Situation Manual. 375 Minutes. Time Allotted. Situation Manual Tabletop Exercise 1 Disaster Resistant Communities Group

Transcription

1 Situation Manual 375 Minutes Situation Manual Tabletop Exercise 1 Disaster Resistant Communities Group

2 Contagion Containment Exercise Play Exercise Briefing During the exercise it will be important to remember and comply with the following statements: The focus of this exercise is to provide an opportunity for management and staff from the Hamilton County Health Department to gain additional insight into the processes associated with providing infection control guidance to county healthcare providers, schools, public / private workplaces and the general public based on a variety of public health emergencies. During the exercise you will be presented with three realistic infectious diseases. During each scenario you will review a series of situations. Based on these situations you will then formulate responses (answers) to the exercise injects (questions) based on your working knowledge of the county s contagion control policies and procedures. It is important NOT to jump ahead in the exercise scenario. In other words don t focus on what might happen, focus on the Common Operating Picture that is presented during the exercise to make informed decisions. In any exercise a number of assumptions and artificialities may be necessary to complete play in the time allotted. During this exercise, the following apply: 1. The scenario is plausible, and events occur as they are presented. 2. There is no hidden agenda, nor any trick questions. Exercise Basics: 1. This exercise contains a total of 27 scenario and inject pages. 2. All videos embedded within this exercise can be enlarged to FULL SCREEN by simply clicking on the full screen icon in the lower right hand corner of the video. 3. Thoroughly review all scenarios and injects as they are presented during the exercise. At the end of the exercise you will need to complete an evaluation (Hotwash) on how your team performed during the exercise. The Hotwash will consist of your team providing comments on three areas in which it performed well (Strengths) and three areas for your consideration to improve or modify existing plans (Areas for Improvement) to enhance your team s preparedness, response and / or recovery capabilities. Found below are Hotwash examples: Strengths During the exercise our team consulted our disaster plans and procedures and found them to be complete. Areas for Improvement During the exercise our team consulted our disaster plans and procedures and found portions of the plans and procedures that need to be revised. Situation Manual Tabletop Exercise 2 Disaster Resistant Communities Group

3 After the exercise each registered participant who took part in the exercise will receive an to log into the ONX System to complete their Individual Hotwash to access their Certificate of Participation. 20 Minutes Situation Manual Tabletop Exercise 3 Disaster Resistant Communities Group

4 Contagion Containment Scenario # 001 Measles Outbreak Scenario No Image The focus of the first Contagion Containment Exercise scenario is a severe Measles Outbreak occurring within the region. CLICK ON VIDEO TO PLAY Just In Time Disaster Training Measles Awareness 10 Minutes Situation Manual Tabletop Exercise 4 Disaster Resistant Communities Group

5 Contagion Containment Scenario # 002 Image of Church Rally Day 1 Saturday May 7 9:53AM During the first full weekend of May churches from across the region have come together to host the first annual "Season of Hope Youth Rally" at the Spirit of the Suwannee Music Park. Over the next two days, rally participants will take part in a wide variety of engaging activities. Day 2 Sunday May 8 5:00PM At the conclusion of the rally everyone gathers for one last time to participate in the rally s Closing Ceremony. Following the Closing Ceremony, rally organizers meet to evaluate the two days of fun and fellowship. Organizers are very pleased that 1,347 young people and their parents participated in the two day event. 10 Minutes Situation Manual Tabletop Exercise 5 Disaster Resistant Communities Group

