UN Country Team Jamaica
Contingency Plan for an Influenza Pandemic
24 July 2006
- Introduction
The purpose of this Contingency Plan is to ensure preparedness for a timely, consistent and coordinated response across the United Nations Family (Jamaica) in an event of an influenza pandemic which could affect UN staff and their dependants.
This preparedness plan sets out measures and actions required of UN Resident Coordinator, UN Country Management Team, Crisis Management Team, UN designated Officials, UN Security Management Teams, individual agencies and staff members to determine and implement, on an inter-agency basis at the country level, the appropriate preparations and precautions.
The UN Contingency Plan is to be linked to the national emergency preparedness plan through established linkages. For instance, the Ministry of Agriculture has an Avian Influenza Preparedness Committee that is chaired by the Honourable Minister of Agriculture. Mr. Roger Clarke, that comprises representation from the Ministry of Health, the Security services, Immigration and Customs, PAHO and FAO, the private sector and others.
- Background information
Influenza is a viral respiratory disease affecting humans and certain animals. Normally, people are infected only by human influenza viruses and not animal influenza viruses. Clinical disease ranges from infection with no symptoms to mild nonspecific illness to many different life threatening complications, including pneumonia.
On occasion, animal influenza viruses, or influenza viruses containing genes from animal influenza viruses can begin infecting people. When a completely new strain of influenza virus emerges among human populations, and has the ability to spread easily from person to person, the virus can spread world wide within months (and perhaps weeks) leading to higher levels than usual of mortality and severe illness. In this situation, all age group are vulnerable to infection, and there can be disruption of all sectors of the society. Such a situation is called an influenza “pandemic”. Pandemic are different from usual influenza seasons and happen relatively infrequently.
There is currently rising concern that an avian or bird influenza virus, known as influenza A (H5N1) or simply as “H5N1”, which is circulating widely among birds primarily in Asia but now parts of Europe, may gain the ability to spread easily from person to person and lead to the first influenza pandemic in the 21stCentury. Many of the prerequisites for the start of an influenza pandemic appear to be in place but the virus still has not gained the ability to conduct efficient and sustained human-to-human transmission. The possibility that the H5N1 virus will gain this ability must be considered quite “real” but also is not certain.
If an Influenza pandemic appears, the following additional considerations will be important to understand and incorporate into additional local planning efforts:
- Given the high level of global travel, the pandemic virus may spread to much of the world within weeks to months, leaving little or no time to prepare.
- In all three 20th Century pandemics, substantially more young people died from pandemic influenza than normal when compared with regular influenza seasons. In the 1918 pandemic, the highest death rates and the largest numbers of deaths occurred in previously healthy young adults. These patterns suggest that the next pandemic could have a substantial impact on the workforce.
- Vaccines and antiviral agents for pandemic influenza, and antibiotics to treat secondary infections will be in short supply initially, while distribution of available supplies is likely to be equal. It will take several months or longer before any effective pandemic vaccines becomes widely available.
- Many if not most medical facilities will be overwhelmed by patients. Moreover, the health care workforce is likely to be reduced because health care workers also will become ill and will also stay home to care for ill family members.
- For weeks at a time, significant shortages of personnel may occur disrupting essential community services.
- For UN staff, the window period for relocation or evacuation is likely to be narrow. Borders may close quickly to prevent the spread of the virus, and available airplane seats may be taken up quickly.
- Once the virus has gained the ability to spread easily among people, then no country or region can be considered a low risk area for infection. In essence, there will be no “safe havens” from potential exposure to the virus.
Note: More background information on influenza is available on WHO web site at in particular, the fact sheet on Avian Flu and the Frequently Asked Questions Booklet.
- Pandemic Preparedness Plan
WHO’s revised global influenza preparedness plan of 2004 and related national plans are based on the concept of pandemic phases, which facilitates preparedness planning (see Table 1). Although activity levels are expected to vary from region to region at any point in time, a pandemic phase will be designated for the world. Each phase is associated with international and national actions. The UN Medical Services contingency plan adapts this framework to the UN organizations level.
Psychosocial support is an important issue and the psychosocial needs of UN staff should be addressed at all stages of the pandemic.
