Pandemic Flu!!!!!!!

Pandemic Flu Preparedness

As an Executive in a non-profit agency, I must frequently respond to requests/demands they make for information, but this was a new one on me. Not that I wasn't keeping up with the news, but when you have to write a plan things become more scary and real. I attended this training session recently and it was not very reassuring.

Notes:
Here is an overview of the training session I attended today. The Commonwealth, at the direction of the federal government, must submit this plan. EOHHS is working with MEMA on the plan.

We have been directed to submit a statement that we have a completed plan, using their guidelines. This plan must be signed by the CEO, the Chairperson of the Board and the person who developed the plan by December 2, 2005 (an extension from the original date). The people signing will do so electronically through a website.

They (MEMA and EOHHS) are operating under the assumption that a pandemic flu is coming. A person from DPH reviewed the way the disease is spread and why it is such a deadly virus. The virus is spread by airborne droplets produced when people cough or sneeze, or by touching the virus on a surface such as a doorknob or countertop. It can remain viable for “days”. They want us to teach everyone “Cough etiquette” (which they realize cannot be taught to some people). They suggest we all have the alcohol based hand sanitizer (we have the ingestion problem here, so we will need small bottles that staff can carry). We need lots of training on Universal Precautions, and we all need to wash our hands with great frequency.

They stated that we would likely know about 2 weeks in advance that it is coming our way, as small pockets of it will begin to show up in the US. They also said that it takes 6-12 weeks to “go through” a community. They discussed the issue of stockpiling enough food and water for 6-12 weeks, and enough medication.

We need to develop a plan that assumes we have a 40% reduction in staff. We cannot assume the same for clients, especially in a residential program. The hospitals would likely be inundated and staff would be caring for the people at home.

Contingent Assumptions:
• Staff levels may be significantly reduced due to high levels of illness and hospitalization
• Staff may be lost due to significant mortality associated with the disease
• Remaining workers may be psychologically affected by disease, family concerns, concerns about economic loss, or fear, and require behavioral assistance (I guess they mean mental health assistance)
• Staff may be reduced by the need for some workers to attend to family illness or to children remaining at home due to school closures.
• Human resource (staff) reductions may be temporary or may be long-term depending on the severity of the influenza strain.

For the administrative part of this exercise, we must determine and list:

• The essential functions of each agency. By this they mean the things that people cannot live without. In our case this is primarily residential.
• There must be a written succession plan with written delegation of authority for essential components of running the agency. This includes management, fiscal and IT support. This needs to cover all top management functions and is there in case we are sick or worse.
• We have to cover “devolution”. How do we organize the agency if the entire top leadership is gone?
• We need communication plans with a list of emergency contacts and everyone should have a cell phone.
• We must develop an inventory of essential tasks and cross train management so that these can be carried out if needed by an alternate person.

They discussed that large congregate settings such as day programs and schools would close if this pandemic hits. People asked about the efficacy of quarantine and wearing masks. We were told that quarantine would not be very helpful in this day and age, as government can’t control people as much as they could in 1918. There was a physician in the audience who was very troubled by this, and pointed out that you cannot have staff coming and going in a situation like this, and the idea of “Clean rooms” was discussed. They suggested that the patients/clients wear masks, but of course that is unlikely to work with our population.

I spoke, and said that I expected that DPH would be very directive about what to do if a person has symptoms, or you see a cluster of people with symptoms. They were actually non-committal. There was much talk from others in the audience about regulatory and licensing concerns. The DPH people said that there would be “Alternate standards of care” that would have to be accepted under the circumstances.

For more information go to www.ma.gov/hhs/coop
This presentation will be on the website. They want us to send in questions and comments. They seemed very confused about things themselves and many people in attendance felt that we would be left to fend for ourselves and they are shifting the liability to agencies by making us sign this plan.