Avian Bird Flu Pandemic

Avian Bird Flu Pandemic Introduction We cannot begin to guarantee that the information we have is correct or adequate in any sense. There are many different sources we're using to hone in on this circumstance. Our hope is simply to give you a solid starting place for beginning to prepare. You may learn most from your local emergency planners and local agencies that are involved in addressing the pandemic response, although there is great disparity from one community to the next on the degree to which people are organizing. We hope to raise awareness, to get you started, to give you web sites and ideas for resources, and to continue to update our web site to give you more. What are the chances that we really will have a pandemic? Pandemics are a cyclical event in world history. Apparently, most of the seasonal flu that we experience each year originated as an avian flu, or swine or another animal. At some point, some of these viruses mutate to become transmissible to humans, and then again to become human-to-human transmissible, and this can become the beginning of a pandemic. Not all viruses are problematic to humans. Clearly, the H5N1 is. We have pandemics about every 40 years, and we've passed that mark since the last one. The H5N1 virus is remarkably virulent, both to birds and the humans who have caught it from birds. At this point, over 50% of those who have been diagnosed with H5N1 flu have died. Each time a human is infected with the virus (catches it from a bird) it is one more opportunity for the virus to mutate to be transmissible between humans. There are two ways this mutation can happen ("shift" and "drift"). One causes a fast flash of contagion (shift), the other is a little more gradual (drift). In watching web sites, none appears to hold out a hopeful scenario for somehow stopping the spread in birds, particularly because it is in the migratory bird population. There are some particularly bothersome aspects. For instance, ducks are able to carry the virus without becoming ill. Duck droppings then come to carry a much more highly concentrated level of the virus. Once migratory birds come in contact with "local" ducks (such as those in our parks) the problem is endemic. Incidence as of mid-March 2006 At this point, there are 10 countries that have confirmed human cases and 47 that have confirmed avian cases. What should schools do to prepare? First, we need to become involved and aware. In mid-March, the first timeline predictions of avian flu reaching the west coast of the Americas via the Siberian-Alaskan bird population surfaced in the news. On March 13, ABC news reported on the contingent of scientists who are stationed in the Aleutians in order to sound the alarm when the first case is confirmed. The problem is that it will take at least a month to confirm the presence of the virus, which will allow it to have spread much further. In the report that evening, the possibility reported was that the avian bird flu could arrive all along the west coast of the Americas as soon as August of this year (2006). Most web sites (CDC, WHO, others) say that our greatest defense will be quarantine. The expectation is that geographical areas will be quarantined, perhaps repeatedly, and the eruptions of cases move from region to region and cycle back again. Quarantines will likely be enforced for between four and ten weeks. Students will be home and schools will be closed for a time that will probably not be known at the beginning of the quarantine. We have nothing to go on to prepare in terms of past experience. If this once becomes human-to-human transmissible, it will move throughout the world remarkably fast because of our mobile lives and how air travel has become so commonplace. First Area of Consideration - Communications Within Your System Here's the greatest consideration for all of this! Whether we end up having a pandemic or not, many districts will face extreme challenges in the next months and years. From tornadoes and hurricanes to shootings and bus accidents, the range of incidents a district might face is too varied to put together one plan that anticipates everything. But anything you put in place for any kind of catastrophic event is likely to be helpful when amended to help in another. If there is one repeating theme when schools are impacted by catastrophic events, it is communications. In one of the counties in Florida hit repeatedly by hurricanes a few years ago, the district was able to purchase Blackberries for key staff. The district tech department was able to power down most of the systems for the district computer network, leaving only the capacity to text message and email. This allowed administrators to continue to communicate as long as they could recharge or keep batteries in stock for their Blackberries. Nextel has the capacity to use two-way radio modes when cell phone towers go down. Web sites may be a great way to post information you'll want staff, students and parents to know. Take time now to determine as many alternative means to communicate as possible. It is impossible to predict whether communications will be interrupted, which communications systems will go down and for how long. Being flexible in your thinking with this part of planning allows your plan