Table 1: - Pandemic Phases
Inter–Pandemic Phase / Less risk of human cases / Phase 1New virus in animals, no human cases / Higher risk of human cases / Phase 2
Pandemic Alert / No or very limited human-to-human transmission / Phase 3
Now virus causes human cases / Evidence of increased human-to-human transmission / Phase 4
Evidence of significant human transmission / Phase 5
Pandemic / Efficient sustained human-to-human transmission / Phase 6
CONTINGENCY PLAN FOR UNITED NATIONS FAMILY (JAMAICA)
This Contingency Plan for the United Nations Family for Jamaica is modeled after the four steps set out by WHO and FAO
Step 1: Establishment of Crisis Management team
In order to avoid duplication, it is recommended that the Crisis Management Team (CMT) should be a sub committee of the United Nations Emergency Technical Team (UNETT). The CMT should include a representative from FAO and PAHO. The roles and functions of UNETT[1] as it relates to emergency operation are already clearly defined and should form the basis for the functioning of the CMT. The CMT should make sure that arrangements are made to address the psychosocial needs of all staff. The CMT like UNETT would report to the UNDMT.
We are recommending that in addition to the normal functions of the CMT, a one day compulsory sensitization workshop should be held in every agency. It is further recommended that further training could be arranged based on needs. PAHO would provide leadership for this activity.[2] The CMT will post the schedule of the workshops so that if an individual finds it convenient to attend the workshop in another agency, then he or she should be free to do so. Heads of agencies are to ensure that their staff attends the workshop. A listing of all staff and their attendance is to be kept.
It is being recommended that the Jamaica Crisis management Team should consist of no more than five persons, of which three places should be reserved for FAO and PAHO.
The following is a suggested CMT
- PAHO (2) Dr. Ernest Pate, Representative; Ms. Ana Treasure, Environmental Health Advisor
- FAO (1) Dr. Dunstan Campbell, Representative
- UNDP (1) Dr. David Smith, Programme Specialist, Environment and Disaster Management
- UNICEF (1) Ms Nada Marasovic, Programme Coordinator.
Step 2: Identification of essential Functions and Associated Staff
Each agency identified the staff needed to maintain essential functions during the pandemic. The defined essential functions will vary among agencies to some extent due to differences in mission, but should include the following:
Physical security of staff;
Medical care of staff;
Maintenance of computers and telephone services;
Ability to communicate with other Organizations and Government;
Ability to make important operational and policy decisions related to the pandemic;
Ability to make important operational and policy decisions, to define the scope of the programme in the event of a pandemic and to ensure programme continuity.
The number of persons identified to perform the essential services should depend on the nature of the pandemic.The following is a list of persons identified as essential staff by agency.
Table 2 - List of Staff to perform essential functions during moderate phrase
UN Agencies / Mild / Moderate / SevereOn-site staff / Off-site staff
UNDP / All Staff / RR; DRR; Angela Atkinstall-Daley; David Smith. / To selected by CMT
UNFPA / All Staff / To selected by CMT
UNESCO / All Staff / 5 / To selected by CMT
UNICEF / All Staff / Sharon Foster
Christopher Pinnock
Melva Armstrong / Bertrand Bainvel
Nada Marasović
Monica Dias / To selected by CMT
ISA / All Staff / To selected by CMT
IOM / All Staff / To selected by CMT
UNEP / All Staff / 15 / To selected by CMT
PAHO / All Staff / To selected by CMT
CFNI / All Staff / Dr. Fitzroy Henry, Mr. Godfrey Xuereb, Dr. Ballayram, M. Tappin-Lee, J. Tai, J. Waugh, W. Williams, S. Locke / To selected by CMT
W/BANK / All Staff / To selected by CMT
ILO / All Staff / To selected by CMT
UNAIDS / All Staff / To selected by CMT
FAO / All Staff / Shawn Shepherd Martin
Genevieve Graham
Robert Salmon / Dunstan Campbell
Karen Pyne / To selected by CMT
GRAND TOTAL
The UNRC should communicate to Heads of Agencies (HOA) the nature of the pandemic. The CMT,on the advise of PAHO, has determined that there should be three (3) stages in the operation of essential staff during the pandemic. The stages within the pandemic phase would be determined based on the incidence of infestation.
- Stage 1- Mild: All staff will be required to report to work
- Stage 2 – Moderate: Essential staff from each agency
- Stage 3 – Severe: Selected essential staff from among the agencies
Given the operational mode of some agencies, essential functions can be performed both on site and off site. Agencies would determine whether the essential staff would be so divided - on site or off site. (Personal Protection Equipment (PPE) will be ordered for all essential staff – onsite and off site). The following is a list of the PPE to be procured.
