List of products identified by Community Containment Workgroup needing by ryandenney

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									Pandemic Flu Community Containment Response Checklist
WHO Level 4-5, Federal Response Stage 2 (Last updated 3-18-09)
              ALASKA PANDEMIC FLU COMMUNITY CONTAINMENT CHECKLISTS
                                     May 2009


CDC Major Project 2008-2009 – “Community Containment”- Completed

The Community Containment Template Workgroup (CCT workgroup) was created in response to local
community emergency planners, who requested a written guidance, on what response capabilities should be in
place, in order to respond to and contain an outbreak of pandemic influenza. This led to the CCT project
inclusion in a request to CDC for funding a number of major projects for the State of Alaska for 2007-2008.
The grant was extended into the 2008-2009 funding year due to the discussions and numerous trial documents
that were created, plus new documents and guidance coming from CDC over the same time period.

The workgroup had its first meeting January 17th 2008. The workgroup consisted of representatives from
Epidemiology, Public Health Nursing, and Alaska Native Tribal Health Consortium (ANTHC). The group
identified 8 community disease containment strategies and populated a matrix with key information for each. A
prototype template for one “Isolation and Treatment” was created. The prototype was useful in identifying
additional documents needing to be created (i.e. draft forms for tracking ill persons, home care instructions,
antiviral delivery packets/kits), but it became obvious that to create this type of template for each of the
identified “strategies” would result in a lengthy document and one which would not be useful to local
emergency planners. It was however, very useful for extensive discussions and the discovery of gaps in overall
planning and response to major public health events.

The workgroup then turned to the community planning checklist, currently in the State Pandemic Influenza
Response Plan. The sections related to disease containment were pulled out and expanded, maintaining the
“checklist” format, to encompass the spectrum of control strategies and responses necessary during a pandemic.
The result was a 3 page operational checklists for when WHO raises the pandemic risk phase to 4 or 5.

The WHO 4 & 5 checklist was presented and reviewed during two multi-agency SERC/LEPC meetings, one
held in Fairbanks, on September 18, 2008 and the second in Juneau, on January 22nd, 2009. Comments and
suggestions were incorporated into the final product.

A second 3 page operational checklists for WHO 6 was developed, modeled after the WHO 4 & 5, except
utilizing adverbs like; activate, implement, and conduct. It is tentatively scheduled to be presented at the
SERC/LEPC meeting scheduled for May 12th 2009.

The final meeting of the CCT workgroup was held March 18th 2009, with the completion of the set of checklists
that can be used to guide local emergency officials in coordinating pandemic influenza containment response
measures during WHO 4 & 5 and WHO 6 phases. These checklists will become Supplement Y, in the next
update of the State of Alaska Pandemic Response Plan scheduled for July 09. The workgroup recognizes that
these checklists are living documents and as they are used, changes and suggestions will be incorporated.

While developing these checklists a number of additional actions items for pandemic influenza planning and
response were identified. These action items are listed in Table 1, along with the workgroup’s suggestions on
who should be responsible for their development.

While the original project has been completed the CCT workgroup members will continue their efforts on those
tasks below to which they are assigned.
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Pandemic Flu Community Containment Response Checklist
WHO Level 4-5, Federal Response Stage 2 (Last updated 3-18-09)
I would like to formally thank and recognize the hard work and efforts of the members of this workgroup:

       Joe McLaughlin - Section of Epidemiology - Chief
       Beth Funk – Section of Epidemiology – medical officer
       Ted Smith – Directors Office- Preparedness
       Kathy Miller – Section of Public Health Nursing- Nurse Consultant II
       Mike Bradley – Alaska Native Tribal Health Consortium
       Pete Petram - Alaska Native Tribal Health Consortium
       (Barbara Smith – Section of Epidemiology– Nurse Epidemiologist and Lead)




Table 1. List of products needing development to support the containment response
checklists 3-18-09



