Loughborough University

Contingency Plan for a potential Flu Pandemic

Background

Action Plan Prior to the Pandemic Alert Level 0 Alert Level 1 Alert Levels 2 to 4 During the Pandemic Scenario A Scenario B Scenario C Appendix Guidance documents Sources of Further Information 8 8 6 6 7 3 3 5

Background 1. Local contingency plans to respond to an influenza pandemic will be initiated as soon as the Department of Health receives confirmation from the WHO of the likely onset of a pandemic. Forecasts of a pandemic within the next 2-3 years are based on past frequency of such events and the spread of avian flu, which may at some point combine with another virus to produce a form capable of pandemic spread amongst humans. It is not possible to say if or when this will occur, nor is it possible to predict the virulence of the virus, nor which age groups will be most vulnerable. This is further complicated by the flu virus tendency to change during the course of a pandemic, meaning that successive waves (see below) may differ markedly in their characteristics. 2. The likelihood is that the virus will first become established outside the UK but it is considered inevitable that the first cases will be seen in the UK within three months, becoming widespread over the following few weeks. It will not be possible to contain the spread of pandemic influenza nationally, regionally or locally. Despite this the public will expect organizations to do as much as possible to limit the transmission of the virus through appropriate measures. 3. It is expected that the pandemic will consist of waves lasting around 3 months with subsequent waves weeks or months apart. The severity of the illness will be greater than seasonal influenza with around 50,000 excess deaths in England and Wales (compared to 12,000 with seasonal influenza). Depending on the nature of the virus, these figures could be considerably worse. The NHS planning assumption is that 25% of the UK workforce will take 5-8 working days off over a three month period. During the peak of the pandemic estimates suggest that absenteeism will double in the private sector and increase by two-thirds in the public sector. Employees may also take time off to care for children if the schools are closed or to care for sick relatives or because they fear exposure to infection. Universities could be disproportionately affected, especially given the possibility of students having come from other affected areas and having been exposed to different strains, as well as living in close proximity in halls of residence. Definitions: Epidemic: Pandemic: Flu pandemic: 6. a serious outbreak in a single population or region epidemic spreading around the world affecting hundreds of thousands of people, across many countries global epidemic of a newly emerged strain of flu

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Loughborough University has established a Pandemic Flu Working Group which will bring together the relevant services responsible for anticipating the effects of a potential outbreak of pandemic flu in the University and planning the response in the event of a crisis. Membership Pro- Vice Chancellor (Teaching) Registrar Health & Safety Officer Director, imago Director Student Guidance & Welfare Doctor, University Medical Centre Vice President (Welfare) Student Union Academic Registrar Head of Public Relations Director of Personnel

To be advised by Consultant, Communicable Disease Control (CCDC)

Action Plan 7. The Universitys Action Plan is divided into two phases: Prior to the Pandemic and During the Pandemic. The Plan for the first phase consists of an escalating series of actions associated with the Alert Levels defined by the UK Department of Health. The Plan for the second phase consists of three alternative sets of actions (A,B and C), corresponding to different scenarios for the seriousness and timing of an the outbreak at Loughborough. A serious outbreak of pandemic flu does fall within the definition of a Major Incident contained in the Universitys Major Incident Plan. However, the detailed provisions of the Plan are not well suited to the management of a pandemic flu outbreak which conforms to the more likely and less severe pattern (Scenario B below). In the event of a more severe outbreak, with a high risk of deaths amongst members of the university or the imposition of quarantine arrangements, then the Plan will be activated (see Scenario C below). Prior to the Pandemic: Alert Level 0 No cases anywhere in the world 8. Remind staff about where they can find general background information: NHS leaflet for families available at www.dh.gov.uk/pandemicflu - alongside other documents including answers to Frequently Asked Questions - such as why antibiotics dont work on flu; why there will be no effective vaccine in the first wave of a pandemic; and why a pandemic can strike at any time of the year see Appendix. Provide access for staff to Contingency Plan via the web and provide copies for information to Council, Senate and Students Union Exec.

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Alert Level 1 Cases only outside the UK 10. Executive Management Group to consider the impact on the institution of the points listed from a. to v. below in the light of emerging information on the seriousness of the epidemic. Report to be made to Senate and Council on the Contingency Plan and Students Union Executive to be briefed. Council to delegate decisions regarding closure or reduction of operations to VC in consultation with Chair of Council, with provision for regular updating of members. Clear arrangements to be made for who will act in their stead in the case of illness. The Working Group to convene and receive/consider emerging guidance relating to aspects such as: Notification of suspected cases What to do if staff or students are exposed to cases Management of staff and students travelling within, to and from UK 13. Produce guidelines and advice for staff and student travel, and procedures for identifying staff who are overseas and unable to return to the UK as planned. Working Group to commission plans from the relevant heads of sections and departments involved below as to how they would maintain service levels in the face of 15% absence level amongst staff, including the identification of key personnel and contingency arrangements for their absence, and what effect a 15`% sickness level in the population at large might have on their operations a. Admissions, including processing of applications, policies for accepting students who may not have been able to sit formal exams; b. Halls of Residence, including care of ill students, quarantine, closure; research the employment position re. the "risk" to staff working in the environment of an affected

