1 - University of Wisconsin–Oshkosh



Oshkosh Flu Plan

By

H.O.Z.E.T.H.

Megan Hanke, Derek O’Connell, Raegan Ziegler, *Rachel Eberhardt, Gary Tuschy, Jeremiah Henning

Emergency Taskforce

In the case of a pandemic occurring, an emergency taskforce will be developed in order to oversee the distribution of supplies, the care of the sick, the disposal of the dead, and the security and overall peace in the community during this time. This taskforce will be made up of several individuals. This includes the Mayor of the cities in Winnebago County, the Chief of Police for each police department, the Fire Chief of each fire department, the Executives from each hospital, the Winnebago County Board of Health, the Oshkosh Board of Health, Executives for the local TV and radio stations, and a Webmaster. If the individuals listed are unable to perform their duties, due to illness or death, that individual will be replaced on the taskforce by the individual next in line in that particular organization.

The duties of the taskforce are to coordinate emergency and medical care during this time, inform the public of any necessary information, and organize the movement of hospital employees, police, firefighters, and utility workers. The taskforce is also in charge of organizing the movement of ambulances, fire rescue response, and police response to 911 calls. They are also to maintain a close working relationship with all groups working in the cities and throughout the county.

The county of Winnebago and the city of Oshkosh will be divided up into corresponding geographical quadrants. Each quadrant will have an entire team dedicated to only that quadrant and will not be sharing team members with another quadrant. These quadrant teams are under the supervision of the taskforce. The division of the county can be seen on the attached maps.2

Each Quadrant team will consist of:

a.) 5 to 6 police officers

- To ensure; food, drug, and material needs among the citizens of its quadrant,

- setting up quarantining zones and maintaining them

- would be responsible for working with pharmacists, department stores (Wal-Mart, Kmart, Target or Shopko), and grocers to aid in getting supplies for desperate citizens

b.) 5 to 6 health care workers

- help citizens to whatever extent is possible

- answering questions of patients

c.) 3 to 4 fire fighters

- maintain quarantine blocks

- removal of deceased citizens

d.) 1 to 2 personnel from the Winnebago County Health Department

- maintaining accurate reports of the number of new cases, the number of deaths, the location of new infections

- maintain surveillance of the spread of the disease

- suggest which areas to be quarantined

Media

The media will play an important part during the time of the pandemic. Therefore, the media will be overseen by the taskforce. This will allow necessary information to be spread rapidly and accurately. All important information briefings of the public will be given by a member of the taskforce. This will allow citizens to be confidant that the information given is accurate and necessary. Information will be spread through local radio and TV stations, the disaster website, and by an informational telephone hotline. If any section of the city/county is quarantined, that section will receive information through the above listed methods, and by police on megaphones/loud speakers if the information is critical for that section.

The Flu-Hotline that will be established and maintained during the pandemic is (920) 232-3026 and (920) 727-8645. This hotline will be set up and maintained by members of the local news departments, such as radio, TV, and newspaper. Also, four healthcare workers will be assigned on a rotating basis to be on hand to answer medical questions that are called into the hotline. The local radio stations that would still be broadcasting during the pandemic are WRST 90.3 FM, WVCY 690 AM, and WOSH 101.9 FM. The TV stations are OCAT CitiCable Chanel 10, and OCAT CATV Chanel 2.

Supplies and Medications

Each sector of the county has a Division overseeing that the sector’s needs are met. In each sector, a team of police officers, doctors, and health officials will move the vaccinations and critical supplies, and will oversee the dispersal of the critical supplies. Grocery store owners will take the lead on setting up food ration, with managers in charge of getting the workers to help divide and sort out food rations. Food will be distributed by mailmen, because the postal department is already set up to deliver supplies to individual houses. Critical supplies will be kept in an undisclosed location that will be guarded by the police or National Guard. The following is a general critical supply list for the whole county. These items are not necessarily needed by each individual. Therefore, they are listed separately from the essential supplies every individual should have stored at all times.

