Upload
leon-daniels
View
243
Download
5
Embed Size (px)
Citation preview
STATEWIDE MEDICAL AND HEALTH EXERCISE
PHASE III: TABLETOP EXERCISE
[Exercise Name/Exercise Date]
WELCOME & INTRODUCTIONS
3
SCHEDULE OVERVIEW
0000 Registration
0000 Welcome and Opening Remarks
0000Module 1: Communication and Medical Surge 30 Minutes
Briefing, Plenary Discussion, and Brief-Back
0000 Break
0000Module 2: Confirmed Case & Incident Command 30 Minutes
Briefing, Plenary Discussion, and Brief-Back
0000 Lunch
0000Module 3: Security & Fatality Management 30 Minutes
Briefing, Plenary Discussion, and Brief-Back
0000 Break
0000 Hot Wash
0000 Closing Comments
4
PRESENTATION GUIDE
BACKGROUND AND ADMINISTRATION
MODULE 1: COMMUNICATION & MEDICAL SURGE
MODULE 2: CONFIRMED CASE & INCIDENT COMMAND
MODULE 3: SECURITY & FATALITY MANAGEMENT
MODULE 4: DEBRIEF QUESTIONS & PLANNING FOR THE FUNCTIONAL EXERCISE
BACKGROUND AND ADMINISTRATION
6
• Cell Phones• Restrooms• Exercise Materials• Breakout Discussion Groups• Parking validation• Mobile phones• Evacuation procedures
– “This is a real emergency.”
ADMINISTRATION
7
• Welcome– Name– Position– Agency/Organization– Optional: Icebreaker
• Logistics – Materials
• Situation Manual– Follow along!
• Feedback Form• Observer Handout
ADMINISTRATION
8
EXERCISE OVERVIEW
• Name– Statewide Medical & Health Tabletop Exercise
• Date– [insert date]
• Scope– 4 phases in program
• Mission Areas– [insert selected]
• Capabilities– [insert selected]
9
• Objectives– [insert selected]
• Threat/Hazard– Pandemic Influenza
• Scenario– Novel Strain of H5N1
• Sponsor– CDPH, EMSA, [insert your agency/organization]
• Participating Organizations– [insert]
EXERCISE OVERVIEW
GENERAL INFORMATIONKEY MATERIAL
11
• Introduction• Objectives & Core Capabilities
– [agency/organization objectives & core capability detail]
• Participant Roles & Responsibilities– Players– Observers– Facilitators– Evaluators– Controllers
GENERAL INFORMATION
12
• Exercise Structure– Module 1 – Communication and Medical Surge
• Breakout group discussion and group presentations
– Module 2 – Confirmed Case and Incident Command
• Breakout group discussions and group presentations
– Module 3 – Security and Fatality Management• Breakout group discussions and group
presentations
GENERAL INFORMATION
13
• Exercise Guidelines– Use current plans/capabilities
• Exercise Assumptions & Artificialities– Impacts across response
community– See Situation Manual
(SitMan) for others
• Exercise Evaluation– Exercise Evaluation Guides
(EEG)– Feedback Forms
GENERAL INFORMATION
14
• National Association of County and City Health Officials (NACCHO)/Centers for Disease Control (CDC) Program
• Currently in development• Major jurisdictions across California have
been engaged in initial planning and testing• See Appendix in the Situation Manual for
more information• This program will be addressed in Module
3
RESOURCE: FLU ON CALL™
MODULE ONECOMMUNICATION AND MEDICAL SURGE
16
• Worldwide influenza pandemics occur when a novel virus emerges to which the population has little immunity
• The 20th century saw three such pandemics– Optional Videos:
http://www.flu.gov/video/2010/01/we-heard-the-bells.html
– http://www.un-influenza.org/?q=content/how-virus-changes-world
BACKGROUND INFORMATION
17
• Strains of avian influenza interact with human influenza
• A mutation can occur, creating a virus capable of human-to human transmission, initiating a pandemic
• 25 to 35% of the population may become ill
• Nearly 200,000 Californians may die
• Impact of the pandemic could last for as long as 18 months, with waves of activity
BACKGROUND INFORMATION
18
• Non-pharmaceutical containment measures are key to controlling the spread of virus– Optional Video:
http://www.un-influenza.org/?q=content/nhs-pandemic-flu-information-health-workers
• Vaccination and antiviral treatment are anticipated to be the most effective
• These may be delayed or in limited supply
BACKGROUND INFORMATION
19
• Real concern for fear and panic among the public as well as the response community
• Will there be enough:– Staff?– Supplies? – Equipment? – Vaccine? – Medicines?
BACKGROUND INFORMATION
20
• How will daily functions be impacted (e.g. schools, transportation, adult care, etc.)?
• Ability of Federal government to support the response in California will be limited at the onset
• Virus will be widespread and not limited to one jurisdiction, region or state
BACKGROUND INFORMATION
21
• Five cases of human-to-human transmission in Cambodia
• Health care providers used stockpiled antiviral medication
• Many residents disregard isolation instructions
MODULE ONE
Communication & Medical Surge
22
• H5N1 quickly spreads • 30% develop symptoms• Seasonal vaccine is
ineffective• Certain antiviral
medications have been shown to help alleviate symptoms
• Sporadic H5N1 cases appear throughout Southeast Asia and Australia
MODULE ONE
Communication & Medical Surge
23
• CDC initiates enhanced surveillance at quarantine stations
• Viral isolates sent to the CDC/National Institute of Allergy and Infectious Diseases (NIAID)
• Hospitals and healthcare facilities asked to increase surveillance and reporting
• Influenza is the lead story for all major news outlets
• Public fear continues to grow
MODULE ONE
Communication & Medical Surge
24
• Health departments try to purchase additional stockpiles of antiviral medications
• California already experiencing an above-average flu season
• Patient workups include testing for H5N1
MODULE ONE
Communication & Medical Surge
25
• "They've brought in extra doctors to handle the overload," said Dr. [insert name] of [insert local hospital name]. "And even with that, you still end up with patients waiting in the emergency room for 24 hours for a bed."
