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Gwa’sala-‘Nakwaxda’xw Nations

EMERGENCY PLAN UPDATED SEPTEMBER 24, 2013 COMMUNITY VERSION

#724 Gwa’sala-‘Nakwaxda’xw Nations PO Box 998 Port Hardy, British Columbia V0N-2P0 Phone: (250)-949-8343 Fax: (250)-949-7402


Table of Contents SECTION 1 – WEBSITE RESOURCE LIST ................................ 2 UPDATED FEBRUARY 3RD, 2013 ............................................................................. 2

SECTION 2 – COMMUNITY CONTEXT ..................................... 4 UPDATED FEBRUARY 3RD, 2013 ............................................................................. 4 2.1

GENERAL LOCATION .................................................................................. 4

2.2

INFORMATION .......................................................................................... 4

2.3

DEMOGRAPHICS ........................................................................................ 6

2.4

GENERAL COMMUNITY INFORMATION ............................................................. 6

2.5

CONNECTIVITY PROFILE.............................................................................. 7

SECTION 3 - EMERGENCY PLAN OVERVIEW ........................ 10 UPDATED AUGUST 28, 2013 ............................................................................... 10 3.1

EMERGENCY OPERATIONS CENTRE LOCATIONS................................................ 10

3.2

AUTHORITY TO ACTIVATE THE EMERGENCY PLAN ............................................. 10

3.3

OPERATIONAL RESPONSIBILITY FOR IMPLEMENTATION OF THE EP......................... 11

3.4

DE-ACTIVATION OF THE EMERGENCY PLAN ..................................................... 11

3.5

LEVELS OF EOC ACTIVATION ..................................................................... 11

3.6

FEDERAL JURISDICTION ............................................................................ 12

3.7

PROVINCIAL AND LOCAL JURISDICTIONS ........................................................ 12

3.8

BRITISH COLUMBIA EMERGENCY RESPONSE SYSTEM RESPONSE GOALS.................. 13

SECTION 4 – EMERGENCY MANAGEMENT ORGANIZATION . 14 UPDATED AUGUST 28, 2013 ............................................................................... 14 4.1

CHIEF & COUNCIL ................................................................................... 14

4.2

BAND MANAGER ..................................................................................... 14

4.3

EMERGENCY PROGRAM COORDINATOR .......................................................... 14

4.4

EMERGENCY MANAGEMENT COMMITTEE ........................................................ 16


SECTION 5 – EMERGENCY RESPONSE & RECOVERY STRUCTURE ............................................................................................ 18 UPDATED AUGUST 28, 2013 ............................................................................... 18 5.1

BCERMS RESPONSE LEVELS ..................................................................... 18

5.2

SITE - INCIDENT COMMAND POST............................................................... 21

5.3

EOC ORGANIZATIONAL STRUCTURE ............................................................. 22

5.4

EOC STAFF ........................................................................................... 22

5.5

BASIC EOC ROLES & RESPONSIBILITIES ....................................................... 24

SECTION 6 – HRVA, EVACUATION & COMMUNITY MAPS .... 26 UPDATED AUGUST 28, 2013 ............................................................................... 26 6.1

HAZARD, RISK AND VULNERABILITY ASSESSMENT ............................................ 26

6.2

HISTORICAL HAZARD RESPONSE MATRIX ....................................................... 29

6.3

EVACUATIONS ........................................................................................ 30

MUSTER STATIONS ............................................................................................ 32 6.4

EVACUATION DOCUMENTATION ................................................................... 36

6.5

COMMUNITY MAPS ................................................................................. 40

SECTION 7 – EMERGENCY SOCIAL SERVICES (ESS) ............ 44 UPDATED FEBRUARY 3RD, 2013 ........................................................................... 44 7.1

EMERGENCY SOCIAL SERVICES (ESS) OVERVIEW ............................................ 44

7.2

EMERGENCY SOCIAL SERVICES (ESS) ASSISTANCE .......................................... 44

7.3

EMERGENCY SOCIAL SERVICES (ESS) RESPONSE LEVELS ................................... 45

7.4

EMERGENCY SOCIAL SERVICES (ESS) COMMUNITY CAPACITY ............................. 46

SECTION 8 - RECOVERY ROLES AND PROCEDURES ............ 48 8.1

PROCEDURE CHECKLISTS FOR RECOVERY STAGE .............................................. 48

8.2

EOC DIRECTOR RESPONSIBILITIES .............................................................. 48

8.3

OPERATIONS RESPONSIBILITIES .................................................................. 48

8.4

PLANNING RESPONSIBILITIES ..................................................................... 49

8.5

LOGISTICS RESPONSIBILITIES .................................................................... 49

8.6

FINANCE/ADMINISTRATION RESPONSIBILITIES ................................................ 50


APPENDIX A – ACRONYMS AND DEFINITIONS ................... 52 APPENDIX B – EMERGENCY PROGRAM BAND COUNCIL RESOLUTION (BCR) ............................................................. 56 APPENDIX C – PANDEMIC PLAN .......................................... 58


Section 1 – Website Resource List Updated February 3rd, 2013

BC River Forecast Centre www.bcrfc.env.gov.bc.ca First Nations’ Emergency Services www.fness.bc.ca Provincial Emergency Program www.pep.bc.ca Tsunami Preparedness www.pep.bc.ca/hazard_preparedness/tsunami_preparedness.html Latest BC Wildfire News www.bcforestfireinfo.gov.bc.ca Ocean Tides, Currents and Water Levels http://www.lau.chs-shc.gc.ca/cgi-bin/tideshc.cgi?queryType=showRegion&language=english&region=1


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Section 2 – Community Context Updated February 3rd, 2013

2.1 General Location Rupert District, on west shore of Hardy Bay, one mile north of Port Hardy, north coast of Vancouver Island.

2.2 Information No.

Name

Location COAST DISTRICT, RANGE 2, BEING LOT 725, ANN ISLAND 07017 ANN ISLAND 7 SMITH SOUND COAST DISTRICT, RANGE 2, ON NORTH SHORE OF 07000 DEDAGAUS 8 SEYMOUR INLET, 1/2 MILE NORTH OF THE NAHWOKTO RAPIDS COAST DISTRICT, RANGE 2, MOUTH OF SMOKEHOUSE 07015 HALOWIS 5 CREEK HEAD OF LONG LAKE COAST DISTRICT, RANGE 2, AT HEAD OF CHIEF NOLLIS 07007 KAI-TOO-KWIS 15 BAY, ALISON SOUND NORTH OF BELIZE INLET COAST DISTRICT RANGE 2, ON NORTH SHORE AT 06993 KEQUESTA 1 ENTRANCE TO NUGENT SOUND COAST DISTRICT RANGE 2, AN ISLAND IN CENTRE OF 06999 KHAZISELA 7 NAHKWOCKTO RAPIDS NORTH END OF SCHOONER CHANNEL COAST DISTRICT RANGE 2, ON EAST SHORE OF ALISON 07006 KO-KWI-ISS 14 SOUND NORTH OF BELIZE INLET COAST DISTRICT RANGE 2, LOT 735, AT THE HEAD OF 07010 KUTHLO 18 SALMON ARM SEYMOUR INLET COAST DISTRICT RANGE 2, ON NORTH SHORE OF 07001 KWETAHKIS 9 WHELAKIS LAGOON OF SEYMOUR INLET COAST DIST RGE 1, NORTH END OF DESERTERS ISLAND W 06996 MAHPAHKUM 4 END OF QUEEN CHARLOTTE STRAIT, INCLUDES 3 SMALL OF-SHORE ISLANDS COAST DISTRICT RANGE 2, 3 SMALL ISLANDS AT MOUTH 06994 NA-KWOCKTO 2 OF NUGENT SOUND 1/2 MILE SOUTH OF KEQUESTA I.R. NO. 1 COAST DIST RGE 2,. LTS726,27,28,29,730,31, BEING 07013 NATHLEGALIS 3 INDIAN ISLAND AND 5 SMALLER ISLANDS IN TAKUSH HARBOUR BROWNING CHNL COAST DISTRICT RANGE 2, AT MOUTH OF THE NEKITE 07012 NEKITE 2 RIVER HEAD OF SMITH INLET 07002 OWH-WIS-TOO-A- COAST DISTRICT RANGE 2, AT ECLIPSE NARROWS,

Hectares 10.10 0.30 3.60 20.80 70.40 0.40 6.40 3 4 7.80

0.40

134.40 66.80 5.30

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WAN 10

ENTRANCE TO FREDERICK SOUND, SEYMOUR INLET COAST DISTRICT, RANGE 1, ON NORTH SHORE OF 06995 PAHAS 3 BLUNDEN HARBOUR NORTH SIDE OF QUEEN CHARLOTTE 39.90 STRAIT PEL-LOOTH'L KAI COAST DISTRICT, RANGE 2, AT EAST END OF THE BELIZE 07009 1.70 17 INLET COAST DISTRICT, RANGE 2, AT HEAD OF WIGWAM BAY 07003 PENEECE 11 3.50 NORTH SHORE OF SEYMOUR INLET COAST DIST. RGE 2, ON THE EAST SHORE OF SCHOONER SAAGOOMBAHLAH 06998 PASSAGE EAST OF BRAHAM ISLAND, INCLUDES 1 ISLAND 1.80 6 OFF-SHORE COAST DISTRICT, RANGE 2, ONE OF THE ISLANDS OF THE 06997 TA-A-ACK 5 13.90 SORM GROUP WEST AND OF QUEEN CHARLOTTE STRAIT COAST DISTRICT, RANGE 2, LOT 733, AT JUNCTION OF 07014 TOKSEE 4 5.60 LONG LAKE AND WYCLEES LAGOON COAST DISTRICT, RANGE 2, AT VILLAGE BAY, EAST SHORE 07005 TSAI-KWI-EE 13 4.60 OF MEREWORTH SOUND TSEETSUMCOAST DISTRICT, RANGE 2, LOT 732, ON NORTH SHORE OF 07016 2.10 SAWLASILAH 6 NAYSASH INLET, SMITH SOUND RUPERT DISTRICT, ON WEST SHORE OF HARDY BAY, ONE 06987 TSULQUATE 4 MILE NORTH OF PORT HARDY, NORTH COAST OF 59.90 VANCOUVER ISLAND COAST DISTRICT, RANGE 2, AT HEAD OF ALISON SOUND, 07008 WAUMP 16 37.60 BELIZE INLET COAST DISTRICT, RANGE 2, ON RIGHT BANK OF THE 07004 WAWWAT'L 12 SEYMOUR RIVER, ABOUT 2 MILES FROM HEAD OF 66.80 SEYMOUR INLET COAST DISTRICT, RGE 2, ON SOUTH SHORE OF SMITH 07011 WYCLESE 1 SOUND AT ENTRANCE TO WYCLEES LAGOON, INCLS 5 OFF- 223 SHORE ISLANDS