• Hospital supplies

o Gloves

o Gowns

o Masks

• Medicines

o Over the counter

o Prescription

• Cleaning supplies

o Bleach

o Disinfectants

• Clean water

• Food

• Fuel

For each individual to be prepared for a possible pandemic, it is suggested that these supplies be on hand at all times. The items are broken down into sections to aid an individual in obtaining and organizing the supplies. The city of Oshkosh will not be able to provide supplies to prevent the spread of disease to every individual. During this time there will be a shortage of these supplies that are available to purchase. Therefore, all citizens are encouraged to purchase these supplies ahead of time. For a complete list of supplies to keep on hand, see the Individual Preparedness section of this flu plan.

a) Flu Care Kit (per person)

• 6 boxes of latex-free hospital gloves of your size

• 3 boxes each of latex-free hospital gloves of other sizes

• 2 rolls of large trash bags

• 1 roll of small trash bags

• 7 bottles of hand disinfectant gel

• 7 bars of soap

• 7 gallons of bleach, 4 bottles of Lysol for clothes

• 7 containers of Lysol disinfectant wipes

• 20 disposable ice packs

• 7 blankets

• 45 boxes of facial tissue

• 150 throat lozenges

• 2 bottles of cough syrup

• thermometer

• Gatorade

• Pedialyte

• Multivitamins

• 3 24-package of white soda – settles stomachs

• 120 plastic cups, bowls, plates, silverware, straws

• 12 rolls of paper towels

• 100 N-95 respirator safety masks $29.50/box of 20 masks1

b) Food (5-6 weeks, per person)

• 45 cans of assorted canned fruit

o 20 cans of peaches

o 20 cans of pears

o 5 jars of applesauce

• 45 cans of assorted canned vegetables

o 15 cans of green beans

o 15 cans of corn

o 15 cans of peas

• Meat

o 7 bags Beef Jerky

o 40 cans of canned meat

▪ Beef

▪ pork

o 30 cans of tuna/chicken

• 45 cans of soup

o Chicken noodle

o Chicken and rice

o Beef and noodle

o Vegetable

• 20 ramen noodles

• 15 packages of assorted pasta

• 2 jars spaghetti sauce

• 4 boxes of instant rice or potatoes

• 6 boxes of instant oatmeal

• 4 boxes of assorted granola/breakfast bars

• 20 pudding snacks or fruit cups

• 5 jars of peanut butter

• 4 jars of jelly/jams

• 6 boxes of crackers

• assorted chocolate

• 3 cans of assorted nuts

• 2 jars of honey, 1 bottle of lemon juice

o tea for sore throats

• powdered fruit drinks

• 6 gallons of juices

• powdered milk

• assorted herbal teas

• assorted alcohol of your choice and items needed to make those particular drinks (chose a few of high alcohol percentages to be used as a disinfectant if needed

• assorted spices

• 2 pounds of butter

• cooking oil

• 10 lbs of flour

• 10 lbs of sugar

• baby food

• pet food

• 2 can openers

c) Water (5-6 weeks, per person)

• 45 gallons

• water purification tablets

• water purification system

d) Miscellaneous

• battery operated am/fm radio/cd player

o 6 extra sets of batteries

• emergency radio with list of emergency radio stations

o 6 extra sets of batteries

• propane/gas operated space heater

o 3 extra fuel sorces

• 2 flash lights

o extra light bulbs – 10

o extra batteries - 30

• camping lantern – 3

o -fuel source – 12

• camping cook-stove

o 6 extra fuel sources for cook-stove

• light bulbs that emit the full spectum of light (like sunlight)

• 6 boxes of candles

• 3 large boxes of kitchen matches

• $1000/person in cash

• bottles of Ibuprofen, Tylenol, aspirin

• extra medicine, contact lenses, and contact lens solution

• 12 rolls of toilet paper/person

• ample feminine supplies

• condoms (what else do you do when you’re bored?)

• washcloths and towels

• mouthwash

• duct tape

• winter window kit

• all purpose tool

• shovels

• weapons—guns, knives, and tasers

• books to read

• games to play

• medical diagnostic/treatment books

• credit cards, birth certificates, social security cards, passports, drivers licenses, medical histories

Pharmacies

The pharmacies through out Winnebago County play an important role in a pandemic situation before the pandemic even starts. Pharmacies should encourage customers to buy and extra prescription out-of-pocket if possible, to stock up on supplies, like needles, insulin test strips, lancets, band aids, and disinfectants, before a pandemic occurs, and to watch their prescriptions and have them refilled before they are low. During a pandemic, pharmacies should attempt to supply as much medicine as possible, 50-70% of their total supply, to those who need it the most—the high risk individuals. Pharmacies will retain 30-50% of their supply to be used later in the pandemic when medicines are no longer coming into the county. This retained supply will be compiled and stored in the same well-guarded, secured location as any possible vaccine and specific flu medications. The pharmacy buildings may have to be guarded by the police and possibly the National Guard if the citizens of the county start to loot and attack the pharmacies. Security for critical businesses will be provided by police officers assigned to that area. Benefits, tax breaks, will be given to citizens who report looting, peace disturbances, and violence. Punishment for looters will be to pick up the dead bodies under the supervision of the fire department/hazmat team

Drug supply

The supply of drugs to the citizens of the county will be critical during this time. Therefore, all pharmaceutical companies, pharmacies, and all health plans/insurance companies will work together with these government agencies in order to attempt to supply the medicinal needs of the nation at a reasonable cost to all.

