Meigs County Health Department

Meigs county Health Pandemic Flu plan

This Plan is provided for general guidance.   As H1N1 conditions change, this document will be adapted to meet the changes.

 

Meigs County Health Department

 

September 2009 revision

 

Overview and Purpose:

Since the last Influenza Pandemic of 1968 and mindful of the scope and devastation of the Pandemic of 1918, Public Health needs to plan for a sudden occurrence of an Influenza Pandemic.

 

One does not need to be reminded of SARS “Panic” of 2003, to know that planning for the outbreak of disease is half the battle in the fight against virus transmission.

 

This plan incorporates the use of vaccinations, medications, common sense Public Health Guidelines, travel limitations, restriction of person-to-person contact, and quarantine (see appendix i).

 

 

Emergency Notification: 

Under emergency conditions, the Health Commissioner will be notified immediately by the Administrator on call, the South Central Ohio (SCO) Epidemiologist or by some other government entity responding to or expecting a response to the emergency.  The Health Commissioner or designee shall notify the Local Government (County Commissioners, Mayors, Meigs EMA, etc.) or their designees if circumstances warrant. The protocol contained in Appendix A shall be followed for media notifications. 

 

Response Team Contacts:

An MCGHD administrator is available 24/7 by calling the Health Department during business hours (8:00 AM-4:00 PM, M-F) or by calling an administrators cell phone. (See Annex C for phone numbers.)  Other staff members can be contacted as needed. Meigs EMA is provided with an updated contact list of staff members and their cell phone numbers.

 

MCGHD has 24-hour access to ODH. An infectious disease specialist will respond to the pager at (614)-728-4279 or the ODH Infectious Disease Hotline (614) 728-3463. (See Annex D for disease reporting protocol for normal and non-business hours.) Additionally, The ODH Disaster Response and Preparedness Program staff is on call as backup for emergencies. All ODH staff is trained in emergency response and, in the case of a public health emergency, will contact appropriate response partners (See Annex D Emergency Notification Roster for a telephone listing of those to be called).  The list includes experts from ODH and also Non-Departmental sources.

 

The initial group of calls made from Annex E  by the MCGHD staffer on duty includes several entities, notified as necessary: the Meigs County Emergency Management Agency (Meigs EMA),Meigs County Emergency Services (EMS), Meigs County Sheriff, and the Ohio ODH. In the event that the ID staffer at ODH determines an emergency exits, they will make calls to initialize emergency notification at the state and federal level: Ohio Emergency Management Agency (Ohio EMA), the Ohio State Highway Patrol, FBI, and CDC Emergency Response Coordination.

 

 

Incident Command: line and staff responsibilities

The Health Commissioner, or his designee, will, when appropriate, institute Incident Command System (ICS) and appoint an Incident Commander. The ICS PIO will assume the duties listed in the ICS job action sheet. Incidents will vary and may not demand activation of all jobs or duties.  However a reasonably complete set are included for reference.  The MCGHD ICS will coordinate activities where appropriate with the Meigs County Emergency Command Center and the ICS set up by the Meigs County Emergency Management Agency (EMA). 

 

In the event of escalating circumstances, the response may exceed local capabilities.  The Incident Command structure will expand to include state and federal resources.  In such extreme cases, the National Incident Management System (NIMS) may be implemented.  The MCGHD is trained in NIMS compliance and will comply with its protocols.  All full-time employees of the MCHD are trained in ICS 100, 200, and 700.  The Meigs CHD ERC is also trained in ICS 300, 400 and 800 and is a member of the Ohio Incident Management Team.

 

 

PUBLIC INFORMATION OFFICER RESPONSIBILITIES

 

Initial response:

Within the first 30 minutes following notification of a public health emergency, ALL media calls should be routed to the HD Spokesperson or PIO or his designee to ensure reporters receive consistent messages and to allow the work of public health professionals to be unimpeded by media inquiries.

 

Ongoing efforts:

The Health Commissioner and PIO in conjunction with the Director of Environmental Health and Director of Nursing or their designees, will: determine media strategy; designate a spokesperson; issue media releases; determine if, when and where a news conference will be held; schedule regular media briefings (if needed);

 

In addition, the PIO or his designee will:

Attend all ICS command staff meetings (if in ICS mode).