**Note: Reserve Highlighted in Red is the only Inhabited Land of the Nations.**

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2.3 Demographics Note: Average Population in Community – 500 people – Christmas can climb to 600 people

2.4 General Community Information Registered Population as of August, 2013 Registered Males On Own Reserve

278

Registered Females On Own Reserve

247

Registered Males On Other Reserves

10

Registered Females On Other Reserves

9

Registered Males On Own Crown Land

0

Registered Females On Own Crown Land

0

Registered Males On Other Band Crown Land

0

Registered Females On Other Band Crown Land

0

Registered Males On No Band Crown Land

0

Registered Females On No Band Crown Land

0

Registered Males Off Reserve

178

Registered Females Off Reserve

208

Total Registered

Health Authority ESS Capacity Fire Department

VIHA Yes Yes – Port Hardy

Agreement with neighboring community Yes  ESS  Fire (MTSA)

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2.5 Connectivity Profile Community Information Band Name

Gwa'Sala-Nakwaxda'xw

Group Affliliation

Band Number

724

Band Population

692

Tribal Council (TC) Affliliation

Kwakiutl District Council

TC Number

2135

Most Populous Reserve

TSULQUATE NO. 4

Reserve Number

6987

Latitude Coordinate

50º 43’ 59”

Longitude Coordinate

Location

RUPERT DISTRICT, ON WEST SHORE OF HARDY BAY, ONE MILE NORTH OF PORT HARDY, NORTH COAST OF VANCOUVER ISLAND

Census Sub-Division (CSD) Name

-127º 29’ 53”

Tsulquate 4

Province/Territory British Columbia

(CSD) Number

5943806

Most Populous Reserve INFRASTRUCTURE Band Administration Office

On-Site

Recreation Centre

OFF Site

Health Centre

On-Site

Heat/Hydro/Water Utility

OFF Site

School

OFF Site

Garbage/Sewage Facility

On-Site

Police Detachment

On-Site

Fire Hall

OFF Site

Number of Housing Units

104

INSTITUTION SPECIFIC CONNECTIVITY Band Administration Office Internet Connectivity Type

High-Speed

Is that Internet Access available to Community Members ? No Health Centre Location

Gwa'Sala-'Nakwazda'xw

Connectivity Status

High-Speed

Number of SchoolNet Sites

1

Facility Type

Health Station

SchoolNet Internet Connectivity Type N/A Police Detachment Location

Port Hardy - Qua^ Sala^ Nakwxxda^ Xw

Police Detachment Internet Access Availability

High-Speed

Community Access Point available at

none available

Nearest Friendship Centre (FC) Address

Wachiay Friendship Centre Society (non-core funded)

P.O. Box 3204, 237 - 3rd St.

Province/Territory British Columbia FC Internet Connectivity Type

City Does the FC have a CAP Site?

Courtenay Yes

DSL, Cable

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GENERAL INTERNET CONNECTIVITY Residential Internet Access Availability

High-Speed

Percentage of Households that Subscribe to the Internet

1-25

Percentage of Households that Subscribe to Satellite TV

26-50

Expected Internet Availability by the end of 2007

High-Speed

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Section 3 - Emergency Plan Overview Updated August 28, 2013

3.1 Emergency Operations Centre Locations The Primary EOC is located at: GNN School 182 Tsulquate Phone :

250-949-7743

The Alternate EOC is located at: Wakas Hall 180 Tsulquate Phone:

250-949-8403

The Off Site/Joint EOC Port Hardy District Office

3.2 Authority to Activate the Emergency Plan The following individuals have the authority to activate the Emergency Plan: 

Community Emergency Program Coordinator Bob Swain or Deputy Jessie Hemphill

Band Manager Les Taylor

Chief Paddy Walkus

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3.3 Operational responsibility for implementation of the EP The EOC is responsible for the implementation of the Emergency Plan and for the coordination and direction of overall operations in respect of preparation for, response to, and recovery from the emergency or disaster. The EOC Director is responsible for the control of all operations within the EOC identified in this Emergency Plan.

3.4 De-activation of the Emergency Plan The EOC Director will terminate the EOC activity for the current event and implement the de-activation plan.

3.5 Levels of EOC Activation There are three levels of EOC activation, described below. Level 1 EOC Activation Level 1 action reflects events that are normally managed by community resources on a regular basis. However, there is potential for the event to escalate and requires monitoring only. There is little or no need for site support activities and the event will be closed in a relatively short time. This level may require the activation of an ICP. Level 2 EOC Activation Level 2 events are emergencies that are of a larger scale or longer duration and may involve limited evacuations, additional or unique resources or similar extraordinary support activities. If the event cannot be managed appropriately from the site, this level requires the activation of an EOC, and notification to Emergency Management B.C.(EMBC). Level 3 EOC Activation Level 3 events are of large magnitude and/or long duration or may have multiple sites that involve multi-agencies and multi-government response.

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3.6 Federal Jurisdiction Gwa’sala-‘Nakwaxda’xw Nations has not ratified a treaty or self government agreement with the Federal and Provincial governments. The community is located on Federal Reserve lands and is currently governed by Federal Acts, specifically the Indian Act. The Federal and Provincial governments have entered into a Memorandum of Understanding (MOU) for Emergency Management B.C. (EMBC) (Formally PEP) to provide emergency management services. In an effort to facilitate the same level of services for First Nations communities EMBC, Aboriginal and Northern Development Canada (AANDC (INAC)) and First Nations Emergency Services (FNESS) utilize the British Columbia Emergency Response Management System (BCERMS) model to standardize delivery of emergency management and response efforts.

3.7 Provincial and Local Jurisdictions The Emergency Program Act requires that all Provincial ministries and agencies utilize the British Columbia Emergency Response Management System (BCERMS). First Nations, who have not ratified treaties or self government agreements with the Federal and Provincial government are governed by federal statute, are not legally required to follow the BCERMS model but are strongly encouraged to incorporate this model into their emergency plans. The majority of municipalities and First Nations utilize BCERMS to ensure consistent emergency management principles and coordinated response efforts. The Gwa’sala-‘Nakwaxda’xw Nations has agreed to follow the principles of BCERMS.

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3.8 British Columbia Emergency Response System Response Goals When responding to an emergency or disaster, the following goals will be used to determine the appropriate course(s) of action (in priority order):

1) Provide for the safety and health of all responders 2) Save lives 3) Reduce suffering 4) Protect public health 5) Protection government infrastructure 6) Protect property 7) Protect the environment 8) Reduce economic and social losses

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Section 4 – Emergency Management Organization Updated August 28, 2013

The Gwa’sala-‘Nakwaxda’xw Nations Emergency Management Program Organization consists of four main administrative components which are discussed below.

4.1 Chief & Council Chief and Council ultimately carry responsibility for preparation, mitigation, response and recovery efforts. These responsibilities, as outlined in Band Council Resolution are delegated to staff and the Emergency Management Committee for action

4.2 Band Manager The Band Manager may be responsible for overseeing the activities of the Emergency Program Coordinator (EPC) and for reporting directly to Chief and Council. The Band Manager may also serve as the EOC Director during EOC activations and serves as a member on the Emergency Management Committee.

4.3 Emergency Program Coordinator The Emergency Program Coordinator is responsible for overseeing and coordinating the Emergency Management Program and for the development, review and revision of this Emergency Preparedness Plan. The Emergency Program Coordinator serves as the liaison between Chief and Council, Band Manager and the Emergency Management Committee. It is the responsibility of the Emergency Program Coordinator to ensure that adequate attention is given to all aspects of the Emergency Management Program.

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The duties of the Emergency Program Coordinator include, but are not limited to, the following: 

Prepare an annual budget, based on input from the Emergency Management Committee;

Manage contracts on behalf of the Emergency Management Program, such as specialists to provide training, exercises or planning;

Coordinate annual assessment of local risks, evaluation of mitigation projects, preparing evacuation plans, and other responsibilities (see below);

Coordinate implementation of strategies selected by the Emergency Management Committee, ex., hold public awareness sessions, organize training, and establishing EOC facilities:

Provide a single point of contact for the overall Emergency Management Program. This position is also responsible for giving presentations on the program to community members and other groups who may request such a presentation:

Update Emergency Plan and associated documents:

Coordinate the purchase and tracking of all equipment, materials and supplies on behalf of the program;

Coordinate training programs and exercises;

Liaise with regional and provincial government authorities, businesses, and industry in the area on concerns of mutual interest;

Produce appropriate agenda, arrange and chair meetings of the Emergency Management Committee;

Implement, monitor and evaluate a training and exercise program;

Initiate, maintain and support volunteer programs;

Report on the effectiveness of the emergency management program to Chief and Council; and,

Research, apply for and acquire alternative funding (JEPP, public/private partnerships, etc.);

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4.4 Emergency Management Committee The Gwa’sala-‘Nakwaxda’xw Nations Emergency Management Program will be supported by an Emergency Management Committee. The Emergency Management Committee is responsible for the following: 

Implementing strategies as outlined in the goals and objectives of the program;

Reviewing policies and procedures contained within the Emergency Plan;

Identifying and participating in training and exercises;

Providing input to implementation strategy development and evaluation;

Conducting an annual Hazard, Risk and Vulnerability Analysis;

Identifying and participating in the planning and evaluation of local mitigation projects such as flood protection works, wildfire fuel reduction, and local development controls;

Developing response policies and procedures, communication plans, EOC facility plans, etc.

Evaluating the progress of the program on an annual basis and consider recommendations for improvement;

Assisting with the development of budgets; and,

Meeting on a regular basis.

such

as

evacuations,

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The Emergency Management Committee is comprised of the following individuals:

Name Les Taylor Bob Swain Jessie Hemphill Jessie Hemphill Don Felkley Nicole McLelland Dean Wilson Conrad Browne Reed Allen Lucy Hemphill Margaret Bernard Cathy Swain Chrissy Johnny Grace Smith Joye Walkus Karla Broadfoot Silena Child Lucy Scow Colleen Hemphill Gloria Le Gal Bob Hawkins Norma Hemphill Daniel Earl Brent Borg Fletcher Chisholm Rob Mozoroff

Position Director EPC/Deputy Director Deputy EPC Operations Operations Planning Planning Logistics Logistics/Band School Finance Finance ESS ESS ESS ESS ESS ESS ESS ESS RDMW EPC PH EPC PH ESSD BCAS PH Fire Captain RCMP RCMP

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Section 5 – Emergency Response & Recovery Structure Updated August 28, 2013

This section covers the three emergency response structures within British Columbia; Incident Command (Emergency Site), Emergency Operations Centre (EOC) and Emergency Management B.C.(EMBC) – formally PEP.

