By the IACP National Law Enforcement Policy Center Board
ealth-care professionals predict that a pandemic influenza outbreak is highly likely, if not inevitable, based on current conditions and historical data. Should the current avian influenza virus (H5N1) or a mutation thereof spread efficiently between humans, a worldwide pandemic could take place within as little as three weeks. The inevitable shortages of employees and resources make it essential that police departments establish plans and take measures in advance to ensure that crucial law enforcement services are not unreasonably disrupted and that employees are provided with the means to prevent or mitigate the spread of infection.1
Purpose of This Article
This article is intended to provide guidance for the development of contingency plans, organization of resources, and establishment of departmental protocols that can be used to respond to and help mitigate the effects of a pandemic influenza or similar health emergency. Figure 1 provides a sample plan to help agencies begin the process of developing their own protocols, and figure 2 shows how protocols should be activated as a pandemic progresses.
For the purposes of this article, the following terms are defined explicitly.
Avian Influenza: Also known as the bird flu, a strain of influenza that naturally occurs among wild birds. It is deadly to domestic poultry. Highly pathogenic avian influenza such as H5N1 has crossed the species barrier to infect humans, but person-to-person spread has thus far been rare, if it has occurred at all, according to some authorities. The potential for it to mutate into a form that is efficiently transmitted between humans who have no immunity has caused it to be closely monitored. There is no human immunity, and no vaccine is yet generally available for public consumption.
Essential Positions and Assignments: Employees who possess special knowledge, skills, or abilities and whose extended absence would create serious disruptions to critical departmental functions.
High-Pathogenicity Avian Influenza (HPAI): Any form of avian influenza—H5N1 being only one potential form—that demonstrates high efficiency in human-to-human transmission.
Incubation Period: The interval between infection and onset of symptoms.
Influenza: Referred to as the flu, an acute infectious viral disease marked by inflammation of the respiratory tract, fever, muscular pain, and bowel irritation.
Influenza Pandemic: The emergence of a new influenza virus for which there is little or no immunity among humans, causing widespread serious illness and spreading easily from person to person worldwide.
Isolation: The separation of infected persons from those who are not infected.
Quarantine: A legally enforceable order that restricts movement into or out of the area of quarantine of one person, a large group of people, or community; designed to reduce the likelihood of transmission of contagious disease among persons in and to persons outside the affected area. When applied to all inhabitants of an area (typically a community or neighborhood), the intervention is referred to as a cordon sanitaire (sanitary barrier).
Seasonal (or Common) Flu: A respiratory illness that can be transmitted from person to person. Most people have some immunity, and a vaccine is available.
Social Distancing: Measures taken to reduce contacts between individuals in order to lower the chance of spreading a communicable disease.
Strategic National Stockpile (SNS): A national repository of antibiotics, chemical antidotes, antitoxins, life support medications, intravenous administration equipment, airway maintenance supplies, and medical and surgical items designed to supplement and resupply state and local public health agencies in the event of a national health emergency.
Voluntary Quarantine: A request that persons remain at home, ban visitors, wear a mask when in the same room as other members of the household, and sleep in a separate room. These protocols were developed to decrease the risk of transmitting the severe acute respiratory syndrome (SARS) coronavirus during its outbreak in Toronto and would likely be the primary means of social distancing during an influenza pandemic.
Volunteer: Someone who performs a service for the department without promise, expectation, or receipt of compensation for services rendered. Volunteers may include unpaid chaplains, unpaid reserve officers, unpaid interns, unpaid persons providing administrative support, and unpaid youths involved in a law enforcement explorer post, among others.
Pandemic Influenza Coordination Committee
The chief executive officer (CEO) of the department should appoint an individual or individuals, as appropriate, to lead and coordinate the department’s preparation for and response to an influenza pandemic by means of a pandemic influenza coordination committee. The committee should include departmental and interdepartmental personnel who bear directly on plan development and who can make preliminary decisions in the following issue areas:
- Personnel (including volunteers)
- Equipment and supplies
- Human resources
- Legal: city or county attorney, district attorney, and representative of the judiciary
- Public information: media relations and community relations
- Communications: dispatch and intraoffice communications
The committee should also identify public and private entities that will have bearing on overall community pandemic response planning and that will interact closely with the department during a pandemic. The committee should integrate key agencies in the planning process in a manner that will explore problem scenarios and solutions, mutual expectations, and support opportunities. Plans should be drawn up and coordinated in conjunction with the necessary response partners to avoid confusion or misunderstanding of roles and expectations. At a minimum, these response partners include the following:
- State and local public health services
- State occupational safety and health administration (OSHA)
- State and local emergency management agencies
- Medical examiner or coroner
- Emergency medical responders
- Hospitals and urgent care facilities
- Fire departments
- Volunteer organizations and disaster response teams
- Vendors and service providers for the police department
- City and county governing body
- State and regional law enforcement agencies
- State department of agriculture
- Animal control
- City or county finance office
- Private business–sector leaders
- The Red Cross
- The National Guard
In addition, the committee should monitor updates from public health authorities on changes in the nature or spread of influenza and relay important developments to committee members and the CEO.
