Situation Manual. 170 Minutes. Time Allotted. Situation Manual Tabletop Exercise 1 Disaster Resistant Communities Group

Transcription

1 Situation Manual 170 Minutes Situation Manual Tabletop Exercise 1 Disaster Resistant Communities Group

2 Malicious Microbes Exercise Play During the exercise it will be important to remember and comply with the following statements: 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 16 scenario and inject pages. 2. The exercise is self-paced and it should take approximately three hours to complete. 3. There is a scheduled 15 minute break approximately half way through the exercise. 4. 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 allow you to provide comments on three areas in which your team performed well (Strength) and three areas for your consideration to improve or modify existing plans and procedures (Area for Improvement) to enhance your team s preparedness, response and recovery capabilities. Found below are Hotwash examples: Strength During the exercise our team consulted our disaster plans and procedures and found them to be complete. Area 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. 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 2 Disaster Resistant Communities Group

3 Malicious Microbes Inject # 001 Image of Hospital Day 1 8:53AM Over the past 18 hours numerous residents have been arriving at hospitals, urgent care centers and primary care providers in the northeast part of the county with "flu-like" symptoms (high fever, chills, fatigue and persistent coughs). The majority of these cases, which include otherwise healthy adults, exhibit signs and symptoms more serious than the common flu. Epidemiology personnel at the DOH-Volusia have noticed several 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) and Respiratory (Resp) symptoms being reported by local hospitals. Typically for this time of year the daily ESSENCE report indicates 20 individuals with ILI symptoms and 120 individuals with Resp symptoms. However ESSENCE currently indicates 49 individuals with ILI symptoms and 207 individuals with Resp symptoms. Further investigation indicates the majority of the reported cases are from Florida Hospital Memorial Medical Center, Florida Hospital Oceanside and Halifax Hospital. 10 Minutes Situation Manual Tabletop Exercise 3 Disaster Resistant Communities Group

4 Malicious Microbes Inject # 002 Image of Flu Patient (CC # 001) Day 1 2:11PM Many of the "flu" patients are not responding to decongestants, analgesics or antiviral medications. Rapid diagnostic testing for influenza has been negative. Blood tests and cultures for fungal, viral and other infectious diseases are still pending. The lack of response to the initial treatment regimen and the relatively large number of patients prompt several frustrated, yet seriously concerned physicians to seek advice and consultation from the Department of Health in Volusia County (DOH-Volusia). Based on current ESSENCE reports and several phone calls from local physicians describe in detail the actions that will be taken by the DOH-Volusia. Situation Manual Tabletop Exercise 4 Disaster Resistant Communities Group

5 Malicious Microbes Inject # 003 Image of Hospital Diversion (CC # 002) Day 2 9:14AM Patients continue to arrive at area hospitals and clinics with mild to severe flu-like symptoms. The most severe cases are hospitalized. However, many more are waiting in the emergency rooms as hospital beds are filling rapidly. The level for ILI and RESP syndromes within the ESSENCE system for Volusia County remains higher than normal. Day 2 3:49PM Throughout the day, hospitals and clinics continue to experience an increase in patients presenting with severe flu-like symptoms. Hospitals have admitted several patients with respiratory difficulties, but most patients are sent home with directions to rest and drink plenty of fluids. Disturbingly, 20% of the patients have died since being admitted to area hospitals. Two physicians have noticed the characteristic widened mediastinum on radiographic studies and have called the DOH- Volusia to report that they believe the current influx of patients with flu-like symptoms might actually be due to anthrax. Based on the current information will the DOH-Volusia 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-Volusia will not activate any of the components of its EOP. Situation Manual Tabletop Exercise 5 Disaster Resistant Communities Group

6 Situation Manual Tabletop Exercise 6 Disaster Resistant Communities Group

7 Malicious Microbes Inject # 004 Image of Health Surveillance (CC # 003) Day 2 4:29PM In addition to ESSENCE, identify and briefly describe any additional public health surveillance processes and procedures that will be employed by the DOH-Volusia due to the current public health emergency. Identify and list all agencies and organizations that should be notified based on current information. Situation Manual Tabletop Exercise 7 Disaster Resistant Communities Group

