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NZ: Exercise Cruickshank to test pandemic plans

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  • NZ: Exercise Cruickshank to test pandemic plans

    Exercise to test pandemic plans

    By KAMALA HAYMAN - The Press | Saturday, 24 February 2007

    An exercise to test the country's preparedness for a deadly flu pandemic will be the largest of its kind, involving almost every government department.

    In May, Exercise Cruickshank will ask authorities to cope with a mock influenza pandemic sweeping the nation, killing more than 30,000 people.

    In a draft scenario, published on the Health Ministry's website, 2007 is described as "the year of the great pandemic".

    The timeline begins in January with sporadic human cases of the bird flu H5N1 in Indonesia. By March, several family clusters are confirmed in west Africa and the Middle East, and by May it is suspected to have spread beyond families in scattered areas of Africa.

    In June and July, cases of human-to-human transmission of H5N1 appear in South America and South-east Asia, killing one in 20 of those infected. The World Health Organisation declares a global pandemic is under way.

    Four clusters appear in New Zealand soon after, traced to an aircraft from North America. They are initially controlled.

    In August, clusters emerge in the Bay of Plenty and Canterbury. They spread despite control measures, and by the end of August the virus has spread throughout the country.

    "By mid-September, the pandemic is very serious and still getting worse," says the draft scenario.

    "Tamiflu has not been as effective as hoped, although it is still of some use."

    By the end of September, 750,000 people have been affected and 2 per cent, or 15,000 people, have died.

    "The major impacts are on the young and the elderly ... (and) pregnant women."

    The country runs out of Tamiflu in early October, but the pandemic peaks. By November, an effective pandemic vaccine becomes available and a national vaccination campaign swings into action.

    More than 30,000 people have died and deaths continue into December with late complications.

    "Many bodies, including those of children, remain in frozen storage, while the survivors of families organise funerals and tangi," says the draft scenario.

    In January, the scenario concludes, a royal commission is set up to investigate New Zealand's management of the pandemic.

  • #2
    Exercise Cruickshank

    Pretend Pandemic to Test Readiness

    By BRISTOW, Robyn

    New Zealand's ability to respond to an influenza pandemic goes under the microscope today with the start of a four-day nationwide exercise.

    Exercise Cruickshank will put to the test border controls, quarantine and hospital plans, disease containment, the deployment of antiviral drugs, the setting up of bases to treat ill people and protocols for the country's recovery.

    The Heath Ministry-led exercise is named after Waimate doctor, Margaret Cruickshank, who was one of 14 New Zealand doctors who died working to save lives during the Spanish influenza pandemic of 1918 which claimed 8500 lives.

    The exercise will involve 30 government agencies, 21 district health boards and their public health services.

    Border controls at international airports, including Christchurch, and sea ports, will be tested today in a simulated exercise as news spreads that an important trading and tourism partner has influenza cases.

    National Pandemic Planning co- ordinator Steve Brazier said being able to work across government agencies and the health sector was essential if New Zealand was going to cope with an influenza pandemic.

    In Canterbury a pandemic roadshow will open in Waikari on May 15 to encourage Canterbury residents to prepare for a flu outbreak.

    (c) 2007 Press, The; Christchurch, New Zealand. Provided by ProQuest Information and Learning. All rights Reserved.


    • #3
      Re: NZ: Exercise to test pandemic plans

      Exercise Cruickshank

      Keep it out (Border Management)
      -implementation of border management measures

      Stamp it out (Cluster control)

      -Notional cases (less than10 in total) will appear in Auckland, Tairawhiti, Capital and Coast and
      South Canterbury early in the day. Some additional cases may appear during the day.
      -700+ contacts spread across the country
      -Border management maintenance
      -Implementation of exit screening

      Manage it (Pandemic Management)

      -DHBs set up Community Based Assessment Centres (CBACs)
      -National Crisis Management Centre (NCMC) will operate to provide National coordination
      -Planning to prioritise and maintain essential services
      -Critical infrastructure tabletop exercise for agencies normally
      represented on the Civil Defence Support for Pandemic
      Response Pandemic Work Group
      -Closure of all education facilities


      • #4
        Re: NZ: Exercise to test pandemic plans

        Christchurch International Airport.
        A group of 30 soldiers will role play as passengers and be processed through the border, arriving from a country possibly affected by Pandemic Influenza. Media can obtain footage of the passengers being processed passing through the border and then being loaded onto a bus to be transported to a quarantine facility. The approximate time this will be occurring is 10.30 -12.00.