Obtain approval of Health Commissioner or his designee on all information before it is released to the public and media.

Have information verified by appropriate program personnel (i.e. verification of content/appropriateness on infectious disease information will be handled by the infectious disease specialist on call).

Update/maintain contact with the Local Government.

Coordinate with other agencies (local/state/federal) to ensure effective, consistent messages.

If another agency becomes the lead agency, provide communication support to that agency as requested.

 

If the situation warrants, the MCGHD may request volunteers from the American Red Cross to assist in crisis communication. A hotline may be set up if necessary. The various information lines at ODH will be used when possible.

 

 

OHIO DEPARTMENT OF HEALTH RISK COMMUNICATION POLICIES

 

Designated spokespersons:

At the local level, the MCGHD Spokesperson is Larry Marshall for medical issues related to our local response to a public health emergency.  Other spokespersons may be designated as the situation demands, whether environmental, epidemiological or general response issues; i.e., communicable disease, Strategic National Stockpile (SNS), and mass prophylaxis/vaccination issues.  Southeastern Ohio Sub-Region One has established a spokesperson at the regional level to augment the county level spokesperson(s).

 

 As of January 2006, the acting spokesperson is: Regional Public Health Coordinator Debbie Elliott for medical issues and epidemiology/response issues.  Emergency Contacts at the local and regional level are found in Annex E.

 

Emergency Messages and Disclosure Guidelines:

MCGHD will have event-ready fact sheets on Pandemic Influenza already developed by ODH and the CDC. Appropriate distribution channels for these and other appropriate information materials shall include dissemination through the media. The information sheets will also be provided to information line workers, and local officials, etc. While the content has already been approved, it must be reviewed for appropriateness to the situation. The MCGHD ICS/UCS/NIMS PIO will approve release of information.

 

Health Department Resource List:

The Health Commissioner/Incident Commander may call upon additional personnel during a public health crisis from local, regional and state health agencies.  For regional, state, or federal personnel, the request must be made through the SCO PH Sub-Region Coordinator.

 

The Meigs Local Emergency Planning Commission (LEPC), the Meigs Emergency Management Agency (EMA), the Meigs County Medical Reserve Corps and the Meigs County RSVP are the primary local resources MCGHD can count on to provide assistance in a public health crisis.

 

Another resource list is the MCGHD Health Alert Network (HAN) (see Annex D and E).  The organizations on the HAN can offer diverse assistance for many varieties of emergency necessities.  

 

PIO Resource list:

The PIO may call upon additional personnel during a public health crisis from local, regional and state health agencies. Additional PIO staff has been identified in other state agencies, and other local health departments.  Many of these individuals are trained and experienced in crisis communication, including setting up and running a Joint Information Center (JIC).

 

American Red Cross may be asked to provide personnel and expertise to set up some aspects of the crisis communication function, for instance, hotline personnel.  The local Radio Club (RACES) can operate ham radios or other communication equipment and provide operators, as needed and directed by the Meigs EMA.

 

 

 

Policies, Media Lists:

All information released to the public/media will be truthful, accurate and as timely as possible. In the event of a public health emergency, MCGHD spokespersons will be forthright with all information. No information will be released without going through the proper process (please see verification and approval and disclosure guidelines above). A media listing, including contact information for daily and weekly newspapers, television stations and radio stations in the immediate area, is available. Using fax and internet-based distribution lists, the MCGHD PIO can transmit information to any/all media outlets in the region. Twenty-four/seven contact information for the Southeastern Region health departments is also available.

 

Debriefing and Evaluation:

Debriefing and evaluation are critical components of emergency response, including risk/crisis communication. "After Action" meetings and reports are a part of routine MCGHD/ODH follow-up to a public health emergency.  This system is used to improve emergency operations in preparation for the next incident.

