Prepared for the Worst

Along with all the disasters Americans can fathom — hurricanes, tornadoes, terrorist attacks, fires — campus administrators have also begun planning how to protect their institutions from something that does not yet exist.

A pandemic flu — which medical personnel define as a global outbreak of a virulent human disease for which there is no vaccine and little natural immunity — is merely a paper exercise today. But it was a real emergency in 1918, 1957, and 1968, with the first attack killing approximately 50 million people. Victims of such a disease would increase tenfold every week after the first, and once we reach a one percent exposure of the national population,“you really can’t ration it back. It’s going to go on its own,” said Norbert Dunkel, director of housing and residence education at the University of Florida in Gainesville.

For colleges and universities, the ramifications of such an event will last far longer than the immediate threat to life.

So as a launching pad, experts say, most pandemic plans will involve the same decision-makers who appear on the scene of other disasters. But this preparedness comes with more than manuals — departments need a healthy supply of items in stock, such as bandages, soap, alcohol-based/waterless hygiene products, tissues, N95 masks, and disinfectant, pointed out Edward Brachman, vice president of Emergency Management International headquartered in Palatine, IL. Fortune 500 firm DuPont even introduced a series of biosecurity kits in early 2007 to assist with this angle.

Around the Table
But before you budget for supply specifics, said Dunkel, a well-prepared campus first identifies its resident experts: the chair of the environmental health and safety department, perhaps someone who works with the county communicable disease office. These folks have their fingers on the latest research, checking into Websites like every couple days for updates, so put them in a position of responsibility to alert the rest of the administration on breaking developments.

Next, appoint an individual to handle this crisis management full-time for the institution. According to Dunkel, that role often falls to the campus law enforcement chief, or the head of the environmental and safety office; smaller institutions task it to a vice president who is good at problem solving, decision making, and facilitating.

Pandemic planning isn’t a case of completely reinventing the wheel, but the trick is not to use your evacuation plan for a bomb incident as the foundation.“You need to start with a clean board,” Dunkel said, “and then see how things like communication protocols can transfer over quite nicely to pandemic planning.” And the same people who sit around the table during natural disaster planning exercises will be in the chairs for these sessions, too.

But with pandemic planning, it’s crucial to invite outside representatives, too, such as representatives from the county health department, ambulance services, EMS, the fire department, and crisis intervention counselors. “If you can get everybody at the table, you have almost jumped over the largest hurdle, I think,” Dunkel added.

On the other hand, bringing 20 people with independent operations into a room can be a little daunting. And what makes sense for an individual department often clashes with others’ priorities. Just ask Ron Kochendoerfer, assistant director of housing at The Ohio State University in Columbus (OSU). His group initially worked out a fine plan of action for housing quarantines and evacuations without input from the Red Cross. Thus they identified Jones Tower — primarily international student housing — as an excellent place to move undergraduates. The Red Cross saw that facility as the perfect infirmary, thanks to its individual kitchens in each room.

Likewise, dining services wanted to be close to loading zones and kitchens, with housing facilities clustered together for more efficient meal delivery. But that can violate what the public health department deems is appropriate for shared air. Even minor details, like ensuring sufficient dumpsters, parking, and bus transportation to handle evacuations, take on vital importance in the decisions, said Kochendoerfer.

However, in his opinion, the weightiest conversations center on designating who is essential and non-essential during the crisis. It often boils down to the old “13 people on the sinking boat and only nine seats in the life raft” exercise: do you need to endanger payroll people, even though steady funds can be critical to making the front-line workers feel supported? Should janitors without families be put at risk before those who do have children? And will people who don’t come to campus be penalized vacation time or sick time to balance those who did take the risk?

Even common definitions like soft close (campus is open but activities involving group interaction are cancelled) and hard close (evacuation) need to be hashed out in advance. “The difference is what kinds of services are available,” Kochendoerfer noted.

Dunkel says many universities veer off track in their planning by not triggering non-pharmaceutical measures (e.g., hard close) soon enough. After all, history and modeling shows cities that introduced non-pharmaceutical measures early in the game have dramatically lower outbreaks and death rates. But it’s not merely a matter of indecisiveness. “As you might guess, there are political pressures, economic pressures, and a legal question of who is going to do it because the courts haven’t settled that yet,” he added.

For instance, while it’s good accounting procedures to have three to four months of operational reserves on hand, in reality that’s not going to happen. “Most departments could probably weather two or three weeks, but three months could bring down a lot of operations,” he observed. And don’t assume, like many people, that the pandemic will calm down in a few weeks; most modeling suggests it’s more like three months.

Putting It into Practice
Tabletop drills are invaluable, university planners say, to spotting the hidden flaws in your pandemic procedures. “It will only be as good as the mock drill you run against it,” Dunkel warned. That’s exactly how Kochendoerfer’s group at OSU discovered its housing plan would expose new groups who weren’t at risk previously.

It’s not essential for individual foodservice workers or custodians to understand the final document. That responsibility lies more with a supervisor two levels above, Dunkel said. However, it is important to identify which triggers mean you need to bring employees up to speed on their specific assignments: if there’s an outbreak at an institution 50 miles away, perhaps. “But on a day-to-day basis, this is no different than the plan you have for a chemical leak,” he pointed out. “When the time comes, the right people will ratchet up and start talking about it.”

Yet that doesn’t hinder Kochendoerfer from involving students now. His next step this spring is to hold a few focus groups with student leaders to get their input. Already he’s learned that plans to resume missed classes in the summer is a dud, as this is when students need to work to earn tuition money in the first place.

“It’s a matter of staying flexible,” he summed up.