5.1 BCERMS Response Levels There are four (4) levels of response within the BCERMS model, discussed below. Site Response Level At the site level resources are applied to solve the problems presented by an emergency incident using the Incident Command System (ICS). Response on-site is directed by a single command, or unified command, from a single Incident Command Post (ICP). Ninety to ninety-five percent (90-95%) of incidents, such as a routine traffic accident or a house fire, will fall into this category and will involve only a site level response. Site Support - Emergency Operations Centre (EOC) In larger incidents responders at the site may require additional coordination, support and policy direction. In circumstances where existing site response cannot adequately respond to the emergency an Emergency Operations Center (EOC) may be activated. The EOC provides policy direction to the site (through the Incident Commander), coordinates resource requests from the site and manages all off-site activities. Provincial Regional Emergency Operations Centre (PREOC) The Provincial Regional Emergency Operation Center (PREOC) level coordinates, facilitates and manages information, policy direction and provincial resources to support local authorities and provincial agencies responding to an emergency. This level does not communicate directly with the Incident Commander at the site but provides a basis for provincial regional and interagency coordination and communicates with the site support level (EOC).

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Effort will be made to coordinate with Emergency Management B.C. (EMBC) Provincial Regional Emergency Operations Center (PREOC) to ensure coordinated response efforts:

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Provincial Emergency Coordination Centre (PECC) The Provincial Emergency Coordination Center (PECC) coordinates provincial resources and prioritizes and establishes provincial government objectives in response to requirements at the other levels. This level also serves as the coordination and communications link with the federal disaster support system. The Provincial Central Coordination level is activated when the key ministry (ies) or the Director of the Provincial Emergency Program considers it necessary to coordinate and direct overall provincial response to an emergency or disaster. The PECC provides inter-region policy direction and coordination for emergencies in the province. The EOC will utilize the PECC 24/7 emergency center for reporting/coordinating emergency response efforts.

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5.2

Site - Incident Command Post Incident Command Structure Role in ICP

Function Incident Commander

Responsible for overall emergency policy and coordination through the joint efforts of government agencies and private organizations.

Operations

“The Doers” Responsible for coordinating all jurisdictional operations in support of the emergency response through implementation of the jurisdiction’s action Plan.

Planning

“The Thinkers” Responsible for collecting, evaluating, and disseminating information; developing the jurisdiction’s action Plan in coordination with other functions; maintaining documentation.

Logistics

“The Getters” Responsible for providing facilities services, personnel, equipment and materials.

Finance/ Administration

“The Payers” Responsible for financial activities and other administrative aspects.

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5.3 EOC Organizational Structure The following diagram displays the organizational structure of the EOC. The Policy Group is comprised of Chief & Council and senior EOC staff. The Policy Group works closely with the EOC staff to develop policy as required. Chief and Council

First Nations Emergency Services(if requested)

EOC Director

Risk Management Liaison Information Public Information Media Relations Internal Information

Operations Section Functional Branches Health Services

Planning Section Situation Resources

Land Management

Documentation

Emergency Social Services Economic Development Public Works

Advance Planning Demobilization Recovery

Logistics Section Information Technology

Finance/Admin Section Time

Communications Computer Systems

OC Support Facilities Security Clerical

Procurement Compensation and Claims Cost Accounting

Supply Personnel Transportaion

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5.4 EOC Staff

Position

Name

Command/ Management Primary Contact

Les Taylor

Backup Contact

Bob Swain

Backup Contact

Jessie Hemphill

Backup Contact

Paddy Walkus

Operations Primary Contact

Jessie Hemphill

Backup Contact

Don Felkley

Planning Primary Contact

Nicole McLelland

Backup Contact

Dean Wilson

Logistics Primary Contact

Conrad Browne

Backup Contact

Reed Allen

Finance / Administration Primary Contact

Lucy Hemphill

Backup Contact

Margaret Bernard

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5.5

Basic EOC Roles & Responsibilities

Management (EOC Director) 

Notify EMBC when EOC is activated via 1-800-663-3456, EMBC will automatically notify AANDC (INAC). Determine if you have the capacity or human resources required to manage the incident, if not request and a FNESS Emergency Response Team. Identify and request additional resources via EMBC as soon as possible, if critical members of your emergency team are unavailable request a FNESS Emergency Response Team to support your emergency operations. Conduct an assessment of what has happened, what resources are available, any impacts to the communication system, power, water and other critical infrastructure.

Operations 

Support EOC Director in defining working area, establishing control perimeter and assist police securing the scene if requested.

Planning 

Assess Impacts.

Create priority based plans ensuring BCERMS Response Goals are addressed.

Prepare to support long-term recovery

Logistics 

Communications

Transportation

Food for EOC

Prepare to support long-term recovery

Finance / Administration 

Track and keep accurate records of expenditures

Submit records to EMBC for reimbursement

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Section 6 – HRVA, Evacuation & Community Maps Updated August 28, 2013

6.1 Hazard, Risk and Vulnerability Assessment Hazard/Risk/Vulnerability Assessment (HRVA) NATURALLY OCCURRING HAZARDS Geological Hazards PROBABILITY

1 2 3 4 5 6

Likely X X

Very unlikely

Unlikely

Earthquake Tsunami Volcano Landslide, Mudslide, subsidence (sinking) X Glacier, Iceberg Erosion, Accretion, Desertification (desert) X Meteorological Hazards

X X

PROBABILITY Likely 7 Flood, Flash flood, seiche (surface movement on enclosed water), tidal surge 8 Drought 9 Fire (eg: forest, range, urban, wild land and urban interface) 10 Snow, ice, hail, sleet, avalanche, blizzard Windstorm, tropical cyclone, hurricane, tornado, water spout, dust/sand storm Heat wave, cold spell Lightning strikes Famine Geomagnetic Storms (disturbance in Earth’s magnetic field (charged particles from solar flares & sun spot activity–drk spots on sun) 16 Fog 11 12 13 14 15

Very unlikely

Unlikely

X X X X X X X X X X

Biological Hazards

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PROBABILITY Very Likely Unlikely unlikely 17 Disease that impacts humans or animals (eg: plague, smallpox, anthrax, West Nile virus, foot and mouth disease, severe acute respiratory syndrome (SARS), influenza pandemic, bovine and mouth disease, bovine spongiform encephalopathy (BSE)) 18 Animal or insect infestation or damage

X X

HUMAN-CAUSED EVENTS Unintentional Events PROBABILITY Likely Unlikely Very unlikely 19 Hazardous material spill or release (eg: explosive, flammable liquid, flammable gas, flammable solid, oxidizer, poison, radiological, corrosive) 20 Explosion/Fire 21 Transportation accident (marine, MVA, plane crash, train derailment) 22 Building/Structure collapse 23 Energy/power/utility failure 24 Fuel/resource shortage 25 Air/Water pollution, contamination 26 Water control structure/dam/levee failure 27 Financial issues, economic depression, inflation, financial collapse 28 Communications system interruptions 29 Misinformation

X X X X X X X X X X X

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Intentional Events PROBABILITY Likely Unlikely Very unlikely 30 Terrorism (eg: explosive, chemical, biological, radiological, nuclear, cyber) 31 Sabotage (deliberate destruction of property/ equipment or action to hinder achievements) 32 Civil disturbance, public unrest, mass hysteria, riot 33 Enemy attach, war 34 Insurrection (rebellion against government) 35 Strike or labour dispute 36 Disinformation 37 Criminal activity (eg: vandalism, arson, theft, fraud, embezzlement data theft) 38 Electromagnetic Pulse (caused by high energy explosions usually nuclear or suddenly fluctuating magnetic fields) 39 Physical or information security breach 40 Workplace Violence

X X X X X X X X X X X

TECHNOLOGY-CAUSED EVENTS PROBABILITY Likely 41 Computers, hardware, software, or application a (internal/external) malfunction or breakdown 42 Ancillary support equipment 43 Telecommunications 44 Energy/power/utility failure

Unlikely

Very unlikely

X X X X

HIGHEST PROBABILITY (Top 8)

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6.2 Historical Hazard Response Matrix The following hazard matrix is to be completed once a Hazard Assessment has been completed to identify the hazards most likely to occur. Potential Hazard

Historical Evidence

Affected Areas

Structural Fire

Spring 2012 Mar. 21, 2013

120 Tsulquate 317 Tsulquate

Severe Weather

SEPT. 25, 2010

Tsulquate

Extended Power Outages

Tsunami

Annually

All Reserves

1964

Ann Island, Ta-a-ack, Nathlegalis, Ah-wat-se

Initial Steps/Priorities Evacuation(s) (which areas) Contacted Port Hardy Fire Dept. Contacted Port Hardy ESS, tenant in hotel District of Port Hardy declared a state emergency. BC Hydro called to restore power. Use portable generators Re-locate to Other family members Neighbours Community Shelter Hotel / Motel

Went to higher ground.

Not required

Shelter in place

Shelter in place

Shelter in place

Emergency Contact PH Fire 250-949-6564 PH ESS 250-949-0247

District of Port Hardy 250-949-7779

BC Hydro 1 (888) 769-3766

Unknown

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6.3 Evacuations Evacuation An evacuation is the action by which one or more persons leave the place they are occupying to avoid a real or potential threat. The process to enact an evacuation (partial, total, and selective) of any First Nation community is performed by a Band Council Resolution. The Band Council will normally be working with the federal and provincial governments and advised of the specific threat or situation. The decision for a planned evacuation is made in stages, when time permits, with notice given initially as an evacuation alert and if required by an evacuation order. When the event is over and it is safe to return home, there will be an evacuation rescind. Volunteer Evacuation Procedures Volunteer evacuation occurs when a community member(s) make a choice to evacuate before the Band Governance, AANDC (INAC) or EMBC issues an evacuation order. Volunteer evacuations are not normally eligible for Emergency Social Service (ESS) resources such as food, clothing and lodging. If an order is issued, volunteer evacuees are only eligible within the time frame that the order was issued, not from the original time the volunteer evacuation occurred and must report to designated ESS facilities and register appropriately - either one established on band property, or to a “host community� out of order or alert area. If the person(s) wish to evacuate because they require specialized medical or other forms of special care, ESS support may be available before an evacuation order is issued. The EOC must contact EMBC and request ESS support for at risk community members before ESS support is provided. EMCB will automatically convey the request to AANDC (INAC). If a FNESS Emergency Response officer or other agency has responded to your incident, identify at-risk community members who may require pre-evacuation due to medical or specialized care requirements.

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Evacuation Stages 1.

Evacuation Alert

A consistent format and process will be used to alert the population at risk of potential need for evacuation. The alert highlights the nature of the danger and that people should be prepared to evacuate the area on short notice. The evacuation alert may allow for the population at risk to begin an orderly preparation to voluntarily leave the affected area, within a specified time frame. However, the reality of the situation may require immediate action with very short notice. When it has been decided that an evacuation may be pending, it is very important to ensure all of those who may be evacuated receive this information as soon as possible. As the stress associated with evacuating one home would be high, providing as much warning as possible and giving a list of suggested items to take with them will assist in alleviating stress. 2.

