Colleges should instead beat a path to the local health department.
Washington is somewhat better prepared for hurricane season 2006, according to Homeland Security Secretary Michael Chertoff. But college and university risk planners should think twice before they expect help and intervention from the federal government to deal with an outbreak of avian flu.
State and local governments "have the principal responsibility to be the first responder. They know their people and geography best," Chertoff states.
Self-reliance is an even stronger theme in the Bush administration's Implementation Plan for the National Strategy for Pandemic Influenza (www.pandemic.cdc.gov) released in May.
- The center of gravity of the pandemic response, however, will be in communities.
- The distributed nature of a pandemic, as well as the sheer burden of disease across the nation over a period of months or longer, means that the federal government's support to any particular state, tribal nation, or community will be limited in comparison to the aid it mobilizes for disasters such as earthquakes or hurricanes.
- Local communities will have to address the medical and non-medical effects of the pandemic with available resources.
Local cooperation
College administrators making avian flu plans need to work with state and local medical, safety and public health officials to identify the first, second and third lines of response - all locally.
A recently published Blueprint for Pandemic Flu Preparedness Planning for Colleges and Universities by Arthur J. Gallagher Risk Management Services, Inc. addresses several of the issues.
- Communications. Coordination of protocols. Progress and impact reports. Telecommunications support. Participation in state and local health and safety communications networks.
- Medical services. Pandemic effects on local services at hospitals and morgues. Storage and disposal of bodies. Notification of next of kin.
- Medications. Availability of antiviral medications and/or vaccines.
- Campus-as-sanctuary. Local or state decision-making for a campus to serve as an infirmary, inoculation facility, or something else.
- Legal issues. State-of-emergency declaration. Travel restrictions. Isolation/quarantine
- Safety Issues. mutual aid agreements between campus and community health and safety services, including panic scenarios.
Though the impact may be national, health care delivery is local
The federal Implementation Plan explains that each community will experience a pandemic as a local event. Even in the best of circumstances, patients and health care resources are not easily redistributed. A pandemic may make the sharing of resources and burdens even more difficult.
Meanwhile the federal government is expanding stockpiles of both vaccines and antiviral medications. But communities should anticipate that in the event of multiple simultaneous outbreaks, there may be insufficient medical resources or personnel to augment local capabilities.
Meanwhile public health services may be a responsibility divided among state, city or county health departments. Usually local governments have direct authority but there are numerous variations, says the National Association of County and City Health Officials (NACCHO). College administrators and risk planners can find their local health departments at http://lhadirectory.naccho.org/phdir/.
Ann Wright is an Arkansas health official and the President of the National Public Health Information Coalition. Wright says local and state health officials are preparing pandemic influenza plans and sharing them across jurisdictions and among functional partners, such as schools, colleges and corporations.
Carolyn Callner is the deputy commissioner of the Schenectady, NY County Health Department. Callner reports, "All of our counties are different and do things differently. Counties in the Capital Region are at leasttrying to coordinatemessages and approaches to things such as ethical guidelines, visitation policies for hospitals, etc. by working together. The State Department of Health also has released a plan and we work with them as well. They in turn are dealing with the CDC. It is a huge undertaking."
"With our assistance and information on the internet, colleges have developed plans of their own. That's ultimately is the best way," she concludes.
A state university with local plans
California is often cited as well prepared for emergency planning. Each of California State University's 23 campuses must complete pandemic flu plans by the end of May, according to Bob Detweiler, California Polytehchnic's (San Luis Obispo) Provost and Vice President for Academic Affairs. The plans assign roles and responsibilities for different conditions -- confirmed cases of human-to-human transmission; suspected cases on campus or in the area; multiple confirmed cases on campus.
The Cal Poly plan is the responsibility of a group of campus administrators who worked with two representatives of the county health department and took many months to develop, according to Vicki Stover, Associate Vice President for Administration.
Who quarantines or closes the campus?
Travel restrictions, isolation and quarantine will be critical issues for colleges, as will be any decision to close the college. Both Callner and Wright acknowledge that local government and public health officials can "shut down virtually everything - streets, theaters, schools and colleges in an emergency." Governors have similar emergency powers.
Ann Wright believes "most of them would work in partnership with school and college authorities regarding closure or other restrictions."
Cal Poly's Stover says the decision to close a campus would probably be made by CSU's Chancellor or the county, but not both. "The decision would be communicated to the county, or vice versa," Stover concludes.
Stover observes that their pandemic planning anticipates a long term and sustained waves of crisis as the disease progresses and ebbs. "Normal emergencies, even earthquakes, happen and are then over," she explained.
Bob Maurer is executive editor of The Greentree Gazette and past president of the New York Higher Education Services Corporation. Reach him at rmaurer@greentreegazette.com.