Mayor Michael R. Bloomberg and Health Commissioner Dr. Thomas R. Frieden today unveiled New York City's Pandemic Influenza Preparedness and Response plan. The plan – created in response to a potential global influenza pandemic – covers critical health areas needed in a pandemic, including disease monitoring, laboratory capacity, vaccine and medicine delivery, hospital preparedness, mental health, and communications. The New York City Department of Health and Mental Hygiene (DOHMH) has been engaged in pandemic flu planning for several years and over the past year has developed this plan with City, State and Federal input, as well as feedback from non-governmental partners in the health care, business and non-profit communities. The plan is part of a coordinated multi-agency emergency response that includes operational planning and preparedness by the Office of Emergency Management (OEM) and the Fire and Police Departments. The Mayor and Health Commissioner were joined for the announcement today at DOHMH headquarters by OEM Commissioner Joseph F. Bruno, Health and Hospitals Corporation President Alan Aviles, FDNY Chief of Counter-Terrorism and Emergency Preparedness Joseph Pfeifer, Medical Director of the NYPD Counter-Terrorism Unit Dr. Dani-Margot Zavasky and Greater New York Hospital Association (GNHYA) President Kenneth E. Raske.
"As the nation's most densely populated city and as a major port of entry, New York City may encounter emerging public health threats before any other city," said Mayor Bloomberg. "As a leader in public health emergency preparedness, we have to be ready for the possibility – no matter how remote – of a pandemic flu. Having a comprehensive plan in place will ensure that we respond rapidly to an influenza pandemic. Through interagency coordination and response, if there is a pandemic, New Yorkers will be less likely to become sick, more likely to get good medical care if they do get sick, and have less disruption to their day-to-day activities."
"This plan provides the framework for a coordinated response to help protect the health of New Yorkers, and it will be refined on an ongoing basis," said Commissioner Frieden. "A severe pandemic would inevitably cause significant illness and social and economic dislocation, even with the best laid and most effectively implemented plans. Our plan will help minimize the impact if there is a pandemic. Without a vaccine, and with medications of limited supply and effectiveness, traditional measures of reducing disease spread - such as covering your mouth when you cough or sneeze, or staying home from work or school if you have fever - would be crucial."
Through its readily mobilized group of trained and dedicated professionals, and in conjunction with City, State and Federal partners, DOHMH would help the City detect, respond to, and recover from a possible flu pandemic by focusing activities around four primary areas:
- Limit severe illness and death from influenza.
- Provide appropriate influenza evaluation and care.
- Maintain essential medical services.
- Communicate rapidly, accurately, and frequently with the public, the medical community and others using all available media.
The plan focuses heavily on the health care system's ability to respond to an influenza pandemic. It describes a wide range of response measures, including how the City would:
- Implement infection control procedures in health care facilities and in workplaces;
- Intensify disease monitoring to track trends in hospitalizations and deaths, and guide response by optimizing detection and treatment;
- Make the most effective possible use of limited medical resources, such as antiviral medications and ventilators;
- Provide guidance to hospitals to address surge capacity;
- Increase laboratory capacity to provide accurate and rapid laboratory diagnostic testing as indicated;
- Enact disease containment measures in community settings if indicated (e.g., closing schools, limiting public gatherings);
- Regularly communicate the most up-to-date information to the public and medical community;
- Address mental health needs of communities, front line health care workers, and others, especially vulnerable populations such as children and elderly, homeless, disabled, and homebound people.
In a worst case scenario, a pandemic that produces widespread serious illness could significantly impact all sectors of society and last for at least several months. The health care system would be overburdened and there could be dramatic reductions in workforce availability in all sectors as employees become ill or remain home to care for sick family members. This is why business continuity planning is so important for organizations in both the commercial and non-profit sectors.
