Pandemic Network: MEETING MINUTES

Pandemic Network

Meeting Minutes

WEDNESDAY, July 11, 2007 at 0900 PST

July 11, 2007

Pandemic Network Meeting

Lisa Trousdale (Facilitating)

Barbara Leone (Notes)

·       Berkeley CIDER conference (Lisa Trousdale)

·       BARC Write-up from Barry (Lisa Trousdale)

·       Open discussion (All)

Lisa Trousdale (Day 2) and BARC Write-up from Barry

Peter Otaki (Day 1)

NOTE: No August meeting.

Barbara Leone will facilitate the next meeting in September

Note Taker: TBD

Confirmation of topics will be announced

Day 1: Peter Ohtaki

Section 1: State of the State and the status from a med standpoint

Howard Backer spoke (Dept of Public Health)

Commented: H5N1 vaccines have limited affect

Govt goal to create a vaccine of 300mil doses in 6months

CDC :

TALKED ABOUT: CDC interim guidance on intervention

1918 Spanish flu emphasized early intervention

Alameda County Public Health-County public health advisory

Develop common guidance for all of the county govt/communities can use.

starling challenge of hospital surge capacity and gave statistics

Volunteer programs Medical Reserve Core

Statutes and regulations relating to the hospital sector

Ted Selby: Surge guidelines and response

Model Partnerships section: King County (Dennis Worshum) outreach and partnership program has periodic meetings and forums with companies in their areas

80 person breakfast, share best practices, providing input and the business community. Starting memos of understanding with the business communities.

BENS did pres. On Atlanta of Strategic national stockpile

San Diego Model:

Sorento Valley consortium presentation pan flu coordinator. Qualcom leads the consortium. Share plans and talked about collective and coordinated response. San Diego coordinator talked about their issues to encourage private sector coordination.

Glen Hammer gave a presentation on the April 20 cross sector summit

Comments:

Well coordinated

Public sector were very interested in the private sector response

Day 2:

Dr Corasiglia from Foster Farms: veterinarian oversight for testing monitoring and access controls. Talked about commercial poultry operations. Was a contrarian he said many robust controls that have any kind of disease. Strict guidelines for chickens. Keep poultry off the floors. Challenges associated with developing countries. Pictures very good and talked about commercial farming is very controlled may not be as high tech or sophisticated nonetheless they do have many controls. People’s relationships with their poultry are very different and the challenges are very high due to the fact that people have them as pets. Very difficult to get people to surrender their poultry. Downplayed the avian flu threat. Was representing foster farms and may have slanted opinion.

Opinions from Network: His perspective differs from the rest of the US the hatcheries and growers are contracted out and the level of control is not the same.

Tabletop:

An Oracle group brought a Younger Chinese group awarded and came to the US and a person became ill and it spread among the group. They had been out publicly and came in contact with thousands of people one of them dies.

How would it be handled? The scenario does not in the beginning discuss the fact that it Avian Flu. How to deal with communication? In large part the public health coordination was not discussed and the message was get public health involved early.

Peter added: the complexity of the agency relationships. Students were hospitalized in Santa Clara County. Oracle is in Alameda County. The CDC gets involved quickly and state public health and the office of Office of Emergency services gets involved.

At the end of the exercise the joint information coordinator and that this would be a public information event and that they would activate this plan.

Panel Discussion:

William Wilkinson; SFO, Linda Kristofferson US air, Dennis Cortman

The airport is designed to move people through. Airports will not close but a restriction on flights. If a pandemic occurs and people were infected on an airplane; No place to hold people and they would move people to a hanger.

Linda Kristofferson

Training program they teach how to handle it if someone becomes ill. How reporting is done etc..

Talked about the airline industry is running very lean. They do not have a lot of excess resources.