        Exercise Cruickshank Questions and Answers

        Why is the government staging this exercise?

        This is the second pandemic influenza exercise to be staged in New Zealand and the first involving an all of government and health sector response.

        The first, Exercise Makgill held in November 2006, involved the health sector only and aimed to assess some of the most difficult aspects of pandemic planning. The exercise focused on cluster control, the ‘stamp it out’ phase of the New Zealand Influenza Pandemic Action Plan (NZIPAP). Lessons learned from this initial exercise enabled existing plans to be modified and reassessed in advance of Exercise Cruickshank occurring.

        Exercise Cruickshank is an all of government drill to practice and strengthen the NZIPAP plans and test the intersectoral response at all four stages of an influenza pandemic.

        It is the largest exercise of its type attempted in New Zealand and encompasses national and local agencies. It is the first time a pandemic response will be exercised to this extent.

        It will enable agencies to practice and test a new set of accountabilities, responsibilities, ways of working, communicating and sharing decision-making at, and between, national and regional levels.

        The objectives have been chosen and prioritised to facilitate learning.

        The possibility of a pandemic occurring is real, therefore it is prudent to hold this Exercise to test New Zealand’s response capability.

        When will the Exercise Occur?

        Exercise Cruickshank will take place over four days in May 2007

        May 10: Keep it Out. The national response will be coordinated from the National Health Coordinating Centre (NHCC) in Wellington with government, heath sector and some private sector agencies participating. As well as the tabletop exercises, Auckland and Christchurch Airports will host operational deployment activities. In addition, the border agencies will hold a discussion exercise.

        May 16: Stamp it Out. This will be a tabletop exercise, coordinated from Wellington’s National Health Coordinating Centre, focusing on cluster control in the community.

        May 17: Manage it. The National Crisis Management Centre (NCMC), which coordinates a multiple government agency response, situated under the Beehive, will be in operation as well as the National Health Coordinating Centre (NHCC). This will be a desktop exercise.

        May 23/30: Recover from it. This will be a discussion exercise held by the regions on May 23 and nationally on May 30.

        What will be tested during Exercise Cruickshank?

        The four day operational phase of the exercise will create scenarios to test each one of the four stages of New Zealand’s Influenza Pandemic Action Plan.

        Exercise Cruickshank will test border control, quarantine, hospital plans, disease containment strategies, public health measures, surveillance and response policies and systems, decision making structures, coordination mechanisms, public communications strategies and arrangements and the Ministry of Health’s ability to coordinate an all of government and health sector response.

        Who will participate in Exercise Cruickshank?
        More than 30 government agencies, all 21 district health boards and their public health services, as well as some private sector agencies, will participate in the exercise.Over 1500 people are expected to take part over the four day exercise.

        What does the government hope to achieve from Exercise Cruickshank?

        The New Zealand Influenza Pandemic Action Plan (NZIPAP), as well as other plans such as the National Health Emergency Plan – Infectious Diseases (NHEP-ID), are continually being updated as new information is received. Exercise Cruickshank will help produce an operational revision of the NZIPAP and HNEP-ID, as well as other government plans for emerging or infectious diseases and for national emergencies.

        What is the expected cost of Exercise Cruickshank?

        A budget of around $750,000 has been allocated to conduct Exercise Cruickshank.

        What is not being tested and why isn’t the entire pandemic response capability being tested?

        It would be impossible to test every aspect of the national and local pandemic response in a four day period. For that reason Exercise Cruickshank has been designed to test specific response elements in the New Zealand Influenza Pandemic Action Plan.