                 Action Item                         Suggested Agencies Responsibility
Home Care Kit                                     Preparedness Program: Sally Abbot and her
                                                  work group
Telephone Hotline Triage Form                     Review hotline issues in DHSS workgroup
Enhanced Surveillance- data needed from           EPI for its data needs, then discuss with other
communities, who collects it, and how and to      agencies in a DHSS workgroup what data
whom to report data                               requirements are needed by them so we have
                                                  one document with data requests
Medical Directives for antivirals                 EPI: Sharon Hamrick and Barb Smith currently
                                                  being worked on
Head of Household form for antiviral pick up      Public Health Nursing: Kathy Miller, PHNs,
                                                  Ted Smith
Morgue Kit-How to report a death during a         Medical Examiner Office, Ted Smith
pandemic
Algorithm of decision process of when to close EPI plus DHSS workgroup, bring School
schools                                        Representatives in and base it on Fed Stages
Template for situation reports (local)         Ted, Mike Bradley and Pete Base it on ANTHC
                                               small community template
Screening Triage Form for work sites/hospitals Barb Smith- Bring this back into state plan
Health Care/Emergency Response Checklist       DHSS workgroup
(specific to this group)




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Pandemic Flu Community Containment Response Checklist
WHO Level 4-5, Federal Response Stage 2 (Last updated 3-18-09)
A coordinated local response is critical to assure effective implementation of disease containment activities,
delivery of quality medical care, and community support in the context of increased demand for services. The
importance of timely and effective public education and information cannot be overstated. The following
checklist can be used to guide local officials in coordinating pandemic influenza containment measures during
WHO Levels 4 & 5
                                                                                                       Completion
                        Command, Control and Management Procedures                                     Date/Person
                                                                                                       Responsible
     Activate Emergency Operations Center (EOC)/Response systems
     Review community pandemic influenza response plans with community stakeholders.
       o    Update 24/7 contact list for community Emergency Operations Center and critical
            partners (local/regional partners, special populations, state)
       o    Review social distancing plans including modifying, closing and reopening of schools,
            businesses, and other public events
       o    Review mass and targeted pharmaceutical dispensing plans (antiviral and vaccine)
       o    Review strategies for respiratory infection control (e.g. work quarantine, community
            hand washing stations)
       o    Review critical functions and notify essential services to assure minimal disruption, e.g.
            fire protection, water, sewer, home health care, and delivery of food to those in need
       o    Review continuity of operations plans (COOP)
       o    Review initial communication systems and lines, including; templates for regular
            situation reports and incident action plans; test communication lines to local
            stakeholders and to the state emergency coordination center (SECC)
       o    Review strategies for mass fatalities
       o    Review population demographic for vulnerable populations
     Conduct pre-pandemic public education and information activities

      Coordinate activities with regional partners
      Review and refill inventory of emergency medical supplies and equipment (coordinate with
       local Public Health Nurses (PHN), Div. Public Health (DPH), SECC and Hospitals for
       delivery of personal protective equipment (PPE) and ventilators
      Review personal protective equipment (PPE) protocols for health care providers
     Review essential travel modes for supplies, medical care, and workers
    Prepare for security and protection of critical infrastructure; review contingency plans for 30
      to 40% absenteeism
                            Community Disease Control Measures
A. Public Education, Information and Risk Communication
    Coordinate with state emergency coordination center (SECC) and joint information center
      (JIC) on process for updating information and modifying messages
    Review existing pre-scripted messages tailored to communities and provided by State EOC
    Activate public education and information systems
      o   Establish community briefing schedule for public information and guidance
      o   Distribute educational materials about pandemic influenza and personal/family
          preparedness to community, local government agencies, tribal organizations, schools,
          private businesses and other local partners
      o   Post instructions on cough etiquette and respiratory hygiene, in all public facilities
      o   Activate/review protocol for community hotline (separate from antiviral hotline) for