Session 1A 1B 1C and 2A 2B 2C

Symantec Session

Lessons learned from Pandemic Exercises (Lisa Trousdale)

Evault creating a plan for a pandemic 101 (Tanya York)

Telecommunications (Verizon rep presented)

Supply Chain Continuity

Creating a Business Continuity Planning 102

Roundtable discussion

Andre Barrow masters in Public Health. Quarantine Public Health Officer

Day 3:

Barry’s write up was read by Lisa

Summary Re: CIDR - DAY 3

Barry Cardoza, CBCP

I’m only referencing Day 3 of this very excellent 3-day event because that was the only day I could attend. It was the “CIDER Summer Intensive Program,” “Building Bridges: Public Health and Private Sectors Responding to Pandemic Influenza,” produced by the Center for Infectious Disease Preparedness (CIDP) of the University of California, Berkeley. When I looked through the 3-inch binder that I was given upon entry it was clear that they had already covered a great deal of material (“intensive” being the operative word here) and was sorry that I had missed days 1 and 2.

Day 3 focused on public health and safety. They had some very prestigious and interesting speakers from both the public (e.g., Cal/OSHA and public health representatives) and private (e.g., Oracle and 3m) sectors. There was also a great deal of roundtable discussion. Most of the attendees were from the public health sector, with a sprinkling of private sector representation. It was fascinating to hear the various public health entities discussing pandemic preparedness.

There were some very solid “take aways” for me. For instance, it never occurred to me that during a contagion-based event you should remove the magazines and newspapers from waiting rooms to avoid passing infection from one person to another. (Duuuh.) And the “blinding flash of the obvious” that when you are giving people instruction on how to use Personal Protective Equipment (PPE) you also need to tell them how to safely remove said equipment without infecting themselves. That’s going into our employee guidance documentation immediately.

Kathleen Harriman shared the Minnesota State Agency Pandemic Influenza Service Continuation Guide.” And, pointed out that California doesn’t have one…that’s something that I will take back to the Governor’s Advisory Workgroup.

Kiefer Mayenkar of Oracle and Mike Lewandowski of 3m (yes, the Scotch Tape people, but they also manufacture a wide range of products including PPE) very generously shared the evolution of their pandemic planning efforts and where they are today. Deborah Gold of OSHA (Occupational Safety and Health A) gave a very educational presentation regarding their view and role regarding pandemic planning and response.

I learned some new terms/acronyms including “cohorting,” (which means grouping people with the same disease together) and “TNTC” (too numerous to count, referring to a huge number of patients with the same illness). I also learned that there are additional considerations around cohorting. For instance, if you are grouping together people who have an influenza infection, you don’t want to throw someone who also has tuberculosis into the mix.

As impressive and valuable as the presentation were, the voluminous amount of information that was shared by the attendees was equally so. The bottom line is that this was one of the best organized and presented events I have attended. If they do this again next year, I would heartily recommend that you participate. You will come away with valuable information that you can take back to your own institutions or agencies and immediately apply.

Pandemic Network

Meeting Minutes

WEDNESDAY, June 13, 2007 at 0900 PDT

Regina Phelps Presentation
Thank you to Barry for being the Note taker and Fiona for Facilitating
June 13^th 2007 Pandemic Network Meeting Summary
Just when you think that you’ve heard every possible angle on the topic of pandemic preparedness, Regina Phelps, founder of Emergency Management and Safety Solutions, comes up with new information and fresh perspectives. Her presentation updated the group on new information coming out of the Centers for Disease Control and Prevention (CDC) regarding their recommendations for the use of masks, as well as a probable upcoming recommendation of the stockpiling of Tamiflu. She even explained how Tamiflu, one type of antiviral, works to prevent the virus from entering the respiratory cells in the human body. She also spoke about a new vaccine that shows promise, although no one can know if it would be effective with a newly mutated version of the virus.

Regina explained that the virus prefers cooler weather, and why we will probably see an increase in infection next winter. Additionally, she said that there is suspicion (not proof) that H5N1 may have mutated in Indonesia to a form that is more easily passed from birds to people. (Not from person to person.) She covered the means by which pandemics can be categorized, based on case/fatality ratios.