        What are the scenarios for the four days?
        There have been influenza cases occurring in several of its cities for a ‘short time.’ These follow notification of an outbreak of human to human transmission of a new form of influenza adapted from H5N1 in Africa.

        New Zealand takes prompt action and the government directs that the pandemic status be escalated to Code Yellow, and that border management functions be escalated at the international points of entry targeting people from areas of concern.

        All of New Zealand’s air and seas ports are setting up their emergency operation centres to some extent. Several air and sea ports will also be exercising response plans.
        The scenario advances with a nominal six to eight week interval to day two. A pandemic is spreading overseas and New Zealand has four clusters of the disease appear in recent arrivals from an unaffected country. The district health boards and their public health services begin cluster control and every effort is made to control the spread of the disease.

        On day three, a further six to eight weeks have elapsed and the disease has spread. The district health boards establish Community Based Assessment Centres (CBACs) to assess the sick. National reserves of antiviral drugs are mobilised and distributed through the CBACs. Data about the nature of the disease and treatment is being analysed.

        On day four, a nationwide pandemic is occurring with 40% of the population unable to work because of illness or childcare reasons, food supplies becoming limited, antiviral stocks running low and funeral services unable to keep up with the demand.

        The exercise days will all begin with a 15 minute DVD news-style presentation to start play and the scenario will develop from there.

        Why is it called Exercise Cruickshank?
        The Exercise is named after Dr Margaret Cruickshank, the first woman to register as a doctor and subsequently engage in general medical practice.

        When the influenza pandemic of 1918 struck Waimate, Dr Cruickshank was already tried and overworked but she responded magnificently to the needs of the district. When her driver fell ill she travelled by bicycle or horse and gig to attend to her patients. She not only gave medical care to her patients but attended to any of their urgent domestic tasks such as feeding babies and milking cows.

        Dr Cruickshank caught influenza herself and, with her strength already depleted by her labour for her patients, died of pneumonia at Waimate on 28 November 1918. She was one of 14 New Zealand doctors who lost their lives during the epidemic, and one of the 17 people who died in Waimate.

        The people of Waimate lined the streets as her cortege passed. In gratitude for her work, a marble statue was erected in the town in 1923. On it is carved the words; ‘The Beloved Physician / Faithful unto Death.’ In 1948 the maternity ward in Waimate Hospital was named in her honour.

        Last Thursday (3 May) was the anniversary of Dr Cruickshank’s registration as a doctor.

        How will the exercise affect travellers on Day 1, (Keep it Out)?
        There are exercise deployments at most the sea or air ports. These will be carried out so there is no disruption for incoming or outgoing passengers or freight.

        It is also important to be clear this is an exercise so there is no misunderstanding by international travellers that there is a new infectious disease developing in any other country.

        How will it affect hospitals? Will health services be disrupted?

        No. The exercise will not have any impact on normal health services.

        Are overseas countries going to be involved in the exercise?
        There will be 15 officials from five countries observing the exercise.

        The Ministry of Foreign Affairs and Trade (MFAT) is a close working partner in the exercise preparations to ensure that countries who wish to observe are able to do so. MFAT is also informing our diplomatic posts of the Exercise so they are aware of the event.

        As Exercise Cruickshank will be a very large exercise, and New Zealand has been considered a leader in pandemic planning, significant international interest is expected.
        Accordingly, sharing the lessons learned from the exercise with other countries is an important aspect of international preparations. International health organisations, such as the World Health Organisation (WHO), will be briefed on preparations and invited to observe the exercise.

        For questions and answers about Pandemic Influenza please visit the Ministry of health’s website



        • #5
          Re: NZ: Exercise to test pandemic plans

          Stunt patients put 24 Hour Surgery to the test

          A pair of ?stunt patients? posing as foreign poultry farmers with pandemic influenza symptoms will put the Pegasus Health 24 Hour Surgery to the test as part of a nation-wide exercise.

