Section V: Community Mitigation

PIRA_Section V: Community Mitigation_TEST - Final
Form Approved
OMB Number: 0920-0879
Expiration Date: 03/31/2018

Introduction
Background
The 2009 H1N1 influenza pandemic underscored the importance of communities
being prepared for potential threats to public health security. Because of its
unique abilities to respond to infectious, occupational, or environmental incidents,
the Centers for Disease Control and Prevention (CDC) plays a pivotal role in
ensuring that state and local public health systems are prepared for these and
other public health incidents.
The identification of the novel influenza A (H7N9) virus illnesses in China in 2013
highlights the importance of influenza pandemic preparedness. To date, the
reported case fatality ratio from human H7N9 infections is more than 30%.
Should the H7N9 virus mutate to allow for sustained human-to-human
transmission, it appears capable of causing severe disease in all ages. To better
prepare for such a scenario, it is important to understand the collective ability of
our nation to prepare for and respond to a pandemic of substantially different
epidemiology than the 2009 H1N1 pandemic.
State and local public health departments are first responders for public health
incidents. To better prepare these agencies to respond, CDC provides funding
and technical assistance for state, local, and territorial public health departments
through the Public Health Emergency Preparedness (PHEP) cooperative
agreement. CDC’s Public Health Preparedness Capabilities: National Standards
for State and Local Planning provide national standards that help state and local
public health departments strengthen their ability to respond to all hazards,
including influenza pandemics, and build more resilient communities. Consistent
with this approach, the following Pandemic Preparedness Readiness
Assessment for State and Local Public Health Planners specifically aligns with 11
public health preparedness capabilities and administrative preparedness
planning goals.
Overview
The Pandemic Preparedness Readiness Assessment for State and Local Public
Health Planners promotes state, local, and territorial public health preparedness
and immunization program collaboration through the administration of a self-

assessment designed to measure jurisdictional readiness to respond to an
influenza pandemic. Although the content of this assessment does not
encompass every contingency or element necessary to effectively respond to an
influenza pandemic, CDC technical experts in differing programs have helped to
arrange content within the following seven priority planning areas:
1.
2.
3.
4.
5.
6.
7.

Vaccination Planning
Epidemiology and laboratory
Medical Care and Countermeasures
Healthcare Systems
Community Mitigation
Public Information and Communication
Public Health and Immunization Workforce

Information collected from the assessment will not be used to score or
competitively rank public health emergency preparedness or immunization
programs. Rather, this assessment is designed to identify preparedness gaps,
as well as promising state, local, and territorial preparedness practices.
Assessment results will be used by the CDC to inform technical assistance and
future program improvement initiatives.
Definitions
Allocation: Amount of pandemic influenza vaccine available for ordering.
Allocating: Process of dividing available vaccine among CDC’s PHEP awardees
or among registered pandemic influenza vaccine providers and facilities within an
awardee’s jurisdiction.
Critical infrastructure personnel (CIP): The full list of CIP is defined in Guidance
on Allocating and Targeting Pandemic Influenza Vaccine; U.S. Department of
Health and Human Services (HHS)/U.S. Department of Homeland Security
(DHS); 2008 Guidance on Allocating and Targeting Pandemic Influenza Vaccine
Distribution: The process of transporting pandemic influenza vaccine from one
location to another.
Enrollment: The process of enabling registered healthcare providers and facilities
to legally provide pandemic influenza vaccine.
Ordering: Process of requesting pandemic influenza vaccine from either the
federal, state, city, or local government. Orders can be placed against an
allocation or independent of allocation.
Non-pharmaceutical interventions (NPIs): Those interventions that can mitigate
transmission of influenza and do not involve medical countermeasures. NPIs