Finally, the committee should develop a detailed pandemic influenza preparation and response plan that includes (but need not be limited to) issues identified herein. Considering that there will be many unexpected developments during a pandemic, the plan should emphasize flexibility and the need to improvise as appropriate. The plan should be completed within 180 calendar days of the issuance of the order.
Staff Training, Education, and Prevention
The department’s training function should develop and deliver as soon as reasonably possible, in cooperation with public or private health-care agencies, information essential to employee understanding of pandemic influenza. This includes but is not necessarily limited to the following issues and topics.
Historical information, experiences, and lessons learned from past U.S. pandemics is important for understanding the potential consequences of a new pandemic. In 1918, the Spanish flu resulted in 500,000 U.S. deaths; in 1957, the Asian flu killed 70,000 U.S. citizens; and the Hong Kong flu of 1968 claimed 40,000 U.S. lives. It is important to distinguish these events from the typical seasonal flu for which many people obtain vaccines every autumn.
Most Likely Current Pandemic Threat
As of June 27, 2007, 315 humans were known to have been infected with the H5N1 bird flu strain, with 191 deaths (a mortality rate of roughly 60 percent).2 Department staff should be made aware of the nature and spread of H5N1 and other forms of highly pathogenic influenza. Other information helpful to staff includes a timeline of a potential pandemic from establishment of efficient human-to-human transmission to worldwide exposure; likely infection rates and number of deaths, nationally, statewide, and locally, and threats posed by secondary bacterial infections such as pneumonia; duration and phases of a pandemic for initial-phase (12 to 16 weeks) and long-term presence in communities; the potential impact on manpower, community infrastructure, and services; the importance of rapid early response;3 and security concerns such as patient safety and privacy as well as pharmaceutical supply chain safety.
Characteristics and Symptoms of the Disease
Persons at greatest risk include infants, the elderly, pregnant women, and persons with chronic medical conditions. The typical incubation period for the disease is two to three days. Infected persons can transmit infection (through a process called viral shedding) for up to one day before the onset of symptoms, and the risk of transmission is greatest during the first two days of illness. Children usually shed the greatest amount of virus and therefore are likely to pose the greatest risk for transmission. Modes of transmission include coughing and sneezing, as well as contact with virus on household, work, and other objects in daily life. Signs of infection can include fever, headache, chills, muscle ache, extreme tiredness, sore throat, runny nose, nausea, and cough and progressive shortness of breath.
In addition, staff should be educated on the emotional and mental health aspects of anticipated and actual infection. It should also be made clear that the lag time in development of vaccines is up to six months; availability of the vaccine to law enforcement personnel is in accordance with the U.S. Centers for Disease Control (CDC) vaccination priority list and state regulations. Regulations are also in place to cover SNS applicability and distribution plans.
Prevention and Control
There are several measures that must be taken and some optional measures that may be considered in order to slow the spread of influenza among employees and others. The following measures and practices should be considered and introduced systematically in accordance with the progression of a pandemic.
Personal Hygiene: Maintain at least six feet distance from others. Do not cough into the hand or the air in public; cough into the elbow if tissues are not available. Otherwise, use tissues and dispose of them properly. Eliminate handshaking, and wash hands frequently and thoroughly after coughing, sneezing, or touching potential contaminants. Use antiseptic towelettes or antiseptic gels if soap and water are not readily available, and make sure these antiseptic gels are readily available at work for each person. Avoid touching the eyes and mouth. Check body temperature daily.