6 Contagion Containment Scenario # 003 Image of Press Release Day 3 Monday May 9 9:17AM IMMEDIATE RELEASE MEASLES CASE IN INTERNATIONAL TRAVELER CONFIRMED IN DUVAL COUNTY ~ Residents encouraged to remember vaccination is the best protection ~ TALLAHASSEE The Florida Department of Health has confirmed measles in an adult international traveler who attended a faith based conference in Jacksonville, Florida, at the Osborn Convention Center. Most of the traveler s time was spent in Duval County; however, the traveler also spent time in Alachua, Suwannee, Hamilton and Marion Counties visiting local churches during the infectious period of April 30 thru May 4, The traveler was hospitalized on May 5 and released on May 6 and on May 7 returned to his country of origin via the Jacksonville International Airport. The department continues to work closely with health care professionals and organizations in an effort to maintain its current level of readiness to identify cases and respond to any diagnosed cases of measles in Florida. The department is also working with the Centers for Disease Control and Prevention as well as the organizer of the faith based conference to notify all conference attendees as well as all establishments the traveler visited while infectious to identify potentially exposed individuals. 10 Minutes Situation Manual Tabletop Exercise 6 Disaster Resistant Communities Group

7 Contagion Containment Inject # 004 Image of Hospital Day 4 Tuesday May 10 11:17AM Over the past five hours numerous individuals have been arriving at area hospitals, urgent care centers and primary care providers with "flu-like" symptoms (high fever, chills, fatigue and persistent coughs). The majority of these cases, which include otherwise healthy young adults and children, exhibit signs and symptoms more serious than the common flu. Epidemiology personnel at the DOH-Hamilton have noticed Red Alerts within the Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE). The causes for the Red Alerts are the elevated numbers of Influenza Like Illness (ILI) symptoms being reported by Shands Live Oak Regional Medical Center. Based on information from the Florida Department of Health (FDOH) regarding measles, Shands Live Oak Regional Medical Center collects blood samples from several patients then ships the samples to the FDOH Bureau of Public Health Laboratories (Public Health Lab) to be analyzed. Based on the current information will the DOH-Hamilton activate any of the components of its Emergency Operations Plan (EOP)? If the above answer is yes. Identify the components of the EOP that will be activated and briefly describe the actions that will be implemented at this time. Yes No If the above answer is no. Briefly explain why the DOH-Hamilton will not activate any of the components of its EOP. 15 Minutes Situation Manual Tabletop Exercise 7 Disaster Resistant Communities Group

8 Contagion Containment Inject # 005 Image of Health Surveillance Day 4 Tuesday May 10 1:29PM Briefly describe the enhanced health surveillance processes and procedures that will be employed by DOH-Hamilton based on current information and the Red Alerts in ESSENCE. 15 Minutes Situation Manual Tabletop Exercise 8 Disaster Resistant Communities Group

9 Contagion Containment Inject # 006 Image of ICS Day 5 Wednesday May 11 8:29AM Over the past 24 hours, area hospitals and clinics have continued to experience an increase in patients presenting with severe flu-like symptoms. Two physicians at Shands Live Oak Regional Medical Center have noticed an increasing number of patients presenting with flat red spots on their faces and necks and come to the conclusion that there may be an outbreak of measles within the region. Following protocols the hospital contacts DOH-Hamilton and other area health departments. The blood samples shipped by the hospital to the FDOH Public Health Lab have tested positive for measles and the DOH- Hamilton has been notified. Based on the current information and with guidance from the FDOH the decision has been made to fully activate the Disease Surveillance and Control component of DOH-Hamilton s EOP. Will the DOH-Hamilton utilize the Incident Command System to effectively and efficiently manage the response to this public health emergency? If the above answer is yes. Identify the individuals by name and title that will be responsible for fulfilling the various ICS roles that will be staffed for this incident. Yes No If the above answer is no. Briefly explain why ICS will not be used and describe in detail how the DOH-Hamilton will manage this incident. 20 Minutes Situation Manual Tabletop Exercise 9 Disaster Resistant Communities Group

10 Contagion Containment Inject # 007 Image of Partners The DOH-Hamilton fully understands that it will need the support of various government agencies (Community Partners) to support its disease surveillance and control measures in response to the measles outbreak. Identify each of the Community Partners in which the DOH-Hamilton plans to rely upon in the days to come. In identifying each partner, list point of contact (POC) information (name and phone number) for the partner, then list the support that the DOH-Hamilton can expect to receive from the identified partner. (Example: Community Partner: County Emergency Management Department / POC: Henry Land / Support: Provide access to the CodeRED mass notification system.) Is there a network of community and / or faith based organizations (Community Partners) within Hamilton County that can be called upon to assist DOH-Hamilton during this public health emergency? If the above answer is yes. Identify all networks then briefly describe how the DOH-Hamilton will utilize each network of community and faith based organizations. Yes No 20 Minutes Situation Manual Tabletop Exercise 10 Disaster Resistant Communities Group

