PITTSBURG, Kan. — Despite the COVID-19 pandemic seemingly receding into memory, and as even the government of China is relaxing its “Zero Covid” policy, in Kansas, health officials are already planning their response to the next pandemic.
Last week, the Kansas Department of Health and Environment released a draft version of the state’s Highly Infectious Disease and Pandemic Plan for 2023. The plan will be available for review and public comment until Jan. 9.
At more than 80 pages, the draft plan explores a range of scenarios and hypothetical responses by various government agencies as well as health care providers. The plan goes as far as predicting specific numbers of infections and deaths from a future respiratory virus pandemic. “Anticipating a high attack rate associated with severe pandemic viruses,” it is estimated that up to 200 million people will become infected nationwide and between 89,000 and 207,000 may die, according to the draft plan. In Kansas, the plan estimates, between 229,000 and 535,000 persons may require outpatient care and between 1,200 and 2,700 individuals may die in a severe pandemic.
Although sustained transmission of Ebola virus disease in Kansas or the U.S. is “highly unlikely,” according to the draft plan, it outlines contingency plans for such an outbreak as well. Unlike respiratory viruses, Ebola is spread through direct contact.
The draft plan also notes the potential economic impact of a future pandemic.
“The Centers for Disease Control and Prevention (CDC) estimates the economic loss associated with the next severe pandemic will be in the billions of dollars,” according to the plan. Additionally, one of the “anticipated local roles” during a future pandemic listed in the draft plan is that local governments may have to “Plan for the potential of civil unrest due to resource scarcity”.
According to the draft plan, re-allocating resources to geographic areas hit particularly hard by a hypothetical pandemic is likely to prove impractical.
“Since novel viruses may be identified in any region of the world, experts believe that no more than 1-6 months would pass from the identification of a novel virus to widespread outbreaks in the United States,” it states. “Outbreaks are expected to occur simultaneously throughout much of the nation, so re-allocation of human and material resources is not a practical option.”
Under the heading of “Medical Surge,” the draft plan notes that there are 123 community hospitals statewide, with numbers of staffed beds ranging from 10 to more than 1,000. “The average daily census indicates there are approximately 1,000 available beds in Kansas on any given day. It is estimated during a highly infectious disease or pandemic influenza incident; approximately 5,000 to 10,000 beds would be needed to provide care for patients,” the plan notes.
“The most serious challenge the medical system (including hospitals and EMS) will likely face during a pandemic is to keep operations functioning despite increases in call volume, workforce shortages and absenteeism, supply chain disruptions and other threats to continued operations.”
Under the heading of “Information Management,” the draft plan notes that “the public will likely encounter some unreliable and possibly false information in the media and on the Internet. KDHE and local health departments will communicate accurate, reliable information regarding the pandemic.”
KDHE will also “educate” various parties, according to the draft plan, including “public health officials, elected officials and the media about what information will and will not be available during a pandemic.”
Under the heading of “Medical Countermeasure Dispensing,” the draft plan also discusses distribution of vaccines during a hypothetical future pandemic.
“During the initial months of a pandemic, no vaccine will be available because it is not possible to produce a vaccine without knowing the characteristics of the novel virus. Unlike annual production of influenza vaccine, wherein strains are selected in the spring leading to vaccine distribution in the late summer, a pandemic disease could be detected at any time. Current manufacturing procedures require at least 6-8 months before large amounts of vaccine are available for distribution. Nevertheless, vaccine administration will likely become an important preventive strategy during the next pandemic, once an effective vaccine is developed,” according to the draft plan.
Ensuring that vaccine distribution plans “are coordinated with the bordering states of Missouri, Nebraska, Colorado, and Oklahoma, as well as the Kansas City Metropolitan Statistical Area” will be the responsibility of the medical countermeasures coordinator at the KDHE-Bureau of Community Health Systems (BCHS), according to the draft plan.
“The Epidemiological Branch Director in the KDHE ICS [Incident Command System] will ensure that studies are in place to monitor vaccine effectiveness as well as assess the quality of surveillance and make recommendations for improvement during the period between pandemic waves and after the pandemic. In addition, the Epidemiological Branch will be responsible for tracking adverse events to vaccine and treatment. The Epidemiological Branch Director will also coordinate the monitoring of health impacts, including deaths and hospitalizations.”
The draft plan notes that at the national level, pandemic response would be coordinated by the Department of Homeland Security.
“The Secretary of Homeland Security will be responsible for coordination of the overall response to the pandemic, implementation of the policies that facilitate compliance with recommended social distancing measures, the provision of a common operating picture for all departments and agencies of the federal government, and ensuring the integrity of the nation’s infrastructure, domestic security, and entry and exit screening for influenza at the borders,” it states, also noting that vaccine distribution would be controlled at the state level.
“A state-controlled distribution of vaccine will be in-place during pandemic response. KDHE will focus distribution of vaccine and vaccine administration supplies to local health departments and hospitals within the state of Kansas. Utilizing vaccination rate data supplied by local health departments and hospitals to KDHE’s Planning Section, KDHE will determine the appropriate time and manner to begin providing state-controlled vaccine to other health and medical sector partners including commercial pharmacies. This determination will include the adequacy of vaccine and supplies, hospital, and health department pandemic response workload factors, and trends in vaccination rates.”
Under the heading of “Non-Pharmaceutical Interventions,” the draft plan also notes the possibility of adverse reactions to a vaccine for the hypothetical novel virus that might cause the next pandemic.
“Epidemiological Branch staff will monitor adverse reactions to vaccine using the VAERS. This effort will be in coordination with the monitoring of infection and fatality rates associated with the virus. Epidemiological studies of cases, adverse reactions, trends, and effectiveness of containment measures will be conducted using standard epidemiological techniques and methodologies. This information will assist state planners and response staff in determining the effectiveness of the vaccine and the need for additional disease containment measures. To promote accurate epidemiological investigations at all levels of government, it is important for local health departments, hospitals, physicians, and other health and medical professionals to be alert for any reactions or trends and report them via VAERS,” the draft plan notes, adding that government officials may be prioritized for vaccination.
“In a severe pandemic, KDHE may promote vaccination of those state government officials and state and federal personnel deemed as priority for maintaining essential services. Utilizing similar methodologies as local jurisdictions, the State of Kansas will identify these personnel. KDHE will coordinate the provision of vaccine to these individuals to promote continuity of government.”
To view the draft plan or submit comments, visit www.kdhe.ks.gov/CivicAlerts.aspx?AID=494.
