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«Outbreak, Epidemic and Pandemic Response Plan August 2009 Introduction This Outbreak, Epidemic and Pandemic Response Plan (OEPRP) is a sub-plan of ...»

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Outbreak, Epidemic and Pandemic Response Plan

August 2009

Introduction

This Outbreak, Epidemic and Pandemic Response Plan (OEPRP) is a sub-plan of the Trent

University Emergency Management Plan (EMP) designed to address the unique requirements of

the university when the campus is experiencing increased incidence of a communicable disease.

This Plan details response to three levels of incidence: outbreak, epidemic and pandemic.

Definitions:

Outbreak:

An outbreak is typically defined as an increased incidence, above the normal experience, of an infectious disease process within an institution. Outbreaks may include, but are not limited to, respiratory symptoms and gastrointestinal symptoms. The existence of an outbreak is confirmed by the local Medical Officer of Health, based on data collection and observation.

Epidemic:

An epidemic is essentially an outbreak that involves a community or region, that is, increased occurrence as noted above but not confined to one institution.

Pandemic:

A pandemic is an extreme public health emergency and occurs when there is a global disease outbreak, affecting or with the potential to affect, countries throughout the world.

Governance Trent University retains governance of university academics and operations except when superseded by the legal authority of the municipal or provincial government.

Under the Health Protection and Promotion Act (HPPA) and the Health Systems Improvements Act of 2007, the Medical Officer of Health (MOH) for Peterborough City and County has the authority to implement public health measures including  Public education – including hand hygiene, cough etiquette, importance of fresh air, how to use masks, social distancing and influenza care.

 Travel restrictions – including travel advisories, voluntary foreign travel restrictions, closing borders and reducing transit use.

 Case management – including voluntary isolation, self care, anti-virals and compliance monitoring.

 Contact management – including education, voluntary and modified quarantine and compliance monitoring.

1  Infection prevention and control measures, social distancing [Social distancing – workplace infection prevention and control, social distancing by operational changes in a university setting (distance learning, cohorting residents, work from home) and restricting public gatherings] and campus closures.

The College of Nurses of Ontario (CNO) retains professional and regulatory authority over the practice of Registered Nurses, including those employed at Trent. Nursing students are not CNO registrants and therefore not subject to its authority.

Purpose The purpose of this plan is to assist Trent University in responding to a communicable disease

outbreak to the best of our ability in a manner that supports:

1. PCCHU and the MOH by minimizing serious illness and overall death and minimizing social disruption.

2. The students, faculty and staff of Trent University by the continuation or re-initiation of the academic program and support services.

3. The Board of Governors by minimizing the disruption and negative impact of an epidemic or pandemic on campus educational, social and economic operations and outcomes.

4. COU and CAUBO by taking mitigating action that is consistent with best practices within the Canadian and Ontario university community.

The Emergency Management Plan assumes an emergency that significantly disrupts university operations and provides a planning framework to restore university operations as quickly as possible. Most emergencies affect university infrastructure. However, the OEPRP recognizes that an epidemic or pandemic will primarily affect the availability of human resources. This may force the university to reduce the level of operations to core functions and to possibly even cease operations for extended periods.

The OEPRP is consistent with the EMP and the pandemic plans of both the Peterborough Regional Health Centre (PRHC) and the Peterborough County-City Health Unit (PCCHU) and is structured on the Incident Management System (IMS) in use in Ontario.

For regional consistency, the OEPRP will follow the ethical planning principles articulated in the

PRHC Pandemic Plan, adapted to Trent. These principles are:

 Protect and promote the health of the Trent community.

 Ensure equity and distributive justice.

 Respect the inherent dignity of all persons.

 Use the least restrictive measures consistent with the recommendations of the Medical Officer of Health.

 Optimize the risk/benefit ratio.

 Work with transparency and accountability.

Trent also adopts the Ontario Health Plan for an Influenza Pandemic approach which is:

–  –  –

Outbreak Planning Assumptions  The outbreak is confined to one residence or to one site (i.e. Peterborough or Oshawa but not both) of Trent University.

 The outbreak involves an increased incidence of symptoms reflective of an infectious disease.

 The outbreak is confirmed by the Peterborough County City Health Unit.





 The outbreak is anticipated to be three to ten days in length.

 Housekeeping staff will have had the appropriate training, will have available the appropriate personal protective equipment and will be assigned in increased numbers to ensure 24/7 coverage.

 Food services staff will have had the appropriate training, will have available the appropriate personal protective equipment and will be assigned in increased numbers to ensure 24/7 coverage.

 Increased food supplies, and specifically fluids, will be ordered and made available on a 24/7 basis.

 Specific precautions and personal protective equipment required will be dependent upon the type of disease but at a minimum, universal precautions will be required.

–  –  –

Students, faculty and staff who are symptomatic will be asked to remain at home, or in their residence room if they are students in residence, limiting to the extent practicable all contact with other members of the university and the general public.

Subject to consultation with PCCHU, work, classes and placement for asymptomatic employees and students will continue as scheduled. Exception: Students who are in practice settings where they are working with vulnerable people may be directed not to attend such placements during an outbreak at Trent. In such cases, they will be provided the opportunity to make up missed practice opportunities following the end of the outbreak. This may require attendance beyond the school year.

