Tabitha Zehms “Team T”
Virology
Dr. Shors
5/08/06
1. a. Flu Care kit
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Pain and Fever Reducer
Decongestant (Pseudoephedrine)
Cough medicine
Thermometer
Tea or juice
Chicken soup and a non-electric can opener
Throat lozenges (adults and older children only)
Tissues
Blankets
Nitrile gloves
Respirator masks (ex. 3M’s N95)
b. Food Stockpile
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Manual can opener
Canned/jarred baby food and formula
Canned juices
Dried fruit
Dry, crisp crackers
Potatoes
Canned meat, fruits, and vegetables
Read-to-eat cereals
Peanut butter
Jelly
Hard candy, chocolate bars, and canned nuts
Energy bars
c. How much water should be stockpiled?
1 gal/person/day, for two weeks. Use two drops of chlorine/quart of water, or
boil for fifteen minutes or purchase chlorine purification tablets. One can get
tablets at camping/sporting goods stores.
d. Other miscellaneous items:
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Medical supplies and First Aid manual
Hygiene supplies
Portable radio, flashlights and extra batteries
Shovel and other useful tools
Money and matches in a waterproof container
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Fire extinguisher
Blanket and extra clothing
Infant and small children’s needs (if appropriate)
Pet food and supplies
Disinfectants
Cash and credit cards
Sturdy shoes or work boots
Candles
Fluids with electrolytes
Alcohol-based hand sterilizer
e. Recommended masks
Respiration masks are meant to protect the wearer. These are better than
surgical masks, which allow air in and are meant to protect the environment from
your breath. If exposed to the flu virus, the outside surface of masks can
become contaminated. This would require having a stockpile so one could
discard masks after a few uses. A box of 20 costs anywhere from $7.00 - $30.00
Shelf lives of masks range from five years to 20 years to indefinite, if properly
stored. Masks can be conveniently purchased online or at home medical supply
stores.
2. Emergency Workforce Team
Oshkosh Emergency
Operations Center
Serves as the main hub of all planning and
executing of emergency response to the city’s
Situation in the event of a pandemic.
Fire Chief Timothy Franz
Will call for the EOC (Oshkosh’s Emergency
Center) to come together. Will also maintain
normal operations of the Fire Dept and
Emergency Response teams.
Health Director Paul Spiegel
Will serve as the coordinator for maintaining
Hospitals and clinics in working order. Will
Be responsible for making information on how
To stay healthy (i.e., preventing spread of flu
And water purification, etc.) available to our
Citizens. Will also establish efficient methods
Of placing the deceased in proper containment
And burial.
Police Chief David Erickson
Will assure safety is established and
Maintained at hospitals, clinics, nursing homes,
And other places where medical treatment may
Be available. May also be required to protect
Food/water/medicinal supplies brought into the
City.
Transportation Director
Mark Huddleston
Will coordinate with Police Chief to ensure that
the maximal levels of supplies can be
Transported safely into the city. May call upon
Public works crews and park crew to keep the
The city free of garbage, waste, and deceased.
City Manager
Richard A Wollangk
A governmental leader of the city. Will be
expected to execute key decisions with the
Mayor and other members of the EOC.
Mayor William Castle Jr.
Will coordinate with the state and
Federal agents so the city can
Receive whatever instructions
And aid it’s entitled to. Will also
Work with local businesses and
Schools to monitor closings.
Deputy Mayor Frank Tower
Will assist in executing the
Mayor’s responsibilities.
City Council:
May serve on the EOC and lead
Bryan Bain,Meredith Scheuermann
efforts of city quarantine as
Burk Tower, Paul J. Esslinger
designated by the EOC.
Shirley Brabender Mattox
Hospital Directors:
Mercy Medical Center
Aurora Medical Center
St. Elizabeth Hospital
Clinic Directors
Will work with the Health Director
in order to provide aid to the sick.
City Clerk Pamela R. Ubrig
Deputy City Clerk Angela G. Koch
Both City Clerk and Deputy City
Clerk will be essential in keeping
Accurate records of the sick and
Dead, in cooperation with the
Hospital directors.
3. Role of the Media (educating the community)
As long as electrical power is received, information should reach the community
via TV. National news broadcasts, if running, would provide information on the
state of the nation. Local news stations, such as FOX 11, ABC, etc., would also
be expected to provide information on what local cities/counties are doing during
the pandemic. Undoubtedly, OCAT (Oshkosh Community Access Television),
would be an immediate source of information for Oshkosh citizens. Any
decisions that need to be explained to the public by the Oshkosh Emergency
Operations Center will be relayed on this station.
