appendix a - justice & safety center | justice & safety centermodule 5: isolation and...

Participant Guide Isolation and Quarantine for Rural Communities

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Module 5: Isolation and Quarantine Resources - Online Prerequisite Supplement

March 2014

Appendix A

Participant GuideIsolation and Quarantine for Rural Communities

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Appendix A

Isolation and Quarantine for Rural Communities Appendix 5-A

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Typed Resource Example


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Appendix B


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Appendix B

Tips for Typing

1. Some departments may have resources listed in “disciplines” other than their own, or have resources in various “discipline” categories.

2. Some resources may be used by more than one of the disciplines that NIMS has listed. This may result in different terms for the same resource.

3. Only identify those 120 typed resources that are in your inventories that meet the exact descriptions.

4. The list is simply a list; it does not imply that you should or should not have the resource.

5. There are some resources that reside only at the federal and/or state level. Some are state-only.

6. Involve other people in the typing of inventory. Others may be aware of volunteer or private sector resources or resources shared among your discipline on a day-to-day basis.

7. Some resources may be counted more than once if they are shared resources among different jurisdictions or disciplines; or they may consist of individuals that serve on more than one “team” such as a search and rescue team and a Specialized Weapons and Tactics (SWAT) team.

8. Available resources do not exclude those that may be used by more than one discipline or team. If mutual aid/state agency coordination is capable to assemble and deliver the resources for a strike team/task force, then that resource capability is to be counted.

9. Resources that are not functional should not be counted.

10. Resident Disaster Medical Assistance Team (DMAT) teams are not to be counted as state assets since they are only available for a federally declared disaster.

11. Private and volunteer resources should only be counted by those jurisdictions that have written agreements that list the jurisdiction having priority usage.


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Appendix C


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Appendix C

Isolation and Quarantine for Rural Communities Appendix 5-C

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EMAC Request Checklist

□ Mission Assignment: What task or mission will the resource be required to perform?

□ Resource Needed: Date and time when resource is needed in the Requesting State

□ Work Location/Facilities: o State EOC o Local EOC o Field – Impacted area o Joint Field Office o Other

□ Working Conditions: o Normal o Supplies & Equipment Needed

□ Living Conditions: o Normal -‐ all amenities available o Minimal -‐ some hotels/restaurants available o Base Camp (or similar) -‐ meals/lodging provided o Primitive – self sustaining for all amenities

□ Health & Safety Concerns: o None o Immunizations or vaccinations suggested o Personal protective equipment needed

□ Safety Concerns/Remarks: Specific comments on health or safety concerns

□ Additional Comments: Specify any specific equipment needed, or other concerns such as licensure & certification requirements

□ Staging Area: Address where the resource should report upon arrival and check out when demobilized

□ Name, Title, Phone, and E-‐mail of the person who is making the request and most knowledgeable about the type of resource being requested

□ Resource Release: Date & Time resource is demobilized to go back home


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Appendix D


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Appendix D

Isolation and Quarantine for Rural Communities Appendix 5-D

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Sample Mission Package

BASIC LIFE SUPPORT TRANSPORT PACKAGE A. TASK & PURPOSE:

To provide life support response within the state in support of emergency management objectives.

B. MISSION: • Basic emergency medical care • Medical unit • Field hospital support • Shelter medical support • Evacuation support • Medical monitoring

C. ESFs: 8 D. LIMITATIONS • Integration with local medical response

system • Medical protocol issues with local medical

control • Supply replacement • Communications

E. PERSONNEL: 10 F. EQUIPMENT (5 Vehicles) • Basic life support ambulances • BLS equipment • GPS units • Cell phones

G. REQUIRED SUPPORT: • Will require billeting and meal

support • Fuel for vehicles • Maps of disaster response area • Medical supplies

H. WORK WITH: • Medical unit leader • EMS providers • Hospitals • Base/Camps • Hazmat/USAR teams

I N-‐HOUR SEQUENCE: N+24 J. SPECIAL INSTRUCTIONS: • Must be integrated with local system • Must be self-‐supporting for up to first 72

hours • Equipment costs will vary depending on

type of response K. ESTIMATED COST PER DAY: PERSONNEL: $4,800 EQUIPMENT: $5,160 TOTAL: $9,960