• 9-1-1 had triple the number of calls compared to this same time last year
MODULE ONE
Communication & Medical Surge
26
• Elect a group spokesperson• Use the Situation Manual and exercise materials to
take notes• Focus on
– Strengths– Areas for improvement
• As it pertains to: – Doctrine– Organization– Personnel– Training– Equipment– Support
DISCUSSION FORMAT
CONFIRMED CASE & INCIDENT COMMAND
MODULE TWO
28
• On Monday, a 33-year old woman in a neighboring county becomes the first confirmed H5N1 case in California
• While ill, she attended a large fair with over 5,000 attendees in the neighboring county last week
• Hospitals in the neighboring county experience a wave of ILI cases, many who attended the same fair
MODULE TWO
Confirmed Case & Incident Command
29
• Monday - 12:30 PM: First confirmed H5N1 fatality in CA in a neighboring county
• Tuesday– The [insert your jurisdiction]
public health department operations center (DOC) is activated
– Strategic National Stockpile (SNS) assets are requested
• Wednesday– SNS assets are available for
distribution
MODULE TWO
Confirmed Case & Incident Command
30
• Extra security requested for:– Healthcare facilities– Government buildings– Point of Dispensing (POD) Sites
• Local public health– Distribute vaccines to hospitals
and local health departments– Activate a select number of
PODs
• At least 80 suspect H5N1 cases in the neighboring county
MODULE TWO
Confirmed Case & Incident Command
31
• 9:00 AM on Thursday: three patients, a mother with two children ages six and nine, present at a local hospital
• They attended the fair with several members of their church last week
• Also, the mother attended an event at her children’s school three days ago
MODULE TWO
Confirmed Case & Incident Command
32
• Healthcare facilities experience a surge of ILI cases, many of whom had contact with the confirmed H5N1 cases
• Several individuals calling in with questions about their symptoms
• Many confirm they were at the county fair or school event three days ago
• The mother and the youngest of her two children become the first confirmed local H5N1 fatalities
MODULE TWO
Confirmed Case & Incident Command
33
• The Local Health Officer is faced with an onslaught of crucial decisions to make:– Ongoing risk
communications strategies– DOC/EOC coordination– Disease
investigation/surveillance and coordination with authorities
• The Governor declares a state of emergency
MODULE TWO
Confirmed Case & Incident Command
34
• Elect a group spokesperson• Use the Situation Manual and exercise materials to
take notes• Focus on
– Strengths– Areas for improvement
• As it pertains to: – Doctrine– Organization– Personnel– Training– Equipment– Support
DISCUSSION FORMAT
SECURITY & FATALITY MANAGEMENT
MODULE THREE
36
• In the following days:– Healthcare facilities
continue to experience a surge
– Concerned citizens present at healthcare facilities asking for antiviral medications and vaccines
– News crews camp out in front of hospitals, public health departments, and City Hall seeking more information
MODULE THREE
Security & Fatality Management
37
• Local public health begins a contact tracing campaign
• Officials asked to publish guidance on: – appropriate diagnosis and
treatment – public information for
proper hygiene, hand washing, and contact with others
• 15 additional cases present
MODULE THREE
Security & Fatality Management
38
• State and local agencies again asked to intensify influenza surveillance and communications
• CDPH considers special programs
• Asymptomatic citizens begin to:– Seek medical attention– Demand prophylactic
treatment– Buy out over-the-counter
medications
MODULE THREE
Security & Fatality Management
39
• News commentators criticize government officials
• Local hospitals reporting staff absenteeism
• Law enforcement agencies respond to civil unrest calls
• Dispatcher reports an increase in the number of calls
• Of the confirmed H5N1 cases, roughly 25% have been fatal
MODULE THREE
Security & Fatality Management
40
• Local Department of the Medical Examiner/Coroner’s Office: – activates their DOC– contacts EOC for mutual-aid
assistance
• Hospitals implement mass fatality management plans
• PODs are activated• Hospitals experience their
most significant medical surge yet
MODULE THREE
Security & Fatality Management
41
• Medical personnel are at the breaking point in dealing with:– fears of the worried well – surge in decedents
• Personnel in key positions are absent due to:– Illness/exhaustion/burn
out– fear of illness– caring for ill family
members
MODULE THREE
Security & Fatality Management
42
• Elect a group spokesperson• Use the Situation Manual and exercise materials to
take notes• Focus on
– Strengths– Areas for improvement
• As it pertains to: – Doctrine– Organization– Personnel– Training– Equipment– Support
DISCUSSION FORMAT
43
CONCLUSION OF THE DISCUSSION-BASED TABLETOP
DEBRIEF QUESTIONS & FUNCTIONAL EXERCISE PLANNING
MODULE FOUR
45
• Debrief questions• Exercise levels
– Level of play– DOC/EOC activation
• Exercise duration• Scenario development• Participation• Testing of plans & procedures• Role of State agencies
MODULE FOUR
46
• Please complete your Participant Feedback Form or Evaluation Notes/EEGs and return them to an Exercise Facilitator at Registration
• Please clean up your area and take all your materials with you
• Additional materials can be found at the Statewide Medical and Health Exercise Program website: www.californiamedicalhealthexercise.com
CONCLUSION
STATEWIDE MEDICAL AND HEALTH EXERCISE
PHASE III: TABLETOP EXERCISE
[Exercise Name/Exercise Date]