HHS Pandemic Influenza Plan

U.S. Department of Health andHuman Services

November 2005

U.S. Department of Health andHuman Services

November 2005

HHS Pandemic Influenza Plan

HHS Pandemic Influenza PlanTABLE OF CONTENTSStatement by Secretary Leavitt ................................................................................................................1

Preface .........................................................................................................................................................2

Executive Summary ....................................................................................................................................4

PART 1 - STRATEGIC PLAN .....................................................................................................................15The Pandemic Influenza Threat ........................................................................................................................16

Planning Assumptions .........................................................................................................................................18

Doctrine for a Pandemic Influenza Response ..............................................................................................20

Key Pandemic Influenza Response Actions and Key Capabilities for Effective Implementation..22

Roles and Responsibilities of HHS Agencies and Offices .........................................................................26

HHS Actions for Pandemic Influenza Preparedness and Response .......................................................32

Appendices

A. National Response Plan ........................................................................................................................A-1

B. Pandemic Influenza Background........................................................................................................B-3

C. WHO Pandemic Phases .........................................................................................................................C-8

D. NVAC/ACIP Recommendations on Use of Vaccines and NVAC Recommendations on Pandemic Antiviral Drug Use......................................................................................................D-10

E. Legal Authorities...................................................................................................................................E-30

F. Current Key HHS Activities ................................................................................................................F-33

G. HHS Research Activities.....................................................................................................................G-42

H. International Partnership on Avian and Pandemic Influenza.................................................H-59

I. Acronym List............................................................................................................................................I-61

J. Internet Resources on Pandemic Influenza...................................................................................J-63

PART 2 - PUBLIC HEALTH GUIDANCE FOR STATE AND LOCAL PARTNERSIntroduction...........................................................................................................................................................I-1

Supplement 1: Pandemic Influenza Surveillance..............................................................................S1-1

Supplement 2: Laboratory Diagnostics ................................................................................................S2-1

Supplement 3: Healthcare Planning.....................................................................................................S3-1

Supplement 4: Infection Control ...........................................................................................................S4-1

Supplement 5: Clinical Guidelines ........................................................................................................S5-1

Supplement 6: Vaccine Distribution and Use ....................................................................................S6-1

Supplement 7: Antiviral Drug Distribution and Use ........................................................................S7-1

Supplement 8: Community Disease Control and Prevention ........................................................S8-1

Supplement 9: Managing Travel-Related Risk of Disease Transmission....................................S9-1

Supplement 10: Public Health Communications ............................................................................S10-1

Supplement 11: Workforce Support: Psychosocial Considerations and Information Needs ....................................................................................................S11-1

One of the most important public health issues our Nation and the world faces is the threat of a globaldisease outbreak called a pandemic. No one in the world today is fully prepared for a pandemic -- butwe are better prepared today than we were yesterday - and we will be better prepared tomorrow thanwe are today.

This HHS Pandemic Influenza Plan provides a blueprint from which to prepare for the challenges that lie ahead of us. Being prepared and responding effectively involves everyone: individuals,communities, businesses, States, Federal agencies, international countries and organizations. Here athome, we can use this Plan to create a seamless preparedness network where we are all workingtogether for the benefit of the American people.

In the century past, we have experienced influenza pandemics three times: as recently as 1968 and1957 and what has been called the Great Influenza in 1918, a pandemic that killed 40-50 millionpeople worldwide. At some point in our nations future another virus will emerge with the potentialto create a global disease outbreak. History teaches us that everything we do today to prepare for thateventuality will have many lasting benefits for the future. We will realize important advances inhealthcare, and we will be better prepared for other types of emergencies.

I am humbled by the enormity of the challenge that the global community confronts should there bea pandemic. Public cooperation and global partnerships will be essential tools in fighting back andcreating a constant state of readiness. If together we take the steps necessary, we will be able to savethe lives of millions of people in our country and all around the world.

Mike LeavittHealth and Human Services Secretary

1

Statement by Health and Human Services Secretary Mike Leavitt:

All plans should remain living documents. They should be updated periodically in the time

before, during, and after a pandemic. All plans should be exercised to identify weaknesses

and promote effective implementation.

Adequate planning for a pandemic requires the involvement of every level of our nation, and indeed, the world.The ubiquitous nature of an influenza pandemic compels federal, state and local governments, communities,corporations, families and individuals to learn about, prepare for, and collaborate in efforts to slow, respond to,mitigate, and recover from a potential pandemic. The development, refinement, and exercise of pandemicinfluenza plans by all stakeholders are critical components of preparedness.

This document, the HHS Pandemic Influenza Plan, serves as a blueprint for all HHS pandemic influenzapreparedness planning and response activities. This plan updates the August 2004 draft HHS PandemicInfluenza Preparedness and Response Plan and features important additions and refinements. The Planintegrates changes made in the 2005 World Health Organization (WHO) classification of pandemic phases andexpansion of international guidance and now is consistent with the National Response Plan (NRP) published inDecember 2004.

The HHS Pandemic Influenza Plan has three parts, the first two of which are contained in this document. Part1, the Strategic Plan outlines federal plans and preparation for public health and medical support in the eventof a pandemic. It identifies key roles of HHS and its agencies in a pandemic and provides planning assumptionsfor federal, state and local governments and public health operations plans. Part 2, Public Health Guidancefor State and Local Partners, provides detailed guidance to state and local health departments in 11 key areas.Parts 1 and 2 will be regularly updated and refined. These documents will serve as tools for continuedengagement with stakeholders, state and local partners.

Part 3, which is currently under development, will consist of HHS Agencies Operational Plans. Each HHScomponent will prepare, maintain, update and exercise an operational plan that itemizes their specific rolesand responsibilities in the event of a pandemic. These individual plans will also include detailed continuity ofoperations plans such as strategies for ensuring that critical everyday functions of each operating division areidentified and maintained in the presence of the expected decreased staffing levels of a pandemic event. Inaddition to operations, these plans will elaborate on coordination, command and control, logistics, andplanning, as well as financial and administration considerations.

Recognizing that an influenza pandemic has the capacity to cause disruptions across all levels of governmentsand in all communities, pandemic influenza preparedness is a shared responsibility. The following list includessome of the additional plans that will be required to mitigate the impact of a pand