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          basic pandemic flu information and community resources including:
             1. When and where to seek emergency and non-emergency medical care
             2. When to stay home and not going to work or into the community
      o   Include pandemic flu and emergency preparedness information on city website if
          available.
      o   Conduct functional public information officer (PIO) exercises
      o   Identify spokesperson(s) for media interviews with community leaders
      o   Coordinate with SECC and JIC on process for updating information and modifying
          messages
      o   CDC information in major languages at : http://emergency.cdc.gov
    Review community media contact names and numbers and develop draft press releases
    Review 24/7 contact list for EOC, JIC and critical partner staff
    Review communication protocols among Local/Regional partners, special populations,
      community officials and the State of Alaska
    Review plans for communicating with special populations
    Coordinate activities with regional partners

B. Surveillance
    Begin enhanced disease surveillance activities utilizing the State of Alaska Enhanced
      Surveillance form, pg. 61 of State Pandemic Influenza Response Plan.
      o   Identify primary contact and alternate, for reporting of surveillance information from
          key sources within your Community
      o   Monitor Community hospital/clinic census of ill clients that meet case definition and
          provide surveillance information reports to the SECC through local point of contact
      o   Monitor absentee rates in community government offices, businesses and schools and
          notify SECC through local point of contact, regarding any unusual levels of activity
    Health care providers should review:
      o   Criteria for diagnosis of novel strain of influenza
      o   Infection control procedures to protect providers
      o   Treatment guidelines
      o   Reporting procedure
      o   Health care facilities’ surge plans and capacity
    Implement pre screening criteria:
      o   Critical infrastructure employees and others as identified; phone monitoring or
          worksite monitoring for fever, cough, influenza like illness
      o   Health care facility(s) public health centers employees; Respiratory hygiene stations,
          triage algorithms, separate cough illness locations
    Prepare for specimen collection, shipping supplies and protocols in coordination with the
      State Public Health Lab; Identify points of contact for specimen collection, supplies and
      execution of shipping to the State lab
C. Social Distancing Measures
    Review infection control measures; eliminate shared equipment, frequent disinfecting of
      surfaces, increased desk spacing
    Review federal doc. Community Strategy for Pandemic Influenza Mitigation:
      http://www.pandemicflu.gov/plan/community/community_mitigation.pdf




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Pandemic Flu Community Containment Response Checklist
WHO Level 6, Federal Response Stage 3-6 (Last updated 3-18-09)
    Review community social distancing plans for criteria and process of:
      o    Isolation-cohorting of clients/home /alternate site
      o    Quarantine-contacts/home/alternate site/work/community
      o    Altered work strategies- tele-work, teleconferencing, staggered shifts
      o    Cancellation of public activities and gatherings (i.e. Sports events, potlatch)
      o    Closure or modifying activities of schools, childcare, nonessential businesses
    Review Alternate Care/Home Care plan
      o    Identify Alternate Care Site Locations, (hotels, schools, churches), staffing, supplies,
           and equipment needs
      o    Establish teams for Home Care Support
      o    Distribute Home Care checklists to community
          http://www.redcross.org/www-
      files/Documents/pdf/domestic%20programs/pandemic_flu_home_care_brochure.pdf
    Review strategies to maintain essential travel modes for supplies, medical care, and
      worker protection
D. Antiviral Management
    Review community antiviral distribution plan, reviewing critical functions/essential
      workers. Supplement A of State of the Alaska Pandemic Influenza Response Plan.
      http://www.pandemicflu.alaska.gov/panfluplan.pdf
      o    Review plan for local hotline for antiviral requests
      o    Review plan for head of household antiviral delivery
      o    Review plan for home delivery teams or drive through points of delivery
      o    Update antiviral amount to be delivered to communities served
    Identify targeted populations for distribution of antivirals:
      http://www.pandemicflu.gov/vaccine/antiviral_use.pdf
    Alert community providers about treatment protocols including antiviral drug availability
      and dispensing plans
    Inventory antivirals supplies provided by DPH at hospitals/ clinics
    Receive and store any additional antiviral medications delivered by Department of Health
      and Social Services (DHSS) to “Hub” communities
    Review delivery of antivirals from storage location to local dispensing site(s) and outlying
      communities where appropriate
    Prepare to track and report antiviral utilization

