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Develop a tabletop exercise for Phase 4

C

Christian Rivers

Senior Moderator
Let me propose that we consider preparing for social distress associated with the sudden awareness of the pandemic threat once we go to Phase 4. I plan to write up a ?virtual tabletop? on the topic late tonight and post in the psychological aspects thread early tomorrow. Feel free to start without me.
C R
 
Re: Develop a tabletop exercise for Phase 4

cr What a great idea, I look forwards to reading it. Hopefully I'll find a way to contribute too!
 
Re: Develop a tabletop exercise for Phase 4

AnneZ
Thanks for the link to Operation Virex.

I will add three tabletops in preparation for this thread.
One is from April 2003 in Leon County Florida
http://www.tallytown.com/redcross/exercise/InfluenzaPandemicTabletopExercise.pdf
Updated from MN in Jan 006
http://www.tallytown.com/redcross/lcte.html

The other was developed by the Harvard School of Public Health I Jan 2006.
http://www.hsph.harvard.edu/hcphp/p...search="Harvard Table top pandemic influenza"
and the general table top from HHS
http://www.hhs.gov/nvpo/pandemics/tabletopex.html

A striking feature to me as I study the tabletops is that they are designed to test us for a pandemic in the early stages of dissemination (ie from first case to pandemic level deaths is less than 60 days). Thus the best available table tops test our REPSPONSE to a pandemic. In this thread we will narrow down to examine our PREPAREDNESS PLANS at the community level for a pandemic.

The initial assumption is that when WHO announces that we are a Phase 4 of pandemic alert there will be a mass movement towards preparedness. What will be the impact of the population engaging in preparedness and has the public been provided the most effective instructions. As we examine the preparedness plans, we will see that once the public reads them we are very behind in are level of preparedness at the Phase 3 level.

The goal of this thread on tabletop for WHO Phase 4 is to help our communities to advance in preparedness while we are still WHO Phase 3.
JT
 
Re: Develop a tabletop exercise for Phase 4

On Stockpiling Personal Supplies

From HHS in USA: Pandemic Planning for Individuals
http://www.pandemicflu.gov/planguide/checklist.html
Stockpile two week supply of food, water and medicine

Pandemic Influenza: Preparedness and Response Plan, Public Health Department, Santa Clara County
http://www.sccgov.org/SCC/docs/Publ...pdf#search="Santa Clara County Pandemic Plan"

P 188 ? in Phase 3, to be repeated in Phase 4
same Checklist as Federal Plan above but also adds advice to stockpile masks, gloves, and usual medications.

So, what happens when we go to Phase 4, and our community realizes we have not supplies ourselves as called for in phase 3. Do we all go out to the store and try to do the stockpiling all at once? What impact does that have on our supplies in general? What happens when shelves run bare? Do we really want to tell the population at the beginning of phase 4 to go get their household stocks urgently, or do we want to modify the message? Should we modify the public messages for phase 4 and 5 based on the assessment of preparedness at the time of the event, rather than the assumption of meeting the prior level of preparedness called for in the plans?

Does the lack of progress on phase 3 plans actually set up a crisis if we go into phase 4?

As a beginning response, I suggest that the message we send out for phase 4 goes something like this
#1 Phase 4 represents a higher level of alertness but at this time our community is free from experiencing pandemic flu.
#2 (assume phase 4 is prior to summer 2007) As we recognize phase 4 we need to work together as a community to prepared for the very real risk of a pandemic.
#3 The learn about pandemic flu and to prepare as a community will take several hours of study and many more hours of meetings and planning.
We will meet several times per week beginning this week at ...

just suggestions
C R
 
Re: Develop a tabletop exercise for Phase 4

A pandemic Phase 4 fictional scenario
For use as a tool to engage others in thinking about how a pandemic could affect them. Change the dates and locations to suit your situation. Project the scenario just one or two weeks ahead of the present to create the sense of immediacy. The key is to make it believable and personal for the listener. I have used this technique in 4 different settings among health care workers with productive impact.

- - - - - - -
Situation Report Oct 19, 2006

Avian Pandemic Influenza is worldwide. Most prominent in SE Asia, Africa. Human H5N1 influenza is endemic in Indonesia. Each case of human H5N1 influenza increases the probability of mutation to a form that will develop into a human pandemic. Current mortality rate is 60%. Spanish influenza mortality rate 2.5%

FICTIONAL SCENARIO​
(NOTE: the locations and origins of the scenario are fictional)
Tuesday October 24

WHO declares pandemic Phase 4 due to 68 hospital workers in (40 in Jakarta and 28 in Bandung) coming down with suspected Avian influenza based on contacts with probable cases, fever >101 and severe pneumonia. There are preliminary reports of a cluster in province outside of Bangkok Thailand. WHO is investigating cases of patients in hospitals during the past two weeks

Wednesday October 25

Florida Department of Health (DOH) issues alert based on PCR H5N1 positive results in a patient admitted to Orlando Regional Medical Center. A health emergency is declared in Florida.

Thursday October 26

More information released on Orlando patient by FL DOH in the Emergency Operations Center (EOC) at 7am.

Patient arrived in US from Jakarta on Friday, October 20. Patient was arrested later the same day for creating a disturbance at the airport.

When booked into Orange County jail the patient was placed in the mental health unit due to bizarre behavior. On Monday morning he was noted to be withdrawn. On Tuesday evening he was unresponsive and noted to have a fever. He was transferred to Orlando Regional Medical Center ER at 9pm and admitted to respiratory isolation at 4 am of Wednesday. Due to the Phase 4 alert and history of travel from affected area, a PCR test was conducted and was positive.
END FICTIONAL SCENARIO​

Now what? What happens in your community? Who is in charge? Who do you talk to? Who do people trust for information and advice? What happens as they look at what the Federal and State plans call for at phase 4? Are people going out to buy supplies? What is the impact? Should your friend go to work tomorrow? etc., etc. Now you have engaged your audience to participate in problem solving.

NOTE: The jails have high turnover, especially with transfers of patients from the mental health unit to state hospitals throughout the week. Other inmates are sent to prison or are released back home into the community. Knowing the amount of social contacts in the index setting such as the jail, allows you to tailor the scenario so that a contact from the jail comes into proximity of your audience as part of the scenario. Jails and hospital ERs are universal sources of close contact and turnover. Mix in some international travelers and the scenario is a real as your front door.

JT
 
Re: Develop a tabletop exercise for Phase 4

A suggestion may be that your community has several members of the staff of the local jail / detention center as well as the hospital. This will help the audience to understand that the infiltration of the virus is not just from some low life bad people since they live in such great areas and would never associate with such rift raft. This can help to demonstrate how quickly and unexpectedly this virus can spread.

Additionally there is ExCELLENT material in John Bush's book Disaster Response - A handbook for church action. It is an old book but the information is very timely, in many ways like it is written for today. The community reaction discussion is very pertinent to this discussion and table top exercise I think. Herald Press, Scottdale PA ISBN 0-8361-1893-6
 
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