Pandemic Influenza Plan - Questar III

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Antiviral Medication Priority Group Recommendations Appendix 7-C Group Estimated population (millions) Strategy** For target group # Courses (millions) Cumulative Rationale 1 Patients admitted to hospital*** 2 Health care workers (HCW) with direct patient contact and emergency medical service (EMS) providers 3 Highest risk outpatients— immunocompromised persons and pregnant women 4 Pandemic health responders (public health, vaccinators, vaccine and antiviral manufacturers), public safety (police, fire, corrections), and government decision-makers 10.0 T 7.5 7.5 Consistent with medical practice and ethics to treat those with serious illness and who are most likely to die. 9.2 T 2.4 9.9 Healthcare workers are required for quality medical care. There is little surge capacity among healthcare sector personnel to meet increased demand. 2.5 T 0.7 10.6 Groups at greatest risk of hospitalization and death; immunocompromised cannot be protected by vaccination. 3.3 T 0.9 11.5 Groups are critical for an effective public health response to a pandemic. 5 Increased risk outpatients— young children 12-23 months old, persons >65 yrs old, and persons with underlying medical conditions 85.5 T 22.4 33.9 Groups are at high risk for hospitalization and death. 6 Outbreak response in nursing homes and other residential settings NA PEP 2.0 35.9 Treatment of patients and prophylaxis of contacts is effective in stopping outbreaks; vaccination priorities do not include nursing home residents. February 7, 2006 1
Appendix 7-C 7 HCWs in emergency departments, intensive care units, dialysis centers, and EMS providers 8 Pandemic societal responders (e.g., critical infrastructure groups as defined in the vaccine priorities) and HCW without direct patient contact 1.2 P 4.8 40.7 These groups are most critical to an effective healthcare response and have limited surge capacity. Prophylaxis will best prevent absenteeism. 10.2 T 2.7 43.4 Infrastructure groups that have impact on maintaining health, implementing a pandemic response, and maintaining societal functions. 9 Other outpatients 180 T 47.3 90.7 Includes others who develop influenza and do not fall within the above groups. 10 Highest risk outpatients 2.5 P 10.0 100.7 Prevents illness in the highest risk groups for hospitalization and death. 11 Other HCWs with direct patient contact 8.0 P 32.0 132.7 Prevention would best reduce absenteeism and preserve optimal function. *The committee focused its deliberations on the domestic U.S. civilian population. NVAC recognizes that Department of Defense (DoD) needs should be highly prioritized. A separate DoD antiviral stockpile has been established to meet those needs. Other groups also were not explicitly considered in deliberations on prioritization. These include American citizens living overseas, non-citizens in the U.S., and other groups providing national security services such as the border patrol and customs service. **Strategy: Treatment (T) requires a total of 10 capsules and is defined as 1 course. Post-exposure prophylaxis (PEP) also requires a single course. Prophylaxis (P) is assumed to require 40 capsules (4 courses) though more may be needed if community outbreaks last for a longer period. ***There are no data on the effectiveness of treatment at hospitalization. If stockpiled antiviral drug supplies are very limited, the priority of this group could be reconsidered based on the epidemiology of the pandemic and any additional data on effectiveness in this population. (Source: HHS Pandemic Influenza Plan, Part 2-Public Health Guidance Supplements, Supplement 7) February 7, 2006 2
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February206 Pandemic Plan NewYorkSt
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Introduction Pandemic influenza occ
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example, at this time, it is realis
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Acronyms (cont.) IND IHANS IRB ISHS
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Section 1: Command and Control I. O
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Section 1: Command and Control pers
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February 7, 2006 Appendix 1-A
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Appendix 1-B The Public Health Law
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Appendix 1-B communicable diseases
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Appendix 1-C Management Office or t
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Appendix 1-E Suspension of Public M
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Appendix 1-G A Guide to New York St
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Appendix 1-G health commissioner. P
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Appendix 1-G 8. State Institutions
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Appendix 1-G b. Governor May Invoke
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Appendix 1-G may direct, pursuant t
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Appendix 1-G c. Commissioner of Gen
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Appendix 1-G Designation of emergen
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Appendix 1-G physician’s assistan
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Appendix 1-H Summary of Public Offi
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Section 2: Surveillance and Laborat
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Appendix 2-A • Surveillance Crite
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Appendix 2-A • In New York City,
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NYSDOH Novel Influenza Case Report
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Appendix 2-C to health care provide
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Virus Detection History NYS Lab Num
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Section 3: Healthcare Planning and
