Anne Arundel County MD: Pandemic preparedness faces test

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Source: http://www.baltimoresun.com/news/local/annearundel/bal-ar.pandemic18jun18,0,4738456.story

Pandemic preparedness faces test
Simulations to include surge in patients, shortage in staff

By Jasmine Jernberg | Sun Reporter
June 18, 2008

Scores of employees of the Anne Arundel County Department of Health and Fort Meade will descend on the county's two hospitals this morning with complaints of fevers, body aches and fatigue in a wide-ranging test of the county's preparedness to face a flu pandemic.

Anne Arundel and Baltimore Washington medical centers will practice assessing a surge in patients to the emergency department, amid their own mock shortages in staff, while the Department of Health and the Office of Emergency Management will tackle their own challenges of having staff reduced by influenza and directing their remaining resources.

The joint effort will be the first time all the groups have come together in a realistic exercise.

"The more we can plan for now, the better that AAMC can design protocols for the future and the more streamlined our response will be," said spokesman Justin Paquette. "Our main goal is protecting our patients in the future."

The Annapolis hospital is expecting about 40 mock patients from the Department of Health from 7 a.m. to 9 a.m. and will be treating the influx of patients along with "affected" staff members as they arrive. Hospital personnel will practice assessing emergency situations and directing patients in a security lockdown with only one open entrance.

The exercise is not expected to interfere with normal hospital activity. There may be staff with medical masks, but information desk personnel have been instructed to inform patients and visitors that it is only a drill. Fliers will also be distributed to explain the event.

Baltimore Washington Medical Center will be expecting 80 to 100 mock patients from Fort Meade and the county Department of Health. According to the hospital's director of emergency nursing, Carol Ann Sperry, this number is consistent with levels several weeks into a flu pandemic. The center will triage and direct treatment for the patients, address an atypical doctor-to-patient ratio and test an auxiliary treatment area that can handle an additional 80 patients.

Regular patients can expect unusual traffic patterns and limited parking, though the drill will not affect treatment.

"You want to be able to perform when your community needs you the most," Sperry said. "That's how basketball players get good at what they do. They practice, practice, practice. And that's how we get good at what we do."

At the Department of Health, employees will arrive to a thermometer reading, testing all staff for potential infection. County Health Officer Frances B. Phillips said that in line with typical pandemic statistics, 30 percent of the staff will be "infected" and transferred to local hospitals. Remaining staff and management will assess how many employees remain and determine which clinic and business operations must remain intact and which can be cut back or suspended.

Phillips believes this is especially important for Anne Arundel County, because pandemics can spread quickly by way of international travelers entering the country through BWI Marshall Airport.

"I think it is so important our public health system be on our toes in the event of any biological emergency," she said. "It is a continuing matter for the county to remain vigilant."

jasmine.jernberg

@baltsun.com

 

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Re: Anne Arundel County MD: Pandemic preparedness faces test

Source: http://www.hometownannapolis.com/cgi-bin/read/2008/06_19-10/TOP

Flu pandemic scenario tests county's resources
Mock emergency brings 'patients' to AAMC, BWMC
By SHANTEE WOODARDS, Staff Writer
Published June 19, 2008

Infected patients were bused to Anne Arundel Medical Center wearing surgical masks with symptoms ranging from coughing to vomiting.

The patients weren't really infected. They were workers from the Anne Arundel County Department of Health who participated, along with workers from other county agencies, in a pandemic flu drill yesterday.

The scenario: About one third of county residents have become ill and medications and vaccines are not available. More than 100 sick or infected "patients" from the Department of Health and Fort George G. Meade participated and were bused to AAMC or Baltimore Washington Medical Center.

This was the first drill of its kind in the county, conducted with multiple agencies. Still, this wasn't the first time the county had to deal with widespread flu. Nearly 100 years ago, several public places in the county were shut down because of the spread of influenza, organizers said.

Antigone Vickery, program manager for emergency preparedness and response, said the exercise was important for health care workers.

"(This scenario) is expecting that we lose 30 percent of the population, so we have to see how we cope in that environment," he said, referring to the portion of the population who would die or be incapacitated because of the illness.

At the Department of Health, workers rolled dice to get their assignments. If they rolled a six or a one, they were assigned to be patients for a day. If they rolled any other number, they were sent to another room to get fitted for a surgical mask. They were required to wear the mask the duration of the drill.

Dr. Joseph Horman and Cristy Sandoval both rolled a one. They were given cards that gave them a short biography of they patients they were supposed to be.

Dr. Horman, the county's public health veterinarian, was assigned the role of a 4-year-old boy named Jeff Jamison. Jeff was crying, but also had vomiting and diarrhea, his card stated.

Ms. Sandoval played the part of Geraldine Graham, a 21-year-old with a cough, vomiting and muscle pain. Ms. Sandoval, an administrative specialist with the Department of Health, speaks Spanish and also was instructed to speak Spanish throughout the drill.

They were bused to the AAMC emergency room, where masked staff members awaited them at the ambulance entrance. Once their symptoms were reviewed, the patients were taken inside on a wheelchair. A portion of the emergency room was devoted to the drill and doubled as the triage area.

"Infected" patients were given beds, chairs and in some cases, stretchers. One man's card said he had to be left to die.

"These kinds of ethical issues are what a lot of places are struggling with now," said Debra Curro, community health nurse for the Department of Health, who helped coordinate the drill. "(But) that is the reality if hospital staff is down."

Interpreter John Van De Kamp was able to translate for Ms. Sandoval, whose pretend character received an IV and blood work.

Dr. Horman had to be taken to pediatrics in a wheelchair, repeatedly saying "I want my mommy," as the staff examined him. He received an IV, oxygen and was able to watch television while he was being monitored. Afterward, he said he thought everything went well, but emphasized it would be different in reality.

"In a real-life situation, there would be a lot happening that people wouldn't be prepared to handle," Dr. Horman said. "There would be so many things happening ? the hospital would get very inundated and that would be very difficult."

At BWMC, emergency room workers prepared for about 120 extra people on top of the 250 people they see on an average day. Hospital officials said it took 27 minutes to clear the waiting room and add 100 stretchers to accommodate the influx of new patients.

"This is just testing how we process large number of patients in a small amount of time," said Dr. Larry Linder, senior vice president and the hospital's chief medical officer.

Outside the hospital were two tents: one for medical care and another for a waiting room. The drill turned the participants into actors. Each received a card listing a name, age and complaint along with heart rate, respiration rate, blood pressure and temperature.

Karli George, who registers patients at the hospital, said the day was "good, but a little bit crazy."

"The best part was just seeing the people and the way they are acting is funny," said Ms. George.

A major outbreak of the flu hit the county in the fall of 1918. The Naval Academy, Fort Meade and St. John's College were quarantined in September. By October, movie theaters and schools were closed, according to archives from The Maryland Gazette and The Evening Capital.

Health officials estimated there were 2,068 cases of influenza with 857 deaths in the county, including 700 deaths at Fort Meade.

This was AAMC's first time doing a drill with so many different agencies. Separately, the staff constantly undergoes training for similar scenarios, said Douglas Abel, incident commander.

"It's why we run the drills," Mr. Abel said. "We don't want to try to figure things out when this is occurring. We push ourselves to work through scenarios that could happen to us."

Reporter Sean Norris contributed to this story.