11 Contagion Containment Inject # 008 Image of Volunteers The DOH-Hamilton s Community Partners are ready to step-up and assist during this public health emergency. However most indicated that their paid and / or volunteer staff members do not have the training to assist with disease surveillance and control activities. Explain in detail how the DOH-Hamilton will provide just in time training for individuals that would like to assist but have no training. This includes DOH-Hamilton staff members that do not have the necessary training. 15 Minutes Situation Manual Tabletop Exercise 11 Disaster Resistant Communities Group

12 Contagion Containment Inject # 009 Image of Church Day 5 Wednesday May 11 10:19AM Most of the churches in Hamilton County participated in the Season of Hope Youth Rally held at the Spirit of the Suwannee Music Part. It has been confirmed that several of these churches were visited by the adult international traveler who had measles on April 31. (Note: The traveler was infectious between April 30 and May 4.) Will DOH-Hamilton need to work with county churches as part of its measles surveillance and control actives? Yes No If the above answer is yes. Describe in detail the activities that will need to be undertaken by DOH-Hamilton in regards to coordinating measles monitoring and infection control with county churches. If the above answer is no. Briefly explain why DOH-Hamilton will not coordinate with county churches. 20 Minutes Situation Manual Tabletop Exercise 12 Disaster Resistant Communities Group

13 Contagion Containment Inject # 010 Image of School Day 5 Wednesday May 11 12:48PM DOH-Hamilton has coordinated with local church leaders to engage them in an effort to prevent the spread of measles. With the focus of the last weekend s Season of Hope Youth Rally being to bring young people together for a weekend of fun and fellowship the leaders of area churches are encouraging DOH-Hamilton to coordinate their measles monitoring and prevention measures with the Hamilton County School District. Will DOH-Hamilton work with the Hamilton County School District to effectively control the spread of measles within the county s schools? If the above answer is yes. Describe in detail the activities that will need to be undertaken by DOH-Hamilton in regards to coordinating measles monitoring and infection control with the county s schools. (Note: Access an example of a measles notification letter for parents of school students.) Yes No If the above answer is no. Briefly explain why DOH-Hamilton will not coordinate with the county s schools. 20 Minutes Situation Manual Tabletop Exercise 13 Disaster Resistant Communities Group

14 Infirmary Intimidation Stop Point No Image Controller Note: Conduct an open discussion among all exercise participants regarding the actions taken during this scenario. Situation Manual Tabletop Exercise 14 Disaster Resistant Communities Group

15 Contagion Containment Scenario # 011 Influenza Pandemic Scenario No Image The focus of the second Contagion Containment Exercise scenario is the county s response to a severe Influenza Pandemic which threatens the health and welfare of county residents. CLICK ON VIDEO TO PLAY Just In Time Disaster Training - Influenza Pandemic Awareness 10 Minutes Situation Manual Tabletop Exercise 15 Disaster Resistant Communities Group

16 Contagion Containment Inject # 012 Image of Rural China Day 1 An outbreak of unusually severe respiratory illness has been identified in a small village in southern China. At least 25 cases have occurred affecting all age groups; 20 patients have required hospitalization, five of whom have died to date. Day 11 Surveillance in surrounding areas has been increased resulting in new cases being identified throughout the province. Viral cultures collected from several of the initial patients are positive for type A influenza virus. Samples of the virus have been sent to the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) for further characterization. The CDC has determined that the samples are type A H5N1, a subtype never before found in humans. Day 29 The findings from the CDC have been transmitted back to the Ministry of Health in China and throughout the WHO network. The CDC, in collaboration with the WHO, has dispatched a team of epidemiologists and laboratory personnel to further evaluate the outbreak and disseminates a Health Alert Network (HAN) advisory notifying clinicians and health departments in the United States to be on the alert for patients with severe respiratory illness and a history of travel to the region of Asia where the human cases occurred. Samples of the H5N1 influenza virus are sent to the United States Food and Drug Administration (FDA), Novartis, Sanofi Pasteur, MedImmune and GlaxoSmithKline so that work can begin on vaccine production. Identify the name and title of the individual at the DOH-Hamilton who will receive the HAN advisory. Assuming that the chance of DOH-Hamilton staff encountering patients that may have been exposed to the virus is very remote, will the information contained in the HAN be shared with all of the DOH-Hamilton s staff? Yes No Situation Manual Tabletop Exercise 16 Disaster Resistant Communities Group