Avoiding Contact with Infected Persons or Objects: Obtain an annual flu vaccination to mitigate the impact of possible pandemic strains. Identify drugs to help mitigate the impact of an influenza infection.4 Disinfect vehicles to whatever degree possible and practicable between transportation of prisoners. Disinfect surfaces and common areas to whatever degree possible. Use disposable cups and utensils in the workplace. Adhere to universal precautions or other measures outlined by public health officials.5
Changes in Procedures and Practices: Place masks on all persons arrested, transported, and/or questioned. Identify temporary housing for officers and other employees in essential positions where practicable to reduce travel, contact with others, and other exposure (arenas and hotels, for example). Create a departmental disease surveillance protocol to monitor employees for signs of illness. Eliminate unnecessary travel. Cite violators rather than arresting them when legally possible and judicially sanctioned. When possible, avoid use of temporary holding facilities for interviews and interrogation. Hold conference calls instead of meetings. Whenever possible, use e-mail or telephone rather than personal contact. Require symptomatic employees to stay home in voluntary quarantine. Delay return to work of employees who have been exposed to family members, friends, roommates, or other persons known to be ill until incubation period has elapsed.
Facility Modifications: Enhance ventilation of building and offices by opening windows if possible. Separate work spaces where practical. Create barrier separation of public service desks from public and related person-to-person contact locations.
Personal Protective Equipment (PPE): Make N-95 or higher particulate respirators available to all employees and provide training and fit testing for effective use of respirators, following OSHA mask guidance. Provide surgical gloves and eye protection to all officers and other employees as deemed appropriate. Use hand sanitation materials and products provided to all officers and nonsworn employees.
Assistance to Family Members: During a pandemic, many employees may feel compelled to use leave in order to assist ill family members. In order to prevent undue loss of employees for this purpose and to provide employees with reassurance of their family’s well-being, the department should assist employees’ families by providing all reasonable information and all assistance to reduce the chances of infection. Additionally, all employees should take the following steps with family members, roommates, or other household members to assist in this effort:
- Obtain annual seasonal flu vaccinations to help mitigate potential impact of pandemic influenza
- Stockpile flu aids (such as Tamiflu) and over-the-counter treatments as available
- Obtain vaccination against pandemic strain when developed and approved6
- Stockpile enough food, fuel, water, required prescription medications, and related living supplies for at least 14 days7
- Share all information on prevention and treatment with family members
- Provide family members with relevant information on the department’s pandemic response plan that may affect them, such as temporary housing arrangements for sworn personnel and policy modifications concerning sick leave and mandatory isolation when symptomatic
- Review relevant employee assistance programs that may be used
- Discuss voluntary quarantine or isolation measures and the use of protective masks or other PPE that may be provided
- Develop a family plan and practice drills8
Potential New Service Demands
The onset of pandemic influenza will inevitably result in new types of requests for police service, even as the department experiences reduced staffing levels and continues to provide routine law enforcement services. In anticipation of these challenges, the committee should coordinate with other critical agencies and stakeholders to identify needs, expectations, potential levels of service demands, reasonable alternatives to the use of sworn police personnel, and reciprocal means of assistance between public and private sectors, among other factors. Additional police responsibilities during a pandemic may include the following:
- Guarding vaccine distribution chains and distribution sites from the SNS to maintain order, establish traffic patterns, and prevent theft
- Providing protective services to hospital emergency rooms, temporary treatment shelters, and triage centers during patient surges
- Providing additional preventive patrols or other measures to targets of opportunity resulting from the emergency (such as pharmacies and supermarkets)
- Providing added security to critical infrastructure components (such as utilities and telecommunications facilities)
- Providing emergency assistance to special population groups (such as the elderly, the hearing or visually impaired, and the nonambulatory)
- Enforcing closure orders, curfews, travel limitations, and restrictions on gatherings
- Enforcing quarantine orders, mandatory isolation orders, and other involuntary restrictions or requirements (such as mandatory vaccination or hospitalization of the ill)
- Arranging for secure disposition of dead bodies during surges in deaths in cooperation with the coroner, funeral homes, and crematoriums
- Policing civil disturbances and disorders related to forced mandatory vaccinations, shortage of therapeutics or medical care, and similar problems
- Arranging for additional incarceration facilities should mass arrests be necessary or infected persons need isolation during incarceration
- Assisting health-care providers and other agencies with security for delivery of essential food and medicine to quarantined areas
- Developing alternative protocols for investigation of unattended deaths
Alternative Staffing Strategies
Department supervisors should consider a number of alternative staffing strategies to help prevent the spread of influenza among employees and to better meet service demands with reduced staff. The following should be considered for systematic and progressive implementation coincident with the progressive seriousness of a pandemic and loss of staff.
Telecommuting: Some employees may be able to perform essential work duties from remote locations, particularly their homes, using telephones and computers linked to the department and the Internet.