Regina then talked about potential economic impact, the ongoing need for preparedness. This was a very valuable presentation and we are fortunate that Regina has permitted the Pandemic Network to post it on their website in its entirety.

The presentation was followed by Q&A with Regina and also considerable discussion amongst the attendees. Lisa Trousdale was good enough to share considerations regarding Tamiflu stockpiling that have been discussed within Earnst & Young, and there are a great many considerations. Those include the logistics of storage and distribution, medical requirements for a screening and prescription prior to distribution, potential ethical and liability issues, etc. Every company will need to make its own decisions regarding this topic.

WEDNESDAY, March 14, 2007 at 0900 PDT

I. Steve Kaplan from Access Flow will talk to us about Virtual Disaster Recovery

Steve Kaplan is president of AccessFlow, a VMware Premier Partner offering virtual DR solutions. Kaplan has co-authored multiple books and written dozens of IT articles on the business aspects of various IT subjects ranging from security to disaster recovery to regulatory compliance. He frequently gives talks on virtualization and disaster recovery around the globe including the keynote for ThinPower 2006 in Norway and a presentation at 2005 Continuity Insights Conference in New Orleans. Kaplan holds a BS in business administration from U.C. Berkeley and an MBA from Northwestern’s J. L. Kellogg Graduate School of Management. He is a Microsoft MVP for Terminal Server.

Outline for Pandemic Network Meeting

Overview – Pandemic DR from IT perspective

Most DR plans fail

·        Gartner

·        Meta

·        National Archive & Records

Why is Failure the Norm?

Lack of Access Consideration

·        Client

·        Connectivity

·        World Trade Center and Hurricane Katrina examples

Lack of Identical DR Site Equipment

·        Tight coupling of Windows OS and hardware

·        Very expensive to purchase and manage

Lack of Testing

Expensive and Time-Consuming

The Virtual Alternative

·        Virtualize the data center

·        Virtualize clients

·        Virtualize access/connectivity

·        Virtualize telephony

Effective DR – even Pandemic DR – becomes almost a byproduct of Virtualization

II. Peter Ohtaki Spoke about BENS: http://www.bens.org

Business Executives for National Security, a nationwide, non-partisan organization, is the primary channel through which senior business executives can help enhance the nation's security. BENS members use their business experience to drive our agenda, deliver our message to decision makers and make certain that the changes we propose are put into practice.

BENS members have used their business experience to find practical solutions to pressing national security challenges since 1982, when the organization was founded by business executive and entrepreneur Stanley A. Weiss. Then, as now, there was a need for a nonpartisan business organization that could cut through ideological debates on national security issues. Members come from a broad range of business sectors and political views yet they are united in their commitment to a strong, effective, affordable defense and developing ways to prevent the use of weapons of mass destruction. BENS' results-oriented approach has produced a solid record of achievement:

BENS played a major role in developing the process for closing obsolete military bases, freeing up billions of dollars in savings and allowing local communities to put unneeded military facilities to more productive use.

BENS was active in garnering support for the Cooperative Threat Reduction program - known as the Nunn-Lugar program - that has funded the dismantling of Russian nuclear weapons.

BENS was an early advocate of the Pentagon developing a five-year business plan and making it available to Congress.

BENS created the BENS Business Force, a public/private partnership bringing states and business together to improve homeland security.

BENS pressed Congress to streamline and improve its oversight of the Department of Homeland Security.

BENS pushed for restructuring the Joint Chiefs of Staff to create a more business-like chain of command and to operate and plan requirements jointly.

BENS' educational effort, combined with members' personal outreach to key Senators, is widely recognized as essential to the successful ratification of the Chemical Weapons Convention.

BENS helped create the U.S.-Soviet Nuclear Risk Reduction Centers that played an important stabilizing role in the U.S.-Soviet nuclear face-off of the 1980s.

As superpower relations improved and nuclear fears ebbed, BENS advocated rigorous weapons testing, increased competition for military contracts, and reforms long a part of business but missing from the Pentagon.