Evacuation Order

If the Gwa’sala-‘Nakwaxda’xw Nations population is at risk, and is ordered to evacuate, the affected area(s) will be identified by means of a Band Council Resolution. The RCMP is the formal agency that enforces evacuation orders on Federal Reserve lands. Normally community members will comply, however any information should clearly indicate that emergency response personnel will not return for residence that refuse to comply with an evacuation order. A statement should be included in all bulletins, pamphlets, warning and orders that makes it very clear to all Gwa’sala-‘Nakwaxda’xw Nations Band members, that, while the evacuation order is in effect, the area in question may have controlled access and that a pass may be required to regain access to the area. 3.

Evacuation Rescind

When the emergency which necessitated the evacuation is under control and the emergency area is declared safe, a rescind of the Evacuation Order should be implemented.

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General Community Location Rupert District, on west shore of Hardy Bay, one mile north of Port Hardy, north coast of Vancouver Island.

Access & Egress Routes One bridge connecting community with the town of Port Hardy.. If there is only one may in and out, find and organize an alternate route.

Muster Stations Internal: People in the tsunami zones would go to the Reception Centre (Wakas Hall). External: People would go to the Port Hardy Reception Center (Civic Center) through a mutual aid agreement.

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Tsunami Information Notification System Tsunami Warning Message:

(This is the highest and most serious level of tsunami notification.)

Warnings are issued when there is imminent threat of a tsunami or confirmation of a tsunami wave. When communities are issued a warning, local emergency plans should be activated and public safety actions taken. Such actions are likely to include the immediate evacuation of at-risk coastal areas and restricting access to emergency response routes and coastal beaches. Warnings are updated as conditions change. Tsunami Advisory: (The second highest level of tsunami alert.) Advisories are issued due to the threat of a tsunami that has the potential to produce strong currents dangerous to those in or near the water. Significant inundation is not expected for areas under Advisory but coastal regions prone to damage due to strong currents may be at risk. Appropriate actions by emergency management personnel may include closing beaches and evacuating harbours and marinas. Additionally, local officials may opt to move boats out of harbours to deep waters, if there is time to safely do so. Tsunami Watch Message: This is notification based on early seismic information that provides advanced alerting to areas that could be impacted if a tsunami has been generated. When communities are issued a Watch, local emergency plans should be activated, and local authorities should prepare for possible evacuation in the event that their area is upgraded to a Warning. Tsunami Information Message: This is awareness notification. Tsunami information messages may be issued based only on preliminary seismic information without confirmation of a tsunami wave. These types of messages are issued as a means of providing advance alert to areas that could be impacted by a tsunami. Tsunami Cancellation Message: This cancellation message is issued when a Warning or Watch message has been issued but where damaging waves have NOT been generated.

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Tsunami All Clear Message: This is issued when a tsunami has been generated and the threat of further tsunami is over. This message is to advise stakeholders that the tsunami event is over and no further waves are expected. Tsunami Zone The community is located in Tsunami Zone “B� Tsunami High Ground Reception Center (Wakas Hall) is on high ground with currently no supplies.

.

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6.4 Evacuation Documentation

Evacuation Procedures Instructions In the event RCMP or other Agencies cannot get to _______________________ quickly, follow the steps below: For 34 homes on Tsulquate reserve  Go door to door quickly.  Advise occupants of evacuation order and give them a copy of the evacuation order along with the instructions. A Personal Information Form will need to be filled out.  Remind occupants of their designated reception center. Wakas Hall 180 Tsulquate  If the occupants are not home leave the evacuation order along with the instructions in a visible location.  If the occupants refuse to evacuate do not force them. Leave the evacuation order along with the instructions with them.  If the occupants refuse to leave determine if there are children in the dwelling (under 19yrs). If so, advise the EOC of this as police will visit the dwelling to speak to the occupants.  Evacuees can bring their family pets; however, they cannot bring them into the reception center, only Seeing Eye dogs & special service dogs permitted. With their pets they must also bring a leash or kennel to secure or house their pets. Animals will be kept in a secure location outside of the reception center. Owners must also bring food for their pets.  Remind evacuees of evacuation route: ENTER ROUTE HERE Please ensure that you complete your entire checklist form and do not leave any blank fields (u/k for “unknown” and n/a for “not applicable).

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Task # Evacuation Route is as follows:

Incident # IR# 724

ALL residents who have evacuated must register at the Emergency Social Service Reception Center at 180 Tsulquate Other routes available will be utilized only under extreme circumstances.

** THE ORDER TO EVACUATE WILL BE INITIATED BY POLICE SIRENS** 1. In the event that the Gwa.sala-‘Nakwaxda’xw Nations Community is issued an Evacuation Order the RCMP will be notified by the District of Port Hardy EOC Operations Section and the RCMP will deliver the Evacuation Order in an efficient manner to the residences of the Gwa’sala-‘Nakwaxda’xw Nations Community. 2. RCMP will set up checkpoints to inhibit travel into the evacuated area located at: ENTER LOCATION HERE_______________________________________________ 3. Perimeter Control Posts will be established by RCMP, which will also be coordinated by the Ministries MOFR/MOTH. 4. In the event of an Emergency, the Gwa’sala-‘Nakwaxda’xw Nations Emergency Operations Centre will be relocated to 182 Tsulquate. Other Information:  Regular Inter-Agency Meetings with EOC Director in District of ______________will be held at ____________________________________________________.  Evacuation Procedure Notices prepared and distributed to volunteers, re: Evacuation Alert and/or Evacuation Order (when needed).  Short term lodging will be made available in ENTER BUILDING NAME HERE upon registration with the Emergency Social Services Reception Centre.

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Family Evacuation Plan WHAT YOU SHOULD DO WHEN AN EVACUATION ALERT IS IN EFFECT You should be prepared for the evacuation order by:  Locating all family members or co-workers and designate a safe meeting place in the event that an evacuation order is called.  Gathering essential items such as medications, eyeglasses, valuable papers (i.e. insurance), immediate care needs for dependants and, if you choose, keepsakes (photographs, etc.) You may wish to follow the Evacuee Documentation List provided. Have these items readily available for a quick departure.  Consider moving any disabled persons and/or children to a safe area.  Moving pets and livestock to a safe area. Follow Livestock Evacuation Plan.  Arranging to transport your household members or co-workers in the event of an evacuation order.  Arranging accommodation for your family if possible. In the event of an evacuation, emergency accommodation will be provided if required.  Monitoring news outlets for information on location of Reception Centres and status of evacuation orders. IF YOU HAVE TO EVACUATE:  Take an emergency survival kit with you.  Make sure you take prescription medicine and identification for the entire family.  Listen to the radio and follow instructions from local emergency officials.  If you are instructed to do so, shut off water, gas and electricity.  Make arrangements for your pets. Local emergency officials will advise you.  Wear clothes and shoes appropriate for the conditions.  Lock your home.  Follow the routes specified by emergency officials. Don’t take shortcuts. A shortcut could take you to a blocked or dangerous area.  A staging area has been established at 180 Tsulquate  If you have time, leave a note telling others when you left and where you went. If you have a mailbox, you can leave the note there.  If you have time turn off all outside water sprinklers so water is conserved for firefighting efforts.  If you are evacuated, register with the local ESS emergency reception centre at 180 Tsulquate (Wakas Hall) so you can be contacted or reunited with your family and loved ones.

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Evacuee Document List If time permits provide the following suggested Key Documents which residents should consider taking with them.

                

 

Driver’s Licence Insurance Policies Insurance Agent’s name/contact information Credit Card number’s Mortgage Papers Name/phone number of children’s school Birth Certificates Name/address of Doctor Medical Card Status Card/Identification Name/number of out of town/province contact Passport Bank account numbers Photo’s or video of personal property Will Title to vehicles (cars, boats, RV’s etc) Medication lists (suggest they write down what they take and how often) Professional licences and Credentials Medical Information

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6.5

Community Maps

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Section 7 – Emergency Social Services (ESS) Updated February 3rd, 2013

7.1 Emergency Social Services (ESS) Overview ESS is a community-based provincial emergency response program required to preserve the well-being of people affected by an emergency or disaster ranging from single house fire or calamities involving mass evacuations. The goal of ESS is to help people begin to re-establish themselves as quickly as possible after a disaster. ESS plays an important role in emergency management in British Columbia by: 

Helping people meet their basic survival needs during a disaster; and,

Reuniting families separated by disaster;

7.2 Emergency Social Services (ESS) Assistance ESS provides short-term temporary services for individuals and families affected by disasters so they can begin to plan their next steps following a disaster. Services may be provided on site for small scale events, or at a Reception Centre facility for larger responses, and may include: 

Food

Emotional Support

Lodging Volunteer Services

Clothing Child Care

ESS is typically available for 72 hours. During these first 72 hours, evacuees should immediately plan their next steps by contacting their insurance agents, families and friends, or accessing other possible resources. The Provincial Emergency Program’s ESS Office may extend ESS under exceptional circumstances only.

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7.3 Emergency Social Services (ESS) Response Levels Level 1 Response 

A house fire or very small ESS event (previously known as Personal Disaster Assistance – PDA)

Level 2 Response 

A single Reception Centre (RC) activation

No Emergency Operations Centre (EOC) or Department Operations Centre (DOC) activated

Resources coordinated within the reception centre

Level 3 Response 

A single RC activated

An EOC activated

Some resources may be coordinated at EOC

The Provincial Regional Emergency Operations Centre (PREOC) may be activated

Level 4 Response 

Multiple Reception Centres and/or Group Lodging facilities activated

EOC activated

PREOC activated

Some resources may be coordinated at the EOC and/or PREOC

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7.4 Emergency Social Services (ESS) Community Capacity No community capacity: call EMBC and request ESS support – 1-800-663-3456 

Evacuation within Community -

Explain situation and obtain EMBC Task Number Talk to ESS staff and determine level of financial assistance based on number of people evacuated to allow for purchase of supplies. Ask about billing – if meals are cooked in a central location or explain the situation to determine how reimbursement can take place.

Evacuation outside Community -

Obtain EMBC Task Number Talk to ESS staff and request ESS assistance at destination. o let them know the number of people and their destination to allow for the arrangement of reception centre and lodging o request that they provide transportation assistance at destination o request someone to provide instructions to those arriving

Agreement with neighboring community District of Port Hardy Level of Capacity Level 2 ESS Facilities 

Reception Centres 7400 Columbia( Pt. Hardy)

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Phone: 

250-949-6686

Group Lodgings Facilities  

Location & Phone Numbers Location & Phone Numbers

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Section 8 - Recovery Roles and Procedures 8.1 Procedure Checklists for Recovery Stage Recovery operations in the EOC utilize the same functional positions as in response, but may involve different tasks. This section summarizes the core functions in recovery to assist the effort. Note that the functions may be decentralized due to the duration of the recovery process. In order to understand the scope of the recovery process, a generally accepted rule is for every one day of the event the recovery period will require forty days (if the event lasts 4 days; recovery period will take 160 days).

