H1N1 Tests Campuses' Pandemic Plans

A flu pandemic lasts 12 to 18 months. With that said, we’re halfway through the H1N1 pandemic, which began in April 2009. Likely, every campus administrator reading this article is looking forward to it ending. Bob Wirag, director of University of Central Florida (UCF) Health Services, is: “It feels like we’ve been living it for a year and a half.”

As soon as the Centers for Disease Control and Prevention (CDC) in Atlanta announced the virus, administrators dusted off their pandemic plans and started preparing to cope with the potential crisis. DePaul University, a large private institution in Chicago, has an obvious — yet unique — moniker for its pandemic plan: “We call our plan a communicable illness plan, rather than a pandemic plan,” said Ed Gregory, director of Business Continuity Planning in the office of the EVP, “so that it can function for a variety of infectious diseases or communicable illnesses.”

“We started looking at our plan the end of spring semester, when the first round of H1N1 came out,” confirmed Anna Martin, vice president for Administration and chair of the Emergency Management Team at the College of William and Mary in Williamsburg, VA. “We didn’t have any cases on our campus, but schools around us did. So we looked at it through the summer for what would happen in the fall.”

At Rice University, a small private school in Houston, planning time was split between H1N1 and hurricane preparedness, participation in higher education teleconferences, and producing internal communications. “At the end of August,” said Dan Fu, MPH, MBA, business process consultant at Rice, “we started classes, and that first week there were only freshmen on campus. The second week, with everyone back on campus, the Student Health Center saw an unusual number of Influenza-Like Illness (ILI). We activated the crisis management response team on September 4, specifically for H1N1.”

And whether there’s been a crisis caused by H1N1 depends on which administrator you speak with. Martin, for instance, says there has not been a crisis on her small public campus. “We’ve managed it as a very large seasonal flu,” she said, “so it hasn’t had much of an impact on our emergency planning because it really hasn’t been an emergency. We didn’t implement any emergency response to this.”

On the other hand, the pandemic team at UCF, a large public school, continues to meet almost weekly, and the campus has already experienced several waves of illness, with peaks in August and September. “We’re suspicious and concerned that there may be another wave in January,” said Wirag, “when students come back from break and the temperature and humidity factors are just right.

“We never let our guard down on this one,” Wirag continued, “and we won’t until we get word from the CDC that there’s nothing to be concerned about. You always fear the unknown, and we don’t know what we still have to deal with.”

Recommendations From Administrators

As administrators have managed H1N1, they’ve learned a few things. Here is what they recommend all administrators consider when working through a pandemic plan.

Create a plan that works for your institution. Every institution is different — rural, urban, small, large, multiple campuses — and the list of individualizing factors is endless. So you don’t want to copy another university’s emergency plan; you do want to create a plan that’s unique to your circumstances.

 “I’m not a big proponent of best practices,” confirmed Gregory, “because, depending on your organization, it may not be the best practice for you.”

Similarly, and regarding the H1N1 pandemic specifically, Gregory’s team listened to advice offered by the CDC and WHO, reviewed their campus emergency plan, and then, based on all that information, tailored an approach that fit their needs.

“What is important to us,” Gregory said, “is the ability of the disease to affect a large number of people in a specific community, like the basketball team or an entire residence hall. Because there are not a lot of deaths associated with H1N1, we kept an eye on what was going on and what was happening in that nature and responded to it. But definitely our biggest concern was how we would handle the situation if a specific group became ill.”

Flexibility is a key element. Move away from the attitude that your emergency plan is written in stone, and use what’s applicable from the various parts of your plan. Fu points out that the CDC has been very good about focusing on local control. “Take our neighbor, the University of Houston, for example,” he said. “It’s primarily a large school, and 80 percent of its students commute. We are the opposite, a small school with 75 percent of our students living on campus. You have two schools in the same geographical location with very different student populations. Therefore, taking guidelines from the CDC and state and local officials, and applying what makes sense for your situation is critical. The keyword is flexibility.”

Communication is critical. The crisis management team must identify how communication around emergency mitigation should take place. “It may sound trivial that you have a point person and an e-mail protocol that updates the senior executive team with a condensed and bulleted update only when it’s relevant,” said Mark C. Titzer, associate vice president in the Office of the EVP at DePaul. “Everyone wants to be in the loop, but it’s not necessarily efficient, and it can cause confusion if dozens of e-mails are flying around.”

Gregory agrees, pointing out that all messages are first filtered through him, the media relations point person, and the committee. “Virginia Tech is still being questioned and scrutinized for the way they communicated during the shootings in 2007,” he said, “and I am sure they continue to review and test their communication protocols.”

It’s a bit of a Catch 22, added Titzer. “You don’t want to needlessly over-communicate a situation that is not serious. On the other hand, if you under-communicate something that is in fact serious, it could obviously have safety implications. It’s a delicate balancing act that the emergency planning committee has to be mindful of. There are better ways to do it than not. I suspect it’ll be a never-ending challenge for every organization.”

Develop relationships with city, county, and state officials. Fu recommends face-to-face contact on a regularly scheduled basis with these partners. “For us,” he said, “it has proven beneficial in understanding what they’re thinking, knowing what systems are available to us, and what feedback we can give them so that they can position their available resources.

“One caveat for any event,” Fu continued, “is that you’re better off developing those relationships before the event occurs. The first time you meet those partners shouldn’t be when you’re calling for help.”

Plan to keep staff healthy.
“It’s important to consider the staff that is involved in supporting the university infrastructure,” said Wirag. He notes that there is a security concern in keeping staff healthy: How do you secure a viable sustainable workforce in the face of a public health threat?

UCF administrators made an effort to involve the physical plant, including housekeepers, janitors, and trades, encouraging them to get the vaccine in order to stay healthy and on the job. Communication included sit-down classes for staff not using technology, and handouts in Spanish for staff whose first language is Spanish.

The Uncertain Future
There is a potential for a third wave of H1N1 at same time the seasonal flu hits this winter. Fu asks two questions. First, if it hits, will it be additive or will it displace seasonal flu? Second, if everyone is vaccinated and the third wave doesn’t materialize, is it because everyone is vaccinated or is it because there was no third wave? His answer is that we simply won’t know until there’s a history. The one thing that is definite is that everyone will be relieved when the pandemic passes.