Violent incidents, including but not limited to acts of terrorism, an active shooter, assaults, or other incidents of workplace violence can occur on campus or in close proximity with little or no warning. An "active shooter" is considered to be a suspect or assailant whose activity is immediately causing serious injury or death and has not been contained.

We cannot predict the origin of the next threat. Assailants in incidents across the country have been students, employees, and non-students. In many cases, there were no obvious specific targets and the victims were unaware they were a target until attacked. Being aware of your surroundings, taking common sense precautionary measures, and heeding any warning information can help protect you and other members of the community.

The following information regarding law enforcement response will enable you to take appropriate protective actions for yourself. Try to remain calm as your actions will influence others. The following instructions are intended for incidents that are of an emergent nature (i.e., imminent or in progress).

For more information, Active Shooter Resources

• Be aware of your environment and any possible dangers
• Examine the doors.  How can you secure them
• Take note of the two nearest exits in any facility you visit
• Ask yourself the "what if?" questions. This will enable you to develop effective response strategies
• Is there a phone in the room
• Is there a fire extinguisher or other improvised weapons nearby
• Add USF Public Safety 415-422-2911 to your phone

**These videos contain potentially disturbing situations that may be harmful to some viewers.** 

This video was produced by the CSU to provide valuable information about the best way to respond to a potential active shooter incident. 

California State University - RUN.HIDE.FIGHT

In this FBI training video, customers at a bar are caught in an active shooter event. By employing the run, hide, and fight tactics, as well as knowing the basics of rendering first aid to others, they are prepared, empowered, and able to survive the attack.

FBI - RUN.HIDE.FIGHT

RUN.

If there is an accessible escape path, attempt to evacuate.

• Have an escape route and plan in mind.
• Evacuate regardless of whether others agree to follow.
• Leave your belongings behind.
• If possible, help others escape but do not let them hinder you.
• Prevent others from entering the area.
• Keep your hands visible, follow law enforcement instructions.
• Call Public Safety at x2911 from an on-campus phone or at (415) 422-2911 and 911 when safe. This allows for Public Safety Officers to respond more quickly and assist arriving first responders.

HIDE.

If evacuation is not possible, find a place to hide where the shooter is less likely to find you.

• Your hiding place should:
  • Be out of view
  • Provide protection if shots are fired in your direction
  • Not trap or restrict your movement options
• If an active shooter is nearby:
  • Try to enter an office or room with a door and lock, if possible. Blockade with heavy furniture, if possible.
  • Close any windows and shades
  • Turn off all lights
  • Silence your cell phone
  • Turn off any source of noise, remain quiet
  • Hide behind large items
• If you are hiding (defending-in place):
  • Remain secure until directed by a law enforcement officer, a USF Public Safety Officer, or notification from USF Alert
  • Do not open the door to anyone other than a law enforcement officer or a USF Public Safety Officer
  • Do not respond to any voice commands until you can verify with certainty that they are being issued by a law enforcement officer or a USF Public Safety Officer

FIGHT.

As a last resort, you need to be prepared to fight. Attempt to disrupt and / or incapacitate the active shooter. Act as aggressively as possible against the active shooter. Fight as a team and have a plan.  Use whatever objects around you (fire extinguisher, metal water bottle, chair, scissors, garbage can, etc…) Defend yourself and don’t stop until the threat has stopped.

Emergency situations should be reported to DPS Dispatch by dialing x2911. Dispatch will then be able to send USF Public Safety Officers as well as contact the San Francisco Police Department. You may hear multiple rings - stay on the line until it is answered; do not hang up. Be prepared to provide the operator with as much information as possible. This may include:

• What is happening
• Where you are located including building name and room number
• Number of people at your specific location
• Injuries, if any, including number of injured and types of injuries
• Your name and any other information requested

Try to provide information in a calm, clear manner so that the dispatcher can quickly relay your information to responding law enforcement and emergency personnel.

What to Report

Try to note as much information as possible about the assailant, including:

• Specific location and direction of assailant
• Number of assailants
• Gender, race, and age of the assailant
• Language or commands used by the assailant
• Clothing color and style
• Physical features - height, weight, facial hair, glasses, etc.
• Type of weapons - handgun, rifle, shotgun, explosives, etc.
• Description of any backpack or bag
• Do you recognize the assailant? Do you know their name?
• What exactly did you hear? Explosions, gunshots, etc.

