention and spread of the disease. Public communications through the City
      and HKPR Health Unit officials will be paramount to the delivery of accurate and
      up to date Pandemic Influenza information.

Infection Control

The following are infection control measures that should be instituted and promoted now
as common practices by all departments within the City:

Annual influenza vaccination – encourage all staff to get the annual flu vaccination.
While this will not protect from the pandemic new virus strain, it will prevent other forms
of influenza in 70% of the healthy population.

Hand Washing – frequent hand washing with soap and water or hand sanitizers is very
effective in limiting the spread of infection. Effective hand washing involves wetting
hands, applying liquid soap, scrubbing for 15 seconds, rinsing and drying with a paper
towel. Effective use of sanitizers involves applying enough sanitizer for hands to stay wet
for 15 seconds, spreading sanitizer over all surfaces of hands and rubbing hands
together until dry.




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Hands should be washed or sanitized:

   • After coughing, sneezing or blowing the nose.
   • After using the washroom.
   • Before preparing food.
   • Before eating.
   • Before touching the eyes, mouth or nose.
   • After shaking hands.

Sneeze/Cough Etiquette – Covering your mouth and nose while sneezing and coughing
will help limit the spread of infection. If possible cover your mouth and nose with a tissue
or cough/sneeze into your upper sleeve. Dispose of used tissue and wash your hands
after coughing or sneezing.

Stay at home if ill – Staying at home when ill will help limit the spread of infection. In all
workplaces, schools and childcare centers, it should be a common practice to stay home
when ill.

Environmental Cleaning – The virus can survive on environmental surfaces (up to 48
hours on hard surfaces) frequent cleaning can reduce the spread of the virus in the
home or at workstations. Cleaning should take place using common household
disinfectants.

Increase fresh air in buildings where possible.

Reduce non-essential travel and avoid crowds and close contact with people who are
sick.

Practice other good health habits – Get plenty of sleep, be physically active, manage
stress, drink plenty of fluids, eat nutritious foods, and avoid smoking.

Business Continuity Planning Process

The primary threat to maintaining essential services during a Pandemic Influenza is high
absenteeism.

The objective of a business continuity plan, is to determine how to maintain essential
services/functions given high rates of absenteeism for reasons that may include:

   1. sickness
   2. staying at home to care for those family members who are ill
   3. staying at home to care for children in the event that schools and day cares are
      closed
   4. fear of coming into the work environment




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There are five (5) phases to our internal planning process which will be described below:

1. Identification of Essential Services – Complete Appendix 1

   1. List all the services provided by your department.
   2. Break the functions down within each service
   3. Using the provided definitions assign a Priority to each function
   4. Priority 1 services are those that relate to Health and Safety and cannot be
      eliminated or reduced during a pandemic.
   5. Assign a rating to each function as to the potential for increased demand for that
      function during a pandemic.

2. Staffing Essential Services – Complete Appendix 2

   1. Utilize only the Priority 1 functions from Appendix 1. Enter current staff assigned
      to function
   2. Enter the minimum staff requirement to do the function. Enter Pandemic staff
      (65% of Current staff)
   3. Calculate the shortfall (C - D)

3. Business Continuity for Priority/ Function Services – Complete Appendix 3

   1. Develop your business continuity plan for each function.
   2. Utilize the Priority 1 functions only
   3. This will ensure that there is a plan to maintain essential services in the event of a
      pandemic

4. Considerations

   1.   Who are the decision makers and their alternates?
   2.   Will there be any surge arising from the pandemic?
   3.   Are there alternate staffing resources (retirees, volunteers)?
   4.   Develop and implement cross training plans for staff?
   5.   Are their enough supplies to last for 6 weeks?

5. Complete the Plan

   1. Communicate your plan with all staff so they become familiar with the plan.
   2. Show which Priority 2 and 3 functions will be discontinued, freeing up staff for
      essential services
   3. Where applicable have staff trained for utilization in the delivery of the Priority 1
      services
   4. Send a completed copy of the plan to the Community Emergency Management
      Coordinator for insertion into the Pandemic Business Continuity Plan.




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Conclusion

The objective of the Pandemic Business Continuity Plan is to ensure minimal
disruption of the delivery of essential services to the general public, and at the
same time, address emerging challenges and issues faced by City staff in the
event of a Pandemic outbreak.