8 Malicious Microbes Inject # 005 Image of Notification (CC # 004) Day 3 8:31AM Given the increased presentation of ill cases the Florida Department of Health (DOH) uses the Health Alert Network to issue a statewide health alert to all county health departments. The purpose of the HAN is to notify local Health Officers, Epidemiologists and Public Health Preparedness staff throughout the state that the DOH will be holding a conference call to discuss the recent outbreak and share the latest clinical information. Identify the title of the individual(s) at the DOH-Volusia that will receive the HAN alert. Situation Manual Tabletop Exercise 8 Disaster Resistant Communities Group

9 Malicious Microbes Inject # 006 Image of Media (CC # 012) Briefly explain the role of the DOH-Volusia s Public Information Officer (PIO) during this public health emergency as it pertains to monitoring and interfacing with traditional media (local television, radio, newspapers, etc.). Identify and briefly describe the key messages in which the DOH-Volusia s PIO will focus in an effort to keep the public informed regarding the current public health emergency. Situation Manual Tabletop Exercise 9 Disaster Resistant Communities Group

10 Malicious Microbes Inject # 007 Image of Laboratory (CC # 005) Day 3 2:37PM Pathologists at the DOH Bureau of Public Health Laboratories (Public Health Lab) have received the clinical specimens taken from a woman who died at one of the area hospitals. These specimens have tested Polymerase Chain Reaction (PCR) positive for Bacillus anthracis. Results from the Public Health Lab are forwarded to the Centers for Disease Control and Prevention (CDC) in Atlanta Georgia for confirmation. CDC further confirms the presence of Bacillus anthracis from the samples. Based on the Public Health Lab confirmation of Bacillus anthracis will the DOH-Volusia fully activate its Emergency Operations Plan (EOP)? If the above answer is yes. Briefly describe the process for activating the DOH-Volusia s EOP. Yes No If the above answer is no. Briefly explain why the DOH-Volusia will not fully activate its EOP. 20 Minutes Situation Manual Tabletop Exercise 10 Disaster Resistant Communities Group

11 Malicious Microbes Inject # 008 Image of ICS Day 3 5:21PM The decision has been made to activate the DOH-Volusia s EOP and its Strategic National Stockpile (SNS) and Mass Prophylaxis Annexes. Based on the current situation briefly describe the Incident Command System (ICS) structure that will be utilized by the DOH-Volusia. List the ICS roles that will be utilized by the DOH-Volusia and identify individuals by title that are qualified to fill each identified ICS role. Situation Manual Tabletop Exercise 11 Disaster Resistant Communities Group

12 Malicious Microbes Inject # 009 Image of SNS Day 3 5:42PM One of first action to be taken upon activating the DOH-Volusia EOP and its SNS and Mass Prophylaxis Annexes will be to request the necessary antiviral medications that will be dispensed to county residents. Describe in detail the processes associated with requesting antiviral medications from the Strategic National Stockpile. 20 Minutes Situation Manual Tabletop Exercise 12 Disaster Resistant Communities Group

13 Malicious Microbes Inject # 010 Image of Partners (CC # 007) The DOH-Volusia fully understands that it will need the support of various government agencies as well as community and faith based organizations (ESF 8 Partners) to successfully respond to the current public health emergency. Identify all ESF 8 Partners the DOH-Volusia plans to rely upon in the days to come and list the support that the DOH- Volusia expects to receive from the identified partner. (Example: Partner: Volusia County Sheriff s Office / Support: Provide site security for the POD once it has been opened.) Situation Manual Tabletop Exercise 13 Disaster Resistant Communities Group