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Appendix E


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Appendix E

CDC Resources

GuidesPublic Health Emergency Response Guide for State, Local, & Tribal Public Health Directors – All-hazards reference tool for health professionals who are respon-sible for initiating the public health response during the first 24 hours (i.e., the acute phase) of an emergency or disaster. Cooperative Agreement Guidance for Public Health Emergency Preparedness – Guidance for CDC emer-gency preparedness funding for states. CDC Support for the Emergency Management Assistance Compact (EMAC) – Information about EMAC, the interstate mutual aid agreement that pro-vides a mechanism for sharing personnel, resources, equipment & assets among states during emergencies & disasters. (CDC, n.d.)Comprehensive Preparedness Guide 301: Interim Emergency Management Planning for Special Needs Populations – Provides scalable recommendations for planning for special needs populations.Cities Readiness Initiative (CRI) – Pilot program to aid cities in increasing their capacity to deliver medicines and medical supplies during a large-scale public health emergency.Community-Based Mass Prophylaxis: A Planning Guide for Public Health Preparedness – Planning guide to help state, county, & local officials meet federal requirements to prepare for public health emergencies. Outlines five components of mass prophylaxis response to epidemic outbreaks. Addresses dispensing operations using a comprehensive operational structure for Dispensing/Vaccination Centers (DVCs) based on the National Incident Management System (NIMS). Division of Strategic National Stockpile Emergency MedKit Evaluation Study Summary – Guidance for pro-viding necessary countermeasures in a timely manner.

ToolsSurveillance Tools – Tools for tracking infectious disease appearance over time and geography.

• International Surveillance for Pandemic Preparedness

• Epi-X: The Epidemic Information Exchange • National Electronic Disease Surveillance System

(NEDSS)Risk Assessment Tools -- Risk assessments to help assess the threat of influenza viruses with pandemic potential.Influenza Pandemic Preparedness Tools – Resources to help hospital administrators and state and local health officials prepare for the next influenza pandemicModel Agreements – Gathered, reviewed, analyzed, condensed and categorized provisions from numerous and varied mutual aid agreements assembled by the CDC’s Public Health Law Program for public health officials.Pandemic Flu Toolkits Helping to Build Partnerships with the International Community – Via workshop, Oak Ridge Institute for Science and Education (ORISE) and CDC partnership to produce and provide training information.Resource Tracking – Tools to locate resources.

• National Vaccine Supply Shortages• Standardized Resource tracking (e.g. IRIS)


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Communication and Educational MaterialsBelow are selected resources to help leaders commu-nicate with and educate people and communities about how to slow the spread of infectious diseases through nonpharmaceutical interventions (NPIs).General NPIs

• Nonpharmaceutical Interventions and CDC’s Community Interventions for Infection Control Unit

Personal NPIs• Everyday Preventive Actions • Cover Your Cough Posters• Handwashing: Clean Hands Save Lives• Happy Handwashing Song E-Card• Happy Handwashing Song Podcast• Deck Yourself with Flu Protection Song E-Card• Deck Yourself with Flu Protection Song Podcast

Seasonal Flu• Good Habits for Preventing Seasonal Flu• Take 3 Actions to Fight the Flu• Seasonal Flu Materials for Refugees• Flu-Related E-Cards• Flu-Related Podcasts• Free Flu Resources

School NPIs• How To Clean and Disinfect Schools to Help Slow

the Spread of Flu

Pandemic Flu• Pandemic Flu Resources• Pandemic Flu Planning Resources• Flu.gov

Appendix E


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Appendix F


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Appendix F

Surveillance ToolsProMED-Mail (PMM)The first disease surveillance network, ProMED-Mail (PMM) is a free, nonprofit, noncommercial, moderated e-mail list that serves in excess of 37,000 subscribers in more than 150 countries, as well as anyone with access to the website. In addition to volunteer reporters who provide informa-tion on possible infectious disease outbreaks specific to their geographic area, PMM receives information from subscribers and from staff-conducted searches of the Internet, media, and various official and unofficial web-sites. Moderators assess these reports for plausibility via established rumor verification protocols and private query to experts, edit them as necessary, and often add comments or context before posting. Because PMM aggregates reports from various loca-tions, it can reveal the geographical extent of an outbreak. This system has resulted in several emerging disease reporting “firsts,” including outbreaks of Ebola virus in Zaire (1995), West Nile virus in the United States (1999),SARS in China (2002), and H5N1 avian influenza in Indonesia (2003).

HealthMapHealthMap, a freely available, web-based surveillance network operating since September 2006, provides a global view of infectious disease outbreaks as reported by the WHO, PMM, Google News, and Eurosurveillance. There is an abundance of open-source electronic surveillance networks for infectious disease, but none provide a truly global perspective due to gaps in geo-graphic or population coverage and expertise. HealthMap attempts to bridge these gaps by aggregat-ing and integrating information from several surveillance networks to produce a graphic, continually updated model of global disease outbreaks over space and time. Alerts are displayed on a global map that can be viewed at a wide range of resolutions and they are linked to source sites that provide news of the outbreak and information on the disease.

Global Outbreak Alert and Response NetworkTo connect the growing number of surveillance networks that followed PMM in terms of capacity for infectious

disease diagnosis and response, WHO established the Global Outbreak Alert and Response Network (GOARN) in 2000. Conceived as a “network of networks,” GOARN pools human and technical resources from more than 100 institutions around the world in order to rapidly iden-tify, confirm, and respond to outbreaks of international importance.