Table 3 -
List of Personal Protective Kit (PPE) EquipmentItem / Description / Unit / Units per Individual
1 / Protective goggles, polycarbonate / Each / 3
2 / Face mask grade P2 (or N95) / BX/20 / 1
3 / Surgical face mask 3-ply green / Each / 15
4 / Surgical glove, size 6.5, anatomically shaped, latex, reusable, non-sterile / Pair / 7
Surgical glove, size 7.5, anatomically shaped, latex, reusable, non-sterile / Pair / 7
Surgical glove, size 9, anatomically shaped, latex, reusable, non-sterile / B/50PR / 7
5 / Surgical glove, size 6.5, anatomically shaped, latex disposable, sterile. As per ASTM 3577 FDA 510(K) / Pair / 3
Surgical glove, size 7.5, anatomically shaped, latex disposable, sterile. As per ASTM 3577 FDA 510(K) / Pair / 3
Surgical glove, size 8.5, anatomically shaped, latex disposable, sterile. As per ASTM 3577 FDA 510(K) / Pair / 3
6 / Apron, 125cm, white, 0.02mm thick PE, embossed, disposable / Each / 9
7 / Operation cap, size M (diam 50cm), blue, non-woven, PP, disposable, elasticized / Each / 9
8 / Shoe cover, abt 38cm length, embossed PE / Each / 18
9 / Surgical gowns, disposable, non sterile / Each / 9
10 / Alcohol rub disinfectant **Dangerous goods** UN code 1987, Class 3 / Bottle/1000ml / 1
11 / Disposable bag for bio hazardous waste, large, with "Bio Hazard" print, polypropylene / Each / 6
12 / Disposable bag for bio hazardous waste, small, with "Bio Hazard" print, polypropylene / Each / 6
Operational continuity of the Agencies mandate in Jamaica during stage 2 should be performed by the Agencies’ essential staff. However, should the UNRC declare stage 3 then a core group of staff (Cross Agency) to be determined by the UNDMT will have to be identified to perform the UN’s Jamaica mandate. The locale for operation will also be determined by the UNDMT
It is envisaged that normal functions will be disrupted during the pandemic; therefore, in preparation for stage 2 it is recommended that staff stock up on food supplies and other essentials so as to avoid having to leave your home. Once there is infection in your home then this is the safest place to be during the pandemic. Agencies should consider providing salary advances to staff to allow them to meet the additional emergency expenses.
Step 3: Acquiring Medical Supplies
In order to safeguard the health of the UN staff and their dependants for an imminent AI pandemic it is advisable that medical supplies be purchased and stock up. The following is a list of staff, their dependents and household support persons for the UN family in Jamaica. Medical supplies will be purchased using this list as a guide.
PAHO will prepare purchase orders based on the list of staff and dependants to be sent to each agency for their approval. Once approved, PAHO will proceed to purchase the supplies for the agencies. The agencies would be asked to deposit their portion of the bill into a bank account. Only when the deposit is made would orders be placed. PAHO (PRO) procurement office will transmit to each agency a copy of the purchase order, when placed.(see Excel Spreadsheet with Table 4 for details of costing)
1
Table 5 – List of Staff and Dependants for Medical Supplies.
UN Agencies / Int’lStaff / Int’lDependents / National
Staff / National
Dependents / Consultant / Consultant
dependents / Household helpers for all staff / Children
>12 yrs 40kg / >3 yrs < 12 yrs >15 < 40kg / 3 yrs <15 kg
UNDP / 82
UNFPA / 42 / 19 / 7 / 4
UNESCO / 23 / 13 / 5 / 2
UNICEF / 70 / 12 / 2
ISA / 65
IMO / 2
UNEP / 56 / 1 / 8 / 4
PAHO / 55 / 19 / 7 / 4
CFNI / 84 / 24 / 5 / 1
W/BANK / 12 / 2
ILO / 3
UNAIDS / 3 / 1 / 4
FAO / 42 / 2 / 8 / 2
GRAND TOTAL / 539 / 59 / 51 / 15
Table 6 - The procurement cost per agency will be calculated as per table below
Agency / Total Personnel[3] / % of total personnel / % of total estimated cost / Final cost USDUNDP / 82 / 12.35 / 3324.27 / 3324.27
UNFPA / 72 / 10.84 / 2917.82 / 2917.82
UNESCO / 43 / 6.47 / 1741.54 / 1741.54
UNICEF / 84 / 12.65 / 3405.02 / 3405.02
ISA / 65 / 9.79 / 2635.19 / 2635.19
IMO / 2 / 0.30 / 80.75 / 80.75
UNEP / 69 / 10.39 / 2796.69 / 2796.69
PAHO / 85 / 12.80 / 3445.39 / 3445.39
CFNI / 114 / 17.17 / 4621.67 / 4621.67
W/BANK / 12 / 1.81 / 487.20 / 487.20
ILO / 3 / 0.45 / 121.12 / 121.12
UNAIDS / 8 / 1.20 / 323.00 / 323.00
FAO / 42 / 6.32 / 1701.16 / 1701.16
TOTAL / 664 / 100 / 26,917.17 / 26,917.17
Step 4:
Identification of Local Health Care Facilities
The UN certified doctors[4] will be contracted and the following documents will be sent to them: -(1). National Influenza Pandemic Preparedness Plan. (2). Isolation Procedures.