The second half of the meeting we was an open forum for questions and discussion

Pandemic Network

Meeting Minutes

WEDNESDAY, February 14, 2007 at 0900 PDT

Summary of the 2007 Seasonal Pandemic Influenza Conference

Pandemic Network

Meeting Minutes

WEDNESDAY, JANUARY 10, 2007 at 0900 PDT

Presenter: Dr. Michael Greger's Book

Dr. Greger presented background information about diseases and information contained in his book. Please go to: http://www.birdflubook.com to read more about his well researched and scholarly approach to understanding the Avian Flu Pandemic.

Pandemic Network

Meeting Minutes

WEDNESDAY, DECEMBER 13, 2006 at 0900 PDT

Presenter: Jim Rooney, VP Medical Affairs, Gilead Sciences; physician in internal medicine and infectious disease; involved in development of Tamiflu with Roche and pandemic planning efforts.

Most of the slides are numbered in lower left-hand corner. [THE SLIDES]

Please see the slide presentation for the bulk of the material.

Seasonal Flu: More pronounced symptoms than the common cold; outbreaks usually last 6-8 weeks; both preventable and treatable.

Facts: Death toll from influenza is 3 times greater than from AIDS; flu is one of the most significant illnesses in terms of infectious diseases; can cause significant morbidity and mortality particularly in vulnerable populations; causes significant economic loss; it’s a very serious disease.

Severe pandemics involve symptoms other than what we see with seasonal flu.

Prevention: Vaccine is the cornerstone; can significantly reduce infection, death rate and hospitalization rate; protects yourself and others to get vaccinated.

Vaccine: Either injection or nasal; used prior to exposure that boosts immune system; since flu varies from season to season the CDC and WHO usually pick three types of virus to include in the vaccine every year; 50-70% reduction in hospitalization; vaccine not as good in elderly or children; U.S. gradually moving toward recommendation for universal vaccination which we could see in the next 5yrs.

Treatment: Vaccine not helpful after you get the flu; Tamiflu (pill) and Relenza (inhaled) are both effective for treatment and prevention.

Clinical Studies: Difference between treated and placebo subjects is 32 hrs. sooner to resolution; must be administered within the first three days; more effective within 48 hours; the earlier the medicine is administered, the more effective it is.

Benefits of Tamiflu/Relenza: Reduction in hospitalization of 60% and in high risk patients 50%; reduction in pneumonia of 55%; bronchitis and any anti-biotic use is reduced.

Other uses of anti-virals: Daily prophylaxis in high risk settings; post exposure prophylaxis; take for one week following exposure to someone with flu; in studies exposed family members were given the med and there was a 90% reduction on incident of influenza.

Bird/Avian Flu: A number of strains commonly infect birds and are very common in particularly waterfowl; all flu virus that affect humans originates in birds; virus can go through intermediate hosts/pigs; virus can change composition.

Differences between bird and human virus: Usually viruses that infect birds to not affect people. H5N1 is still primarily a bird virus but it’s gradually migrating a bit and beginning to attach to human cells. Risk of avian flu in people is low. No vaccines for H5N1.

Spread: From Asia to Europe and now Africa; thought to be through migratory birds that may not be symptomatic; easy to contaminate a pond and other birds get sick; also spread thru illegal immigration of birds; Africa’s problem thought to be from illegal birds form China.

Low pathogenic: Causes mild illness in chickens and decreased production.

High pathogenic: Kills birds; doesn’t come along as often; H5N1 is very pathogenic in birds.

Advance of infection: Mortality rate has been roughly 50%, making it highly pathogenic for humans; 1918 strain had a mortality of 2.5%; H5N1 is much more pathogenic.

Can anti-virals treat H5N1: Some types are sensitive to drugs; may depend up on the strain of what size of dose required; some evidence of resistance to drugs; not known how well oral drugs are absorbed when someone is vomiting and has diarrhea; most national and local pandemic plans include the use of these drugs.

When will the next pandemic occur: Not known; there will clearly be another pandemic, we’re due in the next few years; remains a significant concern.