8.2 EOC Director Responsibilities The EOC Director is responsible for leading the overall recovery effort. During prolonged recovery efforts, consideration should be given to identifying a position responsible for the oversight of recovery to perform the required submission and liaison with EMBC and AANDC (INAC). Typical recovery duties include: 

Inform and brief Chief and Council

Provide leadership for decisions

You can request advice and/or guidance from AANDC (INAC) if required.

Issue public information releases

Ensure safety of recovery activities

8.3 Operations Responsibilities The Operations Section is responsible for restoring community services and utilities to normal pre-emergency/disaster day-to-day operations. Typical recovery duties include: 

Provide building and public safety inspections

Remove debris

Restore medical facilities and services

Restore government facility functions

Demolish buildings

Restore utilities

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Provide emergency housing

8.4 Planning Responsibilities The Planning Section documents and provides direction for recovery activities. Planning involves consideration of long-term hazard mitigation as part of the recovery process. Typical recovery duties include: 

Provide documentation of response and recovery for disaster assistance

Provide after-action reports consistent with BCERMS requirements

Provide direction in land use and zoning issues

Issue building permits (e.g. a decentralized function with link to recovery).

Develop alternative building regulations and code enforcement

Review and revise the Community Plan, as needed

Provide an Action Plan for recovery operations

Prepare redevelopment plans

Prepare recovery situation reports

Document recovery operations

Recommend mitigation plans

8.5 Logistics Responsibilities The Logistics Section is responsible for obtaining resources necessary to carry out recovery operations. This includes coordination of volunteers and staging areas for heavy equipment. Typical recovery duties include: 

Allocate office space

Provide recovery supplies and equipment

Provide vehicles and personnel

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8.6 Finance/Administration Responsibilities Finance/Administration handles the community’s recovery financial transactions, including the recovery of funds associated with assisting other agencies. Typical recovery duties include: 

Facilitate application process for Emergency Response Funding and Disaster Financial Assistance

Manage public finances

Prepare and maintain the recovery budget

Develop and maintain contracts

Process accounting and claims

Manage insurance settlements

 

Ensure correct EMBC task number and authorization by contacting the Emergency Coordination Centre at EMBC in Victoria (1-800-663-3456). Complete appropriate EMBC claims and task forms. Submit forms to EMBC Regional Manager within 60 days of authorized emergency response task.

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Appendix A – Acronyms and Definitions British Columbia Ambulance Service (BCAS):  History; Created in 1974, the BC Ambulance Service (BCAS) is legislated to provide emergency medical services in BC under the Medical Services Act. British Columbia Emergency Response Management System (BCERMS):  The BCERMS identifies the standardized approach to emergency response management to be utilized and practiced by provincial government agencies, ministries, and crown corporations. The BCERMS is based on the Incident Command System (ICS). Emergency Operations Centre (EOC):  An Emergency Operations Centre (EOC) is activated to oversee and coordinate activities in the event of a major emergency. Emergency Social Services (ESS):  Emergency Social Services are those Municipal services that are provided short term (generally 72 hours) to preserve the emotional and physical well being of evacuees and response workers in emergency situations.  Responsibilities:  To plan for the short-term basic needs of all individuals in the event of an emergency or disaster Incident Commander (IC):  This individual is responsible for the management and coordination of all operations at the Incident Command Post during an emergency/disaster.  This role is delegated to the most senior staff member on site, and will remain in that position until relieved by a more qualified person. Incident Command System (ICS):  A standardized emergency management concept specifically designed to allow its user(s) to adopt an integrated organizational structure equal to the complexity and demands of single or multiple incidents, without being hindered by jurisdictional boundaries. The ICS is based on the following principles.

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Incident Command  Sets objectives and priorities  Has overall responsibility at the site Operations  Directs resources  Carries out the response activities described in the plan  Directs operations and ensures safety of staff Planning    

Collects and evaluates information Develops incident action plans Maintains resource status (personnel, equipment) Maintains incident documentation

Logistics  Provides support to meet the incident needs  Provides resources  Provides other services to support the incident Finance/Administration  Monitors costs related to the incident  Provides accounting, procurement, time recording and cost analysis Neighbourhood Emergency Management Program (NEPP):  A NEPP is made up of individuals and neighbors working in partnership towards emergency preparedness. The program involves both, personal preparedness as an individual or family, and planning/training as a neighborhood to respond safely and effectively during a disaster. Provincial Emergency Coordination Centre (PECC):  If a PREOC is established, then the Provincial Emergency Coordination Centre (PECC) in Victoria is also established. The PECC provides inter-region policy direction and coordination for emergencies involving more than one PREOC. It acts as an overall provincial coordination centre in the event of simultaneous multi-region disasters, such as earthquakes, floods or interface fires.

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Emergency Management B.C. (EMBC)(Formally PEP):  EMBC assumes the following responsibilities in the event of a major emergency or disaster.  Coordinates all requests for provincial or federal emergency assistance.  Makes appropriate requests to Provincial Ministries, if the requesting parties resources are not adequate for an effective response to the disaster.  Recommends to the Provincial Government that a Provincial State of Emergency be declared.  Maintains a Provincial Public Information program during all phases of a disaster.  Responsibilities:  Arrange for Worker’s Compensation coverage to registered emergency workers.  Provides and maintains a Provincial Public Information Program during all phases of a disaster.  Contact Information 1-800-663-3456 Provincial Regional Emergency Operations Centre (PREOC):

 An Emergency Operations Centre established and operated at the regional level by provincial agencies to coordinate provincial emergency response efforts.

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Appendix B – Emergency Program Band Council Resolution (BCR)

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Appendix C – Pandemic Plan

Gwa’sala-‘Nakwaxda’xw Nations

PANDEMIC INFLUENZA PLAN

Prepared by

JEL Life Specialists Life Specialists

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Table of Contents Page Records of Amendment

3

Pandemic Influenza

4

Preparing for Pandemic Influenza

6

Goals and Objectives of this Plan

6

Public Health & Prevention

7

Before Pandemic

7

 Community Responsibilities

7

During A Pandemic

    

 Community Responsibilities  Emergency Response Vaccine Antivirals Health Services Surveillance Communication

9 9 11 11 12 14 15

After Pandemic  Community Responsibilities

Appendix A (Notice to Community) Appendix B (Ways to Prevent the Spread of Influenza) Appendix C (Cleaning Information) Appendix D (Flu Treatment) Appendix E (Is it a Cold or Flu) Appendix F (Child’s Symptoms and Care Guide) Appendix G (Community Illness Reporting Form)

16

17 18 19 22 25 26 28

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Record of Amendments Amendment Change Number

Subject

Page

Date Amended

Inserted by

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Pandemic Influenza Influenza is a respiratory illness of the nose, throat and lungs caused by influenza virus type A, B or C. It is characterized by:  Sudden onset with fever  Cough  Runny Nose  Sore Throat  Joint & Muscle pain  Extreme Exhaustion Spread occurs either through the air by formation of droplet aerosols, or through direct contact with respiratory secretions. Influenza can spread rapidly through a community. It can be the cause of secondary bacterial infections such as pneumonia, which in some cases can lead to death. In fact in Canada, between 4 and 8 thousand people die each year from influenza related secondary bacterial infections, and as many as 100 to 250 thousand people worldwide. Because the virus continuously changes (virus drift) each year, there is a need to develop new vaccines to protect ourselves, as well, there can be more than one influenza virus circulating in a flu season. In Canada the flu season runs between the months of October to April. A pandemic is a World Wide event that happens everywhere at almost the same time. A pandemic is not restricted to influenza; there are many people in the world who one day hopes for pandemic peace! A pandemic influenza is a result of a major change in the virus (virus shift) which results in a never seen before virus, not introduced into people before, and once that virus manifests itself and meets the following 5 criteria, an influenza pandemic is likely to result. They are:  Never seen before virus  We have no immunity against it  Spreads person to person  Causes higher than usual rates of illness and/or death  No developed vaccine

History of pandemic influenza: Influenza pandemics have been occurring every 10 to 40 years since 1650, with four pandemics within the last 100 years. The most severe one being the Spanish influenza pandemic of 1918/1919, is estimated that it affected ½ the world’s population and killing as many as 50 million people worldwide. As most influenza outbreaks more severely affects those very young and the elderly, this particular strain was different in that the attack rates and mortality were highest among adults 20 to 50 years of age, with between 30,000 and 50,000 Canadians having died. In 1957 the Asian influenza pandemic was first identified in the Far East. Unlike the virus that caused the 1918 pandemic, the 1957 pandemic virus was quickly identified. This pandemic

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caused about 70,000 deaths in the US, with immunity rare in those under 65, but mortality rates highest in the elderly. In 1968 the Hong Kong influenza pandemic was first detected in Hong Kong. The first cases in the U.S. were detected as early as September of that year, although illness did not become widespread in the U.S. until December. This pandemic was the mildest of the three pandemics, affecting all age groups on all continents, causing about 34,000 deaths in the US. In 2009, a swine flu originating in Mexico, was discovered. This influenza was a result of a major shift in the virus mixed up in the belly of a pig. It like pandemics of the past was a Type A influenza, subtype H1N1, which was a similar virus type of the 1918 Spanish Flu. Swine flu viruses do not normally infect humans; however, human infections with swine flu do occur and cases of person-to-person spread of these viruses have been documented. Swine flu viruses cause high levels of illness and low death rates in pigs. These viruses may circulate among swine for many years before being passed onto humans and at which time can lead to large influenza outbreaks of a brand new virus. The symptoms of swine flu in people are similar to the symptoms of regular human seasonal influenza and include high fever, cough, headache, general aches, fatigue, eye pain, shortness of breath, and lack of appetite. During the 2009 outbreak there were also reports of people who had shortness of breath, bad cough, sore throat, nausea, vomiting and diarrhea. Like the 1918 Spanish flu, the average age of people most severely affected by the 2009 outbreak were those between 20 and 40, with the average age of those hospitalized in the USA being 24 years old. Avian influenza (Bird Flu): A type of influenza virus carried by wild birds, and can be passed onto domestic birds (chickens & ducks). Infected birds may have reduced egg production, coughing, sneezing or diarrhea. The virus is found in saliva, nasal secretions, and feces. Usually, ‘avian influenza virus’ refers to influenza A viruses found chiefly in birds, but with these viruses can occur in humans. The risk from avian influenza is generally low to most people, because the viruses do not usually infect humans. However, confirmed cases of avian influenza infection in humans have resulted from contact with infected poultry (e.g., domesticated chicken, ducks and turkeys) or surfaces contaminated with secretion/excretions from infected birds.

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Preparing for Pandemic Influenza Why plan for a pandemic? Pandemics are unpredictable, but occur on average three or four times a century. Experts agree that another influenza pandemic is inevitable and possibly imminent (World Health Organization, Jan 15 2004). Planning ahead for such a public health emergency can minimize serious illness and deaths. It is also important in order to minimize the social disruption that would probably result.

