Central Maine Healthcare Coalition Thursday, October 23, :30 AM 11:30 PM CMMC Conference RM A, B and C

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1 Central Maine Healthcare Coalition Thursday, October 23, :30 AM 11:30 PM CMMC Conference RM A, B and C PRESENT: Joanne Lebrun, Tri-County EMS; Joanne Potvin, Androscoggin EMA; Teresa Glick, Oxford EMA; Allyson Hill, Oxford EMA; Stephanie Violette, Kennebec Kidney Center; Todd Tracey United Ambulance; Nathan Yerxa, United Ambulance; Kevin Oliveira, St. Mary s; Mike Hatch, St. Mary s; Julie Lee, DFD Russell Medical Center; Cindy Swift, Androscoggin Home Care; Megan Berube, Androscoggin Home Care; Steve Doyon, Androscoggin Home Care; Angela Moore, Interim Healthcare; Karen Mentus, Bridgton Hospital; Whitney Allen, CMMC; Mike Senecal, Franklin Memorial; Doug West, Rumford Hospital; Richard Comstock, MaineGeneral Medical Ctr.; Dennis Passmore, Togus VA; Cindy Quinlan, Clover Health Care; Jeffrey Lacroix, Rumford Community Home; Laudan Behrouz, Maine CDC; Jamie Paul, MeCDC; Susan Jamison, Kennebec Kidney Center; Garth Conrad, Rumford Hospital; Paula Thomson, MeCDC, GUEST: Toby Martin, Turner Rescue; Nancy Doherty, CMMC, Greg Levin, CMMC; Daniela Skalina, CMMC; Ann Marie Mahar, Rumford Hospital CMRRC: Kara Walker, Director; Kris Gammon, Operations Manager Welcome and Announcements Topic Presenter Discussion/Talking Kara Walker, Director MeCDC has announced the launch of a new website to streamline guidelines and updates on the latest information regarding Ebola for healthcare providers and Maine citizens. See notification for details. Disaster Behavioral Health: A Critical Response Training CMRRC has purchased MCI mannequins (30 adult and 10 pediatric) for use during exercises. Contact our office if you need to reserve them. Scheduled for November 3-4 in Augusta, November in Portland and December 3-4 in Rockland.

2 Mass Notifications - Delivery of information to Maine 211 so it is available to people who call them. - GovDelivery notification system delivers text messages to cell phones for those who have signed up for the service. - Integrated Public Alerts and Warning System (IPAWS) will be able to deliver text messages to anyone in the area, regardless of whether they have signed up (dependent on the individual cell companies agreeing to participate in program) - NOAA weather radio is available 24x7, for those who have battery, crank or solar powered receivers. NWS will carry non-weather related emergency information if requested by the state. Enterovirus D68 (EV-D68) Sara Robinson, MPH Maine CDC Epidemiologist - Non-Polio Entervirus is a very common virus causing million infections in the US - Infants, children and teenagers are more likely to get infected and become sick. - Mild symptoms include: fever, runny nose, sneezing, cough, and body/muscle aches. - Sever symptoms include difficulty breathing and wheezing. - Spread through coughing, sneezing and touching contaminated surfaces. - To date, confirmed cases include 938 See attached Enterovirus D68 powerpoint

3 Influenza Topic Presenter Discussion/Talking Sara Robinson, MPH MeCDC Epidemiologist people from 46 states with 1 confirmed case in Maine. - EV-D68 requires laboratory testing. - Samples will only be sent out for testing if: positive enterovirus test; clinical information complete; outbreak situations. - Typing requires MeCDC collaboration - Infection control: treat the same as any respiratory virus. - Alcohol based hand gel is not effective against enteroviruses. Use soap and water. - There are two main types of influenza viruses: Influenza A and Influenza B - The only predictable thing about influenza is its unpredictability - Definition: Influenza is a contagious respiratory illness caused by influenza viruses. - Complications: can include bacterial pneumonia, ear infections, sinus infections, dehydration, and worsening of pre-existing medical conditions. - Influenza can cause mild to severe illness and can possibly lead to death. - Statistics in the US: 5-20% of population gets influenza every year; more than 200,000 are hospitalized due to complications annually; older adults, young children and some with previous See attached Influenza powerpoint

4 Ebola Workshop Topic Presenter Discussion/Talking Kara Walker and CMRRC Healthcare Coalition Members Daily Situation Reports from MeCDC Ebola Task Force Meetings conditions are at a higher risk of complications. - Signs and Symptoms: fever, headache, extreme tiredness, dry cough, sore throat, runny/stuffy nose, muscle aches, stomach symptoms (nausea, vomiting and diarrhea). - Influenza viruses spread mainly from person to person through coughing or sneezing. - Most healthy adults may be infectious 1 day before symptoms begin. You could pass on influenza before you know you are sick. - Single best way to prevent influenza is by getting vaccinated. Representation from various state agencies: Dept of Environmental Protection, Attorney General s Office, MEMA, State Police, multiple programs within MeCDC as well as Southern, Northern and Central Maine Regional Resource Centers. Topics actively being pursued at regular task force meetings include: Waste management (both medical waste and wastewater treatment perspective) - Including potential decon issues surrounding personal property of confirmed Ebola patients.

5 Other Information Shared Legal aspects of responding to Ebola - Law enforcement role in potential quarantine situations - Questions regarding what level of care EMS should provide of a patient codes while enroute to a regional hospital. - Potential need for interpretation services. - Revised traveler requirements at 5 major airports in US. - Discussion of select agent protocols (further detailed information on US CDC website) - Regional laboratory for New England in Boston. Development of a Regional Ebola Response Plan. The Regional Resource Centers have been tasked with the responsibility of developing a Regional Ebola Response Plan. The CMRRC will be developing this plan with the input and guidance from hospitals, EMS and other regional partners. Proposed Plan Initial Screening: Call - Call to a healthcare facility - Walk into a healthcare facility Kara Walker will write plan in coordination with a five person coalition workgroup.

6 Concept of Operations What Next? Coalition level tabletop exercise for regional Ebola Plan Hospitals asked for training on Isolation Transport Units Further Screening: - Connect Referral to Regional Hospital - CMMC - MaineGeneral DRAFT Plan Discussed: - Call On-Line Medical Control (OLMC) at the receiving hospital - Contact CONNECT - Contact Maine CDC - Person Under Investigation - Maine CDC, US CDC - Key Stakeholders - Phase 1: Assessment and Confirmation of Ebola Cases - Phase 2: Notification Process - Phase 3: Consequence Management Steps - Response for Suspected Case - Response for Probable Cause - Response for Patient Under Investigation (PUI) CMRRC will use their next scheduled Healthcare Coalition date of 12/18 for the tabletop exercise once a plan is developed. Purchased by Aramsco in Each CMRRC hospital received one. Details to follow Kris Gammon will contact Aramsco to inquire if they will provide

7 training. NEXT MEETING: Ebola Response Plan Tabletop Exercise Thursday, December 18, :30 am 2:30 pm * exact time to be determined CMMC Conference Center Rooms A, B and C