E. Vaccine Management
    Prepare to receive, store, and secure pre pandemic and pandemic influenza vaccine
      delivered by DHSS
    Emphasize annual seasonal influenza vaccine and the use of pneumococcal
      polysaccharide vaccine during the Inter-pandemic and Pandemic Alert Periods
    Review priority groups for pre-pandemic and pandemic vaccine per state recom-
      mendations: Supplement B of the Alaska Pandemic Influenza Response Plan:
      http://www.pandemicflu.alaska.gov/panfluplan.pdf
    Review state standing orders for pre-pandemic and pandemic vaccine
    Review community pre-pandemic and pandemic vaccine administration plan
    Review tracking and reporting of pre-pandemic and pandemic vaccine utilization
    Review Vaccine Adverse Event Reporting System (VAERS) for pre-pandemic and
      pandemic Influenza vaccine

   Note:
    The State of Alaska Pandemic Influenza Response Plan is located at:
      http://www.pandemicflu.alaska.gov/panfluplan.pdf

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Pandemic Flu Community Containment Response Checklist
WHO Level 6, Federal Response Stage 3-6 (Last updated 3-18-09)
   The State of Alaska Emergency Operations Plan is located at:
    http://www.hss.state.ak.us/prepared/eop/PDFs/EOP.pdf (Annex F-Mass dispensing)




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Pandemic Flu Community Containment Response Checklist
WHO Level 6, Federal Response Stage 3-6 (Last updated 3-18-09)
The following checklist can be used to guide local community officials in coordinating pandemic influenza
containment measures during World Health Organization influenza response level 6.
                                                                                                  Completion
                      Command, Control and Management Procedures                                  Date/Person
                                                                                                  Responsible
           Activate local Emergency Operations Center (EOC)
            o Implement local pandemic influenza community plan
            o Implement medical surge and infection control plans at local health care
               facilities
            o Prepare to activate mass and targeted pharmaceutical plans
            o Prepare to close all but essential functions
            o Prepare to activate continuity of operations plans (COOP)
            o Prepare to protect and supply the needs of essential workers
           Establish regular briefing schedule with State Emergency Coordination Center
            (SECC), media and local stakeholders, and publish regular situation reports and
            incident action plans
           Track inventory of emergency medical supplies and equipment and submit
            resource requests to the SECC through local point of contact
           Provide personal protective equipment (PPE) information and supplies to all high
            risk positions and essential workers
           Implement community mass fatality plan
           Implement plans to protect critical services. Services may include fire protection,
            water, sewer, home health care, and delivery of food
           Implement security and protection plans for critical infrastructure including
            contingency plans for 30 to 40% absenteeism
           Coordinate activities with partners, (i.e. outlying communities, Tribal entities,
            major private industries. and State Emergency Coordination Center)
                            Community Disease Control Measures
    A. Public Education, Information and Risk Communication
        Implement community risk communications plan and joint information center (JIC)
          protocols where appropriate
        Continue delivery of pandemic influenza messages;
          o Conduct scheduled community briefing for public information and guidance
          o Post community briefings and recommendations in prominent locations
          o Distribute educational materials about pandemic influenza and personal/family
            preparedness to community, local government agencies, tribal organizations,
            schools, private businesses, and other local partners
          o Post instructions on cough etiquette and respiratory hygiene in all public
            facilities
          o Distribute information on personal protection equipment (PPE)
            recommendations for the general public
          o Continue availability of community hotline number (separate from antiviral
            request line) for basic pandemic flu information and community resources
            including:
               1. When and where to seek emergency and non-emergency medical care
               2. When to stay home and not go to work or into the community



