Transcript Emergency Preparedness Planning Exercise

Annual Impact of Influenza
• 114,000 excess
hospitalizations/yr
• 43% 65+ yrs
• 20,000 deaths/yr
• >90% 65+ yrs
Influenza - Clinical Features
• Incubation period 1-5 days
• Abrupt onset of fever,muscle aches, sore
throat, cough, headache
• Severity of illness depends on prior experience
with related viruses
• Spread through contact with respiratory
droplets, possibility of airborne spread, hands
• Most infectious 24 hours prior to onset of
symptoms and during first 7 days of symptoms
Projected Impact of Pandemic
Influenza in Minnesota
• 1,544,000 ill
• 772,000 outpatient medical care
• 15,000 - 172,000 hospitalized
• 2,250 – 25,700 ICU care
• 1,120 – 12,900 mechanical ventilation
• 3,600 - 32,900 influenza deaths
• Outbreak period - 6-8 weeks
Pandemic Influenza
• A “novel” influenza virus not previously known to
infect humans
• Person to person transmission
• Highly infectious
• Population has little to no immunity
• The virus will infect all age groups
• The “novel” virus spreads rapidly worldwide
Influenza Pandemics in the
Twentieth Century
• 1918 “Spanish Influenza”
• 1957 “Asian Influenza”
• 1968 “Hong Kong Flu”
Spanish Influenza of 1918-1919
25 million cases
600,000 deaths
Emerging Infections are only a
Plane Ride Away
Pandemic
Influenza
Tabletop
Exercise
Exercise Objectives
• Exercise using the Incident Command System (ICS)
• Raise awareness about impact of pandemic influenza
• Increase understanding regarding the responsibilities of LPH
• Identify gaps in coordination between agencies
Exercise Overview
The exercise addresses planning issues that will arise
during the course of an influenza pandemic over an
array of areas including:
• Surveillance
• Vaccination
• Antiviral medications
• Communications
• Emergency response
The emphasis of this exercise is on the public health
response.
Sample Command Structure
Incident Commander
______________
Safety
_______________
Liaison
_______________
Public Information
_______________
Operations
____________
Planning
_______________
______________
________________
_______________
______________
________________
________________
Logistics
_____________
Finance
_______________
_______________
_______________
____________
______________
_______________
_____________
“It’s Coming”
Questions “It’s Coming”
1. Who is leading the public health response and what
are the roles and responsibilities of the persons who
report to this individual?
2. What are the key issues the health department needs
to address at this point?
3. Who are the key partners with whom these issues
need to be addressed?
4. What specific assistance will Stearns County need
from external agencies/organizations?
Questions “It’s Coming”
5. What steps are being taken to prepare the provider
community and the general public for the events of
the next 2-3 months?
6. What kinds of messages need to be crafted for the
public before the outbreak occurs and in response to
predictable issues once the outbreak occurs?
7. How are you working with local media so they will
help your efforts?
8. How are non-English speaking populations being
addressed?
Questions “It’s Coming”
9. What plans do you have in place to step up
surveillance activities? Where will additional staff
needed for extra workload come from?
10. On what medical care-related areas does public
health need to collaborate with the hospitals,
emergency rooms and outpatient providers?
11. What plans been developed to vaccinate priority
groups after first shipments of vaccine arrive?
12. Are plans in place for mass vaccination? If so, in
what locations and who will staff them?
“It’s Here”
Questions “It’s Here”
1. How do you plan to address anticipated staff shortages
in the health department; what essential functions must
remain in place? Who decides how limited staff and
other resources are allocated?
2. What essential services must be maintained in the
county? How will resources be allocated and accounted
for in order to maintain these services? Who decides
these issues?
3. What role is public health playing with respect to
hospitals and the prospect of facilities being
overwhelmed? Are you tracking availability of beds?
Questions “It’s Here”
4. How are laboratory services being prioritized to deal with
the high demand as well as staff shortages?
5. You are receiving daily inquiries about the number dying
of influenza. How are you responding? How severe is
the pandemic in your area and how do you know this?
6. In anticipation of soon receiving vaccine that will be
targeted for health-care workers and first responders,
how are you addressing public concerns about lack of
vaccine?
Questions “It’s Here”
7. Health care workers and first responders express
concern about exposure. What advice can be given?
8. What are your plans to manage the very small supply of
antiviral medications received from (MDH, CDC)?
9. How will you prioritize who gets antiviral medications,
and how will you distribute these medications?
Questions “It’s Here”
10. What are the primary responsibilities of 911 dispatch,
sheriff, police, and fire departments? What resources will
they need?
11. At what point will you decide whether schools will be
closed and whether public gatherings and events will be
cancelled? How will you balance school closures with
the impact on the workforce when parents stay home
with children? Who will be involved in making these
decisions?
“It’s Bad”
Questions “It’s Bad”
1. Hospitals are full, and there are severe staff shortages.
The least ill patients are being sent home. Have any
plans been made for provision of home health care?
2. What special issues need to be considered related to
various populations such as persons who are
geographically isolated, non-English speakers, hearing
impaired persons, the elderly, and others with already
limited access to healthcare?
Questions “It’s Bad”
3. How will the deceased be safely and respectfully
handled, and how will religious beliefs be addressed?
4. National recommendations have been issued stating
that health-care workers and first responders are the
highest priority groups for vaccination when the vaccine
first becomes available. As you make plans to begin
vaccinating, how are you responding to the angry
public that wants vaccine, and in particular to panicked
parents?
Questions “It’s Bad”
5. Because you will not be able to vaccinate every
health-care worker and first responder in your
jurisdiction, how are you determining which healthcare workers are eligible in this first round of
vaccination?
6. Health-care workers are demanding that their family
members also receive vaccine. How are you
responding to this?
Questions “It’s Bad”
7. How do you plan to safeguard and monitor your
vaccine?
8. What mental health needs of citizens, health workers,
emergency responders, and others must be
considered and addressed? How will this be
accomplished?
Months Later….. Update
• The number of ill persons has been on the
decline for 3 weeks.
• Hospital staff are exhausted. All those
available to assist in providing health care
have been pulled in.
• Vaccine is finally becoming available on a
larger scale for vaccination of more people.
Final Questions……
1. The health care community, both public and private, has
been stretched thin responding to the clinical are needs.
Who will staff the vaccination clinics?
2. What can be done to alleviate the stress for those who
have already been enlisted with other efforts during the
past 8 weeks?
3. Turnout for vaccination is less than expected. What is
your communication plan to increase interest in
vaccination?