Emergency Emergency Preparedness:Becoming a Preparedness:Becoming a

Part of Regional Planning for Part of Regional Planning for the Unexpectedthe Unexpected

ACHA June 2014ACHA June 2014

ScenarioScenario

First 24 hoursFirst 24 hours

A bioengineering grad student at your A bioengineering grad student at your universitybecomes angered and irrational universitybecomes angered and irrational because his advisor rejects his proposed because his advisor rejects his proposed anthrax research project as ” unethical”anthrax research project as ” unethical”

..

The student decides to demonstrate the The student decides to demonstrate the efficiency of his spore delivery apparatus efficiency of his spore delivery apparatus by blowing naturally occurring anthrax by blowing naturally occurring anthrax spores into the football stadium while he spores into the football stadium while he worked behind the counter of a pizza worked behind the counter of a pizza stand during the homecoming football stand during the homecoming football game attended by 60,000 people.game attended by 60,000 people.

To make sure his work would be To make sure his work would be recognized, he left a bag of white powder recognized, he left a bag of white powder and a note for the police when he left the and a note for the police when he left the pizza stand.pizza stand.

Within hours the FBI counterterrorism Within hours the FBI counterterrorism squad confirms that the powder contains squad confirms that the powder contains highly refined anthrax spores.highly refined anthrax spores.

At 24 hours the squad confirms that At 24 hours the squad confirms that anthrax spores have been spread anthrax spores have been spread throughout both halls of Memorial throughout both halls of Memorial Stadium, and are detectable in the homes Stadium, and are detectable in the homes of several randomly selected individuals of several randomly selected individuals who attended the game .who attended the game .

It is assumed that clinical cases of It is assumed that clinical cases of inhalational anthrax will emerge in a few inhalational anthrax will emerge in a few days.days.

Regional health planners decide to Regional health planners decide to distribute a thirty to sixty day supply of distribute a thirty to sixty day supply of antibiotic to all 180,000 people in antibiotic to all 180,000 people in Champaign County within the next 48 Champaign County within the next 48 hours.hours.

They also decide that they need capacity They also decide that they need capacity for 1000 hospital beds in a community for 1000 hospital beds in a community which has only 500 total, and daily census which has only 500 total, and daily census runs about 90%.runs about 90%.

It could happen at your It could happen at your universityuniversity

Recent major outbreaksRecent major outbreaks– MumpsMumps– MeningitisMeningitis– Multiple casualtiesMultiple casualties

Potential University Potential University ResourcesResources

BuildingsBuildingsBrainsBrainsMuscleMuscle

PolicePoliceFireFire

work forcework force

air portair portMoneyMoneyPeoplePeople

volunteer forcevolunteer force

Defined CommunityDefined Community

Coordination with CommunityCoordination with Community

roles of hospital and other agenciesroles of hospital and other agenciesCUPHDCUPHDRed CrossRed CrossPolicePoliceFireFireAmbulanceAmbulanceGovernment LeadersGovernment Leaders

Calling in resourcesCalling in resources

FireFire

AmbulanceAmbulance

National GuardNational Guard

Press/mediaPress/media

PrisonsPrisons

Traffic controlTraffic control

DefinitionsDefinitions

Surge FacilitySurge Facility

Strategic National StockpileStrategic National Stockpile

Specific University InvolvementSpecific University Involvement

Works with community on several possible Works with community on several possible scenariosscenarios– Dry pipesDry pipes– Boil ordersBoil orders– Distribution scenarioDistribution scenario– Surge Hospital set upSurge Hospital set up– ContagionContagion– Power failurePower failure– Radioactive release or toxic gasRadioactive release or toxic gas

Written plans exist for each of the aboveWritten plans exist for each of the above

Most Important of AllMost Important of All

A living business continuity planA living business continuity plan

How to startHow to start

Dialogue with administrationDialogue with administration– Find out about the general university postureFind out about the general university posture

Dialogue with collaboratorsDialogue with collaborators– Public healthPublic health– HospitalsHospitals– Red CrossRed Cross– Government officialsGovernment officials– Make a business continuity planMake a business continuity plan– Make a plan to help-whereverMake a plan to help-wherever

Plan TestingPlan Testing

Table top exercisesTable top exercises– Key people in roomKey people in room– Simulated disasterSimulated disaster

Focus on decision making, communication, policy Focus on decision making, communication, policy gaps gaps

Live exercisesLive exercises– A simulated disaster with real people acting A simulated disaster with real people acting

as victimsas victimsFocus is on actual mechanics of response, uses Focus is on actual mechanics of response, uses “injects”“injects”

This is what a live exercise This is what a live exercise looks likelooks like

Open a surge hospitalOpen a surge hospital– Go from zero to sixty is just 2 hoursGo from zero to sixty is just 2 hours

This is what a community mass This is what a community mass distribution looks likedistribution looks like

One of five in our countyOne of five in our county

This is our mass distribution This is our mass distribution facilityfacility

Home of the Fighting Illini basketball teamHome of the Fighting Illini basketball team

This is what we turn it into if This is what we turn it into if neededneeded

Avian Flu/Pandemic PlanningAvian Flu/Pandemic Planning

The Game PlanThe Game Plan

Detect “bad” flu earlyDetect “bad” flu early– SurveillanceSurveillance

Stop spreadStop spread– Restrict travel, stop public events, stay at homeRestrict travel, stop public events, stay at home

Form a ring around every patientForm a ring around every patient– Limit contactLimit contact– Treat everyone in the ringTreat everyone in the ring

Stop multiplication-eradicate local poultryStop multiplication-eradicate local poultry

““Buy” time, vaccinate if availableBuy” time, vaccinate if available

PlanningPlanning

FederalFederal

StateState

LocalLocal

The Bush Proposal submitted November The Bush Proposal submitted November 1, 20051, 2005

Federal PlanningFederal Planning

Significant planning already accomplished Significant planning already accomplished for possible bioterrorismfor possible bioterrorism– Much is adaptable to Avian FluMuch is adaptable to Avian Flu

Strategic National StockpileStrategic National Stockpile

Surge Hospital PlanningSurge Hospital Planning

Biologic Detection SystemsBiologic Detection Systems

Biohazard Detection SystemBiohazard Detection System

Installed at Installed at Champaign Postal Champaign Postal Facility—Aug 05Facility—Aug 05

Able to test only for Able to test only for AnthraxAnthrax

No false positives..yetNo false positives..yet

Have to medicate Have to medicate Postal Staff if alert Postal Staff if alert happenshappens

State PlanningState Planning

Communication regarding SNS, surgeCommunication regarding SNS, surge

Distribution supportDistribution support

New Legislation regarding “special New Legislation regarding “special powers”powers”

Local PlanningLocal Planning

Live tests accomplished Live tests accomplished – Surge FacilitySurge Facility– Mass distributionMass distribution– CommunicationCommunication– Coordinated responseCoordinated response

Two Principal Local PlansTwo Principal Local Plans

Activation of Surge Activation of Surge HospitalHospital– Carle is the lead agentCarle is the lead agent– McKinley participation McKinley participation

at discretion of at discretion of ChancellorChancellor

Broad Emergency Broad Emergency DistributionDistribution– McKinley is the major McKinley is the major

community distribution community distribution sitesite

Four other sites will Four other sites will operate in Champaign operate in Champaign CountyCounty

So far, Chancellor feels So far, Chancellor feels we need to service we need to service students and students and employeesemployees

University Planning-You Try It!University Planning-You Try It!