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       o Maintain updated situation report on community emergency preparedness
         websites, or other public notification systems
      o Arrange media interviews with designated community spokespeople
      o Coordinate with SECC and JIC on updating information and modifying
         messages
      o CDC information in major languages available at : http://emergency.cdc.gov
    Maintain 24/7 contact list for EOC, JIC and critical partner staff
    Establish regular media advisories and press briefings through local media contacts
    Continue communications with special/vulnerable populations
B. Surveillance
    Continue enhanced surveillance activities utilizing the Enhanced Surveillance
      Form. ( pg. 61 of the State Pandemic Influenza Response Plan
      http://www.hss.state.ak.us/dph/DPHPP/pandemicflu/panfluplan.pdf )
    Update case definition information
      ○ Monitor community hospital/clinic census of ill clients that meet the case
         definition and provide surveillance information reports to the SECC through
         the local points of contact
      ○ Monitor absentee rates in community government offices, businesses and
          schools and notify SECC regarding any unusual events
      ○ Health care providers should screen for and assess cases of influenza-like-
         Illness, follow diagnostic guidelines, keep a daily tally of cases, and
         report data to designated community point of contact (e.g. infection control
         practitioner, EOC staff, or public health center staff)
      ○ Reinforce facility and staff respiratory/hand hygiene, as well as facility infection
          control procedures
    Continue to implement pre-screening of critical infrastructure employees, health
      care facility(s) public health centers employees and others identified, for influenza
      like illness. May utilize systems such as:
      o Phone monitoring with triage algorithms
      o Separate clients with cough illness to different locations
    Facilitate specimen collection and shipping in coordination with the State Public
      Health Laboratory. (see Supplement C of the State Pandemic Influenza Response
      Plan) Request additional specimen collection supplies to the SECC through, your
      local point of contact
C. Social Distancing Measures
    When advised by the State Medical Officer, implement community social
      distancing plan for:
      o Isolation-cohorting of clients /hospital /home /alternate care sites
      o Quarantine – contacts /home /work /alternate care sites
      o Cancellation of public activities and gatherings (i.e. Sports events, conferences)
      o Partial or full closure of schools, businesses, other public gathering places




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      When advised by the State Medical Officer, implement: alternate care/home care plan
       to:
       o Pre-stage supplies and equipment at designated alternate care site location and alert
          staff of possible eminent activation
       o Activate alternate care sites as needed
       o Implement home care support systems
       o Conduct just-in-time training for alternate care site, hotline, home care support team
          staff/volunteers
       o Continue to distribute home care checklists to community
          http://www.redcross.org/www-
          files/Documents/pdf/domestic%20programs/pandemic_flu_home_care_brochure.
          pdf

     Implement restrictions of nonessential travel and implement strategies to ensure
      essential travel for supplies, medical care, and workers protection
D. Antiviral Management
      Update diagnostic, treatment, and infection control information based on current
       pandemic information
   □ Prepare to receive, store and secure antivirals in pre-identified locations
   □ Prepare to deliver antivirals from storage location to local dispensing site(s) and
     outlying communities where appropriate
      Prepare to implement a community antiviral distribution plan
      Review critical functions/essential workers numbers, vulnerable/special populations,
       and priority groups (see Supplement A of the Alaska Pandemic Influenza Response
       Plan at: http://www.pandemicflu.alaska.gov/panfluplan.pdf )
       o Implement local report/request line for antiviral treatment and symptom triage
       o Implement home delivery systems
       o Implement drive through protocols for pharmacy pick up of antiviral medications
       o Activate head of household antiviral delivery
      Track and report antiviral utilization
E. Vaccine Management
    Receive pre-pandemic and pandemic vaccine from DHSS at regional “hub”
      communities and send out to other communities served
    Receive, store and secure pre-pandemic and pandemic vaccine in pre-identified
      locations when available
    Administer pre-pandemic and pandemic vaccine according to local dispensing plans and
      priority groups contained in Supplement B of the Alaska Pandemic Influenza Response
      Plan: http://www.pandemicflu.alaska.gov/panfluplan.pdf
    During delivery and dispensing, assure the security of influenza vaccine
    Track and report pre-pandemic and pandemic vaccine utilization
    Activate vaccine adverse event reporting system (VAERS) for pre-pandemic and
      pandemic Influenza vaccine

       Note:
        The State of Alaska Pandemic Influenza Response Plan is located at:
          http://www.pandemicflu.alaska.gov/panfluplan.pdf


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   The State of Alaska Emergency Operations Plan is located at:
    http://www.hss.state.ak.us/prepared/eop/PDFs/EOP.pdf (Annex F-Mass dispensing)




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