Dispatch will notify law enforcement and other emergency services agencies - fire and rescue. EMS will respond to the site, but may not enter the area until it is safe for them to do so. You may have to treat the injured as best you can until then. Remember basic first aid:

• For bleeding, apply pressure and elevate. Many items may be used for this purpose, including clothing, paper towels, newspapers, etc.
• Severe bleeding to the limbs can be controlled with a tourniquet such as a belt.
• Reassure those in the area that help will arrive – try to stay quiet and calm.
• Once the threat is stopped, emergency personnel will begin treatment and evacuation, this may take a while.

USF Public Safety Officers will immediately respond to the area assisted by other local law enforcement agencies if necessary. Remember help is on the way. It is important for you to:

• Remain inside the secure area.
• Law enforcement will locate, contain, and stop the assailant.
• The safest place for you to be is inside a secure room.
• The assailant may not flee when law enforcement enters the building.

Injured Persons

Initial responding officers will not treat the injured or begin evacuation until the threat is neutralized and the area is secure.

• You may need to explain this to others in order to calm them
• Once the threat is neutralized, officers will begin treatment and evacuation

Evacuation

Responding officers will establish safe corridors for persons to evacuate.

• This may be time consuming.
• Remain in secure areas until instructed otherwise.
• DO NOT open a door unless you can verify law enforcement is on the other side of the door.
• Follow instructions. Law Enforcement needs to ensure the assailant is not posing as a victim.
• You may be instructed to keep your hands on your head.
• DO NOT run towards law enforcement officers
• You may be searched. If you have a weapon, let the officer know.
• You may be escorted out of the building by law enforcement personnel. Follow their instructions.
• After evacuation, you may be taken to a staging or holding area for medical care, interviewing, counseling, etc.
• Once you have been evacuated, you will not be permitted to retrieve items or access the area until law enforcement releases the crime scene.

A fire may include visible flames, smoke, or strong odors of burning. 

For the person discovering the fire:

• ALARM – pull the nearest fire alarm
• CONTAIN the fire – close all doors but do not lock them and call 415-422-2911
• EXTINGUISH the fire only if you can do so safely and quickly
• EVACUATE – evacuate the building, if necessary

For occupants of the building:

• ALARM – pull the nearest fire alarm
• Close but do not lock the doors to your immediate area
• Immediately EVACUATE the building via the nearest exit. Assist others in exiting the building
• DO NOT use elevators
• Avoid smoke-filled areas

For persons evacuating from the immediate fire area

• Before you open a door, feel the door you intend to open from top to bottom. If it is hot, DO NOT open it.
• If the door is cool, crouch low and open the door slowly. Close the door quickly if smoke is present so you do not inhale it.
• If no smoke is present, exit the building via the nearest stairwell or exit. The closest stairwell may be behind you.
• If you encounter heavy smoke in a stairwell, go back and try another stairwell.
• Go to your designated emergency assembly area

Hazardous conditions that pose a danger to individuals or campus property should be reported to Facilities Management at 415-422-6464 (7:30am – 4:30pm) or the Department of Public Safety at all other times.

Earthquakes are an infrequent reality when living in San Francisco. While we cannot predict when earthquakes will hit, we can take a number of precautions to stay safe in the event of a seismic event.

• Create a personal preparedness kit
• Form a communications plan with friends and family

• First aid kit (including relevant prescription medication)
• Hygiene products (including toothbrush, hand sanitizer, etc.)
• Eyeglasses or contact lens care
• Water (recommended one gallon per day)
• Food (non-perishable)
• Sweater / jacket
• Comfortable shoes
• Cash
• Copies of Social Security Card and passport
• Phone charger
• Blanket
• Can opener
• Flashlight
• Batteries

Watch "What You Need Before the Next Earthquake"

Emergency Go-Kit Flyer

Drop, Cover, and Hold On

If you are indoors:

• Stay inside until the shaking stops.
• DROP to the ground; take COVER by getting under a sturdy table or other piece of furniture; and HOLD ON until the shaking stops. If there is not a table nearby, cover your face and head with your arms and crouch in an inside corner of the building.
• Stay away from glass, windows, outside doors and walls, and anything that could fall, such as lighting fixtures or furniture.
• Be aware that the electricity may go out or the sprinkler systems or fire alarms may turn on.
• Do not use elevators.
• If you are in a stadium or arena:
  • Stay at your seat and protect your head and neck with your arms. Do not try to leave until the shaking is over. Walk out slowly watching for anything that could fall in the aftershocks.

If you are outdoors:

• Stay there.
• Move away from buildings, streetlights, and utility wires.
• Once in the open, stay there until shaking stops.
• Be aware of uneven roadways and tripping hazards.