"The City's public hospitals have 11 emergency departments that are well equipped and have well trained staff to serve as first respondents to any large scale crisis," said HHC President Aviles. "Our facilities conduct drills throughout the year to ensure our continuing readiness as a first line of emergency response, and we also participate in the citywide emergency preparedness exercises. A pandemic would certainly tax our system, but we stand ready with significant emergency resources, personnel and expertise to help meet the needs of our patients and the public."
"GNYHA is committed to ensuring that its member hospitals are prepared to respond to emergencies that could take place in the New York region," said GNYHA President Ken Raske. "I commend Mayor Bloomberg and Commissioner Frieden for their continued leadership in preparing New York City for any public health emergency that we may face."
Over the past several years, DOHMH has worked closely with the emergency services, health care, business and not-for-profit sectors to prepare for a possible flu pandemic. The City has participated in more than 50 tabletop, functional, and full-scale exercises and drills over the past five years to test, assess and strengthen response capabilities. For example, a large-scale multi-agency field exercise called PODEX focused on response to a biological hazard. The two-day drill, held in June 2005, tested the City's ability to provide medication to individuals affected by a biological attack and examined interagency coordination in accordance with the Citywide Incident Management System (CIMS), overall emergency response, and the integration of federal, state and regional assets.
In addition, individual City agencies have also staged biological hazard response exercises. Each year, the Fire Department conducts its BIOPOD exercise. The most recent, in November 2005, tested the FDNY's response to a simulated biological agent that had the capacity to be easily passed from human to human. The FDNY has held two previous BIOPOD exercises all of which tested the efficacy of distributing to first responders vaccines and other necessary medications in the event of exposure to biological hazards.
The Police Department has also conducted several agency drills to test their response to a potential biological or infectious disease outbreak. In the event of a pandemic, the NYPD would be responsible for safeguarding medications and vaccines upon their arrival and during their distribution. In addition, the NYPD would provide security, as well as traffic and crowd control at approximately 200 points of distribution citywide. The Pandemic Influenza Preparedness and Response plan draws on lessons learned from these efforts, providing a comprehensive, scalable, and flexible strategy to protect the health of New Yorkers in the event of a flu pandemic.
"The Fire Department is committed to taking every step necessary to better prepare for the emerging challenges we face," said Commissioner Scoppetta. "This comprehensive response plan is designed to ensure that both the Fire Department and the City draw upon the best expertise possible. Coupled with the FDNY's own preparedness initiatives, we'll ensure that our Firefighters, EMTs and Paramedics will be able to continue to respond to and provide care to individuals impacted by a possible pandemic. Our mission is, and always will be, the safety of New Yorkers."
"The NYPD has taken an active part in all of the City's biological emergency exercises testing response capabilities to intentional or natural infectious disease outbreaks," said Commissioner Kelly. "In addition, the NYPD regularly conducts its own internal exercises, continuously drilling our responses to a variety of emergencies. We also have a robust plan and capability to distribute medications and vaccines, when these become available, to all Department personnel."
In the event of a pandemic, OEM would assist in the implementation of decisions made by DOHMH. In addition, OEM would implement its continuity of operations plans to help the City to continue to provide essential services to residents. New Yorkers can also do their part by preparing themselves for any emergency by creating a household disaster plan. Steps include stocking non-perishable food, water, medications, and other essential household items in advance.
"OEM will help make sure City government continues to provide essential services in the event of a pandemic flu emergency," said Commissioner Bruno. "While no one can predict what types of emergencies the future may hold, having a family preparedness plan, a ‘go bag' and supplies at home will help ensure that all New Yorkers are as ready as possible for anything that comes our way."
A pandemic influenza strain does not currently exist. However, a new strain of avian influenza (H5N1) has been spreading in bird populations in Asia for several years. While the disease has a high fatality rate among people who have become ill, nearly all have gotten sick through direct contract with poultry. A genetic change in this virus could conceivably allow the disease to become more widespread. If that were to happen, a number of factors would determine whether a pandemic would occur, including how readily the disease spreads, how virulent it is to humans, and whether a vaccine is available.