17 If the above answer is yes. Briefly explain how this information will be disseminated to all of the DOH-Hamilton staff. If the above answer is no. Briefly explain why the information in the HAN will not be shared at this time. 15 Minutes Situation Manual Tabletop Exercise 17 Disaster Resistant Communities Group

18 Contagion Containment Inject # 013 Image of Phase 4 Pandemic Alert Day 37 The WHO has issued a Phase 4 Pandemic Alert. Influenza vaccine manufactures have been placed on alert and have begun to prepare for the production of a vaccine to combat the H5N1 influenza virus. The outbreak caused by the novel influenza virus is headlined in every major newspaper, is trending on Twitter and has become the lead story on CNN, MS-NBC and Fox News. Day 46 Key United States government officials continue to be briefed on a daily basis as surveillance is intensified throughout Southeast Asia and the Pacific Rim. The CDC has issued a Level 3: Warning for those traveling to and from China and Indonesia, and a Level 1: Watch for most of the other Southeast Asian countries. Human cases of the H5N1 influenza virus have been reported in Hong Kong, Singapore, South Korea and Japan. Based on the current information from the CDC and WHO will the DOH-Hamilton activate any of the components of its Emergency Operations Plan (EOP)? If the above answer is yes. Identify the components of the EOP that will be activated and briefly describe the actions that will be underway at this time. Yes No Situation Manual Tabletop Exercise 18 Disaster Resistant Communities Group

19 If the above answer is no. Briefly explain why the DOH-Hamilton will not activate any of the components of its EOP. 15 Minutes Situation Manual Tabletop Exercise 19 Disaster Resistant Communities Group

20 Contagion Containment Scenario # 014 Image of Phase 5 Pandemic Alert Day 66 Although cases are reported in all age groups, young adults appear to be the most severely affected, and case-fatality rates approach 9% of those individuals stricken with the virus. Public unease grows because a vaccine is not yet available and supplies of antiviral drugs are severely limited. The WHO issues a Phase Five (5) Pandemic Alert. Day 89 CLICK ON VIDEO TO PLAY Video Library Public Health Video # 1 Influenza Pandemic Overview - GNN State and local public health agencies are asked by the CDC to intensify influenza surveillance. 10 Minutes Situation Manual Tabletop Exercise 20 Disaster Resistant Communities Group

21 Contagion Containment Inject # 015 Image of Health Surveillance Day 91 Briefly describe the enhanced health surveillance processes and procedures that will be employed by the DOH-Hamilton due to the current health emergency. Day 92 With guidance from the FDOH the decision has been made to fully activate the DOH-Hamilton s EOP. 15 Minutes Situation Manual Tabletop Exercise 21 Disaster Resistant Communities Group

22 Contagion Containment Inject # 016 Image of Flu Prevention Upon activating the EOP one of the first actions that will need to be taken is to develop a community outreach plan which focuses on the influenza prevention measures that will need to be taken by county residents to reduce the chance of their families contracting the FLU. Describe in detail the preventive measures that will need to be implemented by county residents. (Note: For future reference you may want to access the Just In Time Disaster Training Library for additional information on Flu Pandemic Preparedness for the Workplace / Flu Pandemic Preparedness for Families. These videos are too long to view during today s exercise. Flu Pandemic Preparedness for the Workplace / Flu Pandemic Preparedness for Families) OPTIONAL 20 Minutes Situation Manual Tabletop Exercise 22 Disaster Resistant Communities Group