If you are in a moving vehicle:

• Stop as quickly as safely possible and stay in the vehicle. Avoid stopping near or under buildings, trees, overpasses, and utility wires.
• Proceed cautiously once the earthquake has stopped. Avoid roads, bridges, or ramps that might have been damaged by the earthquake.

• After the shaking has stopped, evaluate your surroundings.
  • Look for safety hazards such as fire, smell of gas or fumes, dangerous debris or obvious structural damage.
  • Look for injured or trapped people.
• If you are in a building and there are no obvious hazards, do NOT evacuate.
• If the structural integrity of your building is compromised or your surroundings are hazardous, evacuate. Use the stairs. Assist in the building evacuation of people with special needs.
• Determine if emergency responders are needed. If yes, dial x2911 from a university phone or 415-422-2911 from an outside line.
• Expect aftershocks. If you feel additional shaking, drop, cover, and hold on until the aftershocks stop.
• Wait for information from USF via USF Alert and the outdoor speaker system. You may also receive information from the City of San Francisco through AM radio stations: KGO 810; KCBS 740, and KNBR 680.

• Do not move the person unless danger is present.
• Call Public Safety at 415-422-2911. Give Public Safety Dispatch the following information:
  • Building name, address or location
  • Cross streets
  • Floor and room number
  • Nature of the emergency
  • Your call-back number
  • The following instructions serve as a reminder for providing emergency assistance ONLY if trained or certified and it is safe to do so.
    • American Red Cross - First Aid Steps

• Remain calm and immediately refer to the Telephone Bomb Threat Checklist. If applicable, pay attention to your telephone display and record any information shown in the display window.
• The objective is to keep the caller on the line as long as possible to attempt to gather as much information as possible. Try not to anger the caller at any time.
• While engaging the caller, try to pay attention to any background noise and distinctive sounds (traffic, machinery, other voices, music, etc.) that may provide clues on the caller's location.
• Note any characteristics of the caller’s voice (gender, age, accent, education, etc.).
• Attempt to obtain information on the location of the device (building, floor, room, etc.).
• Attempt to obtain information on the time of detonation and type of detonator.
• At the conclusion of the call, immediately notify Public Safety at 415-422-2911. For non-Hilltop campus locations, dial 911.
• If the threat was left on your voicemail, do not erase.
• Notify the immediate supervisor within your work area.

Next Actions

The decision to evacuate a University building shall be made after a thorough evaluation of the information available, including but not limited to, the following:

• Nature of the threat.
• Specificity of location and time of detonation.
• All circumstances related to the threat (including series of events leading to the threat, political climate, etc.).
• Discovery of a device or unusual package, etc.

The University of San Francisco Department of Public Safety will organize the search of the building. Local emergency services will be notified of the threat and asked to stand by for further instructions. Persons leaving the building should report to that building’s Emergency Evacuation Area (EEA), or other designated assembly location. 

• Get out of the building as quickly and calmly as possible. Call x2911 from a university phone or 415-422-2911 from an outside line.
• If items are falling off of bookshelves or from the ceiling, get under a sturdy table or desk.
• If there is a fire, stay low and exit the building as quickly as possible. Activate the building fire alarm system, if possible.
• If you are trapped under debris, tap on an object or wall so that rescuers can hear where you are.
• Assist others in exiting the building. Do not use the elevators.
• Untrained people should not attempt to rescue people who are inside a collapsed building and should wait for emergency personnel to arrive.
• Once outside, keep moving away from the building and proceed to the Emergency assembly area or other designated assembly location. Keep roadways and walkways clear for emergency vehicles.
• Let emergency personnel know the location of people who are trapped or unable to evacuate the building.

Detecting Suspicious Packages or Letters

The U.S. Postal Service and the Bureau of Alcohol, Tobacco, and Firearms have designated the following characteristics as indicators of suspicious packages:

• Lumps, bulges, or protrusions on package
• A lopsided or heavy-sided package
• Excessive tape
• Handwritten addresses or labels from companies (check to see if the company exists and if they sent a package or letter)
• Packages wrapped in string
• Excess postage on small packages or letters
• No postage or uncanceled postage
• Handwritten notes such as “To Be Opened By…”
• Restrictive markings such as “confidential” or “personal”
• Improper spelling of common names, places, or titles
• Generic or incorrect titles. Titles with no name attached
• Oily discolorations or crystallization on wrapper
• Protruding wires, string, tape, etc.
• Hand delivered or “dropped off for a friend” packages or letters
• No return address or nonsensical return address
• Foreign mail, air mail, and special-delivery packages
• Any letters or packages arriving before or after a phone call from an unknown person asking if the item was received

Immediate Actions

If you receive or discover a suspicious package or foreign device, do not touch it, tamper with it, or move it. 

