Governor Jindal Holds Press Conference Discussing the State's H1N1 Preparedness Efforts
Press Release
Today, Governor Bobby Jindal held a press conference with members of the Unified Command Group (UCG), made up of leaders across state agencies, to discuss the state's H1N1 preparedness efforts and the steps being taken to prepare and educate Louisianians as flu season approaches. The press conference followed a meeting of the UCG at the Governor's Office of Homeland Security and Emergency Preparedness (GOHSEP).
The Governor said, We are taking many precautionary steps across state agencies to prepare for an expected increase of the H1N1 virus as we enter fall and the flu season. Our efforts include working across state government to develop a public information campaign on preventing the spread of illness and where and when folks can go to get a H1N1 vaccine, once it is approved and distributed by the federal government to our state.
Our discussions in the UCG meeting today centered on updates and our plans related to six main areas, including an update on the virus, our ongoing preparedness efforts, vaccine distribution plans, public information campaign, preparing hospitals for possible surge of activity, and plans to prevent the spread of illnesses at our schools and universities. We will continue to work closely across state government, and in coordination with our federal partners to ensure we are doing everything possible to take steps now to prepare and protect the health and wellbeing of our people.
Update on H1N1 Virus
First, the Governor outlined facts and figures on H1N1's current impact on the nation and the state.
The Governor said the CDC estimates that 99% of all influenza activity in US is due to H1N1. The CDC also reports that current visits to doctors for influenza-like illness are down from April, but are higher than what is expected in the summer. Visits to doctors for influenza-like illness were highest in February during the 2008-09 flu season, but rose again in April 2009 after the new 2009 H1N1 virus emerged.
During recent weeks, influenza activity remained stable or continued to decline in most areas of the U.S.; however, the CDC reported that activity appears to be increasing in the Southeast.
A total of 8,843 hospitalizations and 556 deaths associated with 2009 influenza A (H1N1) have been reported to CDC, while the proportion of deaths attributed to pneumonia and influenza was low and within the bounds of what is expected in the summer.
In Louisiana, it is estimated that the total number of H1N1 cases in the state since April is about 30,000 cases. While transmission is still strong, health officials have not detected any changes in severity.
The Governor noted that to date, three deaths have occurred in the state connected to the H1N1 virus, including a young adult female in the Greater New Orleans area, one adult male in Central Louisiana, and one adult male in Southwest Louisiana.
Louisiana Preparedness Efforts
Secondly, the Governor said that FEMA's regional office has indicated that Louisiana is on the forefront of preparedness efforts when compared to other states in the region and across the nation. Louisiana has sponsored several summits and educational events throughout the state, and continues to prepare for future events, including:
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H1N1 educational conference for emergency managers and first responders in concert with the Louisiana Emergency Preparedness Association annual conference in May, one-day emergency management workshop for all Parish OEP Directors in June;
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H1N1 summit in New Orleans for emergency managers, first responders, and health officials in August;
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H1N1 workshop in Natchitoches for OEP directors and first responders this week; and
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H1N1 workshop for school superintendants in Baton Rouge coming up in September.
Additionally, the state has sent information for developing local plans to parish OEP Directors, first responders including sheriffs, fire, and police units, public and private primary and secondary schools and colleges and universities. A public information campaign has also been developed - including a public service announcement (PSA) already distributed to media markets throughout the state - and additional PSAs are being produced to promote preparedness and the importance of getting vaccinated for the flu.
The Governor said, Louisiana is leading the effort in preparing for the spread of H1N1 virus in the upcoming flu season and we must continue to take whatever steps we can to protect Louisianians and inform folks about preventing the spread of this virus.
Vaccination Distribution
Third, Governor Jindal discussed the specifics of state plans for distributing the vaccinations needed for H1N1, once they are approved and dispensed by the federal government in the coming months.
The Governor said, Currently an H1N1 Core Planning Team assembles bi-weekly to discuss implementation of the H1N1 Vaccination campaign. DHH is planning to distribute Louisiana's share of the federally manufactured H1N1 vaccine to providers and partners for distribution. This includes pediatricians, OBGYNs, internal medicine physicians, family practice physicians, retail pharmacies, other vaccine for children providers, the Department of Corrections, the U.S. Veterans Administration and other military partners.
Additionally, provider pre-registration letters have been sent out to community providers to inform potential providers of the vaccination campaign, and a pre-registration website has been set up, along with a formal letter that will be sent out to all that receive the preliminary provider letter to inform them how to register.
The Governor said that the vaccine will also be distributed to the public sector through public health units, school-based health centers and school nurses, Federally Qualified Health Centers and rural health clinics. In accordance with CDC guidelines, the vaccine will only be immediately available to high-risk population groups, including frontline health care workers, school-aged children to age 22, caretakers of young children, pregnant women, and non-elderly adults with chronic medical conditions.
Vaccines to prevent the 2009 H1N1 virus have not yet been licensed; however, initial doses of licensed vaccines may be available by mid-October 2009 or November. Currently, the CDC is expecting approximately 45 million doses to be available for shipment by mid-October, with more coming to the state every three to four weeks.
Governor Jindal said the new H1N1 vaccine will be pushed from the federal government to the state and a distributor will ship the vaccines to the vaccinators that are enrolled in the system set up by DHH. That initial enrollment process has already began and notice was sent to all providers asking them to sign up.