• US department of Health and Human Services

• World Health Organization

• Federal Emergency Management Agency

• Centers for Disease Control and Prevention

High risk individuals

These individuals are those in the community with special health needs. They are considered at high risk for having complications if the supply of their medications is disrupted. These are not necessarily the individuals at the highest risk of contracting the specific flu that caused the pandemic.

• Elderly

• Terminally ill

• Diabetics,

• Transplant recipients

• Individuals dependent on heart medication

Quarantine, Mass Gatherings, and Curfew

Quarantine

The area/city/town where the outbreak occurs will be quarantined. This will be enforced in order to protect individual citizens and to slow down or stop the spread of the disease. If a small area of a city or town is infected, the police will be able to quarantine it. If the outbreak is widespread throughout Winnebago County, then the whole county will be quarantined. If the outbreak is isolated to Winnebago County and not the rest of the state, the outside help from the military or National Guard will be needed to ensure that the quarantine of the county is in full affect at all times. Travel into and out of quarantined areas will be strictly monitored. Only personal to remove dead bodies for disposal and to remove the sick and bring them to a hospital/quarantine center will be allowed to enter. These individuals must be properly attired in protective clothing, masks and gloves, and decontaminated after they leave the area. Masks must be worn at all times by the patients who have been removed from the quarantined area. Individuals may leave the quarantined area if they have a “work permit” and are properly attired—are wearing a mask. In this way, businesses necessary for the operation of the county/city may remain open during the pandemic. Food will be brought to specific, designated areas in the quarantine section for distribution among the citizens.

There will be no designated house checks on any individuals during the pandemic by a designated group of people. Individuals who live alone will be on their own, just like everyone else. They may be checked on by family members or friends who are in the same quadrant of the county. The quadrant itself may decide to set up a list of individuals within that quadrant that may need to be checked on and set up a group of individuals from that quadrant to do the checking. There will not be enough individuals from the whole area to be able to assign massive home checks weekly for the whole community. Also, massive home checks would be limited to only within a quadrant due to the high risk of rapidly spreading the disease throughout the area. Massive home checks of all the quadrants by the same group of individuals would not be permitted due to quarantine measures.

In each of the quarantined areas there will be a designated building in which sick individuals are brought to. There will be a daily collection of the sick/dead by properly attired removal personnel. Schools in remote locations will make excellent locations for emergency hospitals. The doctors and nurses who live in that remote area can staff those emergency hospitals without leaving the quarantine areas. If possible, sick individuals will be brought to one of the hospitals or clinics listed below.