In keeping with this goal, the Plan facilitates the identification of essential services
that should be maintained, outlines roles and responsibilities of all levels of staff,
identifies staff deployment and training requirements to fulfill these
responsibilities, and offers recommendations on management of suspect
influenza cases at work.

It is important to recognize that the current Pandemic Business Continuity Plan is
a preliminary plan that requires ongoing revisions. As the Pandemic unfolds and
more information regarding the nature and transmission pattern of the Pandemic
Influenza become available, the Pandemic Business Continuity Plan must be
updated to reflect and address previously unforeseen areas of need.
                                                                         Appendix 1
                                                            Identification of Essential services



           1.      For your Department, list each service in Column A (use core services info). Remember that
                   there are four seasons that you need to consider i.e. Ops - Winter plowing; Summer grass
                   cutting.
           2.      List the functions associated with that service in Column B.
           3.      Using the following planning criteria categorize each function in Column C:

                  Priority 1     Potential to affect, health and safety of the public, is legislated or required by
                                 law.
                  Priority 2     Major inconvenience to the Customer but does not affect health and safety.
                  Priority 3     Minor inconvenience to the Customer; service probably not missed over the
                                 short term (6 weeks)

           4.      In Column D, enter your assessment of the potential increase in demand for this service
                   during a pandemic.
           5.      Those service activities listed as Priority 1 are considered Essential Services that must be
                   maintained during a pandemic.
     Example:
                                             Department: Works


        A                              B                          C                             D
      Service                       Function                   Priority         Potential for Increased Demand
                                                                                     (Low, Medium, High)
WSIB Case Mgmt.
                          Provide coaching to Mgrs.               3                            Low
                          Coordinate reporting to WSIB            1                            Low
                          Process and audit payments              2                            Low


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                                                         Appendix 1
                                            Identification of Essential Services


                      Department:


       A                   B                        C                           D
Function/Service   Functional Activities         Priority      Potential for Increased Demand
                                                                    (Low, Medium, High)




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                                                                       Appendix 2
                                                          Essential Services Staffing Template
                                                             Priority 1 Functions/Services



       1.     In Column A, list the Priority 1 functions (identified using Appendix 1 from Column B).
       2.     In Column B, list the current number of staff performing this service.
       3.     In Column C, list the assessed minimum number of staff that could perform this service.
       4.     In Column D, calculate the pandemic staff reduction by multiplying column B by 65% (the worst case
              planning assumption is 35 % staff off).
       5.     In Column E, calculate the possible staffing shortfall by listing the difference between Column C and
              Column D (difference between staff remaining after applying 35% reduction and the minimum
              required to perform the service).

      Example: (Illustrative only)
                                          Department: O and ES Department

                                                      Function:
            A                          B               C                    D                           E
        Priority 1                   Current       Minimum           Pandemic Staff            Potential Pandemic
    Function/Service                  Staff          Staff         Reduction (B X 65%)           Staff Shortfall
Snow Clearing (full operation)         35             25                   23                           2



      NOTE:       This table provides basic information as a basis for planning. More detailed planning is
                  required. Within a complement of staff there will be positions that may be identified as more critical
                  than others because of number and/or qualifications and these should be examined more
                  closely.




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                                               Appendix 2
                                  Essential Services Staffing Template
                                     Priority 1 Functions/Services



       A             B          C                 D                           E
Function/Service   Current   Minimum        Pandemic Staff           Potential Pandemic
    Activity        Staff      Staff      Reduction (B x 65%)          Staff Shortfall




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                                               Appendix 3
                                             Pandemic Plan
                                        Business Continuity Plan


                              Department:



        Function/Service:
        Director:
        Manager:
        Alternate:
        Alternate:


Potential for Increased
Service Demand
                                                 Low               Medium   High
(which may affect assessed
minimum staff required)
Minimum Staff Required: (list
types/qualifications i.e. supervisor,
technical, other)

Potential Staff Shortfall: (From
Appendix 2. List the number of
staff and qualifications required.)

Alternate Staff Sources (e.g.
retirees, staff from other
Departments, supervisors)

Training Requirements (for
alternate staff or cross training of
current staff)

Alternate Service Delivery
Options


Critical Supplies and
Suppliers


Critical Support from Other
Departments/Organizations (e.g.
IT requirements)



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