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hall and possibility contingency arrangements. c. Position of students in private sector and third party accommodation

d. Teaching, including alternative non-contact methods; e. Examinations and Assessment; f. Research students, including continuation of work and impact on fieldwork;

g. Placement students, including PGCE students in event of school closures; h. Management of teacher training and sandwich courses in the event of school/workplace closures and the inability to complete placements; i. j. k. l. 15. Recruitment and Open Days; International students; Student support financial and non financial; Press and media relations;

Working Group also to consider following issues: m. Central services identifying which core services must be maintained, and in particular arrangements for Availability of premises officers/ key holders to open/ close buildings; Security and insurance issues; Heating and buildings services if caretakers/ estates officers absent; Effect of lack of cleaning staff at time when improved hygiene required; Catering Web and eMail communications

n. A central source of information and Helpline to respond to students and parents enquiries; o. Student and staff health care including vaccinations, support for unwell students; p. Availability of information and speakers in other languages in case of need to speak to relatives of international staff/students; q. Whether students should return home and what to do if they cant; r. s. The possible provision of sick bays; How to conduct a voluntary isolation system for all close contacts, should the University have one of the first cases of flu in the UK; Health & safety considerations;

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u. Financial risks and business recovery; v. Liaison with local authority and Students Union on communication and advice;

w. Working with Unions and Staff Associations to agree appropriate local staff flexibilities, and working practices; x. Availability of suitably qualified staff to maintain operations/ deliver services and provision includes whether it is necessary for HSE to carry out risk assessments

where staff undertake new or less familiar tasks; 16. Director of Student Guidance & Welfare to organise the collection and dissemination of official guidance as provided by national and local agencies. Registrar, Director of Student Guidance & Welfare and Publicity Office agree content of information provision to go to staff and students, and the media (if required). The Registrar to implement restricted travel arrangements, according to WHO and Foreign Office guidelines. Director of Personnel to agree content of information sheet providing advice to University staff required to travel abroad on business. The Students Union to run a hygiene campaign covering hand-washing and respiratory hygiene in collaboration with the University, who will undertake similar activity for staff; University to review physical arrangements which may compromise good hygiene e,g use of cloth towels. Make sure there are lists of contact names, phone numbers and addresses for all staff and students, and in particular Heads of Departments and Sections. Encourage staff and students to keep these details up-to-date.

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Alert Levels 2 to 4 from first cases in the UK to widespread activity 21. Small sub-group of EMG, the Pandemic Response Group (PRG), to be activated to manage University response, with reports from operational managers, and advice as necessary from members of Working Group. Membership Deputy Vice Chancellor Registrar Director Student Guidance & Welfare Director of Personnel Head of Public Relations 22. alternate in case of illness PVC(Teaching) Academic Registrar Director of imago Mrs Sandra Jasper Director of Marketing & Communications

PRG to categorise the outbreak as A,B or C dependent on severity and timing and proceed accordingly (see below for criteria and plan). In the case of Scenario C, PRG activates the Universitys Major Incident Plan. PRG should review their categorization at regular intervals in the light of the progression of the pandemic and its local and national characteristics. Arrangements to be implemented for cascade of regular briefings of university managers, to pass on official information and provide appropriate guidance on university policy, as well as how to deal with their responsibilities in the light of the pandemic. This chain of briefings will also be used to collate information on the effect of the pandemic across the range of university activities and by an upwards flow of information inform the development of university policy and planning . Director of Student Guidance & Welfare to continue to liaise with the University Medical Centre and Consultant, Communicable Disease Control to ensure that the flow of information relating to the pandemic directed at the University is collated and disseminated in an appropriate and effective manner. The Helpline to ensure, that the families of all hospitalized students are kept informed of progress in their condition (with the students permission). Whereas the model suggests 25% of the student population may be affected over the period of the outbreak it will be a lower proportion of these who become acutely sick.

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During the Pandemic: Scenario A:

The University is the site of the first, or one of the first outbreaks in the country. In this situation there will be massive media interest and great concern from staff, students and parents. 26. 27. PRG to co-operate closely with health authorities in isolation of cases and contact tracing. PRG to establish policies with respect to movement on campus and possible cancellation of activities in the light of health authority advice. PRG, with help of LSU and others, to establish immediate lines of communication to students, staff and parents providing information and advice, ensuring consistency with official statements and taking into account media reporting. University, in collaboration with health authorities, to establish media relations strategy which is designed to reduce panic and speculation and minimize university profile.