Swing Shifts: Some employees presently working only day shifts may be able to perform essential duties during off hours, such as from 4:00 p.m. until midnight, thereby reducing the number of persons on duty at the same time.
Flex Time: Employees may be given greater latitude in when to report to work or when split shifts may be possible.
“Snow Days”: Liberal leave may be provided to personnel who must care for sick family members who are unable to care for themselves or to select employees when the department is experiencing a high incidence of sick employees and an employee can be excused without unreasonable harm to department operations.
Overtime: Overtime may be authorized in cases where essential employees are unavailable to work due to illness and other employees may effectively fill in to perform their duties with overtime. Personnel who have recovered from illness and are considered immune may also be used for extended work hours.
Reduced Hours: Select employees may be allowed or directed to work reduced hours.
Reassignment: Certain civilian or sworn employees may be reassigned to alternate duties (such as telephone report taking or answering questions at a community service walk-in desk).
Leave: The department may cancel vacation leave and other forms of leave with or without pay.
Cross-Training of Personnel: Personnel in the same department or in similar jobs may be cross-trained to perform the duties of other employees. Training must begin before the onset of a pandemic.
Several alternatives may be used to supplement departmental employees while they are on sick leave during a pandemic.
Volunteers: Community volunteers may be used to staff select nonsworn positions, including clerical and telephone answering duties. Some of these duties may be conducted from a volunteer’s place of residence. Volunteers should be recruited and trained well in advance of their assignment. Plans are also required in advance for the anticipated use of spontaneous volunteers or registered or affiliated disaster service volunteers.
Reserve Officers: Reserve officers should provide an important resource of manpower to assist in backfilling fulltime patrol officer shortages.
Auxiliary Personnel: With advance orientation and training, auxiliary personnel may be used to backfill certain nonsworn full-time civilian positions.
Retired Officers: Officers who have retired in good standing with the department may be recruited in the early planning and preparation stages to backfill sworn and nonsworn positions. Departmental supervisors and command staff who anticipate the need for such individuals should determine legally required reentry requirements for reassignment. Retired officers may also be used for investigative assignments involving minor crimes and traffic accidents where sworn status is not required. The department should compile a list of eligible retired officers and ascertain the willingness of those eligible retired officers to volunteer.
Police Cadets: The role of police cadets may be expanded to duties in additional nonenforcement capacities.
Police Candidates: Candidates who have not yet graduated from the academy may be temporarily released from training to assume nonsworn duties in the department.
Sworn Officers from Mutual Aid: The department may consider the use of sworn officers from departments under the regional mutual-aid agreement where those officers can be spared for full-time or part-time duty.
Neighborhood Watch and Citizen Patrols: To help supplement routine police patrols, the department may establish, reinforce, or reconstitute neighborhood watch programs and may consider providing enhanced communication capabilities between watch groups and the department.
Private Enterprise: The private sector may be engaged in contracts to perform some specialized functions that cannot be readily addressed by existing department employees. These may include such duties as equipment maintenance and logistical support, maintenance or expansion of computer capabilities to meet added demands, or related services needed by the department and available through private contractors.
Modification of Department Responses to Calls for Service
Under reduced staffing emergencies during a pandemic, the department should consider implementation of alternatives to traditional responses to calls for service. These include but are not limited to the following.
Prioritization of Calls for Service
The department may consider modifications to its call prioritization system that would allow for significantly deferred response or the use of alternative responses to certain types of calls for service (such as suspension of all responses to nuisance offenses, minor thefts, or burglaries).
Differential Response to Calls for Service
The department may consider expansion of its telephone reporting unit (TRU) and the types of calls taken by this unit. It may consider the use of sworn and nonsworn employees and trained civilian volunteers as TRU operators. Other differential response modes may also be considered, to include expanded duties of the community service desk and community service officers and Internet reporting of minor property crimes and other misdemeanors or nonviolent crimes.
Development of Division Plans
Based on the foregoing staffing alternatives and methods of influenza mitigation, division commanders in cooperation with unit supervisors should develop individual response plans in anticipation of pandemic influenza. Division plans should be submitted to the committee within 60 days of issuance of this order and should contain the following information. The committee should integrate each division plan into the overall departmental response plan and the local or regional plan.