 

The Plan Outline

 

As with “normal” influenza outbreaks an assessment must be made on treatment options.  A pandemic influenza will have no vaccine.   Since it will be a “new” strain of influenza a vaccine will have to be developed.  With no vaccine available, then the plan’s attention will shift to these three areas:

 

1. Disease surveillance

2. Preventive measures

Restriction of  movement

 

DISEASE SURVEILLANCE

 

Regional Epidemiology

 

The Regional Epidemiologist for the Athens, Gallia, Hocking, Jackson, Meigs and Vinton County Health Departments will use all resources available for surveillance for a flu pandemic.

 

The Epi-Plan is contained in Annex Y of the Meigs County Emergency Response Plan.  It is updated every six months by the Regional Epidemiologist.

 

 

PREVENTATIVE MEASURES

 

Non-Medical Measures

 

Limitations on Contact:  People-to-people contact must be limited as a factor in prevention.  Hand shaking, large get-togethers in closed buildings, public displays of art, music, movies, etc. may  be limited.  Large gatherings in the workplace should be kept as small as possible.

 

Thorough hand washing must be carried out by all to limit the transfer of the contagion.   

 

Not touching the face, mouth, eyes or nose with the hands.  The hands can transfer germs to areas that can become easily infected.

 

Medical Measures

 

Antiviral Medications:  Although antivirals are useful for the mitigation of various known influenza strains and other viral diseases, their effectiveness with an unknown strain of influenza will have to be shown as will their effectiveness as a prophylactic measure.  The MCHD will, if provided by the ODH thru the SNS,  stockpile antivirals for use during a pandemic episode of the flu.  If a shipment of antivirals is sent to the MCHD, it will be distributed in accordance with our Mass Vaccination Plan, Annex Z. 

 

No antiviral medications will be distributed to individuals through the health department.  This would violate the hd’s pharmaceutical license.  MCGHD will distribute antivirals to LHD approved providers.  The providers must:

▪ Show a need or usage of their stock and want replacement.

▪ Provide pickup and transport of the meds from the HD to their place of business.

Arrange for security of the product through the transportation process.

 

Vaccinations:  Vaccine will not be available for up to six months (or longer) after the onset of the disease.  When vaccine is available, it will distributed according to federal CDC protocols or, if quantities are sufficient, our Mass Vaccination Plan (Annex Z).

 

Hospitalization:  Meigs County has no hospitals.  Meigs County has one doctor and several small clinics.  Hospital care will have to be provided by hospitals outside of the county and even outside of OHIO.

 

SNS Plan:  The Meigs County General Health District has a county Strategic National Stockpile plan.  In short, when the disease reaches proportions that severely affect county resources, we can notify the local Meigs EMA.  Meigs EMA will then start the protracted process to bring Meigs portion of the federal SNS package.

 

 

RESTRICTION OF MOVEMENT

 

Restriction of Movement may be used in the following manner:

· During heightened outbreak occurrences, the MCHD will talk to schools to disclose their procedures for closing schools  due to illness absence of students and/or  staff (like a “snow” day) to limit contact among children.

If the flu reaches extraordinary levels, the MCHD may ask for the people of Meigs County to “Shelter-in-place,” as a means to limit disease spread.

 

QUARANTINE AND ISOLATION

 

The Meigs County Health Department has ability through the Ohio Revised Code to order quarantine and isolation.  This ability will be severely limited in Meigs County.

 

Quarantine and isolation demand a support structure to enable those quarantined to survive.  Meigs County has a very limited support infrastructure and will not impose quarantine or isolation on its own.

 

If quarantine or isolation becomes necessary, then the Meigs County Local Emergency Planning Committee (Health Department, EMA, EMS, RSVP, etc.) will work with Ohio Department of Health (ODH) to have the ODH declare the Quarantine.  ODH will have to then support the Meigs Quarantine and the EMA and other organizations can use their resources to support the quarantine.  

 

 

 

SUMMARY

 

In short, the Meigs County Health Department is as prepared for an Influenza Pandemic as it can be, given the likelihood of a pandemic and the medical, fiscal and resource limitations of the county and the Ohio Department of Health.  The Meigs County Health Department will perform as well as can be expected to limit the effects of a Flu Pandemic.

 

 

This is a dynamic document and will be reviewed periodically for changes and updates. 

 

 

Reviewed and revised 02/12/2007 fgorscak

Reviewed and revised 09/20/2009 fgorscak