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Vol. LVIII, No. 20
October 6, 2006

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People Get Ready
NIH Team Races to Prepare for Pandemic Flu

On the front page...

NIH is developing a continuity of operations plan (COOP) for pandemic avian influenza (bird flu). The effort is being led by Dr. Pierre Noel, assisted by a team of 10 working groups. The goal is to maintain critical operations and protect patients, visitors and employees, as well as animals and ongoing work.

“We need a critical number of employees to maintain operations [in the event of an emergency],” Noel says. “A lot of people ask, ‘What if panflu does not occur?’ The answer is: We are working through a process that will apply to any emergency on campus. Even if panflu never occurs, we will still be much better off because of this effort.”

Chief of hematology in the Clinical Center’s department of laboratory medicine, Noel was appointed last winter as pandemic flu COOP coordinator (see NIH Record, Mar. 10, 2006). An Air Force Special Operations Command flight surgeon and an advisor on weapons of mass destruction, disaster planning and biodefense, Noel also recently accepted a detail as acting associate director for security and emergency response in the Office of Research Services.


“Regarding personnel and physical security, he covers the waterfront,” says Marie Lagana, CIT’s planning, evaluation and communications director. Lagana, currently on detail to Noel, served as his point person for a recent test of IT/telework readiness (see box on p. 9).

Panflu COOP Meeting, Oct. 19

On Thursday, Oct. 19, NIH will hold a Pandemic Flu Operational Continuity Conference open to all employees. The conference will be held in Masur Auditorium, Bldg. 10 from 9 a.m. to noon and will address the plans and strategies to sustain mission-critical functions in the event of a pandemic flu outbreak.

Issues to be discussed include: emergency communications, continuity of operations management, acquisition strategy, Clinical Center, facilities, information technology, emergency telework, emergency leave guidance, extramural research and intramural research animals.

Avian influenza is an infection caused by bird viruses. Influenza A (H5N1) virus is a subtype that occurs mainly in birds, is highly contagious among them and can be deadly to them. Of the few avian influenza viruses that have crossed the species barrier to infect humans, H5N1 has caused the largest number of detected cases of severe disease and death in humans. The cumulative number of confirmed human cases currently reported to the World Health Organization shows a mortality rate over 50 percent. Normal seasonal human flu viruses have a death rate of less than 1 percent. People infected with H5N1 usually have been exposed via direct contact with H5N1-infected poultry or H5N1-contaminated surfaces, not by a cough or sneeze. However all influenza viruses have the ability to change and researchers are concerned that H5N1 virus one day could be able to infect humans, morph into a new virus to which humans have no natural immunity and spread easily from one person to another.

If this novel virus then “learns” to spread from human to human via a cough or sneeze, an influenza pandemic (worldwide outbreak of disease) could begin. Multiple waves of illness could occur, with each wave lasting 6-8 weeks.

While HHS has an official plan, NIH (with 18,000 employees and more than 6,500 contractors) is developing an NIH-specific plan. That is why Noel stresses that in this team effort, credit should go to the people in the working groups “who are going out of their way to prepare.”

Here’s an update:

  • NIH Pandemic Flu COOP was submitted to HHS in March 2006.
  • NIH established panflu working groups to look at: Clinical Center/public health; human resources (leave guidance); acquisitions (logistics and contracts); IT and telework; intramural research animals (animal care); facilities; extramural (grants); communications and NIH COOP panflu management plans.
  • The working groups have reported on corporate NIH policies and services and have identified IC responsibilities for panflu preparations.
  • Noel has kept NIH management apprised of planning progress, briefing executive officers, scientific directors and steering committees that advise the NIH director.
  • IT infrastructure and service has been upgraded to better support emergency telework if required.
  • The IT/telework test on Aug. 25 of network, email, videocast, help desk and critical NIH systems affirmed overall IT capability to continue essential functions if there is a disruption to regular NIH worksites. Additional testing may be conducted as ICs work to refine their continuity of operations plans.
Other issues being addressed include:
  • Defining leave authorities. In the event of pandemic flu, schools, stores and other public venues may be closed and people may be asked to consider “social distancing.”
  • Establishing contingency plans for facilities.
  • Ensuring critical contracts are identified and alternative sources of goods are available to obtain such items as animal care supplies.
  • Ensuring the continuation of essential grant award and management activities.
  • Developing an NIH-specific web site to provide up-to-date information on the status of NIH during an emergency.
Calvin Jackson, chief of NIH’s News Media Branch, says, “We realized very early on in the planning process that we needed a web site to address the concerns of NIH employees, contractors and our neighboring community. We’re diligently working on the development of this site, which we are hoping will serve as a one-stop shop for pandemic flu information.” In the near future, a special link will be available on the employee information page located at

Meanwhile, assuming that 30-40 percent of employees may be absent from work during the peak of panflu, now is the time to resolve any local IT problems and communications gaps. Even if you didn’t participate in the recent IT/telework test, you can still update your laptop and exchange cell phone numbers.

This is a work in progress, not set in stone, Noel emphasizes. “There are multiple algorithms,” he observes, “that are constantly being looked at. If a plan doesn’t fit with reality, it gets reinvented.”

Vaccines vs. Antivirals in Bird Flu

What's the difference between a vaccine and an antiviral drug?

A vaccine inoculates a person with an antigen to stimulate the body to mount an immune response. Once immunized, the body "remembers" the virus and so can fight it more effectively. An antiviral drug is medicine given to ward off infection, or to treat those already infected. The antiviral needs to be started early enough-usually within the first 2 days of infection-to be effective.

Is there a vaccine for H5N1 influenza (bird flu)?

An effective vaccine is not yet available, but NIAID has begun clinical trials to evaluate vaccine candidates. Preliminary data indicate that in 113 healthy volunteers, the immune response knocked out the virus. Studies are ongoing.

NIH Tests Work-from-Home Scenario

What would happen if the Washington region were crippled by a 6-8 week pandemic flu outbreak, requiring NIH and most offices and public venues to shut down except for critical operations?

In the event of an outbreak, NIH may implement "social distancing" measures for most employees and contractors, who would telework from their homes in an attempt to limit spread of the virus. Designated personnel would be asked to report to campus to maintain critical functions.

With the advent of telework, VPN and parachute accounts and other forms of remote access, communications with employees and NIH computers should not come to a halt in this situation. Many important functions could be continued if a robust system for accessing the NIH IT infrastructure were in place.

On Aug. 25, this is exactly what the IT/telework working group of the NIH pandemic flu planning team wanted to test. Employees were encouraged to participate in a remote-access testing event, teleworking from home and other locations to simulate an emergency situation.

On average, NIH has 761 employees teleworking at least once a week, with 180 employees teleworking up to 3 times a week. For the event, a target population of 5,000 teleworkers was originally planned. Although the mark wasn't reached, approximately 1,500-1,800 employees did participate, providing a significant increase from the normal telework population. This simulation allowed staff to measure successes and deficiencies in the IT infrastructure and service built to support an emergency telework situation in the future.

The test included simultaneous remote use of networks, email, videocasting, Outlook meeting requests, help desk and other critical systems. It confirmed overall capability to continue essential functions. Although problems were identified, lessons were learned and the test was a success with 76 percent of personnel able to "perform regular duties" and 20 percent able to perform their duties "with some problems."

Future remote-access testing may be conducted to ensure a robust NIH response in the event of a flu outbreak or other disruptive event.

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