23 Contagion Containment Scenario # 017 Image of Antiviral Medications Day 96 With MS-NBC, CNN, Fox News, USA Today along with other news organizations continuing to report on the effects of the current health emergency individuals and families throughout the United States begin to panic. In an effort to prepare, individuals begin to purchase and hoard food, medication and other supplies that they believe will be needed to survive a public health emergency. Due to panic buying days or even weeks before the onset of the worst of the influenza pandemic, retailers such as grocery stores, drug stores and even gas stations begin to feel the strain and are unable to maintain adequate supplies for normal daily consumption. Based on the idea of supply and demand, many stores begin to raise prices for basic supplies. 10 Minutes Situation Manual Tabletop Exercise 23 Disaster Resistant Communities Group

24 Contagion Containment Inject # 018 Image of Media Briefly explain the role of the DOH-Hamilton s Public Information Officer (PIO) during this health emergency as it pertains to monitoring and interfacing with the local media. Identify and briefly describe the key influenza prevention messages in which the DOH-Hamilton s PIO will focus in an effort to keep the public informed regarding the current health emergency. Will the DOH-Hamilton utilize the internet and / or social media tools such as Facebook and Twitter as part of its plan to keep the public informed? (Note: For future reference you may want to access the Just In Time Disaster Training Library for additional information on the Social Media During Disasters. These videos are too long to view during today s exercise. Social Media During Disasters / Text Messaging During Emergencies) OPTIONAL If the above answer is yes. Briefly explain how this will be accomplished. Yes No 15 Minutes Situation Manual Tabletop Exercise 24 Disaster Resistant Communities Group

25 Contagion Containment Inject # 019 Image of Chamber of Commerce The DOH-Hamilton continues to work with local media and to use its web site as part of its community outreach plan to prepare county residents for the flu pandemic. In addition to traditional media and the internet it will be important to also engage local agencies and organizations in the effort to ensure county residents are armed with the information that they need to protect themselves, their families and their co-workers from contracting the flu. Identify local agencies and organizations that the DOH-Hamilton will coordinate with to mitigate the spread of flu to county residents. 15 Minutes Situation Manual Tabletop Exercise 25 Disaster Resistant Communities Group

26 Contagion Containment Scenario # 020 Image of Phase 6 Pandemic Alert Day 98 CLICK ON VIDEO TO PLAY Video Library Public Health Video # 2 Influenza Pandemic Overview - ANS Newspapers throughout the region are asking city, county and state officials for copies of their Influenza Pandemic Response Plan so that they can be printed in a special influenza pandemic response edition. The World Health Organization (WHO) issues a Phase 6 Pandemic Alert. 10 Minutes Situation Manual Tabletop Exercise 26 Disaster Resistant Communities Group

27 Infirmary Intimidation Stop Point No Image Controller Note: Conduct an open discussion among all exercise participants regarding the actions taken during this scenario. Situation Manual Tabletop Exercise 27 Disaster Resistant Communities Group

28 Contagion Containment Scenario # 021 Ebola Threat Outbreak Scenario No Image The focus of the third Contagion Containment Exercise scenario is the threat of county residents being exposed to Ebola. CLICK ON VIDEO TO PLAY Just In Time Disaster Training Ebola Awareness (CNN Version) 10 Minutes Situation Manual Tabletop Exercise 28 Disaster Resistant Communities Group

29 Contagion Containment Scenario # 022 Image of Ebola May 23 The World Health Organization (WHO) continues to investigate reports of Ebola throughout Western Africa. Ebola is not airborne but symptomatic individuals are more contagious within the first 3 days of symptom onset and can continue to transmit the virus for up to 21 days. Ebola has an incubation period of 8 to 21 days. Symptomatic individuals may only have a low-grade fever or symptoms normally associated with the flu. 10 Minutes Situation Manual Tabletop Exercise 29 Disaster Resistant Communities Group

