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V. CONCEPT OF OPERATIONS: <br />Key response actions by phase as identified by the World Health Organization (WHO), <br />specifically "phase 4" when "community-level outbreaks has been verified." <br />A. PHASE4 <br />1. Disseminate surveillance guidelines to physicians, clinics, and hospitals <br />2. Track possible cases identified in Kittitas County <br />3. Establish case definition that aligns with Department of Health and Human <br />Services (HHS), CDC, and DOH. <br />4. The Public Information Officer (PIO) or designee will develop information <br />related to pandemic influenza activity and forward to media and news sources. <br />5. KCPHD will develop and disseminate guidelines regarding antivirals based on <br />guidance from CDC and DOH. <br />6. Develop public information messaging based on expected amounts of vaccine and <br />priority groups. <br />B. PHASES <br />1. Develop or refine protocol for active surveillance at KVH and other facilities. <br />2. Provide healthcare sites with instructions about gathering samples from individuals <br />who display symptoms of influenza like illness (ILi) and who are at increased risk for <br />infection according to established guidelines. <br />3. PIO or designee will disseminate information regarding status of outbreak to all <br />healthcare providers and other facilities at regular intervals. <br />4. Implement plans for requesting any available drugs through state, federal, or private <br />sources. <br />5. Monitor adverse reactions to antiviral medications under the guidance of CDC and <br />DOH. <br />6. Distribute antivirals to priority groups. <br />C. PHASE6 <br />1. Screen and/or quarantine international travelers recently arriving in Kittitas County <br />from an area known and/or suspected to be infected, following federal guidelines. <br />2. Continue to monitor workforce absenteeism within the community through reporting <br />from major employers. <br />3. Review surveillance data for potential risk factors that either prioritize or deprioritize <br />infected individuals for receiving antivirals and/or vaccine, following state and federal <br />guidelines. <br />4. Set up a call-in line for healthcare professionals to answer questions relating to the <br />pandemic (unpublished call in line -not for general public). <br />5. Distribute antivirals to priority groups. <br />6. Monitor adverse reactions as resources permit. <br />7. Monitor any cases of resistance to antivirals. <br />65