• Call Public Safety at 415-422-2911. For non-Hilltop campus locations, follow your campus procedures and notify your local authorities dial 911.
• Immediately secure and evacuate the area. Move people away. Do not move or open the package. Do not investigate too closely. Do not cover or insulate the package.
• Turn off ventilation, if able, or call Facilities Management at x6464 (415-422-6464) to do so.
• Thoroughly wash hands, remove clothing, and place clothing in a plastic bag.
• Do not return to the area until cleared by the Department of Public Safety, or the Environmental Safety Office or your local authority.

Immediate Action 

As necessary with the appropriate Personal Protection Equipment (PPE) Gloves, Gowns and/or Eye Protection, simple spills should be cleaned up by the person that caused the spill if they are adequately trained to do so.

Major spills or emergencies:

• Call Public Safety at 415-422-2911. For non-Hilltop campus locations, dial 911.
• Evacuate and assemble at a safe and upwind distance. This may include the Emergency Evacuation  Area (EEA), or other designated assembly location.  
• Account for all individuals
• Wait for, and provide, information to first responders

Call the Environmental Safety Office at 415-422-6464 regarding any simple or major hazardous materials spill.

For major spills or emergencies, the emergency response agency (local fire department, Environmental Safety Office, or a HAZMAT Team) will determine if the incident is under control and stabilized. After immediate hazards have been controlled and stabilized, the transfer of authority and responsibility for the site will be returned to the University.

Immediate Action

• If a critical incident is experienced relating to water, electricity, or steam, call Facilities Management at 415-422-6464.
• If a critical incident is experienced relating to telephone or computer systems, call Information Technology Services at 415-422-6668.

In case of Major, Campus-Wide Power Outage

• Remain calm and remain in your building unless otherwise directed
• If evacuation of a building is required, seek out people with special needs and provide assistance (call 415-422-2911 for additional assistance). For non-Hilltop campus locations, dial 911.
• If evacuation is required, proceed to the Emergency Assembly Area, or other designated assembly location
• Laboratory personnel should secure all experiments and unplug electrical equipment before evacuating. All chemicals should be stored in their original locations. Provide natural ventilation by opening all windows and doors. If this is not possible or natural ventilation is inadequate, evacuate the laboratory until the power is returned.
• Do not use candles or other types of open flame for lighting.
• Unplug all electrical equipment, including computers and turn off light switches.
• Do not use elevators.
• Emergency lighting for exit pathways will function for fifteen to thirty minutes following a power outage. In areas with poor natural light, evacuate promptly.
• Doors equipped with key-card readers will lock and limit entry. To exit, use the “emergency” push bar. Key-card access will be available when power is restored.

If People are Trapped in an Elevator

• Tell passengers to stay calm and that you are getting help.
• Call 415-422-2911 and provide information. For non-Hilltop campus locations, dial 911.
• Stay near passengers until Public Safety or other assistance arrives, provided it is safe to stay. 
• Elevators are equipped with emergency phones that connect to the Department of Public Safety.

Hazardous conditions that pose a danger to individuals or campus property should be reported to Facilities Management at 415-422-6464 (7:30am – 4:30pm) or the Department of Public Safety at all other times.

If any event occurs that jeopardizes public safety and the conditions outside are more dangerous than inside, move inside and defend in place.  Defending in place is different from sheltering in place.  Defending in place includes your actions to protect yourself.

Mask:  Put on breathing protection such as a mask or cover mouth and nose with a cloth.

Move:  If indoors, close windows and move to the highest, most interior room of a house or building. If outdoors, move laterally and upwind away from any smoke or aerosol cloud.

Shelter:  Seek shelter in a building or covered structure. If in a vehicle, pull over and turn off the engine, air conditioner, heater and vents, and roll up the windows.

• Turn off all electrical appliances, fans, air conditioners, furnaces, etc.

• Close and lock all windows, vents, doors, and other openings.

• Seal room windows and doors with duct or masking tape.

• Seal door thresholds with wet towels or clothing.

• Sit adjacent to an inner wall and away from outer walls and windows.

• Call Public Safety at 415-422-2911. For non-Hilltop campus locations, dial 911. Communicate your location with first responders.

Evacuation:  Be prepared to evacuate your home or workplace if circumstances change and require it.