14 Malicious Microbes Inject # 011 Image of Volunteers (CC # 008) The community and faith based ESF 8 Partners are ready to assist during this health emergency. However most indicated that their paid and volunteer staff members do not have the training to assist with activities such as helping to open and operate a POD. Explain in detail how the DOH-Volusia will provide Just In Time Training for individuals that will be able to assist but have no training. This includes the DOH-Volusia s staff members that do not have the necessary training. When paid and volunteer staff members from ESF 8 Partners assist the DOH-Volusia during a public health emergency are they covered by the DOH-Volusia s: Liability Insurance? Yes No Workers Compensation Insurance? Yes No Briefly explain how the DOH-Volusia will effectively manage volunteers from the community who are willing and able to assist. 20 Minutes Situation Manual Tabletop Exercise 14 Disaster Resistant Communities Group

15 Malicious Microbes Inject # 012 Image of Closed POD Day 4 9:17AM Based on CDC guidelines, the DOH-Volusia will need to dispense prophylactic medications to all at-risk residents as soon as possible. Identify the agencies / organizations whose personnel will need to have priority in receiving medications and briefly explain the reasoning for the agency s / organization s prioritization. Will a Closed POD be established to dispense prophylactic medications to personnel from the list of agencies / organizations identified above? If the above answer is yes. Describe in detail how this Closed POD will be set-up and managed. Yes No If the above answer is no. Briefly explain how prophylactic medications will be dispensed to personnel from the identified agencies / organizations. 20 Minutes Situation Manual Tabletop Exercise 15 Disaster Resistant Communities Group

16 Malicious Microbes Inject # 013 Image of Consumable Supplies (OPOD # 013) In preparation to open the POD, review the inventory of equipment and consumable supplies that the DOH-Volusia currently maintains. Other than the medications which are being delivered to the DOH-Volusia are there additional consumable supplies and equipment that will be needed to operate the POD? If the above answer is yes. Develop a list of additional material resources that will be needed to establish and manage the POD. (Note: List each item and its quantity.) Yes No (Example: Item: Wheelchair / Quantity: 2) Briefly explain how the additional material resources will be obtained. (Example: The DOH-Volusia s administrator has access to an emergency purchasing card that can be used in a public health emergency to purchase consumable supplies. The upper limit on emergency purchases is $5,000.) Situation Manual Tabletop Exercise 16 Disaster Resistant Communities Group

17 Malicious Microbes Inject # 014 Image of Non-Essential Functions Almost all of the DOH-Volusia s staff members are now engaged in responding to the current public health emergency. Due to a reduction in the availability of staff members to support normal daily operations will the DOH-Volusia activate its Continuity of Operations Plan (COP)? If the above answer is yes. Identify and list the non-essential functions that will be temporarily suspended until conditions improve. (Example: Dental Services.) Yes No Will ESF 8 Partner agencies / organizations activate their COOP during the current public health emergency? Yes No Situation Manual Tabletop Exercise 17 Disaster Resistant Communities Group

18 Malicious Microbes Inject # 015 Image of Adverse Reaction (CC # 018) Day 4 9:01PM DOH-Volusia staff members, along with the paid and volunteer staff from various ESF 8 Partners have been doing an outstanding job over the past several hours as large numbers of residents have received antibacterial medication. As POD operations continue at a steady rate, will the DOH-Volusia monitor area residents for possible adverse reactions associated with the medications being dispensed? If the above answer is yes. Briefly describe how this will be accomplished. Yes No Identify the agency(s) that will be notified if there are adverse reactions to the medications. If the above answer is no. Thoroughly explain why the DOH-Volusia will not undertake such an important public health mission. Situation Manual Tabletop Exercise 18 Disaster Resistant Communities Group

19 Malicious Microbes Inject # 016 Image of Downsizing (CC # 020) Day 6 4:17PM It is the late afternoon of the third day of POD operations and the activity level has been dropping off since noon. By early evening the DOH-Volusia receives a report from the POD that the number of residents that were provided with medications for the past four hours was negligible. The decision is made to transition all of the dispensing operations back to the DOH-Volusia s primary office and discontinue POD operations. Based on current known conditions and the DOH-Volusia s Mass Prophylaxis Annexes prepare set of Demobilization Plan objectives. (Example: Objective: Conduct an inspection of the host facility to ensure it is returned to the owners / operators in good conditions.) 25 Minutes Situation Manual Tabletop Exercise 19 Disaster Resistant Communities Group