include voluntary home isolation, school closures, respiratory etiquette, hand
hygiene, and routine cleaning of frequently touched surfaces and objects.
Peak vaccine administration capacity: The highest rate at which a jurisdiction is
able to provide pandemic influenza vaccine to its population; CDC recommends a
peak vaccine administration capacity of at least 10% of the population per week.
Point of dispensing (POD) / mass vaccination clinic: Location for dispensing
medical countermeasures, specifically for vaccine, during an influenza pandemic
response. Located in a public or private space, this clinic is designed to
vaccinate a large group of persons over a short time period. The POD or clinic
might target the entire population or people in specific priority or high-risk groups.
Public and/or private entities can manage a POD or clinic.
Closed POD: Point of dispensing/vaccination clinic closed to the general public
and open only to a specific group (e.g., staff of a participating business or
healthcare personnel in a specific hospital).
Open POD: Point of dispensing/vaccination clinic open to the general public,
specifically to provide vaccine, during an influenza pandemic response.
Recruitment: The process of soliciting healthcare providers and facilities
interested in and willing to provide pandemic influenza vaccine.
Registration: The submission of required information, similar to an application, by
healthcare providers or facilities interested in providing pandemic influenza
vaccinations.
Retail-based clinics: Non-pharmacy businesses that sell retail products (e.g.,
Walmart, Target) and serve as PODs/mass vaccination clinics.
School-located vaccination clinics: Vaccination clinics that target students and
are typically held on school grounds.
Public reporting burden of this collection of information is estimated to average 30 minutes per
response, including time for reviewing instructions, searching existing data sources, gathering
and maintaining the data needed, and completing and reviewing information. An agency may not
conduct or sponsor, and a person is not required to respond to a collection of information unless it
displays a currently valid Office of Management and Budget control number. Send comments
regarding this burden estimate, or any other aspect of this information collection, including
suggestions for reducing this burden to CDC/Agency for Toxic Substance and Disease Registry
Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333;
Attention: PRA (0920-0879).

(End of Page 1)

Section V: Community Mitigation
Goal: Each awardee will recommend the implementation of nonpharmaceutical
interventions (NPIs) during the earliest stages of an influenza pandemic. NPIs
are separate from pharmaceutical countermeasures, such as vaccination or use
of antiviral drugs, and routinely include the following:
• Voluntary home isolation (staying home when sick)
• Respiratory etiquette
• Hand hygiene
• Routine cleaning of frequently touched surfaces and objects
Social distancing measures may be recommended to mitigate a severe
pandemic; examples include school closures and postponements or cancelations
of mass gatherings.
Assumptions:
• CDC will provide guidance around NPIs, but implementing them will be a state
and local responsibility.
• NPI recommendations may not be uniform across the nation at any given time.
• If epidemiologic data suggests sustained human-to-human transmission, to
indicate high transmissibility of the novel influenza virus, CDC will recommend
the following additional NPI measures:
o Voluntary home quarantine (staying home if exposed to a family member
who is sick).
o Early, coordinated closures of childcare facilities, K-12 schools, and
colleges/universities before influenza transmission becomes widespread.
o Ask parents to keep children, who are at risk of severe influenza outcomes
and attend childcare facilities or K-12 schools, at home and away from others.
o If schools remain open, promote other school-based social distancing
measures, such as seating students farther apart, canceling classes that bring
students together from multiple classrooms, or postponing class trips.
o Additional workplace social distancing measures to reduce face-to-face
contact between employees and customers, such as supporting flexible work
arrangements, spacing employees farther apart at the worksite, or using home
delivery of goods and services.
o Modifications, postponements, or cancelations of mass gatherings (i.e., any
occasion, either organized or spontaneous, that attracts sufficient numbers of
people to strain the planning and response resources of the community hosting
the event), especially for local jurisdictions where influenza already circulates.
(End of Page 2)

Section V: Community Mitigation
Please select your jurisdiction:

mAlabama
mAlaska
mAmerican Samoa
mArizona
mArkansas
mCalifornia
mChicago
mColorado
mCommonwealth of the Northern Mariana Islands
mConnecticut
mDelaware
mFederated States of Micronesia
mFlorida
mGeorgia
mGuam
mHawaii
mIdaho
mIllinois
mIndiana
mIowa
mKansas

mKentucky
mLos Angeles County
mLouisiana
mMaine
mMaryland
mMassachusetts
mMichigan
mMinnesota
mMississippi
mMissouri
mMontana
mNebraska
mNevada
mNew Hampshire
mNew Jersey
mNew Mexico
mNew York
mNew York City
mNorth Carolina
mNorth Dakota
mOhio
mOklahoma
mOregon

mPennsylvania
mPuerto Rico
mRepublic of Palau
mRepublic of the Marshall Islands
mRhode Island
mSouth Carolina
mSouth Dakota
mTennessee
mTexas
mU.S. Virgin Islands
mUtah
mVermont
mVirginia
mWashington
mWashington, DC
mWest Virginia
mWisconsin
mWyoming