Assist Others:  As circumstances and your training permits, assist others in your building or neighborhood. Depending on the magnitude of the incident, assistance from emergency services personnel may be significantly delayed. 

Severe weather conditions can occur suddenly or be forecasted ahead of time. Severe weather likely to occur in this area includes dense fog, heavy rains, and high winds.

Immediate Actions

Emergency situations that require immediate action and response are reported to the Department of Public Safety at 415-422-2911. For non-Hilltop campus locations, dial 911. 

Heavy Rains and High Winds

• Remain calm and avoid panic.
• In the event of extensive roof or window leaks or imminent flooding of ground floor areas, if safe to do so, unplug electrical devices and secure all equipment by moving them away from the hazard..
• Remain inside the building, away from windows.
• DO NOT use elevators.  Use the stairs just in case the power goes out.
• If outside, avoid areas with the heaviest concentration of trees. Stay clear of sagging or downed power lines.
• Assist community members with disabilities.

Hazardous conditions that pose a danger to individuals or campus property should be reported to Facilities Management at 415-422-6464 (7:30am – 4:30pm) or the Department of Public Safety at all other times.

Flooding at the University of San Francisco would most likely be a result of area flooding from major, multiple rainstorms or a nearby water-main break. In the event of weather-related flooding, the Department of Public Safety will monitor the National Weather Service and other emergency advisories to provide guidance on any necessary actions including evacuation of areas and cancellation of classes.

Immediate Action

In Case of Minor Imminent Flooding

• Secure vital equipment, records, and chemicals by moving to higher, safer ground. Shut off and unplug all electrical equipment.
• Secure laboratory experiments. 
• Wait for instructions from the Department of Public Safety for immediate action. 
• Do not return to your building, if you have evacuated, unless you have been instructed to do so from university administration.

In Case of Major Imminent Flooding

• In the event of major flooding, the impacted areas of campus should be evacuated immediately.
• Do not walk or drive into flooded areas such as streets and intersections.  (Sewer covers or storm drain covers may be missing and pose an unseen hazard)

Next Actions

After a Flood

• Flood dangers do not end when waters begin to recede. Listen to communications from the university, as well as local media, and do not return to the area until authorities indicate it is safe to do so.
• Stay out of buildings if floodwaters remain in or around the building.

Hazardous conditions that pose a danger to individuals or campus property should be reported to Facilities Management at 415-422-6464 (7:30am – 4:30pm) or the Department of Public Safety at all other times.

Description

During a disaster/emergency, the University understands that additional assistance will be required for persons with disabilities.  Additional assistance will be provided for people with a mobility disability, limited vision, or hearing impairment.

The University maintains a voluntary and confidential registry of persons with disabilities who may need individualized evacuation assistance or notification. The registry is accessible to essential staff for emergency life safety events.

While Emotional Support Animals or Comfort Animals are often used as part of a medical treatment plan as therapy animals, they are not considered service animals under the ADA. These support animals provide companionship, relieve loneliness, and sometimes help with depression, anxiety, and certain phobias, but do not have special training to perform tasks that assist people with disabilities

Planning

• Identify two friends or colleagues as emergency companions at the location(s) you frequently visit.
• Communicate with your companion and indicate what type of assistance you will be requesting.
• Identify at least two emergency exits.
• Locate an Area of Refuge in the event of an emergency and you are unable to evacuate the building.

Immediate Actions

• Remain calm and avoid panic.
• Go to an area of safety. Depending on the emergency situation, your actions could include:
  • Evacuate the building if required.
  • Assemble in an Area of Refuge and notify others of your location.
  • In an earthquake, seek interior hallways, stairwells or rooms.
  • In an earthquake, avoid windows and corridors with windows.
  • In a fire, seek an exterior facing room with windows so you can seek help.
  • Defend in Place and call Public Safety for assistance.
• DO NOT use elevators during an emergency.
• Close all doors, including main corridors, making sure they latch, but do not lock.
• Let first responders know if you have a service animal or emotional support animal.

The University of San Francisco Pandemic Influenza / Infectious Disease Prevention and Response Plan was written to address the university's preparedness activities and response to a pandemic that impacts the university community and to minimize impact on operations, students, faculty, and staff. While this plan's primary focus is influenza, it was developed with the intention that it is to be read, understood, and utilized in response to threats and real-world occurrences of any type of epidemic or any disease outbreak that becomes a worldwide pandemic impacting the university. This plan is not limited to a singular disease outbreak, but rather was designed to serve as an all-encompassing template for any potential outbreak. It may be modified in the future to be tailored to a specific disease outbreak.