The Governor added that in addition to the regular high-risk and nursing home seasonal influenza vaccination efforts, the Office of Public Health will also conduct a series of seasonal mass vaccination influenza clinics in early November throughout the state, utilizing the public health units. The additional vaccine (64,000 doses) for this effort will be provided at no cost to the public and will be available to anyone.
Public Communication Campaign
Fourth, Governor Jindal addressed the steps undertaken by the Department of Health and Hospitals in notifying healthcare providers and the general public on the specifics of H1N1.
The Governor said that DHH has distributed a letter from the President of American College of OB/GYNs (ACOG) with need-to-know material concerning influenza and pregnant women and is also developing informational and promotional material for expectant mothers, parents, health care workers and other primary and secondary target audiences, using CDC guidelines and working with the other state agencies and partners to distribute the information.
The Department of Health and Hospitals is also forming a plan to inform and obtain support of principals, teachers, and parent organizations using CDC guidance and working with Department of Education. Governor Jindal said that information is already being shared at state and regional levels, including the Superintendent Summit held this week, and DHH is also partnering with 211 to help provide Louisianians with an additional outlet to receive H1N1 information.
Preparing Hospitals for Possible Surge of Cases
The Governor also addressed concerns for what steps would be taken if a surge of the H1N1 virus in the state begins to affect hospitals.
The Governor said some hospitals, if they have the right capacity, may try to isolate flu victims, but this becomes even more difficult with increased volume. Currently, each hospital has their own plan for how they will manage patients, depending upon their staffing, number of ICU beds, and availability of ventilators.
The Department of Health and Hospitals has established several mechanisms for epidemiology to conduct surveillance. First, they will use sentinel physicians, who report their data to DHH. They are also monitoring all hospital influenza admissions and working with the Department of Education get school absenteeism data. All of these sources of information combined will provide DHH with an indicator of where there may be a surge in activity.
Additionally, DHH has an inventory of how many ventilators are in the state, and the number of ICU beds. Should hospital admissions begin to increase, there will be higher demand for these vents and ICU services. The Governor emphasized that if there are surges on hospitals, it would likely be simultaneously occurring throughout the nation, and the supply of both vents and ICU beds may very limited, therefore, DHH is working to prepare for this possible strain on supplies should it occur.
The Governor said that DHH has the hospital data reporting system, which can provide officials with real time information about what is happening in each hospital. Since last hurricane season, the system has been improved, and officials are prepared to turn it on when there is significant hospital activity.
Governor Jindal also noted that the best thing the state can do to prevent overwhelming the hospitals is to aggressively push both immunization programs (for seasonal flu, and for H1N1 flu) to first prevent the spread of illness. The Governor stressed that it is important that as many people as possible get immunized with seasonal vaccines, since this will decrease capacity pressure on the system and noted that target populations for this vaccine include the elderly.
Department of Education/Higher Education Preparedness Efforts
Finally, the Governor outlined the steps being taken in schools across the state to prepare for H1N1.
The Governor said that Department of Education (DOE) has completed two mailings to schools regarding H1N1. The first mailing was dated in May, which included the DOE Pandemic Influenza Educational Response Plan, and in August, a second letter was emailed to schools regarding H1N1 that included important links to the Centers for Disease Control (CDC) website for information and resources including technical guidance and the school flu toolkit.
The Department of Education has provided schools with several resources on H1N1 that including:
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CDC School Flu Toolkit;
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Action Steps for Schools, which includes important information regarding actions for cleaning, handling absences, and school dismissal, and other items; and a
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What to Do and Why booklet for Schools and Daycare developed by the Office of Public Health.
Additionally, the CDC has developed a database to report closures and asked school districts to identify one person in each district to have the responsibility of reporting closures.
Governor Jindal discussed the Louisiana Department of Education Pandemic Influenza Education Response Plan, which encourages local education agencies to develop alternate procedures to ensure continuity of instructions in the event of school district closures. Web-based instruction is not required by the CDC, but is encouraged along with other distance learning methods.
The Governor also addressed areas in higher education, highlighting that because each college and university campus is unique in its student population, its location to metropolitan areas, and the number of residential and commuter students, therefore they must all develop their own preparedness plan for facing an increase in the spread of the H1N1 virus.
There are several common practices among Louisiana campuses and systems in their efforts to protect students, faculty and the community using adopted guidelines issued by Centers for Disease Control (CDC), including:
* Students/Staff to stay in their homes, dormitories or residence halls until at least 24 hours after they no longer have a fever, and
* Plans to provide meals and supportive care for students in isolation.
* If possible, ill students should return home to recuperate, and minimize the risk of infecting others if they live nearby and can do so without using public transportation.
Moreover, administrators are ensuring that facilities, particularly dormitories, classrooms, elevators, dining halls, and other high-contact areas are cleaned frequently. Officials are also prepared to implement online instruction if necessary and to use broad range of communications channels to reach students including Twitter, Facebook, MySpace, radio, TV, and newspapers.
The Governor noted that school closures to be considered on a case-by-case basis and that students, high-risk staff, and those staff under 25 years of age are slated to receive the H1N1 flu vaccination when it becomes available by the federal government, through DHH.
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