Flu in the workplace/strategies: Employees look to employers for guidance during a crisis; business can be an important compliment to public health response; few companies are willing to go public to discuss their plan.

Key message: preparedness is a good thing and there is a lot of work ongoing.

Mr. Rooney had to skip ahead and did not discuss all of the slides in detail.

Questions:

Is there a value to storing Tamiflu: Open debate at this point; controversy; government has ordered production with the idea it may turn out to have some utility.

Shelf life of Tamiflu: 5 years for pills. SLEP (shelf life extension program) government program to test shelf life. Suspension life is currently 2 years.

Ethical question about stockpiling Tamiflu if its needed for first responders and others: Active debate now; at one point recalled Tamiflu because the government thought people would stockpile it because a limited supply was available; at current manufacturing rate supply is not a limiting factor; have almost met most of the government requests for Tamiflu and for others.

Business for next agenda:

Barry Cardoza will talk about an exercise he is attending now. He has also written a book “Building A Business Impact Analysis (BIA) Process" A Hands-On Blueprint which is on the shelves now.

Next meeting January 10^th

Pandemic Network

Meeting Minutes

WEDNESDAY, NOVEMBER 8, 2006 at 0900 PDT

Paul Matalucci President, of Wordwright Communications, Inc.,

presented:

"Best Practices for Pandemic Communications"

He also clarified that:

"best practices" evolve from long periods of study and at this point in pandemic planning what we have may be more like "best guesses" based on previous experiences. Much of the body of knowledge, he said, comes from a

2004 World Health Organization conference in Singapore in 2004, which provided some guidelines on what communications should accomplish, including "build trust" and "announce early."

Information has also come out of the Centers For Disease Control, which focused on what people want during a crisis, including hard facts, access to all available information, participatory roles, and a return to normalcy as soon as possible. That said, he led the group though what he feels are important guidelines, which

included:

1. Employees will turn to their leaders very eagerly for trustworthy

information.

That information should be coming from people they know and respect.

Assure 100% accuracy of what is being communicated as inaccurate

communications can cause a loss of credibility in any future

communications.

The leaders who would usually be communicating the information may not

be available during a pandemic.

Backups for those leaders should be established in advance, and the

backups should be people who the employees recognize and respect.

Levels of communications should be attached to the WHO pandemic levels

to ensure it is clear which communications should go out when.

We are currently in Phase 3, so now is the time to educate and prepare.

Better that people are aware of the potential impact and ready to deal

with it than to experience panic and paralysis during an actual crisis.

One way to introduce the topic is to address seasonal flu first, and

then expand the discussion into pandemic influenza.

Assume employees will have varying degrees of knowledge, and repeat

major points often.

Help employees prepare to take personal responsibility for their

well-being, rather than expecting to be taken care of by external

entities.

Allow people to participate the institution's planning and preparedness.

Allow people to feel a level of control by being able to pull current

information from a source, rather than just having periodic information

pushed to them periodically.

Consider having localized communications plans and channels in case

unavailability of people at certain levels of a cascading communication

chain are unavailable.

Test any new communications capabilities early on to allow time to learn

about and correct any issues that arise.

Mr. Matalucci said that he would provide some information for posting on the PMI Pandemic Preparedness website. He also praised a book by Peter Sandman and said that information about that book is available from PSandman.com. He also recommended referencing the International Association of Business Communications at www.IABC.com.

Beverly mentioned a booklet about how to care for loved ones at home from San Mateo Public Health, which will be available from www.SMHealth.org.

Fiona mentioned "Your Guide For Preparing for Pandemic Flu" being available from www.SCCPHD.org.

Lisa asked if any companies are taking a position that their roll in providing for employee welfare during a pandemic is to help them fill out insurance forms. There was also a question about whether Workers' Comp would even cover pandemic-related health problems. Fiona offered her perspective and Barry said that while their people feel that some coverage would be available in California (specifically) they are awaiting documentation from their service provider which is due by the end of the year.

Fiona volunteered to be the moderator for the December 13th meeting and Barry agreed to take notes.