          General practice, along with all other facets of the health system, are testing their pandemic preparedness processes and systems via Exercise Cruickshank, which wraps up today (17 May).

          Spotting the patients won?t be difficult for staff since they?ll be wearing eye catching bright orange overalls. What will be under the spotlight is how the 24 Hour Surgery responds to the ?threat?, and whether its internal and referral systems work.

          ?Like all health organisations we?ve done a lot of planning around the way we would respond if it was for real,? says Pegasus Health 24 Hour Surgery General Manger Paul Abernethy.

          ?With a highly infectious virus like pandemic influenza there is no room for complacency. Our infection control, patient isolation and other processes have to work like clockwork, and staff have to respond fast and decisively.?

          ?Staff know what to do and none of it is complex, but like all things pandemic related, even the simple things are easy to miss or get wrong ? probably because they are so simple. The basic principles of pandemic preparedness that every household should be thinking about ? much higher levels of hygiene, the ability to isolate or quarantine sick people from well ones, protecting yourself from the illness and ensuring you?re stocked up with everything you need to handle influenza, including knowing what to do and when - also applies to us. Just to a much greater degree.?

          Mr Abernethy says with its high rate of casual and non-resident patients, the 24 Hour Surgery could very well be the first port of call for a pandemic influenza case.


          • #6
            Makeshift sneeze guard

            NZ's border control tested in pandemic exercise
            The Press | Friday, 11 May 2007


            Health and government agencies will provide good protection for New Zealanders if a flu pandemic strikes, says a top doctor.

            Dr Ramon Pink, a medical officer of health for Canterbury, said yesterday that he had confidence in New Zealand's border controls.

            His comments follow an exercise at Christchurch International Airport that put them to the test.

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            PRECAUTION: Customs officer Karen Hennessy views "passengers" from behind a makeshift sneeze guard during a flu-like pandemic exercise at Christchurch Airport yesterday.

            "We learnt some very valuable things that will provide a really good foundation for national, regional and local operations. I think with a few changes we would most definitely be able to keep it (the flu) out."

            Exercise Cruickshank, the first pandemic exercise involving all government and health sector agencies, was aimed at strengthening the country's Influenza Pandemic Action Plan.

            Yesterday, table-top exercises and a simulated response to a pandemic were held at most international air and sea ports.

            It was the first day of a four- day exercise, costing about $750,000, aimed at testing border control, quarantine and hospital plans, disease containment, deployment of antiviral drugs and establishment of community centres to assess and treat people with influenza.

            Pink said the Christchurch exercise was a great catalyst for agencies that had not worked together before to develop relationships and trust.

            Yesterday, 30 soldiers acting as volunteers embarked from two international flights. Agencies, acting on a warning from the World Health Organisation of an escalation in human- to-human transmission of influenza, met the flights to screen passengers.

            Evaluation of the exercise would help speed up and fine- tune pandemic response, Pink said.

            Day two, on May 16, will be a table-top exercise aimed at stamping out influenza if it breaches the borders, while day three tests management strategies if the flu grips the nation. Day four, in late May, will discuss how to help New Zealand recover from a pandemic.


            • #7

              A mock bird flu pandemic struck Whangarei Hospital last week.

              A community based assessment centre was established in the ambulance bay of the hospital and a range of 'avian flu infected patients' were treated.

              Patients, who were played by Red Cross volunteers and Whangarei Girls' and Boys' High School students - included a schizophrenic and two sisters whose family didn't believe in medicine.

              Another patient had a cardiac arrest in the waiting room and was rushed to a special isolated intensive care unit.

              The pandemic was part of Operation Cruickshank, a nationwide test to see if New Zealand has the ability to deal with an outbreak of bird flu.

              Last edited by Sally Furniss; May 26, 2007, 04:27 AM. Reason: link


              • #8
                Re: Exercise Cruickshank

                Exercise Cruickshank report is out.

                Report on Exercise Cruickshank (Word, 979 KB)
                Report on Exercise Cruickshank (PDF, 383 KB)