Emergency Management

“Influenza and Pandemic’s”

Influenza Pandemic

• Influenza 1918 - the worst pandemic in U.S. History

• First Case March 11,1918 - Fort Riley• Boston registers 1000 deaths from

influenza by the end of September• U.S. Death toll 195,000 Oct• Between September 1918 and April

1919, approximately 500,000 deaths

Pandemic Time Frame

• Warning is generally weeks to months

• Unlike natural disasters, demands on medical care in each community will last 6-8 weeks until the "first wave" of infection is complete

• Second wave of infection may follow months later

Key Issues

• Experts agree that future pandemics of influenza are likely, if not inevitable

• Estimates of a U.S. pandemic today could cause between 88,000–227,000 deaths and that the economic impact would range from $71–$166 billion

• Traditional Emergency Management Models do not work well in this type of event (Mutual Aid, Federal Assistance, Stafford Act)

Emergency Plans• All States and local areas have emergency

response plans that are geared towards natural disasters. However, the next influenza pandemic is likely to pose a series of unique challenges that may not be accounted for in available "All Hazard" plans

• Pandemic planning is a dynamic process, with continual adjustments with changing circumstances, resources, and technology, so that periodic revisions will be necessary

State Emergency Operation Plans

• Provides guidance to state and local officials on procedures, organization and responsibilities

• Provides for an integrated and coordinated local, state and federal response

• Many States have adopted a functional approach that groups the types of assistance to be provided under Emergency Support Functions

Critical Infrastructures

• In contrast to typical natural disasters -- in which critical components of the physical infrastructure may be threatened or destroyed -- an influenza pandemic may also pose significant threats to the human infrastructure responsible for critical community services due to widespread absenteeism in the workforce.

Pandemic Phase Definition

Novel Virus Alert•novel virus detected in one or more humans •little or no immunity in the general population •potential, but not inevitable precursor to a pandemic

Pandemic Alert•Novel virus demonstrates sustained person-to-person transmission and causes multiple cases in the same geographic area

Pandemic Imminent •Novel virus causing unusually high rates of morbidity and/or

mortality in multiple, widespread geographic areas

Pandemic•Further spread with involvement of multiple continents; formal declaration made

"Second Wave"•Recrudescence of epidemic activity within several months following the initial wave of infection

Pandemic over•Cessation of successive pandemic "waves", accompanied by the return (in the U.S.) of the more typical wintertime "epidemic" cycle

1. Novel Virus Alert

2. Pandemic Alert

3. Pandemic Imminent

4. Pandemic

5. "Second Wave"

6. Pandemic over

1. Monitoring

2. Notifications/Planning

3. Partial Activation

4. Full Activation

5. Activation/Recovery

6. Recovery

Pandemic Phases

Emergency Management Actions

ISSUE BIOTERRORISM PANDEMIC INFLUENZA

Likelihood High High

Warning None to days Days to months

Occurrence Focal or multifocal Nationwide

Transmission/Duration of exposure

Point source/limited Person-to-person/6-8 weeks

Casualties Hundreds to thousands

Hundreds of thousands to millions

First responders susceptible? Yes Yes

Disaster Med Teams (DMAT - DMORT)

Yes No (too widespread)

Mutual Aid Yes No (too widespread)

PANDEMIC INFLUENZA and BIOTERRORISMA Summary of Similarities and Differences

State Emergency Management’s Role in an Influenza Pandemic

• State Health - Focus on the illness

• State EM - Focus on the consequences

• Generally – emergency powers vested in the Governor are greater than the State Health Officer

• Governor’s can activate the National Guard

State Emergency Management’s Role in an Influenza Pandemic

• Activation of the State Emergency Management Plan

• State Emergency Operations Center

• Emergency Support Function - Health and Medical (ESF#8)

• Emergency Public Information

• Direction and Control