A Desktop Exercise for: Mecklenburg County Health ...€¦ · Page 002 Mecklenburg County Health...

A Desktop Exercise for:

Mecklenburg County Health Department

National Planning Scenario #3 Pandemic Influenza

Sponsored by SES

Contact Instruct-online

http://data/instruct/dtl1339/slide001.htm [7/24/2006 5:39:07 PM]

Mecklenburg County Health Department Pandemic Influenza Desktop Exercise Tuesday, July 25, 2006

9:00 a.m. - 11:00 a.m. Eastern

FacilitatorGeorge B. Beranek, M.D., MBA

Region 1 Medical DirectorRockford Health System

Assistant Professor of MedicineUniversity of Illinois College of Medicine

ModeratorChris Bellone

Senior Developer and Program DesignerSimulated Education Services


Basic Instructions

For a successful learning experience:

Keep phone on mute when not involved in discussionPromote interactive discussionsDiscuss scenario

Learn & Share ideasCollaborateTake risks for the sake of learning

Consider one spokesperson per discipline per siteConsider one keyboard controller per siteSilence all cell phones & pagersClose doors


Distance Desktop EtiquetteWhen speaking or being requested to speak:

Un-mute phoneIdentify yourself & location (agency represented)Speak clearly near speaker phoneLimit the background noiseDo not place phone on hold

When done:Place phone back on muteResume interactive discussion

To ask a question: Click on Icon Type Question Click Submit

Poll questions: Discuss the question Select most appropriate answer(s) Click submit Real time results will be displayed and discussed


Desktop Exercise Information

The exercise will evolve over a 2 hour period Questions will be asked throughout the Scenario Time will be given to discuss questions by the group


Facilitator

Dr. George Beranek serves as an Emergency Physician, EMS Region 1 POD Disaster Medical Director and Director of Medical Education at Rockford Health System, a 396-bed, Level 1 Trauma Center in Rockford, Illinois.

He received his undergraduate degree in biology-chemistry and mathematics and has an MBA in health care administration and human resource management. He received his M.D. from the University of Illinois College of Medicine, completed residency at Louis A. Weiss Memorial Hospital (University of Chicago Affiliate) and also completed a fellowship in Faculty Development at Rush-Presbyterian St. Luke’s / Cook County Hospital.

In addition to having over 18 years of emergency preparedness experience, George is unique in that he is an active member on the following emergency response teams:

Illinois Medical Emergency Response Team (IMERT) Winnebago County Sheriff's Office Public Safety Commissioner Winnebago County Sheriff's Emergency Response Team (SERT) Winnebago County ESDA Dosimetry Officer Illinois Urban Search and Rescue Team (IL-TF1) Medical Director for the Region 1 Regional Emergency Medical Response Team (ReMERT)


Desktop Objectives

At the conclusion of this session, participants will be able to:

Discuss the implications of pandemic flu on the School System, Community Business Infrastructure, Social Service Organizations, Emergency Management, Law Enforcement, Health care and Mortuary Services and Private Sector Business Planning groups. Describe Community roles in prevention of spread of the flu and identification suspected cases. Discuss the coordination of the functional groups’ Emergency Response Plans and the Mecklenburg County pandemic Flu Plan Identify the threshold for activation of the Incident Command System. Identify key roles and responsibilities within each functional group during a pandemic flu out break. Describe the communication infrastructure between county, State, Federal and Corporate level functional groups. Evaluate the ability to coordinate communications for assistance using current communications channels. Describe staffing strategies during a pandemic flu outbreak across all functional groups. Describe strategies for maintaining basic operations in all functional groups during a pandemic flu outbreak. Identify Community resources needed for special needs, quarantines and dispensing of vaccines. Discuss ways to improve the collective process of critical thinking and decision making between the functional groups.


State Overview


Avian Influenza Background

Since 2003, a growing number of human H5N1 cases have been reported in Cambodia, China, Egypt, Indonesia, Thailand, Turkey, and Vietnam. More than half of the people hospitalized with the H5N1 virus have died.

Most of these cases are all believed to have been caused by exposure to infected poultry. There has been no sustained human-to-human transmission of the disease, but the is concern that H5N1 will evolve into a virus capable of human-to-human transmission.


Spring 2006

The majority of world health officials are focused on the movement of H5N1 avian influenza viruses into humans throughout Southeast Asia. The virus is circulating in bird species all through Asia, Europe, the UK and is likely to reach North America before the end of 2006.


Updated International Health Report June 2006

A number of new human infections with this novel influenza virus occur in rural areas of four countries in South East Asia. Epidemiologic investigation indicates that most patients have direct farm animal contact. Two patients, treated with Tamiflu (oseltamivir), recovered.


July 25, 2006

The Mecklenburg County Health Department and area hospitals receive notification over the Health Alert Network (HAN) that several suspected cased of human to human transmission of the H5N1 influenza virus have been reported in several cities in China.


Discussion Questions

How do you interpret this information?

What Actions are being taken at:

1. Public Health

2. Emergency Management

3. Schools

4. Social Services

5. Community Infrastructure


7. Private Business


July 31, 2006

Several reports of Influenza A are noted in New York, Florida, Texas, California and Illinois. Further testing determines that these cases are H5N1 Influenza.



How do you interpret this information?

What Actions are being taken at:

1. Public Health


3. Schools

4. Social Services



7. Private Business



What are the community’s plans to educate hospital, first response staff and local residents on subjects such as how to care for milder cases of influenza at home and where to go for medical care?

Who has (should have) primary responsibility for developing local health communication programs?