Identification of Essential Assignments
Each department should identify essential personnel and assignments. For purposes of this article, essential personnel are those for whom one or more of the following characteristics applies:
- Employees with specialized knowledge, skills, or abilities, such as employees who have unique institutional knowledge; specialized technical skills and training; or unique command or supervisory skills, abilities, and responsibilities
- Employees who are the only ones—or only one of a few—who have the knowledge, skills, or abilities to perform the duties assigned to a critical position or assignment
- Employees not readily replaceable by transfer of another employee to the position or assignment
- Employees whose knowledge, skills, or abilities would be difficult to impart to another employee through cross-training
Identification of Essential Positions
Plans should identify essential employees by name and position or assignment and should do the following:
- Provide details of the position and the functions or duties deemed essential
- Identify potential negative impacts on the department should the individual be absent from duty for an extended time
- Identify proposed remedies for overcoming the loss of essential employees
- Identify potential costs and obstacles associated with implementing proposed remedies
Overcoming Loss of Employees
Plans should identify specific strategies to overcome overall losses of employees. Strategies should be recommended in an incremental fashion, ranging from the easiest to the most difficult, recognizing the likely progression of absenteeism during a pandemic. They may be adopted from those alternatives identified in this article—modification or reduction of service delivery, use of staff augmentations, or implementation of alternative staffing patterns—or by other means deemed appropriate by supervisors and command staff. Strategies should be accompanied by pre2pandemic implementation requirements, estimations of time required for implementation, potential obstacles and negative consequences to the department or the community if implemented, and associated costs of implementation.
Division plans should identify those influenza mitigation measures that should be implemented during the progression of a pandemic. Plans should identify all materials, facilities, and personnel resources under their command that may be used to enhance departmental disease mitigation efforts. In addition, they should identify the proposed chain of command to be used during the absence of specific supervisors or commanders.
Development of the Department’s Pandemic Flu Preparedness and Response Plan
The committee should organize division plans into a comprehensive departmental preparedness and response plan. The committee’s plan should also examine the following issues as they affect the overall department.
Officer Duties and Responsibilities
A number of legal issues will come into play during an influenza pandemic. These issues may be addressed through the department’s legal service or through the jurisdiction’s legal advisor or contract attorneys.
One major issue is the legal authority to impose, and the responsibility and authority of law enforcement to enforce, orders during public health emergencies involving containment, isolation, or quarantine of civilians; closure of schools and public facilities; declaration of curfews; prohibitions on travel; and other similar emergency actions.
There will also be limitations on law enforcement’s use of force in conjunction with these orders as well as legal authority for other actions, such as restricting the movement of contagious persons and responsibility for documenting, securing, and disposing bodies of the deceased in unattended deaths.
Employee Health and Welfare
Employee contractual agreements as well as federal and state laws may have bearing on the department with respect to protecting employee health and welfare and work conditions.
Collective-bargaining agreements and contracts should be reviewed to establish those issues that may come into play in addressing influenza control and reductions in staffing during a pandemic.
In addition, departmental policy and practice and potential emergency modifications to these protocols should be examined to determine if, and to what degree, they conflict with federal or state laws.
Americans with Disabilities Act (ADA): Provisions for medical clearances prior to returning to work and related matters should be examined with respect to the provisions of the ADA.
Occupational Safety and Health Act: Proposed department emergency protocols should be examined to ensure that the department is taking reasonable precautions to protect employees from contracting influenza in the workplace, protect their medical privacy, and comply with related requirements under the law.
Family and Medical Leave Act (FMLA): The department should determine how best to permit leave for employees to care for family members who are ill, in conformance with FMLA requirements and in light of departmental personnel requirements in an emergency.
Health Insurance Portability and Accountability Act (HIPAA): Issues concerning medical certification for return to work and medical disclosures to local health authorities should be examined under HIPAA requirements.
Wage and Hour Laws: The department should ensure that it is consistent with state and federal wage and hour and antidiscrimination requirements in any plans that restrict leave with or without pay.
Workers’ Compensation Regulations: The department should determine whether and under what circumstances employees may be eligible for workers’ compensation claims if incapacitated by influenza.
Health-Care and Life Insurance Contracts: The department and others in the jurisdiction, as necessary, should examine provisions of the department’s health-care and life insurance to ensure appropriate coverage of employees specific to a national or local health emergency.
Equipment and Supplies
The committee should ensure that an inventory is performed to itemize available departmental equipment and supplies that will be needed in a pandemic. Deficiencies in the following areas should be noted, and steps should be taken to stockpile sufficient supplies (optimally a minimum of 90 days for medical isolation supplies and at least two weeks of food and water, without resupply).
