Washington State University. Unit Pandemic Influenza Tabletop Emergency Exercise

Transcription

1 Washington State University Unit Pandemic Influenza Tabletop Emergency Exercise 0

2 Contents INTRODUCTION... 2 Specific Exercise Objectives... 2 Roles and Responsibilities... 3 Exercise Modules... 4 How the Exercise is Conducted... 4 Exercise Assumptions and Instructions... 4 MODULE 1: Sustained Human-to-Human transmission... 6 Discussion... 8 Questions for the participants... 8 MODULE 2: Outbreak in the U.S October 19 to November 30, Discussion Questions for all Participants MODULE 3: Suspension of Classes November 24 to December 27, Discussion Questions for the Participants MODULE 4: Business Continuity and Recovery Questions for this Module

3 INTRODUCTION This tabletop exercise is designed to assist your unit in planning and preparing for a pandemic or other major contagious disease outbreak that would affect Washington State University. A tabletop exercise utilizes a fictional scenario to review and test your emergency reactions and response. During this exercise, participants will need to rely on their own resources to manage the incident. Afterwards, participants meet to discuss their experience, what they ve learned, and suggest how your unit plan and prepare for a pandemic/contagious disease outbreak emergency. For the purpose of this exercise, unit refers to any organization sub-division within the University, whether Campus, College, School, Division, Area, Department, Office or Station. This exercise focuses on a pandemic flu event that poses a severe threat to public health and safety. The time frame for this exercise scenario is August, 2006, until March, 2007, when the first pandemic wave is over and Washington State University is making plans to resume full operation Overall Objectives The overall goal of the exercise is to: 1. Assess how the existing emergency response structure within your unit will address the challenges posed by a pandemic influenza event. 2. Assess how your unit will coordinate its response with your College/Division/Area leaders and with other units that your unit interacts. 3. Identify gaps and issues to be addressed in your unit Pandemic/Contagious Disease Plan. 4. Educate your unit personnel about contagious disease and the unique challenges a pandemic poses to the health and well being of the WSU community. Specific Exercise Objectives 1. Evaluate selected aspects of responding to a pandemic within your unit. Travel, enforcement and quarantine Social distancing (cancellation of public events, e.g., lectures, theatre, athletic events, etc.) 2

4 How would your unit manage work-at-home or administrative leave Teleworking-Is your unit IT capable of managing it If an academic unit, could distance learning, help you maintain continuity of the educational process Essential services and personnel Internal and external communications Effects of a suspension of classes or closing the University on your unit Continuity of Operations Planning for your unit What steps your unit would need to take upon the re-opening the University If an academic unit, how will course crediting be managed if classes are suspend or interrupted How can your unit help support students remaining on campus If a research unit, how would you provide for continuation of research projects that could not be paused or interrupted Financial implications to your unit 2. To identify training, communication and resource needs. Roles and Responsibilities This should be a facilitated tabletop exercise with the following roles and responsibilities: Participants respond to the situation presented based upon their knowledge, current plans and procedures. Recorder posts group comments and takes notes Group Facilitator moderates discussion. 3

5 Exercise Modules The exercise scenario is divided into four distinct response situations, plus a debriefing: Module 1: Sustained human-to-human transmission Module 2: Outbreak in the U.S. Module 3: Suspension of Classes Module 4: Business Continuity and Recovery Exercise Debriefing How the Exercise is Conducted Each module will be conducted as follows: The Group Facilitator will introduce each module. In each module, scenario information and events will be provided in the order in which they occur. All information will be provided to all participants. At the end of each module, the scenario will be suspended for questions and discussion. Exercise Assumptions and Instructions A tabletop exercise is intended to be a safe environment that encourages open and wide-ranging discussion. Differing viewpoints, even professional disagreements, are expected. The scenario is plausible, and events occur as they are presented. Respond based on your knowledge of current plans and capabilities. You may not use non-existent assets. 4

6 There is no pre-determined solution to this exercise. Make your best decision based on the circumstances presented. Decisions are not precedent setting and do not necessarily reflect your units position on a given issue. This exercise is an opportunity to discuss and present multiple options and possible solutions. Assume cooperation and support from other responders and agencies. Assume that state and federal responders are initiating their plans, procedures, WSU has activated its plans, procedures and protocols while you are concentrating on what you need to do at your unit level. Draw upon your own experience and knowledge of how the University works to pattern you own response. The presented events, information, written material and resources serve as the basis for discussion. The response process and decision-making are more important than details. Feel free to add, modify, delete or change the module questions to best suit your units needs - WHO global influenza preparedness plan WSU Response Levels Activation Criteria LEVEL ONE: Confirmed cases of sustained human-to-human transmission of pandemic flu or other similar threat or serious health risk, somewhere in the world LEVEL TWO: Confirmed cases of pandemic flu or other similar threat or serious health risk within a 400 mile radius of Pullman LEVEL THREE: Confirmed case(s) of pandemic flu or other similar threat or serious health risk in a 50 mile radius of Pullman 5

