Providing for the Public’s Health at Home During Pandemic Flu 

by Marty Fenstersheib, MD, MPH

Health Office, Santa Clara County Public Health Department, Santa Clara Valley Health & Hospital System

As public health professionals and leaders, so much of our job every day involves anticipating, planning and preparing for potential public health epidemics and emergencies.  Often, it seems as if we are asking ourselves and our colleagues hypothetical or theoretical questions; the proverbial “What if?”   

With a number of questions in mind - What if pandemic flu comes to our community? What if healthcare and others essential workers can’t come to work? What if we gave them information so that they could be better prepared at home, would that help? - the Santa Clara County Public Health Department developed a home care guide for pandemic flu preparedness.

  As you may know, pandemic influenza would happen when a new flu virus appears for which the general population has little or no immunity.  In these cases, the disease spreads very easily and quickly from person-to-person, causes serious illness and presents other significant social and economic disruptions to our lives and livelihoods.

Having enough healthy people to take care of our basic societal needs will likely be our most critical commodity. People will be needed to maintain and support key functions in our community like police and fire services.  Recognizing that a lack of human resources is likely in any large-scale emergency, in California and by state law, all public employees may be called upon to serve as Disaster Service Workers. But even with state law behind you, the numbers of public employees who say they’d actually show up in an emergency ranges between 40% and 60%. As part of an effort to increase these numbers, the Public Health Department undertook this innovative project to better prepare our community’s public employees.

The result is our new Home Care Guide: Providing Care at Home During Pandemic Flu, a simple, practical 62-page laminated manual – a mini-handbook, if you will.  It is a hands-on tool for public employees and others to use to be better prepared at home. By using the Home Care Guide, public employees can be ready and better able to fulfill their responsibility as Disaster Service Workers. Working together with personnel at everySanta Clara County agency and department, as well as with all the cities within our county, the Home Care Guide was distributed to over 34,000 public employees. The Home Care Guide provides detailed and valuable information, as well as procedures and protocols, to deal with influenza at home.  Importantly, the Home Care Guide includes lists of essential emergency supplies, guidelines on how to limit the spread of disease at home, and instructions on how to take care of sick family or household members safely and effectively.  The booklet includes key, easy-to-follow sections on: 

• Preparing Your Home – Identifying flu symptoms; caring for people with chronic diseases or conditions; isolating sick people at home; making your own sanitizing solutions.
• Providing Care at Home – Taking temperature; treating & reducing fever; giving fluids and liquids to address dehydration, providing recipes for oral rehydration solutions, calling for medical advice & when to call 911.
• Home Care Supplies – Including general emergency checklist; pandemic flu supplies checklist; essential food supplies checklist; and information on storing and purifying water.
• Fact Sheets – Finally, the booklet contains basic information about pandemic flu, avian flu and protocols and guidelines for isolation & quarantine, and social distancing.

In addition to making this handbook available to all public employees, the information is posted in PDF format on the department’s website at [1] www.sccphd.org.  Translated versions in two major culturally relevant languages in our community, Spanish and Vietnamese, will soon be available. 

The Home Care Guide is part of the Public Health Department’s efforts to protect the public’s health and lessen the impact on our community during a possible influenza pandemic. The Public Health Department has also led the way in overall medical and health preparedness for pandemic influenza.  Other accomplishments include: 

• Development and implementation of the Pandemic Influenza Preparedness and Response Plan – This plan is a coordinated inter-agency emergency response plan for our county to limit the number of deaths in our community, preserve continuity of essential functions such as hospital operations, minimize social disruption such as work and school closings, and minimize economic losses.

• Development of the Influenza Care Centers (ICCs) Plan – With limited hospital beds and staffing, alternate medical care sites need to be established to provide an intermediate level of care (such as IV hydration and oxygen therapy) for very sick people.  Public health officials in Santa Clara
  County, working with area hospitals, public agencies and private organizations, have identified what equipment and supplies need to be on-hand to be able to set up ICC sites throughout the county. 

• Medical Surge Capacity – Working with local hospitals and the state, a tool kit is being developed to help local hospitals effectively plan for medical surge capacity so that we will have the ability to evaluate and care for an increased volume of patients that challenges or exceeds the normal operating capacity of a hospital.

• Pandemic Response for Schools – County health officials have met with local school district and have provided a tool kit specifically for schools in dealing with pandemic flu.  The tool kit provides practical information on how to limit the spread of disease at a school campus, includes guidelines for “no work while sick” for employees, “no school while sick” for students, improved personal hygiene suggestions and policies for all.  Schools will be encouraged to develop education contingency plans for students in the event that they will be closed for extended periods of time to prevent the spread of illness (such as home school lesson plans for parents).

The Public Health Department also works with other agencies responsible for emergency response to help us better prepare for pandemic flu and other health emergencies.  Even with these efforts, it is critically important that individuals and families prepare as well. There are many things that residents can do to prepare: 

• Create a Family Communications Plan – To determine how family members will communicate with each other in the event of an emergency, designate a meeting location if separated by a disaster, pick an out-of-state friend or family member as the point of contact for information sharing, and provide each family member with an emergency contact phone list for their wallet, purse or backpack.

• Hold a Rehearsal – Meet with your family and “rehearse” what to expect and what you would do in the event of different types emergencies or disasters.

• Be Prepared in Your Office or Car – Keep a change of clothing, warm jacket, sturdy walking shoes, prescription medications, personal items and a two-day supply of food and water.

• No More Excuses! – Put together – for once and for all – a medical emergency supply kit at home with, at a minimum, N95 surgical masks, hand sanitizers, one box of disposable gloves, prescription and over-the-counter medicines, and a two-week supply of food and water for your family.
• Spread the Word! – Talk about preparing for the pandemic flu and review the Home Care Guide with your family, friends, neighbors, daycare centers, schools and community groups.

The efforts of our Public Health Department have been well received and recognized as a model that is being used by other Public Health Departments across the nation. It is our hope that these efforts, and especially the Home Care Guide is helpful and useful for our local community, emergency services providers and other healthcare professionals and practitioners in California, the U.S. and even throughout the world. 

*The Home Care Guide: Providing Care at Home During Pandemic Flu was developed as part of Santa Clara

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