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Section 4: Infection Control I. Ove
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Section 4: Infection Control I. Ove
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Section 4: Infection Control A. Bas
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Section 4: Infection Control Drople
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Section 4: Infection Control • Pe
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Section 4: Infection Control o Noti
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Section 4: Infection Control E. Coh
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Section 4: Infection Control If wid
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Section 4: Infection Control • En
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Section 4: Infection Control should
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Section 4: Infection Control Policy
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Section 4: Infection Control o Staf
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Section 4: Infection Control • De
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Section 4: Infection Control • Pr
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Section 4: Infection Control The ma
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Section 4: Infection Control • Up
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Section 4: Infection Control Health
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Appendix 4-A Soiled linen and laund
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Appendix 4-B Respiratory Hygiene/Co
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Section 5: Clinical Guidelines I. O
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Section 5: Clinical Guidelines incu
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Section 5: Clinical Guidelines 1) N
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Section 5: Clinical Guidelines infe
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Section 5: Clinical Guidelines Alth
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Section 5: Clinical Guidelines Infe
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Section 5: Clinical Guidelines •
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Appendix 5-B Clinical Evaluation of
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Appendix 5-C Special Situations and
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Appendix 5-D handling soiled laundr
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DRAFT Appendix 5-E Footnotes to App
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Appendix 5-F February 7, 2006 1
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Appendix 5-F 7. Guidance on the eva
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Appendix 5-H Source: U.S. Departmen
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February 7, 2006 2 Appendix 5-I
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Appendix 5-J Clinical Presentation
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Appendix 5-J diabetes mellitus), re
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Appendix 5-J resistant S. aureus (M
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Appendix 5-K eight patients—all o
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Page 207 and 208: Section 6: Vaccine Procurement, Dis
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Page 275 and 276: Appendix 8-D CONTACT DAILY TEMPERAT
Page 277 and 278: Appendix 8-F Definitions: Intervent
Page 279 and 280: Appendix 8-F facility. No specific
Page 281 and 282: Appendix 8-F • Resources Required
Page 283 and 284: Appendix 8-G Business Pandemic Infl
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Section 9: Communications • A JIC
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Section 9: Communications backup to
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Section 9: Communications • In th
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Appendix 9-A Public Health Risk Com
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Appendix 9-C New York State Departm
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Appendix 9-C PRE-EVENT MESSAGE MAP:
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Appendix 9-C PROTECTIVE MESSAGE MAP
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Appendix 9-C TREATMENT MESSAGE MAP:
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Appendix 9-C BUSINESS CONTINUITY PR
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Section 10: Training and Education
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Appendix 10-A NYSDOH STAFF PRIVATE
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FACILITY- BASED RNs FACILITY- BASED
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Section 11: Workforce Support I. Ov
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Section 11: Workforce Support Pande
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Section 12: Highly Pathogenic H5N1
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Section 12: H5N1 in Non-Human Anima
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Section 13: Public Health Preparedn
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Appendix 13-A NYSDOH Roles Notified
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Appendix 13-B Notifications sent by
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Appendix 13-B HAN posting is used a
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Appendix 13-B notification system t
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Appendix 13-C Overview of the Healt
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Appendix 13-C • Ongoing surveilla
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Table 1. Summary of HERDS Use To da
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Appendix 13-D Commerce Access and A
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Appendix 13-D Table 3. Organization
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