British Columbia "Planning Assumptions" (BCPIPP, section 1.1, 2005):        

   

Based on the last two pandemics, it is estimated that the next pandemic virus will arrive in Canada within 3 months after it emerges in another part of the world. This time could be much shorter due to increases in the volume and speed of air travel. The first peak of illness in Canada will occur within two to four months after the virus arrives in Canada. The first peak in mortality will be one month after the peak in illness. If the pandemic virus arrives close to the usual annual flu season, the time interval between emergence, arrival and / or peak illness and mortality will be shortened. A pandemic usually has two or more waves, either in the same year or in successive flu seasons. A second wave will occur within 3 to 9 months of the initial outbreak wave and may cause more serious illnesses and deaths than the first. Each wave of illness will last 6 to 8 weeks. Vaccine will be the primary means of prevention of pandemic influenza. The supply will be limited during the early stage of the pandemic; therefore, plans for the first wave should assume lack of influenza vaccine and priorities for vaccination will need to be established. A substantial proportion of the workforce will not be able to work for some period of time due to illness in themselves or in their family members. Health care workers are likely to be at higher risk of illness due to their exposures. Effective preventive and therapeutic resources will be in short supply. Essential community services are likely to be disrupted.

GOALS and OBJECTIVES of this Plan Specific objectives of influenza pandemic planning in Aboriginal Communities:      

To minimize serious illness and overall deaths To minimize suffering To increase awareness To develop a plan that ensures readiness to respond appropriately to an influenza pandemic To develop a plan that is consistent with your Health Authority, and FNIHB. To develop a plan that is a living document, changing to meet future needs

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Public Health and Prevention How to minimize risk of spreading the flu:       

Get your annual flu shot Use disposable tissues for nose Sneeze or cough into the crease of your elbow Keep hands away from eyes, nose and mouth Stay at home when you are sick Individuals who are sick with Flu symptoms should be isolated. Clean hard surfaces with 10% bleach solution

NOTE: Proper hand washing has been proven to reduce influenza spread by 50%, and is considered the single best prevention measure against spreading the influenza virus from one person to another. Wash hands thoroughly with soap and water for at least 15 to 20 seconds. Waterless alcohol-based (62% Isopropanol) hand sanitizers can be used in conjunction with hand washing to supplement hygiene when hand washing facilities are not available, however it is not to used as a replacement for proper hand washing. For protection against germs and disease, always wash hands:       

Before preparing food and after handling uncooked foods Before eating or smoking Before breastfeeding After toileting or diapering Before and after providing first aid After handling blood or body fluids Before and after providing care to an ill person

Community-based disease control strategies: Public health control measures alone will probably not be effective at controlling spread of pandemic influenza in the community. Control will likely require availability and use of an effective vaccine. The following are recommendations for community-based strategies:   

Self-isolation: is strongly recommended There may be a need to cancel public gatherings (Schools, Church, Pow Wows, Sporting events). Hand sanitizing stations are recommended in public buildings (Band Offices, Community Halls, Health Centres, and Schools).

Isolated Communities: There may be potential in some of these local areas to delay the introduction of the Pandemic strain of the antivirals or vaccines become available: By introducing:  Strict Public Health Measures  Monitoring and if necessary restricting access to communities during a Pandemic

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Before Pandemic Community Responsibilities  Community leadership and health team members will be responsible for supporting a Pandemic Influenza Preparedness Response Plan as an appendix to their Emergency Preparedness Plan. They should also coordinate with their Health Authority to ensure it is integrated with the Health Authorities Pandemic Influenza plan.

 Community leadership is responsible to support the work required to review, revise and exercise this pandemic influenza annually, or as needed.

 Community leadership will ensure that all community members are made aware of this pandemic influenza plan by providing copies of this plan to each household located in the community and to band members living within close proximity to the community.

 Community health team members are responsible to ensure that community leaders and community members are kept apprised of any updates or information as it relates to health emergencies, such as localised outbreaks, epidemics, or pandemics.

 Pandemic planning team will ensure that everyone whose name has been included in this plan with any responsibilities will be provided a copy of the plan and have their responsibilities explained to them.

 Ensure that you have established contacts with:  Regional Health Authority Medical Health Officer  First Nations Inuit Health  Regional District Emergency Managers/Coordinators  Nearest Hospital  Nearest Pharmacy  Designate a central spokesperson (to the community and media). Plan: The community spokesperson will conduct any media interviews, or communications required on behalf of the community.

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During a Pandemic Community Responsibilities Emergency Response  The community Incident Command team shall meet as soon as possible to review and activate this plan, as well as any local control measures. Each local control measure (such as individual isolation or cancelling of events) will need to be discussed, and decided upon separately, before being implemented. The following has been established as your Incident Command team: Incident Command Structure:       

Incident Commander: Health Board: Community Spokesperson: Operations: Planning: Logistics: Finance/Admin: Note - Each Key Person is aware that they will need to compose a team of one other (if possible) to assist in the event of an emergency. Incident Command  Sets objectives and priorities  Has overall responsibility at the site Operations  Directs resources  Carries out the response activities described in the plan  Directs operations and ensures safety of staff Planning  Collects and evaluates information  Develops incident action plans  Maintains resource status (personnel, equipment)  Maintains incident documentation Logistics  Provides support to meet the incident needs  Provides resources  Provides other services to support the incident Finance/Administration  Monitors costs related to the incident  Provides accounting, procurement, time recording and cost analysis

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INCIDENT COMMANDER

HEALTH BOARD

CENTRAL SPOKESPERSON

OPERATIONS

PLANNING

LOGISITCS

FINANCE ADMINISTRATION

 Health team members will need to coordinate responses with their own Health Authorities, as well as FNIH, BCCDC and the FNHC when applicable.

 Establish communication links with the following: Health Authority Contact: Health Council Contact:

Health Canada (FNIH):

 Open communication with other communities in your area, as it is likely that what affects them can/will affect your community as well. This will also be important in the event that your or their community is severely affected by the outbreak and either community needs help.

Vaccine The single best way to protect against the flu is to get vaccinated each year. The “flu shot” is an inactivated vaccine (containing double killed virus) that is given with a needle usually in the arm, or by a nasal spray of children. Each year the influenza vaccine contains three influenza virus strains, as a way to attempt to cover all possible strains which may be circulating during that influenza season. The viruses in the vaccine change each year based on international surveillance and scientists’ estimations about which types and strains of viruses will circulate in a given year. It takes on average 6 months to evaluate and develop the vaccine to be produced for each flu season, with manufacturers ensuring it is ready during out influenza season.

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After being vaccinated, it commonly takes between 14 and 21 days for someone to develop enough antibodies to become fully protected against one of the influenza viruses contained in the vaccine. During a pandemic, a vaccine cannot be produced until the pandemic strain of influenza has been identified, which means there can be no stockpiling of the vaccine. Therefore, the supply of vaccine available to each region will be limited during the early stages of the pandemic and issued based on risk.

ď ą Plan for mass influenza vaccination clinics. Plan: Once informed vaccine is available and will be coming to the community for a vaccination clinic, a meeting with Health Team members, and Logistics shall occur to confirm dates, times, location, and the best way to advise community members. Currently the Health Centre has been identified as the location of the clinic. Logistics will ensure the building is open with sufficient tables, chairs and supplies to support the health team to complete the vaccination clinic. Signs will be posted outside of the vaccine clinic stating who may not be eligible to receive vaccine at this time. For example, those people displaying influenza symptoms, or those people who may not be in the priority group for that clinic etc. Also, the health team will identify someone to triage the waiting line to ensure that if someone is not sure they can receive the vaccine or to assist with diagnosing symptoms, and to ensure those with mobility issues are not having to stand and wait for extended periods of time. As a result of the recent H1N1 outbreak in 2009, it was identified that all First Nations people living on reserve are considered high risk, and therefore a list of all persons living on reserve will be at the vaccine clinic to ensure all community members who want the vaccine, receive it. Ensure you have the total number of band members living on reserve up to date. If for some reason a community member cannot attend the clinic, either the CHN will attend that persons home or a member of the logistics team will arrange to pick up that community member. Health Team will ensure that your Health Authority is kept up to date on the number of community members immunized, and how many are remaining. It is the responsibility of the Health Team to monitor vaccine coverage and adverse effects. It is also their responsibility to report adverse effects to their Health Authority and FNIH.

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Antivirals Consult your doctor early if you develop flu-like symptoms and you have a condition that puts you at higher risk of complications. Antiviral medication is most effective if given within 48 hours once symptoms start, and the sooner the better. You should also call your doctor if your symptoms get worse, such as shortness of breath or difficulty breathing, chest pain, or signs of dehydration (dizziness when standing, low urine output). Reference: http://www.healthlinkbc.ca/healthfiles/hfile12b.stm

Health Services  Implement infection control measures. Plan: Appropriate infection control measures when dealing with influenza, is a mask (an N95 when possible) and gloves. As influenza is a droplet spread virus, as long as the care giver is conscientious of possible droplet spread surfaces they will be fine utilizing these respiratory infection control measures. Note: It will be the responsibility of the Health Team to consult with either their Health Authority, or FNIH to ensure that these precautions are appropriate.

 Provide health care services on a priority basis. Plan: Once notified by a community member of an illness, a member of the Health Team will either attend their residence, or have them attend a location to triage their level of illness. As other members of the community become ill, the Health Team may establish a priority list indicating who requires what level of care (e.g. at home, alternative care site or hospitalization). When community members are triaged, they may be classified in one of the following ways: 1) Have influenza symptoms and can care for themselves (advise them to self-isolate for 7 days), check back with them 4 – 6 hours later to re-triage. 2) Have influenza symptoms and have family or others who can care for them (advise them to self-isolate for 7 days), check back with them 4 – 6 hours later to re-triage. 3) Cannot care for them and have no family who can care for them, arrange for a health team member to care for them or set up an alternative care site. 4) They are having severe symptoms and need advanced medical care, either call 811 (BC Nurse line) or for an ambulance or have them taken to the hospital

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ď ą Establishing Isolation (Individual, Household, Community) Plan: There are 3 levels of isolation which can be used to assist the community and its members to remain safe in the event that the outbreak is localized. In the case of persons who become isolated, someone will need to be identified to check on those people to ensure they are not getting sicker, or require supplies such as food or medication. 1) Individual Isolation: In the event that a community member becomes ill, they will be required to isolate themselves from other family members and community. To do this, individuals will stay in one room of their home (or the home of a care giver), and remain there for a minimum of 72 hours or longer if advised by a health team member. Someone should clean the home, and ensure that the washroom used by the ill person is cleaned regularly. When possible the ill person should have the use of their own washroom away from others, when not possible it will need to be cleaned after each use. It will be important to keep those persons who are at a high risk away from the ill person, and it may be necessary to either remove the ill person or the person at risk as a way to keep them safe. Ensure that the Health Team has been notified that the person is sick. 2) Household Isolation: When there are 2 or more persons who live within one house who are sick, then this household should be isolated. A sign indicating that there are sick people inside and to not enter without permission should be posted at the door. For medical confidentiality purposes, the persons living in the home will need to be advised that a sign is to be placed at their door indicating that persons are sick and to not enter. Permission will need to be given by household members before the sign is posted. 3) Community Isolation: There may be a need to isolate the community for one of two reasons: a) In the event there is large outbreak of illness in the community; b) There is a large outbreak of illness in the surrounding area, and isolation is being used to keep the outbreak away from the community. The Medical Health Officer for your Health Authority does have the legal ability to isolate your community if required, as does the Chief and Council; however a Band Council Resolution may be required first. Because of the severity of community isolation, it will be imperative to advise the community of the impending isolation so that they can pick up food, medication or other items before the community becomes isolated. When the community is isolated, a meeting/communication must take place explaining fully as to the reasons for the isolation, and any restrictions that are in place because of it, as well as expected timelines of the isolation.