Radio will also provide a consistent medium for updates on the pandemic. As
long as national and local stations run, the Emergency Broadcast System will
convey information. Should those stations be quarantined and shut down,
Oshkosh citizens will know at least about their own communities through WOCT
101.9FM. Information to be provided should include but is not limited to
 Death tolls
 Number of cases
 Decisions made by the EOC
 Fire dept./Police dept./Health Services mandates to the citizens
 Notices of food/water/supply shipments into the city, school closings,
public event closings, etc.
 Information on what to do when you get the flu, how to prevent coming in
contact with it/spreading it, how to keep water clean, etc.
A “What to do about the Flu” website should be ran and maintained by the EOC,
possibly with the help of local volunteers. The website would contain important
information about how to prevent spreading the sickness and how to treat the
sick, etc. A Flu Hotline could also be put into place, but would have to be ran by
volunteers so that health care workers and other emergency personnel could
tend to the sick. Examples are science professors and science students from
UWO.
4. Community Communication (e.g. moving goods and services).
Army National Guard will be solicited to guard hospitals, pharmacies, and supply
storage facilities. Transportation Director Mark Huddleston may utilize the
Reserves and possibly public works crews to bring in necessary supplies, as long
as the governor mandates their use.
US Army Reserve
(920) 231-2354
221 N Sawyer St
Oshkosh, WI 54902
Army National Guard
(920) 424-2439
1415 Armory pl
Oshkosh, WI 54902
Critical Supplies:
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Food and chlorinated water
Pharmaceuticals
First-Aid supplies
Flu vaccines
Hospital supplies (gloves, masks, blankets, medicine, etc.)
Personal hygiene products (soap, shampoo, deodorant, etc.)
Cleaning products (to keep quarantined houses clean!)
Body bags
5. Quarantine measures/Prevention/Travel/Crime Prevention
The only way to prevent the spread of Bird Flu is to quarantine Oshkosh and
Winnebago County. A quarantine must be issued by the city/county government
and will be enforced with the aid of police and the Army National Guard
monitoring all major routes into and out of the city. The WHO recommends
implementing a quarantine after six or more people become infected in the same
neighborhood. Quarantined areas can start at the neighborhood level and
increase to the entire city, as deemed appropriate by the Winnebago County
Public Health Department. Other routes can be blocked. Large fines should
accompany violation of the quarantine. Travel into and out of the city can only be
done by those transporting food and other supplies such as medicine and
hospital needs. If possible, widespread travel of citizens should be discouraged,
even within Winnebago County. Establishing a curfew would ease the security
demands of the city police; as long as the majority of citizens obey, there will
(hopefully) be less nighttime activity, making it easier for policeman to notice any
looting or other crimes going on at night. Police and/or the National Guard will
have to pay special attention to local businesses and stores and maintain
consistent street patrol to prevent the looting of unused businesses during the
quarantine. Police and firefighters will be expected to maintain normal patrols
and first response roles.
6. Public Gathering Policies
There should be a restriction on mass gatherings, for such occurrences allow the
virus to be exposed to many individuals at once. Schools should be closed
during the quarantine, as well as churches, public libraries, and theatres. Even
venues like coffee shops, bars, and other areas of socializing should be
quarantined. The best way to prevent spreading is to keep people (and their
germs) away from each other. This would also include funerals and weddings.
7. Hospitals
Aurora Medical Center
Mercy Medical Center
84 beds
157 beds, w/ special unit 172
8 respirators
8 respirators
Whether or not the hospitals in Oshkosh will be able to handle all of the flu
patients depends largely on how well and how quickly the city responds to the
presence of avian flu when it is first discovered. Based on the simple fact that no
one has immunity to this virus, it is quite likely that we will overfill our hospitals
and will require alternative "Isolation Hospitals." Locations for these "Isolation
Hospitals" could include the Gruenhagen Conference Center, the Park Plaza
Hotel and Conference Center, or gymnasiums in school facilities around the city,
assuming that schools will be closed. Examples include the Kolf Sports Center
at the University of Wisconsin—Oshkosh, or the gym at Oshkosh North or
Oshkosh West, etc.