30 Contagion Containment Scenario # 023 Image of Returning Missionaries June 1 On June 1, 53 members of the Hamilton County Christian Association return from a mission trip to the east African country of Ethiopia. The focus of the trip was to staff a small village health clinic and to help construct an addition to the village s school. As trained healthcare workers, the missionaries took the standard precautions while working in the village s health clinic. Ethiopia is not considered an Ebola affected country. Upon returning to the United States, the missionaries visit family members and friends, and return to work and church. 10 Minutes Situation Manual Tabletop Exercise 30 Disaster Resistant Communities Group

31 Contagion Containment Scenario # 024 Image of Emergency Department June 8 6:43PM Early in the evening, three of the missionaries begin feeling ill with a low-grade fever, nausea and bloody diarrhea. They seek treatment at Shands Live Oak Regional Medical Center s Emergency Department (ED). The attending physician obtains the medical history from each missionary and learns that all have recently returned from Ethiopia. The doctor calls the DOH-Hamilton s on-call Epidemiologist to report an outbreak of unknown cause. Since the three missionaries arrived at the ED within several hours of one another, have similar symptoms and traveled together, DOH-Hamilton Epidemiologists (EPI) begin an investigation to rule out malaria, foodborne and waterborne illnesses and any other potential causes. As their conditions continue to worsen, all three missionaries are admitted to the hospital. 10 Minutes Situation Manual Tabletop Exercise 31 Disaster Resistant Communities Group

32 Contagion Containment Scenario # 025 Image of Sick Missionaries June 9 10:11AM A Health Alert Network (HAN) is released by the CDC indicating that Ebola has been confirmed in an individual in Ethiopia. The CDC adds Ethiopia to the list of Ebola advisory countries. DOH-Hamilton EPI alerts the Shands Live Oak Regional Medical Center of the change in Ebola affected countries and recommends collecting stool and blood samples from the three missionaries and sending the samples to the FDOH Bureau of Public Health Laboratories (Public Health Lab) for rapid Ebola testing. Throughout the day 10 additional missionaries report signs and symptoms similar to those reported by the original three missionaries. June 9 5:27PM The families of the returning missionaries are becoming very concerned about the welfare of their loved ones that have been admitted to Shands Live Oak Regional Medical Center. Some family members believe the cause of the illness is due to their missionary work in Ethiopia. Several family members have also noticed that CCN is reporting that Ebola has been confirmed in an individual living in Ethiopia. Within minutes family members begin to post messages on Facebook, Twitter and other social media networks. Social media posts such as Ebola has been detected in Hamilton County FL and I live in Jasper FL and my father is in the hospital with Ebola are being retweeted at an alarming rate as Ebola in the US begins to trend on Twitter. In less than two hours residents throughout North Florida have heard that Ebola has reached the communities that they live in and begin to concern themselves about the potential of contracting this life threating virus. 10 Minutes Situation Manual Tabletop Exercise 32 Disaster Resistant Communities Group

33 Contagion Containment Inject # 026 Image of Ebola Virus June 10 8:17AM DOH-Hamilton and the Shands Live Oak Regional Medical Center receive positive laboratory results for Ebola for all three of the original missionaries. By the end of the day another seven missionaries report signs and symptoms of Ebola. Based on the fact that 20 missionaries are symptomatic for Ebola, the DOH-Hamilton has activated appropriate components of its Emergency Operations Plan (EOP). Upon activating the EOP DOH-Hamilton management fully understands one of their priorities is to calm the fears that local residents have about contracting the Ebola virus. Describe in detail the content of the information that DOH-Hamilton will provide to county residents regarding the current Ebola threat and the preventative measures that individuals, families and workplace managers will need to implement to mitigate the spread of the virus. 15 Minutes Situation Manual Tabletop Exercise 33 Disaster Resistant Communities Group

34 Infirmary Intimidation Stop Point No Image Controller Note: Conduct an open discussion among all exercise participants regarding the actions taken during this scenario. Situation Manual Tabletop Exercise 34 Disaster Resistant Communities Group