(3). WHO rapid advice guidelines on pharmacological management of humans infected with H5N1 virus. (4). List of UN country offices staff members.
PAHO will provide training on the use of treatment protocols by August 2006.
SUMMARY OF CONTINGENCY PLAN FOR UNITED NATIONS FAMILY (JAMAICA)
Table 7 - UN Pandemic Preparedness Plan
Pandemic PhasePhase 3-5 / Responsible/Agency / Deadline
- Establishment of CMT
- Identify essential staff
- Establish agency staff and dependants list
- Procure medical supplies
- Mandatory training of all staff on health issue relating to AI
- Identify medical facilities
- Establish communication mechanism inter and intra
CMT
CMT
PAHO
PAHO
CMT
CMT/ Agencies / June 2006
June 2006
June 2006
September 2006
August 2006
June 2006
September 2006
- Work with Government emergency committee to establish gaps and identify resources
-FAO- Animal health issues
-UNICEF - Communication issues
-CMT to work with IDP to solicit
funds for identified needs. / PAHO; FAO; UNICEF
CMT/RC / September 2006
December 2006
- Simulation exercise for a moderate state of pandemic
- Activation of emergency procedures
- Medical care and facilities reconfirmation
- CMT to establish protocols for pandemic period – phase 6
Agencies
PAHO
CMT / January 2007
When informed by CMT
December 2006
When necessary
- CMT work with government agencies to test readiness plans.
- UN Support and strengthen public awareness programs
Agencies / Before test
Ongoing
Pandemic Period
- Activation of essential staff and protocols
- Psychological needs
- CMT to liaise with government preparedness team.
- Agencies to respond to specific needs within their mandate
CMT/Agencies
CMT
Agencies / During mild stage of pandemic period
Ongoing
Ongoing
Ongoing
THE UNITED NATIONS TECHNICAL EMERGENCY TEAM
(UNETE)
DEFINITION AND TERMS OF REFERENCE
Who are the members of the UNETE team?
- The UNETE team is made up of emergency specialists from each of the country’s United Nations Systems agencies.
- The Head of each Agency will designate a focal point to be integrated in the team.
- The UNETE team is the UN System’s TECNICAL and OPERATIONAL tool for emergency preparedness and for providing a coordinated response in the moment of a disaster. The team reports directly to the UNDMT.
It is recommended that the UNETE invites other partners, such as the IFRC, etc. and relevant governmental actors (Department of Civil Protection, Ministry of Foreign Affairs, etc), to all of the emergency preparedness and response activities.
It is recommended that the UNETE Team defines and agrees upon the division of tasks during the designing of the Plan. It is important to have previously assigned a responsibility to each member, which they will carry out during the distinct phases of an emergency situation.
It will be a vital endorsement for the UNETE Team to have the Plan and all of its activities validated, approved, and supported by the UNDMT.
The General Terms of Reference for the UNETE Team should include the following activities:
BEFORE THE EMERGENCY
In non-emergency situations, the UNETE members will carry out the following activities:
- Participate in the development and/or updating of the Inter-Agency Contingency Plan (information sheets, annexes, required material and human resources etc.)
- Establish and maintain contact with technical and allied counterparts (authorities, civil society, NGO’s, donors, local institutions, etc.). Obtain and collect useful information to be included in the Plan.
- Alert the UNDMT about potential dangers or threats that could cause emergency or disaster situations.
- Ensure the flow of information regarding emergency situations within the country in order to achieve timely and effective humanitarian response.
- Promote preparedness actions for emergency and disaster situations; advise in the prevention, mitigation, and reconstruction phases.
- Promote risk management within the design of projects and initiatives developed within the Agencies.
- Collect, analyse, and divulge studies and information about hazards, vulnerabilities, and risk from socio-natural disasters at the national and/ or regional level.
- Report on your Agency’s progress in risk management material to the UNETE or the UNDMT as required.
- Monitor man-made disasters, volcanoes, hurricanes, droughts, etc. and alert the UNDMT and the OCHA Regional Office in Panama of the situation.
IMMEDIATE ACTIONS TO BE TAKEN IN THE EVENT OF AN IMMINENT DANGER