Idaho, local emergency pandemic plans outline officials' response to virus outbreaks

Apr. 5--Emergency operation plans are the basis on which local, state and federal agencies react to catastrophes. Idaho is no different, as state and local plans outline how to respond to a variety of situations.

But according to a local expert, those plans can only be so specific, because they are meant to leave communities flexibility.

Michael Mikitish, department chairman for Idaho State University-Meridian's Institute of Emergency Management, said that when the coronavirus crisis hit Idaho, officials had an overall pandemic playbook to follow, but there are no step-by-step breakdowns on each possible outbreak.

Guidelines for disasters are purposefully broad and generic, he said, so that they can be altered on the fly.

"If you're looking for a gold standard response to this, there isn't one," Mikitish said. "This is a disaster we have not seen in our lifetime."

When looking at past pandemics, Mikitish said something that makes the coronavirus different is its ability to spread quickly and thoroughly, much more so than influenza strains -- something that's on display in Blaine County, home to Sun Valley and Ketchum.

Mikitish noted that the world today is a global society, and it's never been easier for a virus to spread from country to country. He emphasized the need for communities to help each other in any way possible: stock food banks, donate blood, limit contact with others. If you have an elderly neighbor, find out whether they need food or supplies, and go to the grocery store for them to reduce their risk of catching the virus.

"The only way we're going to get this under control is to pay attention to the experts," Mikitish said. "And if we don't, it will take us a lot longer to get this under control."

Mikitsh said he believes that state emergency officials are adequately prepared to handle the outbreak. But "from a public health standpoint, this is a very different disaster," he said.

State studies in Idaho

State officials regularly conduct studies into different emergency scenarios, a pandemic among them. The last time Idaho conducted this sort of study for a pandemic was 2017, which Mikitish called fairly recent in the realm of disaster preparedness. That study was included in the state's 2018 hazard mitigation plan.

The study concluded that the entire state was susceptible to a pandemic, with more urban areas having a higher likelihood of spread and more rural areas having less access to medical care.

"Overall, the entire state is exposed and potentially vulnerable to a pandemic event," the report concludes.

All but two Idaho counties are designated as health professional shortage areas, a federal designation that indicates a deficit in primary care services in medical, dental and mental health areas. A state map shows that only Ada and Blaine counties are appropriately staffed, and all other counties have shortages due to either geography or population grouping. Those two counties, it so happens, have by far seen the most confirmed cases of COVID-19, the disease caused by the coronavirus.

The state listed areas of society that would be most affected by a pandemic. Officials found that in the short term, the public would be most severely affected, followed by first responders. In the long term, the public's confidence in the government took the largest hit.

As for mitigation, the state lists its first option as eradicating the organism, which has three factors of importance. The first is to intervene and interrupt transmission of a virus. This could be done by either pharmaceutical means (treatment or a vaccine) or nonpharmaceutical interventions (public education of prevention strategies, like the now well-known practice of social distancing).

A vaccine isn't really an option for the coronavirus right now. Even the generous estimated time frame to develop one is a year to 18 months.

The state's second factor for eradication is to ensure that tools to diagnose a virus are available. The third important factor is to see whether humans are the only means of spreading the virus.

From there, the state indicates that tracking a disease is essential to the public's health. Included in the state plans are other state and federal guidelines for medical waste disposal, mass evacuations, and the possibility of creating alternative care sites -- places such as schools or stadiums that could be used as temporary hospitals.

Nearby counties

On a more local level, Ada and Canyon county emergency management plans designate local health districts to develop a response in case of a pandemic. In the written plans for Central District Health (which includes Ada) and Southwest District Health (which includes Canyon), the districts echo many of the same steps indicated in the state plans, such as mitigation strategies and health guidelines to citizens.

Both districts include a step-by-step guide of what to do during different stages of a pandemic, as defined by the World Health Organization.

For pandemic preparedness, the WHO has three stages: interpandemic period, pandemic alert period and pandemic period. The interpandemic period is when no pandemic is known or circulating among humans. In the alert phase, a pandemic is known and slowly begins to spread into a population. The last phase is simply when a virus is spread at a large scale, which is what we have now.

In the Central District Health and Southwest District Health plans, emergency health operations are inactive during the first phase. Both plans also say that medical stockpile should be housed and maintained during this phase as well.

However, CDH public information officer Christine Myron said that the district no longer uses a medical stockpile, and the health district began to move away from warehousing supplies shortly after the swine flu outbreak of 2009. Since then, CDH has opted to order supplies on-demand.

Myron added that the language mentioning a medical stockpile will be taken out, as the health district's plan is being revised and updated.

Ricky Bowman, public health preparedness and response program manager for SDH, said the district has a limited stockpile of supplies that is distributed based on need. When there is a need for more, the district requests supplies from the state, which then fills those orders, he said.

As a virus becomes known and begins to progress, both plans call for officials to be briefed on the situation. As a virus becomes a pandemic, health officials begin coordinating with local hospitals, clinics, and other state and nearby health districts.

"Early on with novel coronavirus, CDH began working with all of its community partners, including our health care community on coordination and planning for COVID," Myron said in an email. "There were regular coordination calls and meetings to discuss available and needed resources, processes, procedures, and planning for the response when we would begin seeing novel coronavirus cases."

Officials within the Southwest Health District began meeting and preparing a response to coronavirus in late 2019, according to Bowman, when the virus was spreading rapidly in China.

"We've been ramping up as this has progressed," Bowman said.

Health districts are also responsible for keeping track of known cases in their communities, as well as coordinating with media and the public on prevention practices and areas of potential concern.

The Central District plan indicates that its director has the ability to cancel public events. In that case, the department would draft an order and send it to the county attorney's office for distribution. The CDH plan also indicates that a director has the ability to quarantine an area and not allow people to leave, if necessary. That power is possessed by government leaders as well, such as the governor.

Both health districts note in their plans that travel restrictions "may be both impractical and unenforceable," as highway travel is essential for ensuring supplies are distributed.

Unlike the state plan, CDH and SHD plans do not include recommendations from past simulations and provide only step-by-step guides for health officials.

The pandemic plans for the Southwest and Central districts were last updated in July 2019 and earlier this year, respectively, officials said.

___

(c)2020 The Idaho Statesman (Boise, Idaho)

Visit The Idaho Statesman (Boise, Idaho) at www.idahostatesman.com

Distributed by Tribune Content Agency, LLC.