A pandemic is described as a widespread outbreak of a communicable disease which crosses international borders and impacts populations worldwide. These outbreaks are usually characterized by waves of illness spread across an extended period of time. An epidemic, on the other hand, is an outbreak or unusually high occurrence of a disease within a specific population or area. These outbreaks are more localized without the potential sweeping worldwide impact. If an epidemic or pandemic were to occur, higher education will likely be among the industries most severely impacted due to the risks resulting from open and accessible campuses and travel by students, faculty, and staff. These potential impacts include, but are not limited to, large numbers of absenteeism among students, faculty, and staff due to illness; increased demands on student health and counseling; unavailability of essential services; and significant loss of revenue.  

During a pandemic, the primary challenges facing the university will likely be:

• Managing student, faculty, and staff exposure to potential infection both on campus and while engaging in activities off-campus
• Complying with local, state, and federal mandates regarding response to a pandemic while complying with all appropriate local, state, and federal agencies
• Maintaining progress of students towards degrees and faculty research while complying with any orders to close the campus
• Loss of income due to potential closure of campus and the inability to continue to hold classes

Planning a response to a potential public health emergency follows a similar planning cycle as other campus emergency plans. These plans will be reviewed and adjusted periodically by the Office of Campus Resilience, in conjunction with university stakeholders. This plan may be adjusted per incident due to specific incident details.

Influenza Background

Influenza is one of the most common and prevalent viral infections seen worldwide and is divided into three types - influenza A, B, and C viruses. Influenza A and B are the two types that are infectious to humans, with Influenza A being the type that causes epidemics and pandemics. Influenza is a respiratory virus and the representative flu-like symptoms are fever, headache, malaise, and body aches.

The influenza virus is spread through small airborne droplets during talking, breathing, and coughing. These droplets may remain viable and infectious on surfaces, such as countertops, for as long as a day.

Seasonal influenza is seen annually and circulates worldwide. Influenza that is seen annually has an attack rate much lower than pandemic influenza. It is estimated that between 5-10% of adults and between 20-30% of children worldwide are affected each year. While many of those affected will have only minor symptoms, illnesses can result in hospitalization and death. This is mainly found among higher risk population groups which include the very young, elderly, and chronically ill. Seasonal influenza is estimated to result in three to five million cases of severe illness and approximately 250,000-500,000 deaths annually. The most effective way to prevent disease annually is through vaccination. 

Below is a table provided by the US Department of Health and Human Services comparing the seasonal influenza and the characteristics of a pandemic influenza:

Pandemic Overview

Epidemics and pandemics are a result of mutations and reassortment of influenza strains. This mutation occurs due to the virus' ability to infect and replicate in both humans and many animal species - most notably birds and pigs. Multiple strains are able to infect a host, and through a random recombination of these strains, a new virus may form. These mutations are known as antigenic drift and antigenic shift.

Antigenic drift occurs every two or three years and causes localized, less severe outbreaks. These smaller changes in genes occur over time and the genetic changes often cause viruses that are closely related to one another. An immune system exposed to one of these "drifted" viruses still maintains some cross-protection and will usually recognize and respond to the virus in much the same manner as prior to the drift occurring.

Antigenic shifts occur much less frequently but are the cause of the major influenza pandemics of the past. Shifts are major, abrupt changes in viruses resulting in a new protein structure. These shifts usually occur in animal populations which produces a subtype so different than what is commonly occurring in humans that most people do not have any immunity to this new virus.

Past Pandemics

The "Spanish" Influenza of 1918-1919

The first pandemic of the 20th century, the "Spanish" influenza of 1918 is estimated to have impacted one third of the world's population at the time - approximately 500 million people. Total deaths for this pandemic is estimated to have been anywhere from 50 million to potentially as high as 100 million worldwide. Outbreaks occurred simultaneously in both Europe and the United States and lasted over three waves. This pandemic mostly affected adults between the ages of 20-40, which is unusual for influenza. Nearly half of the deaths attributed to this pandemic affected this age group. It is also believed that each pandemic following this has been attributed to this strain as it has remained within the swine population.

The "Asian" Influenza of 1956-1957

This epidemic was believed to have started in China in late 1956 and spread throughout Singapore and Hong Kong in early 1957 before making its way to the United States in the summer of 1957. The World Health Organization estimates that the pandemic was responsible for approximately two million deaths worldwide with 70,000 of those occurring in the United States. This flu strain underwent a shift and caused a milder pandemic that occurred from 1968-1969. 