Please select your position:
mPHEP Director
mEpidemiologist
mOther (please specify) ____________________

(End of Page 3)

Section V: Community Mitigation
1. Please select the statement that best reflects the degree to which your
jurisdiction’s influenza pandemic preparedness plan addresses assumptions and
triggers for implementing NPIs.
mPlan addresses assumptions and triggers in detail
mPlan partially addresses assumptions and triggers
mPlan does not address assumptions and triggers

(End of Page 4)

Section V: Community Mitigation
2. Does your jurisdiction’s pandemic influenza plan anticipate simultaneous
implementation of multiple NPIs during an influenza outbreak?
mYes
mNo >>>> Skip to Page 7: 4. If areas within your jurisdiction meet the CDCestablished epidemiologic criteria to temporarily close schools or cancel mass
gatherings, how likely is it that the jurisdictional and/or sub-jurisdictional
stakeholders would implement these recommendations?

(End of Page 5)

Section V: Community Mitigation
3. Which of the following factors will be considered in choosing which NPIs to
implement? (check all that apply)
qSeverity of illness
qTransmissibility
qPopulations most affected (including vulnerable populations)
qNone of the above
qOther (please specify) ____________________

(End of Page 6)

Section V: Community Mitigation
For the following set of questions, please assume your jurisdiction meets
the CDC-established epidemiologic criteria (based on factors such as
disease severity and transmissibility) to temporarily close childcare
facilities, K-12 schools, and colleges/universities or to cancel mass
gatherings. The questions will ask about:
• The likelihood that decision-makers within your jurisdiction would close
schools or cancel mass gatherings
• Whether your jurisdiction has policies in place to allow you to close
schools or cancel mass gatherings
• The expected time it would take to implement such closures or
cancelations

4. If areas within your jurisdiction meet the CDC-established epidemiologic
criteria to temporarily close schools or cancel mass gatherings, how likely is it
that the jurisdictional and/or sub-jurisdictional stakeholders would implement
these recommendations?

Very Likely

Likely

Somewhat
Likely

Not Likely
at All

Unsure /
Do not
Know

Childcare
Facilities

m

m

m

m

m

K-12
Schools

m

m

m

m

m

Colleges /
m
Universities

m

m

m

m

Mass
Gatherings

m

m

m

m

m

5. Are legal authorities at either the jurisdictional or sub-jurisdictional level
needed to temporarily close either private or public schools or cancel mass

gatherings?

Yes

No

Not
Applicable

Childcare
Facilities

m

m

m

K-12
Schools

m

m

m

Colleges /
m
Universities

m

m

Mass
Gatherings

m

m

m

6. Does your jurisdiction (or the local sub-jurisdiction) currently have that legal
authority?

Yes

No

Not
Applicable

Childcare
Facilities

m

m

m

K-12
Schools

m

m

m

Colleges /
m
Universities

m

m

Mass
Gatherings

m

m

m

7. Are policy changes within your jurisdiction needed to implement a
recommendation to close schools or cancel mass gatherings?

Yes

No

Not
Applicable

Childcare
Facilities

m

m

m

K-12
Schools

m

m

m

Colleges /
m
Universities

m

m

Mass
Gatherings

m

m

m

8. Accounting for jurisdictional decision-making, how long will it take to implement
decisions to close schools or cancel mass gatherings?

Less than
1 day

1 - 3 days

4 - 7 days

More than
1 week

Jurisdiction
would not
close

Childcare
Facilities

m

m

m

m

m

K-12
Schools

m

m

m

m

m

Colleges /
m
Universities

m

m

m

m

Mass
Gatherings

m

m

m

(End of Page 7)

m

m