Question 1

At this point in the scenario rank order the top 5 methods for community/ employee/staff communications from highest(1) to lowest(5):

1st 2nd 3rd 4th 5thTelephone

Fax

Email

Health Alert Network

Brochure

Cell Phone

Pager

Public Service Annoucements


Presbyterian Hospital Tuesday, August 1, 2006

8:00 a.m.


Presbyterian Hospital 8:00 a.m.

68 year old male presents to the registration desk. He complains of shortness of breath, cough and some achiness. He tells the nurse that he has congestive heart failure.

He has no history of recent foreign travel and has not left the local area for several weeks.


68 year old male Upon physical exam the physician finds the following:

Moderate respiratory distress R=32/min.

+JVD

Crackles 1/3 up both lung fields

Pulse oximetry: 91% on room air

A fever of 101°F is also noted

Rapid influenza test is positive for influenza A



How would you interpret this information? What do you do? Who should be called?


Question 2

Under universal precautions, what PPE would you be issuing to your personnel at this point?

Surgical Masks Gowns Gloves N-95 Mask Powered Air Purifying Respirator (PAPR) Supplied Air Respirator Goggles No PPE necessary


Mecklenburg County Health Department & Functional Groups

What consideration would be given to PPE? Do you feel the need to share any of this information with anyone?


August 2, 2006 H5N1 Confirmed

The next day, H5N1 is confirmed by the state lab on the 68 year old patient who was hospitalized.

What is the Public Health Response?

Now that H5N1 is confirmed in North Carolina:

What information would you want communicated to the public and your employees at this time?

How would that message be shared with the public and employees at the local level?


Carolina Medical Center Monday, August 7, 2006


Monday, August 7, 8:00 a.m.

The Emergency Department is seeing large numbers of patients with general flu-like symptoms.

There are a number of patients admitted with confirmed influenza A Positive Pneumonia.

Many need hospitalization.


Carolina Medical Center

How are you separating infectious from non-infectious patients at your hospital?


Disaster Plan Implementation

Describe the activities underway at each functional group location. What level of community response would be underway? Plans activated?

Describe the activities underway at your facility. What is happening from an operational standpoint?

Who is in charge of overall response operations for the area? Is the Incident Command System in place? How does that activation occur?


Incident Command

At what point will the incident command be set up? What should be done initially? How will the information be shared?


Incident Action Plan

Each Functional Group: Create an incident action plan for the next 24 hours.


Mecklenburg County

How do you interpret this information? What Actions are being taken at:

1. Public Health


3. Schools

4. Social Services



7. Private Business


Anti-viral Mobilization

Hospitals and the community partners are requesting that Anti-virals be mobilized for prophylaxis of their staff.

How do you respond?

What actions do you take?

Who should receive these medications when they become available according to the HHS priority list?

How do you provide for the secure receipt and secure transport and distribution of these medications?


Mecklenburg County Staffing levels at the hospitals, private business and community infrastructure are at dangerously low levels. The police and fire departments have instituted a mandatory call back. Local stores are having difficulty keeping supplies on the shelf.

What strategies would you implement to maintain operations given this situation?


Discussion Question

Now that the Mecklenburg county services are experiencing difficulties and the hospitals are in need of more beds:

What communication strategies would you implement?


Monday August 28, 2006 North Carolina

Emergency Departments

All usually available beds in the hospitals are full and the Emergency Departments are full with patients in the hallway waiting for admission.

Calls for referrals are overwhelming the bed placement staff.

There are multiple calls for transfers from the area physician offices and clinics.

All of the symptomatic patients have been tested positive for Influenza A and many of the patients demonstrate signs of pneumonia on CXR.

Ventilators are in short supply.


Mecklenburg County

What are your procedures for addressing this massive influx of patients? (Surge)

What strategies are you using for maintaining adequate staffing at hospitals and pre-hospital providers?

What are the strategies for maintaining business continuity?



Based on the current situation, describe the activities underway at your location. What level of response is underway?

What is happening from an operational standpoint?


Vaccination

The CDC reports that the Food and Drug Administration (FDA) has released approximately 1 million doses of an investigational vaccine against H5N1 influenza.

Secretary of Health issues a statement that 30,000 doses will be sent to North Carolina.


Vaccination

Has your organization developed a plan to identify priority groups to receive a limited supply of vaccine?


Monday September 4, 2006

The local hospitals & clinics are totally overwhelmed.

They are seeing large numbers of patients with lines to be seen.

EMS, Law enforcement and Fire Department resources are exhausted.

Tensions rise between the staff and patients. Fights break out in crowded waiting rooms and parking lots across the region.

How is order maintained within your organizations?



What communication strategies would you use between the functional groups in your county?

What information would you want communicated to the public and your employees/staff at this time?

How is this information communicated at the local, regional and state levels?

How do you maintain order in the County?


Friday September 8 Mecklenburg County Hospitals

12:30 p.m. All available ventilators in the facility are in use. The Incident Command Center has been notified that multiple patients need intubation on the floor and in the emergency department. Many will need ventilators.

What should be done with this information?

Who should be called?

How do you address other critical needs?


Friday, September 29, 2006After weeks of climbing case numbers, the number of new cases each day finally begins to peak and decline. All North Carolina hospitals are nearly back to normal operations.

Staff begins to report to work more than they have been for the last 2 months.

Sporadic cases occur for several weeks.

More vaccine is made available to the region

How do you ramp down operations?


Debriefing


Incident Command Center


Press Conference


Laboratory


A Desktop Exercise for: Mecklenburg County Health ...€¦ · Page 002 Mecklenburg County Health...

Documents

Transcript of A Desktop Exercise for: Mecklenburg County Health ...€¦ · Page 002 Mecklenburg County Health...