The "Hong Kong" Influenza of 1968-1969

The first outbreak of this pandemic occurred in July 1968 in Hong Kong with extensive outbreaks spreading throughout Vietnam and Singapore shortly thereafter. By fall, the flu had spread to the Philippines, India, Australia, parts of Europe, and the United States. In comparison to the previous two pandemics, this pandemic had a lower death rate which may be attributed to the similarity of the 1957 strain and previously built upon immunity. In the United States, approximately 34,000 people died.

The "Swine" Influenza of 2009

The latest pandemic appeared in the spring of 2009 as a reassortment of bird, swine, and human influenza viruses combined with a Eurasian pig flu virus into a new strain. The index case for the pandemic was in Mexico before spreading to the Untied States. Eventually, the influenza virus spread to the Middle East, Europe, and Asia. By 2010, at the end of the pandemic, there was an estimated 623,000 people infected worldwide with approximately 18,000 deaths.

Pandemic Risks

Pandemics present risks to the general population outside of the university setting which must be considered and addressed. These risks include:

• Unpredictability - The seasonality or appearance of a pandemic cannot be predicated with certainty. Historically, influenza pandemic waves occur in the fall and winter though the potential is there for waves to occur outside of this time frame.
• Unknown Timeline - In an affected community, a pandemic stage will normally last approximately 6-8 weeks. Multiple waves, periods during which community outbreaks occur, of illness could occur with each wave potentially lasting between 2-3 months. 
• Unavailability of Medical Interventions - Vaccination is widely considered the first line of defense for reducing a high morbidity and mortality rate that will inevitably accompany a pandemic. However, due to a variety of reasons, no country will have enough vaccine at the start of a pandemic for its population. Additionally, large-scale vaccine production should not be expected to begin until three to six months following the emergent pandemic, depending on the nature of the pandemic. The best case scenario will see the development of a vaccine following the first wave of a pandemic. Antiviral drugs will be expected to be the most useful for prophylaxis and for treatment. There are stockpiles of these drugs as part of the Centers for Disease Control and Prevention's (CDC) Strategic National Stockpile (SNS). These stockpiles contain large quantities of medicine and medical supplies that may be deployed to assist the American public in the event of a public health emergency.
• Disruptions - Expect major disruption to public transportation, health and public service, and normal life and business operations due to large absenteeism of personnel in those industries. 

Pandemic planning is based on assumptions regarding the evolution and potential impacts of a pandemic. Defining the scope of a pandemic is challenging due to the potential for large differences in severity when compared to prior pandemics. These differences are largely related to the severity of infections and the virulence of the viruses. However, the major pandemics of the 20th century, influenza pandemics, share similar characteristics. These similarities are noted in the below assumptions:

General

• Susceptibility to the pandemic may be universal.
• The clinical disease attack rate will be 30% of the overall population. Illness rates will be highest among school-age children (about 40%) and decline with age. Among working adults, an average of 20% will become ill during an outbreak.
• Of those who become ill with influenza, 50% will seek outpatient medical care.
• Risk groups for severe and fatal infections cannot be predicted with certainty.
• The typical incubation period for influenza averages two days. This plan assumes this would be the same for a novel strain.
• On average, about two secondary infections will occur as a result of transmission from someone who is ill. 
• Persons who become ill may shed virus and transmit infection for up to one day before onset of symptoms.
• In an affected community, a pandemic outbreak will last about six to eight weeks, with at least two pandemic waves likely.
• General absenteeism in the community attributable to illness may reach 40% during the peak weeks of a community outbreak.
• Facilities and infrastructure will remain unaffected and functional during a pandemic.

Campus Specific

• The first wave will occur during either the fall or spring semester while classes are in session.
• Students may begin to depart campus of their own volition when the first cases occur.
• Faculty and staff absenteeism will mirror the general population's rate and will be in the 40% range. This number will increase quickly when local K-12 schools, businesses, and other work locations begin to close as members of the university community will remain home to care for family members.
• If the decision is made for USF to cancel classes and advise students to return home, it is expected that some students will remain at USF because of travel restrictions or because they do not have suitable alternative living options. Examples of these students include:
  • International students and domestic students living in residence halls that cannot travel home
  • Students, both undergraduate and graduate, living in off-campus housing will remain in San Francisco and the greater Bay Area
• Any public health recommendations for isolation, quarantine, and social distancing are likely to rely on voluntary participation to be effective. USF will provide for isolation and quarantine of students and residents of USF residence halls.
• Recovery and resumption of normal campus activities will be slow and difficult with great emotional, physical, and financial impact to individuals and the institution.