to be effective in a greater variety of kinds of catastrophic events. Communicating With Those Outside Your System Having email addresses for students, parents, agencies, churches and anyone else you might want to contact is always a good idea. Also, look now for the web sites that will give ongoing, helpful updates. Bookmark our site as well. As long as the internet stays up and running, and as long as we are able to continue to communicate with our web hosting coordinators, we'll continue to give ideas as we learn more. We'll also continue to provide links to suggested sites. Think ahead of time about the timing of your communications. It may be that you want to put together information at this time, but wait to send it out when it is evident that the virus has become human-to-human transmissible. Consider preparing information for families about web sites, about stocking up ahead of time, about how they can prepare. Give them information about symptoms once those are posted on sites. At this point it appears to include deep respiratory and multi-organ break-down, but this may change over time. Continue to check our web site as well. As this phenomenon continues, CMI will continue to post guidelines for various groups, including parents, suggestions for teachers on how to talk with their students, and so on. We, too, are gauging our communications releases based on what we see in the media and what we find on various web sites. Operations Once you've figured out the communications issues, look at what you'll need to do as a district to maintain whatever you can. Would teachers be paid during a six week quarantine? Would you continue to try to do payroll? Would you be able to mail checks? Do direct deposit? Whatever your policy on paid leave, this will be a time for a lenient approach. Academics We're hearing suggestions from the Department of Education that schools begin to look at how they would continue teaching to students should their communities go into quarantine. Some are considering creating web site capacity for teachers to post assignments and the means for electronic transfer of homework. Communication ahead of time with parents While it is important not to over-react, this is a good time to put some things in place and reinforce others. In your next newsletter to parents, reinforce the communication strategies you'll uses in any kind of crisis. Remind them of your web site, email, back-up phone numbers, etc. Acknowledge that you know they're hearing reports of the spread of bird flu, and assure them that you are paying attention and beginning to put things in place behind the scenes. The greatest building of trust is communications, so listen to their concerns and respond in kind. One helpful plan is to decide ahead of time to put voicemail on one of your unlisted phone numbers, such as a phone that rings directly into your library or athletic department. Then, when crisis strikes, you have the opportunity to immediately publicize that number as the place to call for the most up-to-date information, which will help keep your phone lines free when you need them most. Health Now is the time to learn all you can about the role the health department in your community will play, how or whether they'll keep you in the loop (other than what you know by local media releases). Involve your school nurse in working with local health department officials on infection control and related supplies and procedures. Plan now for how you'll decide at what point you'll send students home, even if the health department has not required quarantine, and by what measures you'll determine that an individual student needs to go home because of symptoms. Although the health department will give more precise measures for when to allow students or staff return to school after they survive the illness once the experts have been able to watch its behavior, setting preliminary policy and procedures now is in order. Mental Health What role will your local mental health clinics play? Find out what they are doing to prepare. What can they tell you about the mental health delivery system for pandemics, or what can they suggest they might do for meeting the needs of your students, staff and families, particularly your special needs families? Should the pandemic manifest, it will engender fear and unparalleled anxiety for many. Like Katrina for New Orleans, systems will likely fail. Some of the first who will have heavy exposure to the virus will be emergency workers, law enforcement and hospital staff. The CDC and WHO are indicating that if the virus mutates and becomes human-to-human transmissible, the current 55% mortality rate will drop some, it is still like that emergency response agencies and many basic services are likely to see interruption as many people who keep the utilities and services maintained become sick or die. They, too, will have anxiety about leaving their homes in order to maintain service delivery. The mental health implications could be significant. Coordinating With Local Emergency Planners Is your community planning and actively running table-top or scenario exercises? What role will the school community play? It is possible that the school will be taken over by governmental agencies or emergency responders as command