An outbreak of unusually severe respiratory illness is occurring in China. The US Centers for Disease Control (CDC) has identified the particular strain as Type A H7N3, a subtype never before isolated from humans. The CDC also reports that the H7N3 virus has been isolated from ill airline passengers and large numbers of cases are now being reported in Hong Kong, Singapore, South Korea, Japan and the United States. Young adults are most severely affected and case-fatality rates approach 50%. State and local agencies are asked to intensify influenza surveillance and implement airborne protection measures for staff. News agencies have issued alerts for anyone experiencing flu-like symptoms to immediately contact their health care providers.

There is an increase in the number of persons presenting to emergency rooms with symptoms consistent with influenza. More people are seeking medical care than actually need it. Personnel in key positions are absent due to illness, fear of illness or caring for ill family members. Local pharmacies have run out of antiviral medications and are unsure whether they can expect to receive more. Estimates indicate that 10% of the population is ill with H7N3 influenza. Local hospitals and outpatient clinics are extremely short-staffed; an estimated 30-40% of physicians, nurses and other healthcare workers are absent. Intensive care units are overwhelmed, and there is a shortage of mechanical ventilators for patients with severe respiratory syndromes or postoperative needs. Family members are distraught and outraged when loved ones die within a matter of days. All essential services have personnel shortages, resulting in major reductions in routine services. There are shortages of food supplies due to the nationwide impact.

* HICS recommendations	Medworxx ERS Solutions
Does your hospital provide information and education to staff on infection control precautions, personal protective equipment, exposure prophylaxis and family/dependent care options?	Train all staff on Personal Protective Equipment (PPE), response guides and pandemic plans & policies with online courses. Generate reports to identify education gaps and ensure all staff comply with the latest mandatory courses.
Does your hospital have a plan to notify and maintain communications and exchange appropriate information with: Internal experts, including infection control, hospital epidemiology, and engineering/facilities? External experts, including local, regional and state public health, EOC/emergency management? Other local hospitals?	Integrate with automated notification engines. Export the contact directory from ERS and get a report of who was notified and when they can respond. It makes no difference if the contacts are internal staff or external agencies. Keep the communication going with external responder portals to share information with partners and agencies not on the ERS platform.
Does your hospital have a plan to provide situation and risk communication briefings to staff, patients, and community in conjunction with local public health and emergency management?	Keep everyone informed with ERS' internal content management system. Share status, situation awareness, briefings, incident details and FAQs with the hospital or community as this information is produced.
Does your hospital identify essential personnel (i.e., medical, nursing, environmental services, facilities, nutrition and food services, administrative, respiratory therapy, radiology technicians, medical records, information technology and laboratory, etc.) that would be priority for receiving prophylaxis and PPE to protect those staff most at risk and to ensure the continuation of essential services?	Build and Manage Skills Inventories for all Persons in the system (Internal, External and Volunteers) before an incident. Determine essential skills and run reports on the skills inventory to prioritize prophylaxis distribution.
Does your hospital have a procedure to monitor staff and volunteers for symptoms and a policy for "fitness for duty" procedures?	Prepare screening procedures, policies and decision triggers before an incident. Initiate mandatory check-in procedures during and incident to establish "fitness for duty" for all staff, external responders and volunteers.

* HICS recommendations	Medworxx ERS Solutions
Does your hospital have a policy to monitor the health status and absenteeism of staff during the pandemic?	Audit check-in and check-out times of all staff playing a role in the response via the Incident Command System (ICS) Organization Charts ability to generate time sheets. Run reports on these time sheets to determine absenteeism.
Does your hospital have a plan to track ED, inpatient and clinic census and symptoms?	Integrate directly with existing Admit Dischage Transfer (ADT) systems for patient census and status. If integration is not desired, track patients and beds directly in ERS.
Does your hospital monitor safe and consistent use of PPE?	Build courses to educate on proper use of PPE and assign these to front-line staff or the entire staff. Track deployment of all PPE during a response through the Resource Management module.
Does your hospital have a plan to adjust staff schedules to meet the needs of the response including: Reassigning staff who have recovered from flu to care for flu patients? Reassigning staff at high risk for complications of flu (e.g., pregnant women, immunocompromised persons) to low risk duties (e.g., no flu patient care or administrative duties only)?	Track 'flu status' of all staff through the person module with extensible attributes. Run reports to identify high-risk staff and those already recovered from flu and adjust scheduling accordingly.
Does your hospital have inventory procedures for: Current hospital supplies of medications, equipment and supplies? Receiving medications, equipment and supplies from outside resources (i.e., federal, state or local stockpiles, vendors, other facilities) and returning those medications or supplies upon termination of the event?	Manage resources from typing and inventories through deployment and recovery. Include external supplies in your inventory under unique categories to enhance tracking and returns.