The University of San Francisco identifies six levels occurring before and after pandemic. Each level has associated actions with it that are to be taken by the university once certain trigger points are met. These phases are based on pandemic phases created by the World Health Organization (WHO) and the US Federal Government Response Stages (FGRS). The WHO and FGRS phases are broken out below:

Changes from one phase to another are triggered by several factors including the epidemiological behavior of the disease and the characteristics of the circulating virus.

Inter-Pandemic Period

No new virus subtypes have been detected in humans during this phase. However, a circulating animal influenza virus subtype is prevalent and potentially poses a substantial risk to humans.

Pandemic Alert Phase

This phase is characterized by evidence of human infection in a new virus subtype. No human-to-human spread of the disease may be seen in this phase, or, in rare instances, there may be some close, localized human-to-human transmission. This would suggest that the virus is becoming more adapted to humans, but it may not yet be fully transmissible. There are still no cases within the local community or on the USF campus.

Pandemic Phase

Increased and sustained transmission of infection in the general population. In this phase, there are cases either in the local community or on USF campus.

In the event that the pandemic influenza significantly impacts campus operations, the campus will implement specific response processes and measures and will use the Standardized Emergency Management System (SEMS), in addition to the National Incident Management System (NIMS) to manage campus response activities. This is similar to the operations that the university will conduct no matter the situation.

The Incident Command System (ICS) structure will be modified to address pandemic management as well as continuity planning for campus operations. Early activation of the response is critical and will best allow the university to devise the most appropriate response strategy.

President's Cabinet

The President's Cabinet is responsible for directing the strategic response to a pandemic incident. This group will be comprised of the following and will oversee long-term, continuity response rather than the detailed response operations:

• President
• Provost and Vice President for Academic Affairs
• Vice President for Business and Finance and Chief Financial Officer
• Vice President for Information Technology Services and Chief Information Officer
• Vice President for Marketing Communications
• Vice President for Development
• Vice President for International Relations
• General Counsel
• Vice Provost of Student Life

Command Staff

The Command Staff is responsible for assisting the Emergency Operations Director when needed at the time of the emergency. If necessary, this group is responsible for the tactical control of the incident rather than the strategic response. This group consists of the following:

• Emergency Operations Director
• Safety Officer
• Security Officer
• Public Information Officer

Planning Section

The Planning Section is responsible for overall emergency policy ans well as coordination of response efforts. The Management Section Staff, which is to be headed by the Senior Director of Public Safety, is responsible for providing advice to the Senior Director on policy matters. Staff will also assist in the development of overall strategy and formulation of relevant rules, regulations, policies, etc. The Section includes the following staff functions and will be designated at the time of activation:

• Academic Programs
• International Programs
• Athletics
• Faculty personnel
• Staff personnel

Operations Section

The Operations Section's primary responsibility is to manage the operations of the various response elements that are related to the pandemic response. These elements include, but are not limited to, the following and will be designated at the time of activation:

• Public Safety
• Facilities Management
• Student Life
• Health Promotion Services
• Counseling and Psychological Services
• Office of Grants and Contracts

Logistics Section

The Logistics Section's primary responsibility is to ensure the acquisition and mobilization of resources to support the pandemic response effort. This section is responsible for providing communication services, acquiring equipment and supplies as well as arranging for food, lodging, and other support services as required. The Logistics Section includes, but is not limited to, the following and will be designated at time of activation:

• Care and Shelter
• Supplies
• Communication

The impact of a pandemic on the USF campus community is one that cannot be predicted with any great accuracy. However, through the planning and execution of a campus Business Continuity Plan (BCP), the potential impact can be mitigated. It must be noted that when absentee rates threaten the safe continuity of operations at USF, the university may look to close. It is important to recognize that closure may be directed by any one of the following:

• The California Department of Public Health, acting through City and County Public Health Offices, may invoke social distancing measures which may include the closing of schools.
• The President of USF, or designee, may order the cancelation of classes and cessation of all but critical functions of the university.

The closing of USF notification, and any evacuation of campus, will be made in accordance with the USF Emergency Operations Plan.

The recovery efforts and reopening of USF may occur after an unknown period of time. A number of factors including the number of faculty, staff, and students that will be able to return to campus will ultimately be the deciding factors of the resumption of operations. The President's Cabinet shall determine when and whether partial, incremental, or full return to normal operations is most appropriate.