Pandemic Influenza Plan - Questar III

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Appendix 8-F Passive Monitoring • Definition: The contact is asked to perform self-assessment at least twice daily and to contact authorities immediately if respiratory symptoms and/or fever occur. • Application: Situations in which 1) the risk of exposure and subsequent development of disease is low, and 2) the risk to others if recognition of disease is delayed is also low. • Benefits: Requires minimal resources. Places few constraints on individual movement. • Challenges: Relies on self-reporting. Affected persons may not perform an adequate self-assessment. • Resources Required: Supplies (thermometer; symptom log; written instructions). Hotline to notify authorities about symptoms or needs. Staff to receive telephone reports and provide in-person evaluation and care. <strong>Plan</strong>s and procedures for rapid isolation of persons who develop symptoms. • Partners: Household members. • Forms/Templates: Symptom logs. Instructions for patients and healthcare workers Active Monitoring without Explicit Activity Restrictions • Definition: A healthcare or public health worker evaluates the contact on a regular (at least daily) basis by phone and/or in person for signs and symptoms suggestive of influenza. • Application: Situations in which 1) the risk of exposure to and subsequent development of disease is moderate to high, 2) resources permit close observation of individuals, and 3) the risk of delayed recognition of symptoms is low to moderate. • Benefits: Places few constraints on individual liberties. • Challenges: Requires adequate staffing. Requires a system to track information and to verify monitoring and appropriate actions based on findings. • Resources Required: Trained staff to provide in-person and/or telephone evaluations. <strong>Plan</strong>s and procedures for rapid isolation of persons who develop symptoms. Contingency plans for managing noncompliant persons. Hotline to notify authorities about symptoms or needs. • Partners: Professional and lay healthcare workers to perform evaluations on behalf of the health department. Possible need for law enforcement to assist with management of noncompliant persons • Forms/Templates: Checklist for assessment of active monitoring. Template for recording results of clinical evaluation. Active Monitoring with Activity Restrictions (Quarantine) • Definition: The contact remains separated from others for a specified period (up to 10 days after potential exposure), during which s/he is assessed on a regular basis (in person at least once daily) for signs and symptoms of influenza disease. Persons with fever, respiratory, or other early influenza symptoms require immediate evaluation by a trained healthcare provider. Restrictions may be voluntary or legally mandated; confinement may be at home or in an appropriate February 7, 2006 2
Appendix 8-F facility. No specific precautions are required for those sharing the household with a person in quarantine as long as the person remains asymptomatic. Because onset of symptoms may be insidious, it may be prudent to minimize interactions with household members during the period of quarantine, if feasible. • Application: Situations in which the risk of exposure and subsequent development of disease is high and the risk of delayed recognition of symptoms is moderate. • Benefits: Reduces risk of spread from persons with subacute or subclinical presentations or from delayed recognition of symptoms. • Challenges: May infringe on personal movement. May lead to a feeling of isolation from family and friends. May lead to loss of income or employment. Requires plans/protocols for provision of essential services. Requires plan for provision of mental health support. Risk of noncompliance, particularly as duration increases. May require enforcement for noncompliance. • Resources Required: Staff for monitoring and evaluation. Appropriate facility if home setting is unavailable or inadequate. Staff, funding, and goods for provision of essential services. Hotline for notification of symptoms or personal needs. Mechanisms to communicate with family members outside the household or facility. Mental health and social support services. Delivery systems for food and other essential supplies. • Partners: Professional and lay healthcare workers to perform assessments on behalf of the health department. Community volunteers/workers to assist with provision of essential services. Potential need for law enforcement to assist with noncompliant persons. • Forms/Templates: Checklist for active monitoring. Template for recording results of clinical evaluation. Checklist and guidelines for evaluation of homes for quarantine. Checklist and guidelines for evaluation of community-based sites for quarantine. Guidelines for monitoring compliance with home quarantine. Guidelines for monitoring compliance with quarantine in community-based facilities. Forms for recording compliance with quarantine. • Examples: Home quarantine (voluntary or mandatory). Facility quarantine (voluntary or mandatory). Working Quarantine • Definition: Employees exposed to pandemic influenza but not yet ill are permitted to work but must observe activity restrictions while both on and off duty. Monitoring for influenza-like illness before reporting for work is usually required. This may change based on the clinical presentation of the novel strain. Use of appropriate PPE, including a surgical or procedure mask while at work, is required. • Application: Persons for whom activity restrictions (home or facility quarantine) are indicated but who provide essential services (e.g., healthcare workers). • Benefits: Reduces risk of community spread from high-risk contacts while minimizing adverse impact of activity restrictions on provision of essential services. Clinical monitoring at work reduces the staff required for active monitoring at the quarantine site. February 7, 2006 3
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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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Appendix 5-L Guidelines for Managem
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Appendix 5-L testing should be perf
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Appendix 5-L February 7, 2006 5
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Section 6: Vaccine Procurement, Dis
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Appendix 6-A Vaccine Priority Group
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Appendix 6-B Mass Clinic Planning O
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Appendix 6-C Vaccine and Antiviral
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Appendix 6-C 1. Request Phase The r
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Page 275 and 276: Appendix 8-D CONTACT DAILY TEMPERAT
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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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