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Transcript of Social Distancing in Pandemic Influenza Planning: Meeting the Needs of Vulnerable Populations at the...
Social Distancing in Pandemic Influenza
Planning:
Meeting the Needs of Vulnerable Populations at
the Community Level
Alex Cole-Corde
North Dakota State University
Presentation Overview
•20th Century Pandemics;•21st Century Pandemics; •Pandemic Mitigation Strategies; •Social Distancing Effects;•Vulnerable Populations;•Social Distancing Effects on Vulnerable Populations;•Planning Deficiencies;•Pandemic Research Planning; and, •Conclusion.
20th Century Pandemics
1968 Hong Kong Influenza *US 34,000+
*Global 700,000+Attack Rate 25% – 40%Mortality Rate ≤ 1.0%
1957 Asian Influenza *US 70,000+
*Global 1 million to 2 millionAttack Rate 25% – 35%Mortality Rate ≤ 1.0%
1918 Spanish Influenza *US 500,000+
*Global 40 million+Attack Rate 25% – 35%Mortality Rate ≥ 2.5%
*Conservative Estimate of Pandemic-Related Deaths - USDHHS
Bridge to the 21st Century Pandemic
Bridge to the 21st Century Pandemics:
Not If, but How Many and How Bad?
•States are required to have Pandemic Influenza Plans (funding dependent);
•Most State Plans emphasize health services, pharmaceutical distribution, and limiting viral transmissions; Not societal effects; •20th Century Pandemics occurred in two to three ‘waves’ from six to eight weeks over 12 to 18 months;
Bridge to the 21st Century Pandemics:
How Bad, Continued…
•Pharmaceuticals may not work (viral strain resistant) or be in limited quantities (six to nine months to distribute nationally);
•USDHHS estimates up to 40% Americans ill (≤1% death rate) → 90 million ill, 45 million outpatient, 10 million hospitalized, between 200,000 to 2 million dead; and,
•Federal, State, tribal, and local governments will implement pandemic mitigation strategies.
Pandemic Mitigation Strategies
Non-Pharmaceutical Interventions (NPI)
•NPI(s) are pandemic containment measures engaged without the use of pharmaceuticals to minimize viral transmission by limiting person-to-person contact.
NPI types include:
•Isolation.
•Quarantine.
•Social Distancing.
Community Effects of Social
Distancing Depending upon Pandemic
Severity…
•Close nonessential businesses and noncritical services;
•Close public gathering places;
•Cancel public gathering community events;
•Close, limit, or restrict nonessential movement; and,
•Limit or cancel community services for socially dependent or vulnerable populations.
“In disaster preparedness, the terms vulnerable or special needs people or populations are used to
define groups whose needs are not fully addressed by
the traditional service providers. It also includes groups that may feel they
cannot comfortably or safely access and use the standard resources offered in disaster preparedness, response and
recovery.” ~CDC
Social Dependence of
Vulnerable Populations in
Disasters
Vulnerable Populations
Abused Women and Children and Shelter Dependent;
Animals, Display, Livestock, Pets, and Show;
Blind, Legally Blind;Caregiver Dependent (Human Assistance
and/or Service Animal); Chemically Dependent (drugs, alcohol, or
other);Children, Infants-Teens;
Chronically-Lonely, Depressed, or Suicidal;
Cultural, Ethnic, or Religious Restricted;Deaf, Deaf-Blind, Deaf-Dumb, Hard of
Hearing;Educationally Challenged, Illiterate;
Elderly;Emerging, Traveler, or Transient Special
Needs;
(Institutionalized or Facility Dependent Individuals not listed)
Vulnerable Populations
Habitually Dependent upon Social Services or Social Programs;
Homeless Adults and Children and/or Shelter Dependent;
Illegal and/or Legal Alien: Limited English or Non-English Proficiency;
Impoverished, Low income, Substandard Housed;
Medically Dependent or Medically Compromised;
Mentally Challenged;Mentally Ill;
Mobility Limited;Physically Disabled;
Pregnant Women;Racial and Ethnic Minorities;
Single Parents;University Students.
(Institutionalized or Facility Dependent Individuals not listed)
Negative Effects of Social Distancing
on Vulnerable PopulationsLimited accessibility to services and
resources:
•Consumables;
•Pharmaceuticals;
•Financial resources;
•Public transportation;
•Health care, medical treatment facilities/professionals;
•Hospice, home care or assisted living professionals;
•Child care assistance and education;
•Mentally and physically challenged programs;
•Social support and guidance persons;
•Shelters and missions;
•Welfare, social security, disability, and unemployment programs; and,
•Animal/pet food, supplies, and welfare services.
Gap Analysis to Mitigate Planning
Deficiencies •Gap analyses of state and community pandemic plans to identify disparities between planning strategies and needs of vulnerable population;
•Reassess normal disaster aid distribution mechanisms – POD to DOP;
•No Vacuum Planning – include Community Stakeholders; and,
•Build Community Capacity to meet population needs.
Planning challenge is to identify the right resources to deliver to
the right residents.
Pandemic Research and Planning
Build Community Resiliency
and Capacity
• Identify Community Vulnerable Populations;
• Identify and Assess the Community Needs of Vulnerable Populations;
• Identify and Assess Community Stakeholders, Capabilities, and Resources; and,
• Bring Community Stakeholders
Together.
Building Community Resiliency and
Capacity
The Community Stakeholders
•Governmental Officials;
•Governmental Social Agencies;
•Non-Governmental Organizations;
•Faith-Based Organizations;
•Community-Based Organizations; and,
•Private Businesses.
University Pandemic Planning
ChallengesStudent Dependency
upon the University
System
•In-Residence Universities, Programs, and Classes;
•On-Campus Residents; and,
•Off-Campus Residents.
Coordinate University Pandemic Plans with
Community Pandemic Plans.
Conclusion
•Review State and Community Pandemic Plans;•Identify Vulnerable Populations;•Identify and Assess General and Specific Needs;•Assess Existing Community Resources and Capabilities;•Identify Planning Deficiencies;•Build Community Resiliency and Capacity through Stakeholder Partnerships;•Reassess and Retool the Planning Process;•Bridge the Gap of Planning Deficiencies; and,•Maintain Stakeholder Relationships Over Time.
Reinventing the Planning Process?
Pandemic Planning is not a discrete event that produces a ‘snapshot’ document for posterity; it is an organic, continual process that evolves over time and changes as situations and environments change. Therefore planning is NOT an end product, but a beginning process.
Sources and Acknowledgements
Sources
Glass R.J., L.M. Glass, W.E. Beyeler, and H.J Min. www.cdc.gov/ncidod/EID/vol12no11/06-0255.htm
Cindy Lambdinwww.idready.org
Minnesota Department of Healthwww.health.state.mn.us/divs/idepc/diseases/flu/avian/index.html
North Dakota Pandemic Flu Informationwww.ndpandemicflu.gov/
U.S. Centers for Disease Control and Prevention www.cdc.gov/flu/avian/ENTER
U.S. Department of Homeland Security http://www.dhs.gov/xlibrary/assets/NIPP_Plan.pdf.
U.S. Department of Human Health Serviceswww.pandemicflu.gov/
World Health Organizationwww.who.int/csr/disease/avian_influenza/en/index.html
Acknowledgementsהוה׳ , Carol Cwiak, and Jeanine Neipert
North Dakota State University