Epidemic

Planning Assumptions  The epidemic is at least Peterborough wide, possibly province or even country wide, affecting a larger than usual number of individuals both on and off campus.

 The epidemic involves an increased incidence of symptoms reflective of an infectious disease.

 The epidemic is confirmed by the Peterborough County City Health Unit.

 The length of the epidemic will be dependent on the disease process involved, however a typical range for an epidemic is 4 to 12 weeks.

 Housekeeping staff will have had the appropriate training, will have available the appropriate personal protective equipment and will be assigned in increased numbers to ensure 24/7 coverage.

 Food services staff will have had the appropriate training, will have available the appropriate personal protective equipment and will be assigned in increased numbers to ensure 24/7 coverage.

 Increased food supplies, and specifically fluids, will be ordered and made available on a 24/7 basis.

 Specific precautions and personal protective equipment required will be dependent upon the type of disease but at a minimum, universal precautions will be required.

Operational Management of an Epidemic at Trent University:

An epidemic management team will be appointed by the EOCG or EOCG Director to oversee the response to the outbreak. It is recommended that membership on that team

include representatives from each of:

Communications Food Services Health Services Housekeeping

–  –  –

Clerical support will be required for the outbreak management team. Additional consultants will be added as appropriate.

Students, faculty and staff who are symptomatic will be directed to remain at home, or in their residence room if they are students in residence, limiting to the extent practicable all contact with other members of the university and the general public.

Subject to consultation with the Peterborough County City Health Unit, classes, midterms, exams and placement activities may be cancelled for the duration of the epidemic.

Note: Students who are in practice settings where they are working with vulnerable people (young, old, frail) may be directed not to attend such placements during an epidemic.

Academic departmental plans must address alternative provision of services during an extended period of class cancellation as well as remedial options for students who have not been able to complete course work or placements, mid-terms or exams.

Administrative departmental plans will address business continuity issues such as application of university policies, financial recovery and impact on the university’s reputation.

–  –  –

Pandemic Planning Assumptions  A pandemic event will last up to 18 months; in two or more waves of approximately eight to twelve weeks in duration. The second wave will follow 3 -9 months after the first and likely be more serious.

 20 – 60% of students and employees may be affected at any one time.

5  Hospitalization and death rates will vary depending on the severity of the disease;

 Full normal operations of the University will not be able to be maintained throughout the pandemic period.

 Ontario may have little lead time once a pandemic is declared by the World Health Organization.

 Many members of the Trent community travel internationally, which could contribute to the speed with which a pandemic reaches Trent and Peterborough.

 Persons recovering from the illness will likely be immune during subsequent waves.

 Vaccines will not likely be available for four to six months after the initial outbreak.

 Everyone may require two doses of the vaccine to produce immunity. When enough vaccine becomes available public health units will organize vaccination clinics, prioritized on the basis of risk.

Pandemic Assessment

The World Health Organization (WHO) identifies the following pandemic periods and phases:

1. Inter -Pandemic a. Phase 1. No new animal viruses have been detected in humans.

b. Phase 2. A circulating animal influenza virus is known to have caused infection in humans.

2. Alert a. Phase 3. Human infections with a new sub-type, but no human to human spread, or rare instances of close contact spread.

b. Phase 4. Sustained community level outbreaks caused by human to human transmission.

c. Phase 5. Sustained community level outbreaks caused by human to human transmission in two countries in one WHO region.

3. Pandemic a. Phase 6. Phase 5 criteria plus community level outbreaks in at least one other country in a different WHO region.

Key Activities

Key Activities of the OEPRP will be related to the WHO periods and phases and any public health measures recommended by the MOH. As well, the following two additional planning

periods have been added:

 Interim periods between waves of infection  A post-epidemic or pandemic business recovery period Key activities are attached, indicating the department or office responsible for each activity.

Inter-Pandemic (normal operations)

–  –  –

Post Pandemic Key Activities Responsible Department(s) Determine and communicate return to full EOCG operations plan and timings Marketing and Communications Prioritize recovery needs i.e. funding, staff, EOCG infrastructure, psycho-social services.

Replenish supplies. All departments Reports to PCCHU, MTCU etc EOCG Conduct in-depth lessons-learned analysis Emergency Planning Committee including survey of Trent community re impact, financial impact, enrolment impact, legal impact, reputational impact, personnel impact.

Debrief, evaluation and revision of plan and Emergency Planning Committee deactivate EOCG and Pandemic Management EOCG Team Thank you and acknowledgement of Marketing and Communications community support, losses and changes.

Education and Training Education and training in advance of and during an outbreak, epidemic or pandemic are vital to reducing panic, absenteeism and infection by providing factual information, simple hygiene techniques and avoiding hyperbole and speculation.

Messages should be repeated frequently in a variety of formats. Essential components are:

 A short, plain language explanation of the communicable disease status and characteristics.

 Update the message as more information becomes available.

 Provide a short, practical list of steps that anyone can take to reduce exposure risk.

 Emphasize the importance of hand washing, hand sanitizer, covering coughs and sneezes, avoiding face touching, avoiding casual physical contact, maintaining a clean environment, staying home when ill, and maintaining a meter of distance from anyone coughing or sneezing.

–  –  –



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