Wednesday, August 9, 2006 at 0900 hours PDT

Pandemic Network

Meeting Minutes

Thank you to Lisa and everyone who contributed. Please treat these notes as proprietary. We can use the lessons learned but cannot share any specific company information contained in them.
Al

Pandemic Planning Conference Call

Wednesday, August 9, 2006 at 0900 hours PDT

Barry informed people on the ‘old’ bridge number to inform us of a new number.
OLD BUSINESS: Barry’s article on “Living for Less” during a disaster will come out next month.
Barbara’s movie from Australia is very good. There is another one that Regina put out. It will be also be available from the download area of the website. There are many links and resources available on the website including the daily ProMed bulletins.

Agenda Items:

1. Gap Analysis (Barry )

Everyone has a copy of what Barry sent so it was decided to put off any discussion to the end of the call if time permitted.

2. Lisa T: Overview of the E&Y Pandemic Exercise

Lisa provided an excellent review of the E&Y pandemic exercise. The exercise, which was held in Cleveland, was the first large scale pandemic exercise attempted by E&Y. Lisa did mention that this information is confidential. Please do no copy or print these comments. E&Y has 25,000 people in the US and Canada. They are client service firm with no doctors or medical personnel on staff. Their standard business process is virtual which is to their advantage for pandemic and BCP planning because many employees have the flexibility of working from many locations, including E&Y hotel type offices, customer locations, and their homes.

E&Y’s plan was developed by a task force representing many parts of company including international travelers, HR, America’s IT and Global IT, vendor readiness, facilities and admin, expatriates, and incident response

The team worked with International SOS whose global medical advisor who did a gap analysis of the plan. A second draft of the plan with input from SOS was used for the exercise.

Lisa had two primary objectives for the exercise. The first was to get HR to accept that a pandemic is largely an HR event. The second objective was to change the approach from a US & Canada perspective to a Global approach. These are typical issues that many organizations will need to address.

The exercise was planned for a 7-hour day with a working lunch. Lisa took a major risk by using the video “The Black Dawn” a 52 minute movie set in Toronto on a pandemic to kickoff the exercise. It’s kind of gloom and doom video but the participants reported that this was an excellent way to initiate the exercise.

(Lisa will send ordering information for the video and Barbara will post it on the website)

After the introductions and video, a phone call from a US employee on assignment in Singapore who was on vacation in Bangkok initiated scenario. An outbreak in Thailand had been reported and the employee wanted information. The objective was to focus on what happens when we go from phase 3 to phase 4. International SOS did a series of news casts that helped get people into it.

Travel from Thailand was suspended but some exposed personnel had already gone into both an E&Y office and a customer location.

Questions for the team to answer included:

Action to take regarding travel and travel policy

Supporting expatriates

Employee who visited company office

Customer location visited by employee

Lisa and participants found the exercise a very good learning experience and felt it well worth the time and effort. The major complaint was that it was too short. Participants really liked the video saying that it was a great introduction to the day and the scenario. They also like the phone calls which were directed to specific people.

They really got HR involved and put them on the spot in a way that was positive. It helped HR see their critical role.

Participants also realized the need for more global coordination and alignment of policy among global partners. This was a big success for Lisa and the team.

A couple interesting things surfaced:

1. Triggers – The plan says that WHO phase changes trigger planned actions but decision-makers don’t necessarily need to wait for WHO and the plan should say so. There is need broad based understanding that actions can be initiated when management decides appropriate. What other triggers are needed? Make sure everyone knows this. There was also discussion of the need to make sure that there is no negative impact from ‘jumping the gun’ as this is better than waiting too long to act.

Others agreed that flexibility is needed - Using WHO phases is helpful but local decision makers may want to implement actions and policies earlier. Make sure that there is no penalty for taking action, even if it appears to be ‘jumping the gun’ afterwards. Barbara suggested reviewing the plan on the pandemic network website.

2. Add appendix with just actions – Lisa recommended breaking out actions for each functional area. People don’t want to have to read too much. Provide a checklist type appendix for reference.