- Rubber gloves, eye protection, ventilated N-95 masks, disposable outer boots, general antiseptic cleaners, soap, and individual antiseptic wipes
- Food, fuel, water, bedding, toiletries, and related personal items to allow for an extended period of self-sufficiency
The committee should review and make recommendations concerning the adequacy of information dissemination capabilities both within the department and to the community.
Internal Communications: In order to keep employees informed of developments and to provide factual information both before and during a pandemic emergency, the committee should recommend modifications to current internal information sharing capabilities, as necessary. These may include establishment or refinement of a dedicated employee page on the department’s Web site; development of a dedicated department intranet site; use of hotlines, calling trees, and mass e-mails; or related capabilities.
External Communications: The department should be responsible for providing the community with various types of information and news advisories. This information should be closely coordinated with local and state authorities to ensure that the public receives consistent factual information and that the source of that information remains constant. To this end, the committee should recommend improvements that can be made to the department’s current public information capabilities and changes that might be required during an emergency.
Prioritization of Tasks and Establishment of Timelines
Given the ability of HPAI to spread rapidly and the likelihood that there may be as little as three weeks between onset and development of a pandemic, the committee should develop a prioritized implementation plan to address immediate, near-term, and long-term tasks. The following matters are among those that should be addressed as soon as reasonably possible:
- Training of staff and volunteers in prevention and control measures, covering such topics as risk factors and behaviors of exposure, flu symptoms, personal hygiene, social isolation and distancing, family preparedness, and essential components of the department’s pandemic plan
- Cross-training of staff to fill critical positions
- Identification of community contractual services that may be used to maintain the department’s infrastructure
- Development or refinement of mutual-aid contracts
- Identification of costs associated with immediate, near-term, and long-term requirements so that budgetary needs can be addressed
- Development of modified policies and procedures that can be readily implemented as needed
- Identification of retired officers and other volunteers willing to assist in an emergency and establishment of protocols for their use
Like those who predict another major terrorist attack against the United States, community health experts predict that it is not a question of if, but when, pandemic influenza will strike. Furthermore, all agree that if planning and preparation should be delayed until efficient human-to-human transmission of a highly pathogenic strain emerges, it will be too late to take any meaningful precautions. In a pandemic, law enforcement services will be required to mitigate unnecessary community fears as well as to help ensure that medical services are not overrun and that critical community infrastructure is unharmed—all with reduced staff. Early preparation for pandemic influenza or a similar health threat is essential in order to meet these basic community needs.■
1This article has been adapted from International Association of Chiefs of Police/National Law Enforcement Policy Center, Model Special Order: Pandemic Flu Planning and Response (Alexandria, Va.: International Association of Chiefs of Police, July 2007).
2See U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, “Avian Influenza: Current Situation,” http://www.cdc.gov/flu/avian/outbreaks/current.htm; and World Health Organization, “Cumulative Number of Confirmed Human Cases of Avian Influenza A/(H5N1) Reported to WHO,” June 25, 2007, http://www.who.int/csr/disease/avian_influenza/country/cases_table_2007_06_25/en/index.html (both accessed July 6, 2007).
3See, for example, National Institutes of Health, National Institute of Allergy and Infectious Diseases, “Rapid Response Was Crucial to Containing the 1918 Flu Pandemic: Historical Analyses Help Plan for Future Pandemics,” April 2, 2007, http://www.niaid.nih.gov/news/newsreleases/2007/fluresponse.htm (accessed July 6, 2007).
4See National Institutes of Health, National Institute of Allergy and Infectious Diseases, “Flu Drugs,” November 2006, http://www.niaid.nih.gov/factsheets/fludrugs.htm (accessed July 6, 2007).
5See National Institutes of Health, National Institute of Environmental Health Sciences, “Biological Safety: Universal Precautions,” http://www.niehs.nih.gov/odhsb/biosafe/univers.htm (accessed July 6, 2007).
6See U.S. Department of Health and Human Services, “Tests, Vaccines, Medications, & Masks,” May 31, 2007, http://www.pandemicflu.gov/vaccine/#vaccines (accessed July 6, 2007).
7Consult the National Crime Prevention Council’s “Making Sure You’ve Got What It Takes: Items You and Your Family Should Have on Hand in Case of Emergency,” http://www.ncpc.org/publications/available-online/preparedness/making-sure-you-ve-got-what-it-takes (accessed July 6, 2007).
8See U.S. Department of Health and Human Services, “Individuals & Families Planning,” June 5, 2007, http://www.pandemicflu.gov/plan/individual/index.html (accessed July 6, 2007).