Below is a list of supplies necessary to equip these sites:
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cots/beds
medication to alleviate flu symptoms (cough suppressant, fever reducer,
etc.) and antivirals (if at all available)
bed linens and pillows
meals
patient gowns and staff scrubs/masks/gloves
plenty of soap, hand sanitizers, and disinfectants
thermometers and medical charts
telephones
body bags
vehicles to run back and forth to the hospitals
Staffing of these "Isolation Hospitals" would have to consist of any available
doctors/nurses/CNAs, etc., that could be spared from the local hospitals, clinics,
and nursing homes. Nursing students here at UWO could also volunteer and
work here in exchange for getting vaccinated, if there is an ample supply of an
effective vaccine.
8. Pharmacies/Health Plans
In the event of a pandemic, pharmacies, which depend largely imported
pharmaceuticals, will have to be protected by the police or members of the
National Guard. They will prevent any looting or attempted robbery. If medicines
are unavailable for an unknown amount of time, physicians should be stationed
at each pharmacy and decide who should continue to receive drugs and who
shouldn’t. Whatever antivirals are available should be reserved for health care
workers and those who come in close contact with the extremely sick. If
medicines are available in other countries for purchase, it is likely that health care
plans will not cover the transactions. Cooperation of national health care plans
would have to be mandated by the federal government.
Agencies involved would include:
 Food and Drug Administration
 Department of Health and Human Services
 Department of Homeland Security.
Many in the community have special needs and depend on the pharmacy for
medicines that sustain daily living. These individuals should talk to their doctors
about the shelf-lives of their drugs and possible stockpiling potential. These
would include:
 Diabetics
 HIV/AIDS
 Cancer patients
 Fibromyalgia
 Arthritis
 Hypertension
 Heart disease/high cholesterol
 Anyone that depends on medicine to prevent organ failure/rejection.
Winnebago County should to stockpile its own supply of tamiflu® or other antiinfluenza drugs. Stockpile extractions should be authorized by a health
professional and physician. This would allow the county to treat its health care
workers in a prophylactic manner and hopefully treat moderate to severe cases
of flu and the close contacts of those patients, as suggested by the World Health
Organization. It should be noted that the effectiveness of these drugs against
H5N1 have not been confirmed.
9. Long-term care, including nursing home residents and elderly living alone.
The World Health Organization, in its report on the response and containment of
a pandemic, suggested that antiviral drugs be used to treat moderate to severe
cases of atypical respiratory disease and of the close contacts of those affected.
Should it appear that the disease is spreading quickly or has infected a large
number of people, it is implicated that it would be best to prophylactically treat an
entire geographical area surrounding the severely infected outbreak. It is
cautioned that if it is not deemed feasible by local experts to successfully stop the
spread of the influenza that this type of treatment not be used; this would save
valuable medications that are in scarce supply. In order to prevent such an
uncontrolled outbreak, it is vital that health care workers receive vaccines or
regular cycles of prophylactic treatment with antiviral drugs. It should be stated
again that the effects and success of antiviral drugs against bird flu is uncertain
at this time.
Individuals in long-term care facilities and the elderly community have weaker
immune systems and would be particularly vulnerable to becoming infected.
Employees of these institutions should also be vaccinated and/or treated with
antivirals to prevent bringing the disease into this environment. As far as the
elderly living independently and alone are concerned, should they have any
respiratory infection symptoms, they should report it to a public health official and
their doctor immediately.
10. If a vaccine is available, the following people should receive it first. These
citizens, listed here in a prioritized fashion, need to continue working
during the pandemic and would risk coming in contact with the virus most
often:
Licensed healthcare workers including physicians, physician assistants,
nurses, mental health professionals
• State public health officials including the Chief Medical Officer and State
Health Officer, members of the Clinical Management Team
• First responders (Fire, Police, EMT’s)
• Medical laboratory workers
• Emergency management personnel
• National Guard members that have been called into state service by the
governor
• Long term care facility staff
• Utility field workers (gas, electric, water, sewer, etc.),
• Communications personnel
• Fuel suppliers
• Food suppliers
• Waste management workers (general and medical)
• Public transportation drivers
• Air travel personnel (pilots, air traffic controllers, etc.)