Participants requested a second exercise to test updated plans with better communications scripts and updated HR policies. They will also ask each BCP include a pandemic plan scenario – Make sure corporate support is clear.

Provide simple awareness type package and template for BCP’s

There are many concerns about Bandwidth and access when many people go virtual. (Barbara sent out a news article after the call on this topic) Will internet handle traffic? Can you prioritize who gets access and who gets delayed?

Lisa was pleased with the exercise. They learned a lot and met her objectives, raised awareness and comprehension, got third party validation and are ready to escalate to senior officials. Many ‘next steps’ were developed and additional exercises are planned.

3. Q&A – Discussion (All)

Cindy’s question: How do we monitor all the various regulations?

Karen says that they are in 147 countries. Their team lead in each region is assigned to work with local health authorities and other government regulators since those authorities can override corporate decisions.

It was asked whether any large law firm is keeping up with these regulations? People issues – what you can and can’t do – changes in OSHA or similar rules –

Gene said that he is trying set up future BRMA meeting on these issues –

One companies legal thinks a lot of regulations may be relaxed

Karen will send article by a lawyer from Atlanta regarding “Negligent Failure to Plan” to post on website.

Ian asked about source for surgical masks and Purell effectiveness – Lisa will ask International SOS and send us their answer.

Next Meeting: September 13, 2006 at 9:00 AM – Barbara will send email.

Al will moderate. Barry will be note-taker.

Addendums: http://www.pandemicflu.gov/state/statecontacts.html

12 July 2006

Pandemic Network Meeting Minutes
Agenda Items

Discussion of Union Bank of California contagion-based event initiatives:

Provided list of websites visited daily. UBOC created list of 80

recommendations on Gap Analysis.

Please contact Barry Cardoza or Steven Johnson for a copy of Gap Analysis.

Quarantine and isolation discussed.

In California, authority to order quarantine/isolation comes from State of California Code of Regulations and California Health Code and implemented by various county health departments. Authority to order quarantine/isolation rests with county
Health Officers with support from courts and law enforcement if necessary.
Whenever possible, Health Officers will ask for "voluntary" quarantine/isolation rather than impose orders. CDC has authority for quarantine/isolation at airports, etc. when people are coming in from other countries.
Further discussion on airport in vicinity of Hollister that may be used for SFO overflow or if needed for quarantine/isolation for sick or exposed passengers. CDC does have a quarantine facility SFO, LA, and Seattle airports.
Self-quarantine would be more prevalent than county-ordered quarantine.
Quarantine would only be used in the early stages of a pandemic.
Recovery plans and exercises at UBOC centered on "contagion-based" events where a pandemic would be a worst-case scenario. UBOC implementing a three-step recovery plan/exercise strategy for its business units.

1. Send survey and FAQ to critical-unit business managers to determine which strategies best fit business unit, collect alternative strategies if applicable, and determine number of employees that could perform job functions from home.

2. Business unit managers will be provided information collected in step 1 in addition to detailed instructions for including contagion-based events in their annual disaster recovery plans and for including pandemic influenza in their annual disaster recovery exercises.

3. Above-collected information to be distributed to non-critical units so contagion-based events can be included in their disaster recovery plans.

Discussion concerning ability of IT departments to provide adequate access into company networks.
Banks in Southern California may be asked to participate in Crisis Centers.
Question raised about how bank branches might be impacted during a contagion-based event. Number one priority would be to ensure viability of ATM networks.
Employee awareness program at UBOC discussed. UBOC has a four-step programs:

(1) creation of employee-accessed Home Preparedness webpage

with important links provided,
(2) Employee Awareness program rolled-out in April that included Are You Prepared At Work And At Home document and the FEMA booklet Preparing for Disaster to all UBOC employees. Are You Prepared At Work And At Home document will be provided to all members of Pandemic Network by Barry Cardoza.

(3) UBOC in-house magazine contained article on home preparedness directing employees to the web pages (see #1 above) for more information,

(4) new focus on delivering information to employees about personal preparedness at work.
- UBOC employees reacted very well to information provided. Employees outside of California reacted no differently than California-based
- employees.
- Additionally, information was equally applicable to overseas employees as for employees based in US. Barry Cardoza will be submit an article for the BRMA newsletter on "eating for less" during a contagion-based event.
How will employees be able to distinguish between annual influenza and pandemic influenza? Check the CDC website for additional information.
Are there any companies considering stockpiling Tamiflu?
- Nearly all responses indicated "no." Should companies be involved in providing annual flu shots? Overwhelming response indicated that employees should make their
- own decision. Some companies will, however, sponsor flu shots at work from health care agencies.
Lisa Trousdale will be leaving to conduct a pandemic influenza table-top exercise in Cleveland, OH. At next month's conference call, she will share the results of the exercise.
- It was suggested that Pandemic Network participants view "Black Dawn" DVD.

The next meeting of the Pandemic Network will be on Wednesday, August 9th from 9 to 10am. Further information will be sent prior to the meeting.

June 14 Meeting Minutes

Pandemic Network Meeting Minutes

14 June 2006

Agenda Items

No	Topic	Action
1.	Exercising Pandemic Plans
	Mike Fowler sat in on call on behalf of Lisa Trousdale of Ernst & Young. He/she wanted to know if attendees have exercised pandemic scenarios and what are lessons learned. Also wants to know what scenarios are being devised.
	PMI Group · Barbara Leone advised PMI Group has undertaken extensive work on plans to include pandemics. Regina Phelps has facilitated one pandemic simulation exercise on behalf of US office; another is planned for October 2006. · PMI Group in Australia has exercised simulation test. Their consultant produced a movie in which a little girl is coughing. The movie shows transmission of germs, families watching news broadcasts, small clusters of people affected, hospitals filling up – all to demonstrate human-to-human contact. The exercise focused on how to respond: social distancing, wearing masks, sending people home. · Barbara to check availability of Australian movie to The Pandemic Network group. Gene Tucker requested a copy for the BRMA library. If not able to release, Barbara will look into possibility of showing it via Webex. · Barbara advised Regina Phelps has news broadcasts she is willing to share. Barbara to follow up to see if possible to place on The Pandemic Network website or share with group. · The PMI debrief included a task list for making sure HR policies reflect how people issues are handled e.g. Contagion Disease Policy. Health & Safety has ramped up supplies and ways to protect people passing germs. The company is educating employees through EAP and website on pandemic awareness.	Barbara Leone Barbara Leone
	California Bank & Trust · Al Jolly advised California Bank & Trust parent company has a film that he could share with The Pandemic Network group which is good for educating the troops: the event starts in New York City which addresses human-to-human contact. · Al Jolly has developed a Table-Top simulation exercise which has been exercised by several departments. The scenario follows a Christmas party when people do not show up for work and meetings need to be cancelled. The exercise presents interesting problems when the scenario affects people who have to remain at home for several weeks. E.g. beyond email, what else is required to work from home e.g. common servers, applications, capacity issues for remote access?	Alan Jolly
	Strohl Systems · Linda Pahkim advised she is working with a client who is using a scenario spanning a minimum of 3 weeks. The client anticipates the pandemic would start in Asia and spread round the globe.
	Ernst & Young · Mike Fowler advised E&Y are working with Regina Phelps to exercise their plans in July. The firm has assembled a global team to meet the potential challenges of a pandemic. He advised the firm is used to operating with mobile/virtual teams; it is part of the culture. The infrastructure is also in place e.g. laptops, telecommunications. · Mike Fowler advised Lisa Trousdale is willing to share results of July exercise with The Pandemic Network group.	Lisa Trousdale
	Franklin Templeton Investments · Wayne Behrens suggested covering different points of time during simulation exercises as it puts pressure on the CMT. This becomes more pronounced when they are faced with a pandemic situation.

2.	BARC/BRMA Meeting on Pandemic Preparedness
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