Hospitals3,4,5

Mercy Medical Center

500 S Oakwood Rd, Oshkosh, WI

920-223-2000

• 15 negative pressure, isolation rooms

• 5th floor is negative pressure, so it could easily be an isolation floor

• 157 beds

• 300 medical staff

Aurora Medical Center

855 N Westhaven Dr, Oshkosh, WI

920-303-8700

Aurora Health Center

1370 S Commercial St, Neenah, WI

920-729-6101

Winnebago Mental Health Institue

4100 Treffert Dr, Winnebago, Wi

920-235-4910

• 315 beds

• 4 Residents

St. Elizabeth Hospital

1506 S Oneida St, Appleton, WI

920-738-2000

• 352 beds

• 420 medical staff

ThedaCare

• 100 doctors

Children’s Hospital

130 2nd St, Neenah, WI

920-729-3100

Theda Clark

130 2nd St, Neenah, WI

• 138 beds

Berlin Memorial Hospital

225 Memorial Dr, Berlin, WI

920-361-1313

Clinics3,4,5

Affinity clinics

• 1855 S. Koeller St, Oshkosh, WI

• 2725 Jackson St, Oshkosh, WI

• 515 S Washburn St, Oshkosh, WI—Behavioral Health

Aurora clinics

• Omro

1805 Huckleberry Ave, Omro, WI

920-685-7280

• Winneconne

• Menasha

1151 Midway Rd, Menasha, WI

920-722-7275

Mass gatherings

Individuals inside of the quarantined areas are allowed to gather with other individuals inside of that same area. Individuals outside of the quarantined area are allowed to gather with other individuals outside of that same area. Individuals inside of the quarantine cannot have mass meetings with individuals outside of the quarantined areas. Small meetings will be permitted if extreme safety precautions are in place. All schools, large malls, and all churches will be closed during the pandemic. Church/Worship services may be broadcasted over the radio on WVCY 690 AM. No funeral services will be held. Memorial services will be postponed until 30 days after the disease has dropped to less than 1% of the population. During a pandemic, there is usually a high mortality rate. Due to this fact and the fact that the bodies could potentially spread the disease to more individuals, there will be specific burial procedures that have to be followed in all cases. There will be no exception. The burial procedures are as follows,

• All bodies will be brought to a specific location inside each of the quarantined areas for removal.

• Removal will be done by appropriately dressed members of the Hazmat Team, under the supervision of Chief Neil Cameron or Chief Tim Franz6. The two Hazmat trucks will be designated to carry the bodies to the crematory. If needed, one or two ambulances will also be designated to carry bodies only. After the pandemic is over, the trucks and ambulances will be disinfected completely. If this is not possible, the vehicles will be destroyed.

• Bodies will be brought to one of the crematories in and near Oshkosh.

• Cremation is mandatory. This will be the only way to ensure that the bodies are no longer contagious and that all of the viruses have been destroyed. All materials that are not able to be sanitized will be cremated with the bodies, including masks, gloves, and protective clothing.

• The cemetery supervisor, William Sturm, will be in charge of overseeing the disposal/placement of the ashes.7

Curfew

There will be a curfew imposed during the nighttime hours. It will be lifted during the daylight hours. This will limit the amount of fuel used during the pandemic, decrease the incidences of transmission of the disease, and decrease possible looting and violence. The “work permit” pass will give permission to those who work during the curfew hours to travel to and from their jobs. The “work permit” identifies who that individual is, where that individual lives, where the job is, and when the job is—time of day.

Businesses

During a pandemic, certain businesses are essential to the daily operation of a city. These businesses must remain open during this time and their employees are also critical to the maintenance of the city. A list of businesses to remain open and operational follows.

• Water treatment plants

City of Oshkosh Wastewater Treatment Plant

233 N Campbell Road, Oshkosh, WI

• Electrical power plants

Wisconsin Public Service

3300 N Main Street, Oshkosh, WI

• Gas stations

• Garbage collection

Oshkosh Garbage Collection

639 Witzel Ave, Oshkosh, WI

Winnebago County Solid Waste

105 W Cty Rd Y, Oshkosh, WI

Menasha Waste Management

1860 Novak Dr, Menasha, WI

• Hospitals

• Grocery stores

• Funeral homes/Crematories

All other businesses are optional as to their necessity. These businesses will probably suffer financially during this time, and may not survive the pandemic.

Antiviral Medication

Antiviral medications would be used in cases with the following criteria. The individual works in an essential occupation. An essential occupation is an occupation that is needed for life to continue peacefully in the county and the maintenance of the city/county. The individual works in an essential occupation are

• Health care providers

▪ Doctors

▪ Nurses

▪ Workers in long-term care facilities

• Water treatment personnel

• Electrical personnel

• Waste removal

• Police officers

• Firefighters

• Biohazard team members

• Crematory personnel

• Communication personnel—phone, radio, TV

After all of the above individuals have received the medication, individual who are in otherwise good health and have a chance of recovery would receive it next. The limited medicine will not be wasted on the elderly or immunocompromised. So far the flu attacks those with healthy immune systems harder, so they will need to be treated first. Those with suppressed immune systems, like the elderly, are not at a higher risk of contracting the flu than individuals who are young to middle aged. Antiviral medications may then be used to treat individuals in all other cases if there is a large supply.

Vaccine

If a vaccine becomes available during the pandemic, a hierarchy of individuals to receive the vaccine has been established. The top priority individuals are those who come in direct contact with possible contaminated objects. These individuals include healthcare providers, such as doctors, nurses, and nursing home workers, individuals in essential occupations, such as electricity, water, and waste removal, and individuals who remove the dead and dispose of them. The second priority individuals are police officers and firefighters. The third priority individuals are members of the emergency taskforce, city/county officials, and all healthy individuals between the ages of 18 and 45. The last priority of individuals are individuals with compromised immune systems 18-45, the elderly >45, and the really young ................
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