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Plans and Procedures Infectious Disease Plan

I. Introduction

Infectious disease transmission is disease-specific it may be food or waterborne, it may be in the air or in the ground, and it may spread through close personal contact. Diseases may be naturally occurring, or intentionally released. 

 

This plan is intended to be used in the event a suspected or confirmed disease is present, or has the possibility to be present, on the University of North Florida (UNF) Campus. This plan is functional across different modes of transmissibility and is not intended to be a disease-specific plan.

II. Purpose

The purpose of this plan is to provide a framework for the operations at UNF to enable its various departments and organizations to work together to accomplish the following objectives:

  • Contribute to an effective campus response to a disease,
  • Reduce disease-related morbidity and mortality,
  • Minimize disruption of critical Campus learning, social and medical services during a public health incident, and
  • Mitigate disease-related impacts on critical infrastructure.

III. Situation and Assumptions

UNF’s location in Jacksonville raises concerns that diseases spread through person-to-person contact have the potential to directly impact Jacksonville and UNF due to the existing transportation infrastructure. Jacksonville is home to international logistics operations that serve countries which have experienced outbreaks of disease (such as Covid-19, Ebola Hemorrhagic Fever or MERS-CoV). Below are the transportation infrastructure modalities present in Jacksonville:

  • Ground (I-10, I-95, and rail lines),
  • Sea (JaxPORT, International cruise terminal, Naval Station Mayport, and Marine Corps Base Blount Island), and
  • Air (Jacksonville International Airport, Craig Executive Airport, Naval Air Station Jacksonville, Naval Air Station Mayport, and Cecil Field).

Concerns about the global spread of diseases may escalate the media and the public’s interest in infectious diseases. Some diseases may spread globally in waves, with an incident lasting up to a year or more. In this century, the following global diseases have been of concern:

  • H1N1 (Influenza),
  • H5N1 (Influenza),
  • Seasonal Influenza,
  • SARS (Severe Acute Respiratory Syndrome),
  • MERS-CoV (Middle East Respiratory Syndrome Coronavirus),
  • Ebola Hemorrhagic Fever,
  • EV-D68 (Enterovirus D68),
  • COVID-19 (Coronavirus).

Planning Assumptions

  • A public health incident may impact multiple jurisdictions across Florida and the nation simultaneously.
  • All diseases, and strains of diseases, have different morbidity and mortality rates. Forecasted impacts are dependent upon the threat, risk groups, transmission method(s), incubation periods, and treatment protocols and availability.
  • An ongoing public health incident may increase University absenteeism in students, faculty and staff causing a stress on the University to operate at effective levels. Impacted businesses which may affect University operations may include contractors, suppliers, local grocery and retail stores, first responder agencies, and healthcare agencies. Sheltering in place may create food and commerce shortages.
  • Concerns about the threat of a public health incident may cause increased entrance/exit screening of travelers into and out of Jacksonville and other jurisdictions nationwide.
  • All internal policies and procedures of any agency involved may be altered given new information about the threat; guidance may come from the Centers for Disease Control & Prevention, the Florida Department of Health, or other public health agencies. The Department of Health may also require isolation or quarantines as they deem necessary.

Characteristics and Challenges of Infectious Diseases

  • Potential for Worldwide Spread
    • When an infectious disease emerges, it may have transmissibility and morbidity for worldwide spread.
    • Preparedness activities should assume that multiple population groups, including those atypically affected, may be susceptible.
    • Border crossings may be closed as a mitigative measure to prevent further infection.
  • Healthcare System Needs May Exceed Capacities
    • Vulnerable population groups may have little to no immunity.
    • Healthcare facilities may not have the staff, equipment, and beds to support a response to an infectious disease epidemic.
    • Mortality rates are largely determined by four factors:
      • The number of people who become infected,
      • The virulence of the pathogen,
      • The underlying health conditions and vulnerabilities of affected populations, and
      • The effectiveness of preventive measures.
  • Economic and Social Disruption
    • Travel bans, closing of schools and businesses, and cancellation of events may have a major impact on the University.
    • Worker absenteeism rates may increase as workers elect to stay home to care for themselves or others, or out of fear of exposure. 
     

Assisting Agencies

  • American Red Cross. The American Red Cross is responsible for managing the mass care efforts during an infectious disease incident.
  • Duval County Emergency Preparedness Division. The Duval County Emergency Preparedness Division (EPD) is responsible for initially serving as a liaison to and from other City agencies with FDOH-Duval. EPD may also provide staff to support response operations.
  • Jacksonville Fire & Rescue Department. The Jacksonville Fire & Rescue Department (JFRD) is responsible for transportation and tracking of patients to area hospitals. If JFRD Units are unavailable, Duval EPD will arrange for additional resources.
  • Jacksonville Sheriff’s Office. The Jacksonville Sheriff’s Office (JSO) is responsible to assist the University Police Department (UPD) for security of mass prophylaxis, mass care, and other law enforcement concerns as requested by UPD. If JSO Units are unavailable, Duval EPD will arrange for additional resources.
  • Medical Examiner’s Office. The Duval County Medical Examiner’s Office is responsible for the processing and management of human remains.