7 MODULE 1: Sustained Human-to-Human transmission The following scenario is entirely fictional (We Hope!). August 1-October 18, 2006 August 1 During the summer of 2006, human cases of avian H5N1 influenza continue to be reported from China, Vietnam and Cambodia. However, on July 25, 2006, the Chinese Ministry of Health reported that public health officials are investigating a hospital-associated outbreak of H5N1 influenza. The outbreak appears to be the result of person-to-person transmission. WHO declares a Phase 4 Pandemic Alert August 14 Twenty students from the University of Washington are spending the summer in a special academic program in Xiamen, China. Many international graduate students from South and East Asia are arriving at WSU for continued studies for the fall semester. August 25 Thirty six students and four faculty leave WSU for a six-week long exchange program to China at Shenzhen and Xi'an, as well as Hong Kong. Other Faculty members from Washington State University are also preparing to leave for studies in South and East Asia. 6

8 Sept. 16 Over the next few weeks, additional localized outbreaks of H5N1 influenza that involve person-to-person spread occur in Indonesia, Vietnam and Southern China. The CDC announces a H5N1 vaccine specific to the current strain is being rushed into development but it might be twelve months before it can be distributed. WSU goes to Response Level One. WSU Pandemic/Contagious Disease Plan activated. The WSU Emergency Operations Team (EOT) Director schedules weekly meetings of Tier One of the EOT and the Health and Wellness Director. He also meets weekly with the President and Provost to up date them on the situation status. Sept. 21 WHO declares a Phase 5 Pandemic Alert. Oct. 10 WSU Faculty and students who have been preparing to participate in an exchange program in Europe get ready to leave the campus for the rest of the fall semester. Oct. 13 The 40 students and faculty who were a part of the exchange program in China for the last six weeks, return home via Sea-Tac International and are traveling by bus to the campus. Some of the students have not been feeling well but they assume that it is because of the long trip and the change in time zones. Oct. 15 The 20 Students from The UW return from their program in China. Three of the students are feeling ill and go to UW Student Health for treatment. Oct. 18 The Center for Disease Control (CDC) issues a Travel Health Warning for those traveling to and from China and Indonesia, and a Travel Health Precaution for those traveling to Cambodia, Vietnam and Taiwan. 7

9 Discussion Based on the above information, participants will have 20 minutes to consider these questions. Feel free to add, modify, delete or change the module questions to best suit your units needs Questions for the participants 1. At this stage of the scenario, WSU has gone to a Level One Alert. Based on the planning materials provide, what does the Level One Alert mean for your unit? 2. List the steps might your unit take at this level to make sure your unit has made adequate preparation for a pandemic? 3. If personnel from your unit travel, internationally, what actions should your unit take to determine whether it is prudent for unit staff t travel to affected countries? Countries other than those already affected? 4. What could you be doing at this Level to prepare yourself and family for a possible pandemic? 5. What other issues regarding a looming pandemic can you identify for your unit at this point? What do you need to know that you do not know? 8

10 MODULE 2: Outbreak in the U.S. October 19 to November 30, 2006 Oct. 19 Nearly all of Southeast Asia has been affected by the flu with nearly 50% mortality rates. Estimates are that 5-10,000 people have died in the last month. Confirmed cases of H5N1 have been reported in Los Angeles, Chicago, New York, Boston and Washington, DC, with ten deaths. There are suspected cases in many other parts of the country. H5N1 appears in the Northwest as the Washington State DOH reports three confirmed cases in Seattle. Oct. 20 Other cases are confirmed in Portland and Vancouver B.C. Washington State DOH reports that two deaths in Seattle were from the H5N1 virus. Other deaths around the state are being investigated with a possible H5N1 cause. WHO declares a Phase 6 Pandemic Alert Oct. 26 Several more suspected and confirmed cases of pandemic flu appear on the west side of the State. After lengthy discussions WSU goes to Response Level 2 The EOT Director provides daily updates to the President and his Executive Emergency Management Team (EEMT). Nov. 7 Many more cases of suspected pandemic flu are reported in the state. The Washington State DOH warn all Public Health Offices in the State to fully activate their pandemic preparations. Nov. 13 National media reports that there are more than 300 cases of H5N1 flu from all parts of the country with 155 deaths. Faculty notice that attendance in classes and other academic activities is decreasing as some parents become concerned and insist that their college student children return home. Officials in Washington are encouraging schools, businesses, 9

11 and organizations to cancel all public group activities such as athletic events, meetings and non-essential functions. Washington State University Executives consider all of the issues facing WSU if the need arises to suspend classes and close the University except for essential personnel and critical operations-based on recommendations to close if there is a confirmed case of avian flu within a 400 mile radius. Nov. 17 Regional WSU campuses are reporting increased employee absenteeism and some employees are requesting approval to work-at-home. Registrars at the regional campuses report 40-50% of the students enrolled were not attending classes over the last two weeks. Nov.18- Nov. 23 With the students gone for Thanksgiving Break WSU closely monitors the spread of the pandemic flu and the state s and nation s response to the widening crisis. 10

12 Discussion Based on the above information, the participants will have 20 minutes for discussion. