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City of Decatur

Infectious Disease Initial Response Plan

Reviewed March 2020

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City of Decatur Infectious Disease Initial Response Plan

Executive Summary

The City of Decatur, in collaboration with other local agencies, has reviewed its plans, policies,
and procedures, in the event of a potential infectious disease outbreak.

The foremost goal is to minimize the potential impact from wide-spread diseases, while
preserving normalcy and minimizing economic disruption.

To fulfill this primary objective, the municipal plan has ten response elements:
 Disease Surveillance
 Welfare of the Public, First Responders, and Healthcare Professionals
 Uniform Infection & Exposure Control Methods
 Healthcare Guidance
 Public Information
 Hospital Surge Support
 Intradepartmental Communication
 Disease Management (If Necessary)
 Evaluation of Resource Availability
 Provide a Unified and Controlled Response

The City of Decatur would like to remind residents to continue the daily practices we should all
be doing – washing our hands; covering coughs or sneezes; avoid touching our eyes, nose, and
mouth; and staying home if we feel ill.

I. Novel Virus Situations and Assumptions

Situation

Novel influenza viruses periodically emerge to cause global epidemics, known as pandemics,
either directly from a mutated animal influenza virus or out of combination of animal virus with
a circulating human influenza virus. Such viruses circumvent normal immune defenses and cause
morbidity and mortality at higher rates than seasonal influenza strains; compared to seasonal
influenza, a larger proportion of deaths occur in persons ages <65 years.

Novel influenza viruses that cause pandemics are transmitted from person to person in the same
manner as seasonal influenza; typically, by mucosal inoculation with large respiratory droplets
caused by coughing or sneezing or by touching contaminated environmental surfaces and
subsequently touching one’s mouth, nose, or eyes.
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With the exception of a vaccine, antiviral medication, and advanced medical care, many of the
strategies used to respond to a modern pandemic are the same as the effective measures of
previous generations. The key activities to minimize the impact of a pandemic influenza virus
are:

1. Surveillance for disease activity for situational awareness and timely activation of
response strategies

2. Accurate communication within and among volunteer and professional responding


organizations and with the general public

3. Use of social distancing measures to reduce unnecessary close contacts during a


pandemic wave

4. Distribution and use of all available medical resources and personnel

Novel Influenza Mitigation Strategies:

No intervention short of mass vaccination of the public will dramatically reduce transmission
when used in isolation. However, mitigation strategies using multiple non-pharmaceutical
interventions have been identified as a way to significantly decrease human to human
transmission. An even greater reduction can be achieved by combining such measures with
targeted use of antiviral medication for treatment and prophylaxis.

Reducing the number of persons infected will reduce the burden on the healthcare system, while
minimizing the impact of a pandemic on the economy and society. Such intervention strategies
may include but are not be limited to:

1. Potential isolation and treatment with influenza antiviral medications of at risk persons
with confirmed or probable pandemic influenza. Isolation may occur at home or in a
healthcare setting depending on the severity of an individual’s illness and/or the current capacity
of the healthcare infrastructure.

2. Potential voluntary home quarantine of household member(s) with confirmed or


probable case(s) or with other members of their ill family members. Consideration should be
given to combining this intervention with the use of antiviral medications, providing sufficient
quantities of effective medications are available and a viable distribution plan is in place.

3. Potential dismissal of students from schools (including public and private schools, as well
as colleges and universities), along with school based activities, if deemed necessary per

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consultation with local health officials and the Alabama State Department of Education.
Decatur City Schools has established emergency operations plans to enact e-learning, in the
event that social distancing is required. Upon any dismissal of students, the continuity of
operations plan for Decatur City Schools would mandate a high level of school property
disinfection to mitigate any possible surface exposure upon the return of students.

4. Potential use of social distancing measures and personal hygiene measures for adults in
the community and the workplace are essential steps that should be taken. Examples
include, alteration of workplace environments such as working from home, diligently cleaning
work surfaces, emphasizing healthy personal habits such as frequent hand washing, cough
etiquette, and decreasing the social density within the work environment. In the event of a severe
outbreak, canceling large gatherings must be considered.

5. In the event that effective antiviral medication becomes available for early distribution,
it could be given to healthcare personnel, emergency workers, and individuals required to
provide and maintain critical infrastructure.

Basis of Plan

1. If the characteristics of the actual event do not reflect planning assumptions, responses
will be modified accordingly.

2. While focusing primarily on the response to a pandemic (WHO Phase 6), the plan also
Page 10 of 104 Novel Virus/Pandemic Influenza Response Plan addresses the response to
imported or acquired human infections with a novel influenza virus with pandemic
potential during the Pandemic Alert Period (WHO Phases 3-5).

Objectives of Pandemic Planning

1. Primary objective is to minimize the human impact from disease.

2. Secondary objective is to preserve social function and minimize economic disruption.

Response Objectives

1. Surveillance - Estimate the severity and spread of the outbreak through active and passive
surveillance collected from multiple sources. All available data should be analyzed from across
the country and around the world. Comprehensive surveillance and epidemiologic research plans
should be implemented during the initial days/weeks of the outbreak.

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2. Welfare of the Public, First Responders, and Healthcare Professionals - Use surveillance
and disease monitoring tools to make informed decisions for all involved parties.

3. Control - Establish uniform infection and exposure control measures for clinical,
occupational, public and other settings. Develop initial case definitions and determine population
groups potentially at risk.

4. Healthcare Guidance - Provide information and guidance to healthcare partners to support


appropriate influenza evaluations and care, including the use of antivirals if appropriate.

5. Public Information - Disseminate information to the public as rapidly and as accurately as


possible. Messaging must be consistent with other responding agencies from all levels of
government.

6. Hospital Surge Support - Support hospital preparations and implementation of plans in


anticipation of an increased patient load.

7. Intradepartmental Communication - Notify and update department personnel regarding the


outbreak, mitigation measures to be taken, personnel policies regarding leave for those taking
care of family or children out of school, and any changes in work responsibilities.

8. Disease / Fatality Management - Address any increase in fatalities as a result of an outbreak


and prepare to assist local governments with fatality management as necessary.

9. Evaluate Resource Availability - Assess if the availability of critical resources such as anti-
viral medications, PPE (Personal Protective Equipment), and ventilators are adequate to meet
anticipated needs.

10. Provide a Unified and Controlled Response – Unite as a task force to address any outbreak
that could occur in Morgan County and act as a decision-making body in the event of emergency
operations.