GlobalAvianInfluenza Network for Surveillance (GAINS)The Global Avian Influenza Network for Surveillance (GAINS) seeks to expand international surveillance for influenza in wild birds and promote the dissemination of surveillance information to governments, international organizations, the private sector, and the public. With support from U.S. Department of Agriculture (USDA), the U.S. Agency for International Development (USAID), and the Food and Agriculture Organization of the United Nations (FAO), GAINS trains individuals and organizations to collect samples for analysis by a network of diagnostic labs, the results of which are disseminated through a common, open-access database. Participants in the program, which currently reaches 24 countries, include hunters, birdwatchers, and other members of the public, as well as animal health professionals.

BioSense 2.0BioSense 2.0 is a program of the CDC that tracks health problems as they evolve and provides public health officials with the data, information and tools they need to better prepare for and coordinate. Using the latest technology, BioSense 2.0 integrates current health data shared by health departments from a variety of sources to provide insight on the health of communities and the country. By getting more information faster, local, state, and federal public health partners can detect and respond to more outbreaks and health events more quickly.


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Appendix G


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Appendix G Isolation and Quarantine for Rural Communities Appendix 5-G

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Advantages and Disadvantages of Respirators and Facemasks

Advantages and Disadvantages of Respirators and Facemasks Device Advantages Disadvantages Facemask • Reduces exposure to

splashes of large droplets • Tested for fluid resistance • Easier to handle than a

respirator

• Does not reduce exposure to small inhalable particles

• Cannot be decontaminated • May be shortages during a pandemic • Not designed to form a seal to the face

N95 respirator (filtering facepiece)

• Reduces exposure to small inhalable particles and large droplets

• Designed to form a tight seal to the face

• Filtration efficiency certified

• Cannot be decontaminated • May be shortages during a pandemic • Must be fit-‐tested to assure full protection • Cannot be worn with facial hair that interferes

with the seal between the face and respirator • Harder to breathe through than facemask • Not designed to be used in surgery

N95 respirator with exhalation valve



• Filtration efficiency certified • Exhalation valve makes it

easier to exhale and reduces moisture buildup inside the facepiece compared to other filtering facepiece respirators


with the seal between the face and respirator • Harder to breathe through than facemask • Not designed to be used in surgery • Should not be used when others must be

protected from contamination by the wearer

Surgical respirator (flitering facepiece)

• Reduces exposure to small inhalable particles and large splashes of droplets


• Filtration efficiency certified • Tested for fluid resistance,

biocompatibility, and flammability rated


with the seal between the face and respirator • Harder to breathe through than facemask • Not designed to be used in surgery • Should not be used when others must be

protected from contamination by the wearer • Limited availability


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Appendix G

Isolation and Quarantine for Rural Communities Appendix 5-G

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Elastomeric respirator (flexible, rubber-like facepiece)



• Filtration efficiency certified • Can be decontaminated and

reused • Can reduce or eliminate

impact of shortages • May be more cost-‐effective

for long-‐term use • Has replaceable filters • Can be used by different

people after decontamination

• Full facepiece provides eye protection

• Must be fit-‐tested to ensure full protection • Cannot be worn with facial hair that interferes

with the seal between the face and respirator • Harder to breathe through than a facemask • May interfere with voice communication • Requires cleaning and disinfection between

uses • Should be used when others must be

protected from contamination by the wearer

Powered Air-Purifying Respirator (PAPR) (head/face covering with battery-powered blower unit

• Reduces exposure to small inhalable particiles

• Provides greater level of protection than filtering facepiece or elastomeric respirators

• Filtration efficiency certified • Can be decontaminated and

reused • Can reduce or eliminate the

impact of shortages • Hooded PAPRs do not need

to be fit-‐tested and can be worn with facial hair

• Reduces/eliminates breathing resistance and moisture buildup inside the facepiece/hood

• Has replaceable filters • Can be used by different

people after decontamination

• Full facepiece provides eye protection

• Significantly more expensive than other respirators

• Weight (1.5 – 3 ibs) -‐-‐ blower unit/battery typically worn on belt

• On some units, fan noise can make communication and medical care delivery more difficult

• Requires cleaning and disinfection between uses

• Should be used when others must be protected from contamination by the wearer


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Appendix H


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Appendix H

Isolation and Quarantine for Rural Communities Appendix 5-H

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Stockpiling Estimates for Respirators and Facemasks

Stockpiling Estimates for Respirators and Facemasks Percentage of medium or higher risk employees

Number of N95 respirators needed per employee per shift (high or very high risk)

Number of facemasks needed per employee per shift (medium risk)

Number of N95 respirators needed per employee for a pandemic (120 work days) (high or very high risk)

Number of facemasks needed per employee for a pandemic (120 work days) (medium risk)

Healthcare Hospital: 33% Outpatient office/clinic: 67% Long-term care:25% Home healthcare: 90% Emergency medical services:100%

4 4 1 2 8

0 0 3 4 0

480 480 120 240 960

0 0

360 480

0

First Responders Law enforcement: 90% Corrections: 90% Fire department (non-EMS, career and volunteer: 90%

2 1 2

2 3 2

240 120 240

240 360 240

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