Related Links

World Health Organization (WHO)

U.S. Centers for Disease Control (CDC)

Florida Health (FDoH)

IV. Concept of Operations

Risk Assessment

Infectious disease response operations will be executed based upon multiple factors:

  • Transmissibility (in the United States, in Florida, in nearby counties, and in Jacksonville), and
  • Morbidity and mortality rates.
Not every disease will have the same characteristics. As the threat of a localized incident becomes apparent, the UNF CMT Chairperson or designee, will meet with the Crisis Management Team (CMT) and additional staff as deemed necessary by the Chairperson or designee. The CMT will meet to discuss the disease-specific response and will consider the above characteristics in decision-making in conjunction with the Student Health Center. Subsequent CMT meetings will be held as needed on a frequency to be determined by the CMT Chairperson or designee who may decide to activate the UNF IMT if deemed necessary.

V. Response Planning

Triage

During the peak of an infectious disease, the UNF Student Health Center, hospital emergency departments and outpatient offices might be overwhelmed with patients seeking care. Effective triage will direct individuals to the appropriate level of care according to their needs. This will direct the flow of patients into the healthcare system and ensure that limited resources are used in the most efficient manner possible. Triage should be utilized to:

  • Identify persons infected with the disease,
  • Isolate these persons from others to reduce the transmission, and
  • Identify the type of care they require (home care, dorm care or hospitalization).

Patient Assessment and Triage Centers

Depending on the scope and severity of the incident, community-based triage includes locations at healthcare facilities, off-site locations “in close proximity” to healthcare facilities, and other community locations determined during the incident. Hospitals and outpatient facilities may need increased on-site
triage/screening capabilities, as many patients may present to their typical source of medical care during an emergency. The Duval County EPD in conjunction with FDOH – Duval will be responsible to coordinate off-campus locations and related activities.

INFECTION CONTROL MEASURES

The purpose of infection control measures is to slow/prevent the spread of disease. Dependent upon the infectious disease, containment strategies may be limited by short incubation periods, asymptomatic infections, and non-specific clinical signs. Three types of containment measures may be implemented:

  1. Isolation (the separation of infected individuals from those who are not infected),
  2. Quarantine (individuals who were exposed to the infectious disease are separated from the general population and their movement is restricted by FDOH-Duval. They will be in quarantine until either they become sick or the incubation period has passed),
  3. Social Distancing (individuals who know they may have been exposed are asked to refrain from attending public events/school/work/shopping/worship and to stay at home.)

ANTIBIOTIC ACQUISITION, DISTRIBUTION, AND USE (if indicated and available)

Antibiotics are meant to:

  • Protect persons at risk for infection and mortality,
  • Decrease transmission of the infection to those at the highest risk for mortality (provide indirect protection),
  • Protect the susceptible population at large,
  • Maintain the ability to provide quality healthcare, implement response activities, and maintain vital community services.

More information on antibiotic acquisition, distribution, and use is found in UNF’s Point of Distribution (POD) Plan.

CRITICAL INCIDENT STRESS MANAGEMENT

An infectious disease outbreak, epidemic, or pandemic may pose physical, personal, social, and emotional challenges to healthcare providers, public health officials, emergency responders, and essential workers. As infectious disease outbreaks may occur in excess of several months, it may be difficult for responders to maintain their physical and mental effectiveness. Enhanced workforce support activities may be needed.

 

The establishment of psychosocial support services that will assist workers in managing emotional stress during response efforts may be required. This support will be coordinated by the UNF Counseling Center personnel working in the Human Services Unit in the Operations section of the UNF IMT. 

COMMUNICATIONS AND PUBLIC EDUCATION 

Timely, accurate reporting is necessary during any event. Specific information which may need to be released to stakeholders and/or the University community:

  • General information concerning the infectious disease (including transmission, morbidity, and mortality),
  • Disease control efforts, including the availability and use of vaccines, antibiotics, and anti-viral medications,
  • Infection control measures for implementation by the University community,
  • Current government actions.

Effective communication may be able to reduce panic and as a result, reduce an unnecessary demand on healthcare resources. This information will be coordinated by the UNF Public Information Section of the IMT in collaboration with the FDOH-Duval and Duval County Emergency Preparedness Public Information section.

REMOTE OPERATIONS

Consideration must be given to an occurrence that would require a partial shutdown of University operations and require remote operations. This would include distance learning, telephone and video conference calls, and staff working remotely to minimize spread of infection. Also plan for maintaining essential services such as law enforcement, providing for students that may be quarantined in campus housing, providing for care of research animals and projects, etc.