• Corrections workers
• Morticians/Coroners/Medical Examiners
• Pharmacists
• Red Cross field workers
• U.S. Postal Service workers
• Contracted persons involved in the transportation of vaccine
• Staging: Category B Group
• Day care providers
• Teachers
 Clergy
11. Employees critical to maintaining the city:
Mayor and City Manager
Emergency First Response personnel (EMS, Fire, Police)
Hospital and Clinic employees (everyone from Doctors to Janitors)
Public Works employees
Sanitation employees
Power, Wasteweater Treatment, and Sewage Plants
Pharmacy personnel
Grocery Store personnel
Funeral Home employees
In the event of a quarantine during a pandemic, only businesses that support the
needs of the above employees should stay open. Schools, coffee shops,
museums, etc. are not needed to provide food, supplies, and medical care to the
community. The temporary shut down of non-essential business will prevent the
spread of the disease. Business that do remain open should implement an
immediate sick leave policy that requires any employee with flu-like symptoms to
remain home until deemed appropriate to return by a medical professional.
Employees with sick relatives should not be allowed at work.
The city should attempt to make infection-control supplies, such as masks,
gloves, and sanitizers, available for its citizens. This may not be possible if these
items aren't already being stockpiled.
The sewage treatment plant can maintain water supplies for a maximum of 45
days with the current amounts of chlorine.
Bill Sturm, the Cemetery Supervisor for Oshkosh, said that there is significant
space in the city's Riverside Cemetery and more room in privately-owned
cemeteries. According to Sturm, " Mass graves are unlikely although we would
potentially open a large area for multiple installations, but each would have a
separate plot." Local funeral homes can store bodies, and the city also owns an
old storage facility for bodies that was used before the city performed winter
burials that could house 100 bodies. More should be purchased by the city.
There are six funeral homes and mortuaries in Oshkosh and 13 in Winnebago
County. Cremation or mass burial should be a decision made by the closest
relative.
12.
The Oshkosh Board of Health is currently working on a Pandemic Preparedness
Plan. Oshkosh will follow any orders given by the Winnebago County Public
Health Department. According to Douglas Gieryn, Winnebago County's Director
and Health Officer, a Public Health Preparedness Constortia, consisting of six
counties of 10 local health departments, is establishing a plan. The project is
funded by the CDC through the State's Health Department.
Board of Health Members--City of Oshkosh
Dr. Barbara Strand – Chair, Affinity Medical Group
Jamie Bonell, CFNP, APNP, Aurora Medical Group
Burk Tower - Council Representative
Christine Kniep, UW-Extension
Susan Panek, United Way
Stan Kline- Alternate
Mardell Sowers – Alternate
Winnebago County Board of Health
Nancy Barker
James Koziczkowski
Forrest E. Weber
Thomas W. Widener
Bill Wingren
Alfred Jacobson
Joanne Sievert
Steven Arne
Sources:
http://www.toronto.ca/health/pandemicflu/pdf/toronto_pandemic_influenza_plan.p
df
American Red Cross -- National website www.redcross.org
Local Chapter website www.vbe.com/~redcross/
Federal Emergency Management Agency – website www.fema.gov
http://www.health.state.mn.us/divs/idepc/diseases/flu/avian/preparing.html
Pandemic Influenza: What Can You Do?, MN Dept. of Public Health
items http://www.fema.gov/library/emfdwtr.shtm
FEMA: Emergency Food and Water Supplies
http://www.ci.oshkosh.wi.us/emergency_government_report.pdf
https://www.globalprotectionllc.com/birdflukits/order.html
http://emergencymanagement.wi.gov/category.asp?linkcatid=81&linkid=32&locid
=18
http://www.co.winnebago.wi.us/sheriff/index.htm
http://www.aurorahealthcare.org/
http://www.affinityhealth.org/object/mmchospital.html
http://www.toronto.ca/health/pandemicflu/pdf/toronto_pandemic_influenza_plan.p
dfAmerican Red Cross -- National website www.redcross.org
Local Chapter website www.vbe.com/~redcross/
Federal Emergency Management Agency – website www.fema.gov
http://www.health.state.mn.us/divs/idepc/diseases/flu/avian/preparing.html
Pandemic Influenza: What Can You Do?, MN Dept. of Public Health
items http://www.fema.gov/library/emfdwtr.shtm
FEMA: Emergency Food and Water Supplies
http://www.ci.oshkosh.wi.us/emergency_government_report.pdf
https://www.globalprotectionllc.com/birdflukits/order.html
.World Health Organization. Advice on Use of Oseltamivir. 17 March 2006
http://www.who.int/csr/disease/avian_influenza/guidelines/useofoseltamivir2006_
03_17A.pdf
WHO Pandemic influenza draft protocol for rapid response and containment
http://www.who.int/csr/disease/avian_influenza/guidelines/pandemicfluprotocol_1
7.03a.pdf