posts, hospital satellites, clinics, morgues, or other uses determined at the time. Ask questions now. Become a part of the planning process. We in the US are far behind European countries in their preparations. England is already looking for buildings to convert in order to provide additional morgue space. It is just impossible to know whether this particular virus will cause a pandemic. One thing is obvious, however. The world sees a pandemic about three times per century, and if this virus isn't the cause, there is no reason to believe that this phenomenon has changed. The added challenge now is that air travel makes possible transmission to large new parts of the world population occur in a flash. Supplies Hard to know, but certainly water and some quick energy (protein bars, fruit leather, etc.) and the capacity to listen to the radio when the power goes out. There are some good handouts at sites listed below. It doesn't seem so likely, though, that you'll be dealing with sheltering at schools. It is more likely that quarantine will put all families at home and will restrict all public gatherings for from four to ten weeks at a time, repeated as outbreaks are detected. Some web sites suggest preparing for at least two and possible three waves of eruptions (if you have a first, you're likely to have at least one more). Finally -- Continued Learning for Students It is very difficult to know that there will be any viable way to continue the learning process for students should your community be one that is quarantined. All of the issues above will be higher on the list during the pique challenge times. But once you've worked most of that out to the best of your ability, you might look at whether the web site or other means of communicating will allow you to help students continue the learning process. It is difficult to know whether mail will be moving during quarantines, whether mailing something handled by people with the virus on their hands will still expose the recipients to the virus (it remains viable for days outside of a host), whether radio stations will be willing and able to help get lesson information out to students. This will be something to think about ahead of time, but will probably pale in comparison to the other issues with which we'll all be coping. Put in place the possibilities you can think of now, and know that some aspects of this one may be more earily solved at the time. Collaborate and Coordinate Work with all other schools to see what they're doing to prepare. Share ideas and concerns. Special considerations: Special needs students Language barriers for families, students, staff Economically challenged families Homeless students / families Who are your other at-risk populations? Just one request! We at CMI would very much appreciate your sending us brief outlines or ideas you've come up with that we haven't approached here. We will continue to add to the resource we provide on this page as we learn more from the "standard" sites (CDC, WHO, etc.) as well as from all of us in education who are working on this day by day. We could create an "ideas and suggestions" page with your suggestions if we receive a number of them. And important to remember ~ Most of the measures you need to put into place are the same as for many other kinds of crises. Keep a level head. It isn't time to panic. But thinking this through will give valuable insights that will be helpful in the aftermath of a variety of kinds of events, especially those that are community-wide. Suggested Sites: Links and challenges: Some of the web site pages we've found for links are subsequently pulled or changed. We're working on these links to upgrade their efficiency, so if a link doesn't work, google the agency or organization. Center for Disease Control has an Avian Flu link on their web site, which is target=_blank>www.cdc.gov/flu/avian/index.htm The Department of Health and Human Services site is www.pandemicflu.gov/ Specifics for schools are at target=_blank>www.pandemicflu.gov/plan/schoolchecklist.html#2 World Health Organization Avian web page is: target=_blank>www.who.int/csr/disease/avian_influenza/en/index.html WHO also has a page that explains much about the mutation of the H5N1 virus and some initial implications to human health at target=_blank>www.who.int/csr/2006_02_20/en/index.html Avian FluWiki is a site of another flavor -- it is intended to be participatory. As such, it is no substitute for WHO or CDC or other sites that carry a specific purpose. It is, however, a site where scientists from those and other agencies who are unable to publish some of their research, ideas or opinions because of the politics of their particular agency can have an open forum. Their contributions are all signed as "Revere" after Paul Revere (who carried the message of warning at a critical time!) in order to maintain their anonymity. Thus, there is no way to vouch for accuracy, but this site has links to a myriad of other remarkably varied sites. At the same time, it is also a site where ordinary citizens who are in panic mode are outlining the threats, their precautions and, yes, their worst fears. Use with discretion, and if you ignore the folks that are way out on a limb, you may find it worth a look. target=_blank>www.fluwikie.com/