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 Establish alternate sites for providing medical care. Plan: In the event that community members become too ill to care for themselves (or a loved one cannot care for them), or there are too many community members sick and unable to care for themselves, an alternative care site will be established. When possible these sites should possess the following: an area large enough for more than 5 people to be cared for, running water, washroom facilities, a place to cook, large sinks, heat, and enough room to have patients separated by 3 feet. Other considerations include: Beds, bedding, buckets, lights, thermometers, gloves, masks, wash clothes, sponges, paper towels, scissors, water, soap, oxygen, patient record keeping material.

 Arrange for transportation of ill cases. Plan: If a member of the community has been identified as being too ill to be cared for within the community, the Health Team will arrange for transportation to the closest hospital. The means of transportation will depend upon availability of the BC Ambulance Service.

 Recognise the need for corpse management. Plan: The most current information regarding dealing with persons who have died as a result of the Flu indicates respiratory precautions (mask, gloves) will be sufficient for handling of the deceased. This will be monitored closely by FNIH and if information changes regarding handling of the deceased during the pandemic, then infection control measures may need to be altered. In the case where the number of deaths as a result of the pandemic is so overwhelming that the Hospital, Coroner’s Office, or Funeral Homes cannot receive a deceased person immediately, they may be required to stay in the community. This period of time may be for hours, days or in extreme cases, the community may be advised to keep the corpse on site and to make direct funeral arrangements. (needs to be discussed with chief and council) A place in the community (Cool & Dry) will need to be identified at the time in order to store any deceased remaining in the community. As long as the death was as a direct result from the Flu, there may not be a need for the Coroner’s Office or the Family Physician to view the deceased. After speaking to the Physician, they will decide if there is a need to view the deceased. If the deceased is remaining in the community, then the CHR/CHN needs to complete a Registration of Death (form number HLTH 406 REV 92/12) Province of British Columbia – Ministry of Health et al.

 Discuss funeral arrangement issues. Plan: If the deceased person follows “usual” protocol and is sent to the Hospital, Coroner’s Office, or Funeral Home then returns to the community, normal traditions will be followed. For any person(s) who comes into contact with the deceased, there is currently no evidence to support the need for those persons who are sitting with the deceased (no contact) to wear any protective equipment. This will be monitored by the MHO/Health Canada and if information changes communities will be notified to make applicable changes.

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If the deceased remains in the community from death to funeral, mask and gloves may be required for all persons attending the funeral in case someone attending is ill. The community will also make every effort to bury the deceased as soon as appropriate and possible. It is recommended that only direct family members attend the funeral as a way to limit the number of persons at the funeral (minimize large gatherings). Note: A Death Certificate must be issued before the deceased can be buried.

Surveillance  Establishing local surveillance (monitoring ill people). Plan: It will be a requirement for all community members to report their illness to the Health Team during a pandemic. The Health Team, during annual influenza season, will inform community members of their responsibility to inform the Health Team when they are ill.

 Ensure timely reporting of influenza activity to the communities Health Authority and FNIH. Plan: When a community member is suspected as having the flu, they will notify a member of the health team and be triaged as per the triage section above.

Communication  As soon as the community leadership has been made aware of a health emergency, a community meeting will be held to provide information to community members. Encourage community members who do not live in the community full time to attend. Plan: Hold a community meeting and discuss the following information.  What a pandemic influenza is.  Getting Vaccinated (this is very important to community members who do not live in the community full time, especially if you decided to limit travel into your community).  Antiviral information.  Self-monitoring (if a community member becomes ill, they must inform the Health Team of their illness to get quick and proper treatment).  Personal Hygiene (importance of hand washing).  Travel restrictions (ill people returning to the community).  Infection control measures (the use of gloves and masks). Often experts from your Health Authority, FNIH or Consultants are available to attend these meetings to assist.

 Have a clearly identified central spokesperson. Plan: The community spokesperson will conduct any media interviews, or communications required on behalf of the community. The exception is if he is not available, then someone will be delegated on behalf of the community. Page 72


After Pandemic Community Responsibilities The Pandemic is over when the local, provincial, and federal public health authorities declare it being over. As a pandemic comes in waves, communities should not assume a pandemic is over until it has been announced as formally being over.

   

Your community incident command team shall meet and: Deactivate the plan; Assess the effectiveness of this plan; Revise the plan as necessary.

 Inform the community members of the pandemic being over, and discuss how it affected the community. It would be best to do this in a community gathering, as this would be a good time to support each other as well. As there will be very few persons not affected by the pandemic influenza outbreak, many community members may feel the need for support and counselling.

 Arrange for the return of any community members who may be out of the community in hospital, or at other care sites.

 Provide grief counselling to the community as needed.  Document lessons learned by the community. There are only a few times in history where we have the opportunity to possibly save our community from future pandemics. It is important to write down and pass along how the community did during the outbreak, what worked and what didn’t.

 If the community was financially impacted by the health emergency, then seek financial redress.

 Health Team will complete your surveillance report. The information required by your Health Authority and FNIH.

 Resume regular surveillance activities. Note: There will be a continued need for regular surveillance for illness in the community for some time. Although the pandemic influenza has passed, we need to ensure that if community members become ill, that it is reported to the Health Team. The affects of a pandemic influenza can and will be felt for a long time in the community once the pandemic is over.

 Encourage planning for future pandemics!

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Appendix A

Notice to all community: There has been a recent outbreak of the influenza (Flu) Virus, Date outbreak started: Please pay attention to the poster titled “Ways to Prevent the Spread of Influenza.” This poster gives information on how to protect yourself and others from becoming ill. At all hand sanitizer stations please use 2-3 pumps and rub thoroughly into hands (no water or paper towel is needed). Note: If you or someone in your family is experiencing some or all of the following symptoms, please stay home as much as possible; rest and drink plenty of fluids.        

A temperature of 100۫ F or 37.8۫ C or higher Severe aches and pains Chills and/or shivering Cough- usually dry (mucous is usually not a common symptom of flu Moderate to severe tiredness A headache Chest discomfort Sudden onset of above symptoms usually indicate flu

Your child should receive medical care right away, if you notice:     

Adults should receive medical care right away, if you notice:

Fast or troubled breathing; of breath Bluish or dark coloured lips or skin colour; Drowsiness to the point that you can’t wake up your child; Severe crankiness, not wanting to be held; Not drinking enough fluids and not peeing

• Difficultly breathing or shortness • Pain or pressure in the chest; • Confusion or disorientation; • Coughing up bloody sputum; • Severe vomiting.

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Appendix B

Ways to Prevent the Spread of Influenza Hand Washing One of the most important things you can do to keep from getting sick is to wash your hands. One of the most common ways to become ill is by rubbing your nose, eyes or mouth after your hands have been contaminated with viruses. By frequently washing your hands you wash away viruses that can be picked up from other people, or from contaminated surfaces, or from animals. It is especially important to wash your hands Before, during, and after you prepare food Before you eat, and after you use the bathroom After handling animals or animal waste When your hands are dirty After you sneeze or blowing your nose or After caring for someone that is ill

You should also‌.

Cover your mouth and nose with a tissue when you cough or sneeze

Throw your tissues away immediately

Stay at home if you are sick

Sneeze or cough into the inside of your arm if you do not have a tissue Drink lots of fluids. Fluids that do not have caffeine is best (caffeine makes you lose fluids) Take basic pain/fever relievers e.g. Acetaminophen (Tylenol) Take cough medicine. This helps especially if you have a dry cough Use a hot water bottle or heating pad. Applying heat carefully, for short periods of time, can help reduce muscle pain. Get lots of rest.

Please call 811 (BC Nurse Line), your doctor or 911 if you experience severe symptoms

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Appendix C

Basic Cleaning Tips As the Influenza Virus can live on smooth unclean surfaces for more than 24 hours, during an influenza outbreak it will be very important to disinfect your home, especially if you have a loved one at home who is sick. The following are a few tips on where to clean and how to clean. As bleach has been proven to kill 99.9% of common household germs, such as E. coli, Staphylococcus (Staph), Salmonella and viruses that can cause colds and flu, your cleaning solution should be made up of 9 parts water and 1 part bleach.

Milde w 9 parts Bleach water 1 part bleach

The following common surfaces should be kept clean especially when someone is sick:  Refrigerator and microwave door handles  All sinks, tubs & faucets  Toilet handles, seats & bowls  TV remotes  Telephones  Light switches  Doorknobs  Computer keyboards & Mouse’s  Countertops These surfaces can be cleaned by using the bleach/water cleaning solution, with just a few quick sprays of the cleaning solution and wiping the surface with a cloth. Be sure to give the surface a good rub, while wiping off the cleaning solution. A sink drain needs to be cleaned at least weekly. After you’ve washed out the sink with the cleaning solution, flush the drain by pouring in 1 cup (8 0z.) of bleach down the drain and flush again with hot water.

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Sweep then mop kitchen and bathroom floors with the cleaning solution, and vacuum carpets at least weekly or as needed. To clean plastic cutting boards, wash or rinse with liquid dishwashing detergent and water. Then soak in a solution using 1 tablespoon of bleach per gallon of water. Let stand 2 minutes, then air dry. To clean wooden cutting boards, use approximately 3 tablespoons of bleach per gallon of water to create a sanitizing solution. Wash, wipe, or rinse with dishwashing detergent and water, then apply solution. Let stand 2 minutes. Rinse with a solution of 1 tablespoon of bleach per gallon of water. Do not rinse or soak overnight.

When cleaning telephones, be sure to clean both the receiver and the buttons on the phone, this way the entire phone is clean.

Scrubbing toys weekly is your safest bet. Clean washable, colorfast plastic toys with a solution of ž cup bleach per gallon of water. Soak for 5 minutes, rinse and air dry. Keep in mind that many toys can simply join your dishes in the dishwasher. If your child has been ill you will want to disinfect hard plastic toys with bleach as soon as your child shows symptoms of influenza. Have your children use a plastic tub for the hard plastic toys they've been playing with that day. This way, you can simply pick the whole thing up and clean in one batch. Don't forget to wipe down and rinse the toys and the bin! Toys that trap water (like rubber ducky’s) also need to be cleaned regularly, rinsed well and left to dry.