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Scenario B:
Established pandemic - 25% of the population affected over the period (compared with 5-10% in an ordinary flu outbreak) resulting in a 15% absence level. It could take up to 6 months to produce a vaccine after which a mass immunisation programme will be implemented. 30. Department heads must consider the possible impact of 15% absence rates amongst staff and students for up to a three month period. There will inevitably be lecture and seminar cancellations. Students must be provided with a way of finding out about such cancellations as early as possible, and provided with alternative teaching strategies if appropriate. Each head of department will be asked to put in place contingency plans to cope with absences by key individuals on academic or support staff. General advice for Higher Education is likely to be that institutions and departments should remain open unless staff shortages make it impossible to continue operating. The decision whether all or part of an institution should close, or operations be reduced, will be for the University itself and will be taken by the VC in consultation with the Chair of Council. 32. Students who fall ill will be encouraged to stay at home. This may be in the community, perhaps in quite isolated circumstances, or in Halls of Residence. The Student Union to ensure that students are aware of symptoms and look out for their mates and continue with hygiene advice. Support for students who are in halls will be co-ordinated by the Senior Warden and the Director of imago. Lines of communication will be established to students and staff and parents providing information and advice, ensuring consistency with official statements. A parallel strategy for dealing with media enquiries will be implemented. In the absence of a directive at a regional or national level suspending higher education it is to be assumed that the normal rules for impaired performance apply. This information should be included in the briefings which will be going out to students throughout the pandemic. Academic Registrar to consider impact of mass absences on normal rules of evidence for impaired performance, especially as it may not be possible to obtain certificates from the

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Medical Centre given it will be working under enormous pressure once flu is widespread. 37. Communications throughout the University must ensure information and advice about hygiene and cleanliness is reinforced around the University. Financial provision may be made for increasing the standard of hygiene and cleanliness in all university buildings and halls of accommodation. It will take 4-6 months to produce a vaccine once the pandemic virus has been identified. At first limited supplies will be available and the NHS has identified priority groups to receive vaccine. Later, the Public Health Unit will co-ordinate a programme of mass immunisation. This will require a co-ordinated effort by the University and appropriate space and facilities will have to be identified to support the activity. Venues previously used successfully for mass vaccination are James France exhibition area and the Students Union. It is possible that the University might be asked to provide accommodation for mass vaccinations for people living in the town.

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Scenario C:
The severity of the Pandemic is toward the upper end of the predicted scale with deaths amongst members of the university. There is the possibility of a quarantine applied to halls of residence and a temporary suspension of business. 39. 40. PRG activates Universitys Major Incident Plan (MIP). Membership of PRG is augmented by Bursar, Director of imago Services, Director of Estates Services, Head of Security, Health, Safety and Environment Officer, Director of Computing Services, Secretary to Bursar and UMAL representative (if appropriate). This enables PRG to operate as the Major Incident Team in line with the MIP. PRG adds Co-opted Members as appropriate (MIP para 4.2) including representatives of the Students Union. Alternates for all additional members are identified and put on standby. PRG takes further action as detailed in the MIP, taking into account the following specific provisions:. Vice Chancellor to review current national advice on criteria for closure or reduction in operations and determine appropriate course of action in consultation with Chair of Council. It seems likely that the halls would have to remain open. A permanent establishment would also have to be maintained, depending on the length of any closure, severity of the outbreak, range of tasks and the guidance received from national, regional and local agencies including Public Health, Department for Education and Science, UUK and employee unions. Directors of Estates, imago and the Wardens service will maintain support for students in Halls and security of buildings. The Helpline to provide a source of information to all staff and students as to progress in the pandemic, the Universitys response and steps to be taken to achieve return to normality. Academic Registrar to consider impact of closure on student completion and progression and timing of academic year. CCDC to advise on timing of re-opening and to provide post-pandemic information to staff and students. JMT.8.08.2006

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Appendix

1. Guidance documents used in preparing this plan: UK Health Departments' UK influenza pandemic contingency plan, October 2005 http://www.dh.gov.uk/PandemicFlu Planning for a human influenza pandemic: Guidance to Higher Education Institutions, Department for Education and Skills, July 2006 www.teachernet.gov.uk/humanflupandemic Contingency Planning for a Possible Influenza Pandemic, Version 2, 10th July 2006, Cabinet Office www.pfe.gov.uk/emergency/060710_revised_pandemic.pdf

2. Sources of Further Information Latest health advice to travelers Avian flu information leaflet and poster Public health advice (published 2 March 2006) for those going to or returning from bird flu affected areas. Explaining pandemic flu A guide from the Chief Medical Officer (CMO) for healthcare professionals and the public. Key facts Key facts on pandemic influenza, its causes, and preparations for it. Important information for you and your family This leaflet describes pandemic flu, the risk of it occurring in this country, what makes it different from the ordinary flu we get every winter, and what the UK is doing to prepare for a possible influenza pandemic. Frequently asked questions Answers to commonly asked questions about the likely impact on society. All at http://www.dh.gov.uk/PandemicFlu Current WHO phase of pandemic alert At www.who.int/csr/disease/avian_influenza/phase/en/