*Some of the above information came from the Clorox Bleach website

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Flu Treatment

Appendix D

Need help deciding which treatments are effective for the flu? Though flu treatments won't cure the flu, there are flu treatments that can relieve common flu symptoms such as fever, aches, fatigue, and congestion. Some flu treatments may actually shorten the time you have flu symptoms. However, Health Canada now says that over-the-counter cough and cold medicines should not be given to children under 6. There is some basic home treatment which can help to alleviate the flu symptoms:     

Get plenty of rest. Stay home from work or school as bed rest will also help you avoid spreading the virus to others. Drink plenty of extra fluids to replace those lost from fever. Avoid smoking and breathing other people's smoke. Breathe moist air from a hot shower or from a sink filled with hot water to help clear a stuffy nose. Anti-influenza drugs or antivirals are available by prescription, but these must be started early. They will shorten symptoms by about three days if given within 12 hours, and by about 1.5 days if given with two days of the start of symptoms. Over-the-counter medications can help relieve symptoms such as pain and fever. These are not recommended for children under six years of age. Non-prescription flu remedies are also available at the pharmacy.

Information found at http://www.bccdc.ca/dis-cond/a-z/_f/Flu/overview/default.htm

Which flu treatments should I take for flu symptoms? The flu treatment you should take depends on your symptoms. For example, if you have nasal or sinus congestion, then a decongestant can be helpful. However, decongestants should not be used for more than a few days because, if they are used too long and then stopped, they can cause rebound symptoms. If you have a runny nose, postnasal drip, or itchy, watery eyes -- then an antihistamine may be helpful for your flu symptoms. Over-the-counter antihistamines often make people drowsy, whereas decongestants can make people hyper or keep them awake. Antihistamines can make mucus thick, which can be a problem if you have lung disease such as COPD or asthma. Keep in mind that both decongestants and antihistamines can interact with other drugs you may be taking for conditions such as heart disease, and they may worsen some conditions. Talk to your doctor or pharmacist about which flu treatment may be best for you. Which flu treatment should I use for nasal congestion? If you need immediate relief for swollen, congested nasal passages, you may get relief with an over-the-counter decongestant nasal spray. It is important to stop using decongestant nasal sprays after three to five days to avoid the development of rebound congestion or recurrent congestion. Some doctors suggest using a saline spray instead of a medicated spray. Saline spray works more slowly but has no rebound effect. It may be used for extended periods of time without significant side effects.

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Is it safe to take a decongestant if I have high blood pressure? Decongestants can increase blood pressure and heart rate and increase the risk of heart attacks and strokes. Pseudoephedrine is the primary oral decongestant available. In general, if your blood pressure is well controlled with medications, then a decongestant shouldn't be a problem as long as you monitor your blood pressure. This may not be true, however, with certain types of blood pressure medications. Check with your doctor or pharmacist about which type of medicine may be best for you. Which flu treatment works best for my cough? An occasional cough may clear the lung of pollutants and excess phlegm. A persistent cough should be diagnosed and treated specifically. On the pharmacy shelf, you'll find numerous cough medicines with various combinations of decongestants, antihistamines, and cough suppressants, ask your pharmacist which combination, if any, would be right for your cough. Which flu treatment should I take to lower my fever and body aches? Fever may be a good thing. It helps the body fight off infection by suppressing the growth of bacteria and viruses and activating the immune system. Doctors no longer recommend suppressing fever for most people, except perhaps for the very young, the very old, and those with certain medical conditions such as heart disease or lung disease. However, if you are uncomfortable, then it's fine to take medications. Young people (including those in their early 20s) should avoid aspirin. Acetaminophen (Tylenol and others) or the numerous other medicines like ibuprofen (Advil and others) are your best choices. Each medication has risks. Check with your doctor or pharmacist as to which medication may be best for you. Be careful not to overdose! These drugs are often mixed in with other cough and cold and flu remedies you may also be taking. Your pharmacist can help you make the right choice. Which flu treatment is best for my sore throat? Drinking lots of fluids and using salt water gargles (made by combining a cup of warm water and a teaspoon of salt) can often be helpful for easing the pain of a sore throat. Some oral medications (such as Tylenol) and medicated lozenges and gargles can also temporarily soothe a sore throat. Get your doctor's approval before using any medications, including over-thecounter drugs, and don't use lozenges or gargles for more than a few days. The medications could mask signs of strep throat, a bacterial infection that should be treated with antibiotics. Can antibiotics help my flu symptoms? Antibiotics cannot help flu symptoms. The flu is caused by a virus, and antibiotics only treat bacterial infections. Taking antibiotics needlessly may increase your risk of getting an infection later that resists antibiotic treatment. If you get a secondary bacterial infection with the flu virus, your doctor may prescribe an antibiotic to treat the secondary infection. If your doctor does prescribe an antibiotic for a sinus infection or respiratory tract infection associated with flu, and you do not get relief within a few days, check back with your doctor to see if the antibiotic is working for your particular infection. Certain bacteria have become resistant to some antibiotics in some locales, and stronger medications may be needed.

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When do you need to seek medical advice? If you do not start to feel better in a few days or your symptoms get worse, you should seek medical advice:      

Chest pain Difficulty breathing Wheezing High or persistent fever: more than 38.5ºC for more than 24 hours Severe headache or neck pain Severe throat pain

Seek medical advice if you get sick and you have the following health concerns:    

Heart or lung disease Any chronic health concern that requires regular medical attention An immune system weakened by disease or medical treatment, or You are frail or at risk of serious illness or complications

Information found http://www.bccdc.ca/dis-cond/a-z/_f/Flu/overview/default.htm, http://www.canadianliving.com/health/prevention/colds_and_the_flu_symptoms_and_treatment.php, http://www.webmd.com/cold-and-flu/9-tips-to-treat-colds-and-flu-the-natural-way?page=2

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Is it a Cold or the Flu?

Appendix E

Cold and flu viruses are both respiratory illnesses, but they have different symptoms. The following chart will help you know the difference between the two. Signs and Symptoms Fever Aches Chills Tiredness Symptom onset Coughing Sneezing Stuffy nose Sore throat Chest discomfort Headache Complications

Influenza

Cold

Usually present Rare Usual, often severe Slight Fairly common Uncommon Moderate to severe Mild Symptoms can appear within 3 to 6 Symptoms appear hours gradually Dry, unproductive cough Hacking, productive cough Uncommon Common Uncommon Common Uncommon Common Often severe Mild to moderate Common Uncommon Bronchitis, pneumonia; can be life Sinus Congestion or threatening earache

Information for this chart found at http://www.bccdc.ca/dis-cond/a-/_f/Flu/overview/default.htm, www.flufacts.com and www.webmd.com

High risk groups for seasonal flu include:      

anyone aged 65 years or older people with chronic heart, lung, or metabolic disorders (including diabetes) those with chronic kidney disease, anomia, a weakened immune system, or asthma residents of nursing homes children receiving long-term ASA therapy who may be at risk of developing Reye's syndrome children 6 months or older with respiratory disorders

Written and reviewed by the MediResource Clinical Team Updated, April 8, 2011 http://bodyandhealth.canada.com/channel_section_details.asp?text_id=2383&channel_id=1020 &relation_id=10882

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Child’s Symptoms and Care Guide

Appendix F

The answers to these questions can help determine whether a child is fighting the flu or combating a cold:

Flu vs. Colds: A Guide to Symptoms

Questions

Flu

Cold

Was the onset of illness ...

Sudden?

Slow?

Does your child have a ...

High fever?

No (or mild) fever?

Is your child's exhaustion level ...

Severe?

Mild?

Is your child's head ...

Achy?

Headache-free?

Is your child's appetite ...

Decreased?

Normal?

Are your child's muscles ...

Achy?

Fine?

Does your child have ...

Chills?

No chills?

If most of your answers fell into the first category, chances are that your child has the flu. If your answers were usually in the second category, it's most likely a cold. Some bacterial diseases, like strep throat or pneumonia, also can look like the flu or a cold. It's important to get medical attention immediately if your child seems to be getting worse, is having any trouble breathing, has a high fever, that doesn’t break (or for more than 24 hours), has a bad headache, has a sore throat, or seems confused. While even healthy kids can have complications of the flu, kids with certain medical conditions are at more of a risk. If you think your child might have the flu, contact your doctor.

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Caring for your child: Offer plenty of fluids (fever, which can be associated with the flu, can lead to dehydration). If your child is tired of drinking plain water, try ice pops, icy drinks mixed in a blender, and soft fruits (like melons or grapes) to maintain hydration. Encourage your child to rest in bed or on the couch, with a supply of magazines, books, quiet music, and perhaps a favorite movie. Give acetaminophen or ibuprofen for aches and pains (but do not give aspirin unless your doctor directs you to do so). Dress your child in layers so you can add and remove layers during bouts of chills or fever. Take care of yourself and the other people in your family ensure you wash your hands thoroughly and often after taking temperatures and picking up used tissues. It’s also a good idea to give your house a thorough cleaning using a bleach and water solution, focus on: common areas such as door knobs, TV remotes, light switches, sinks and taps.

Information reference:

http://kidshealth.org/parent/h1n1_center/h1n1_center_treatment/tips_take_care.html

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Appendix G

Community Illness Report Form Patient’s Name _____________________________ Date: ________________________________________ Time:_________________________________________

Symptoms:  ? A temperature of

F or

. or higher

 ? Severe aches and pains  ? Chills and/or shivering  ? Cough- usually dry (mucous is usually not a common symptom of flu  ? Moderate to severe tiredness  ? A headache  ? Chest discomfort  ? Sudden onset of above symptoms usually indicate flu Other:_________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ Documented By:__________________________ Date:_________________________

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First Nation Reference Websites 1) British Columbia Government: http://www.gov.bc.ca/ 2) Interior Health: http://www.interiorhealth.ca/ 3) First Nation and Inuit Branch: http://www.hc-sc.gc.ca/fniah-spnia/index-eng.php 4) BC Centre for Disease Control: http://www.bccdc.ca/default.htm 5) Health Canada: http://www.hc-sc.gc.ca/index-eng.php 6) HealthLink BC: http://www.healthlinkbc.ca/kbaltindex.asp 7) Environmental Health BC: http://www.vch.ca/environmental/ 8) Public Health Agency of Canada: http://www.phac-aspc.gc.ca/index-eng.php 9) World Health Organization (WHO): http://www.who.int/en/ 10) Assembly of First Nations. A First Nations Holistic Approach to Pandemic Planning: A lesson for Pandemic Planning. Available at: www.afn.ca/cmslib/general/pan-planning.pdf 11) Interior Health Pandemic Influenza Plan: www.interiorhealth.ca – Pandemic Influenza 12) Pandemic Plan

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Gnn public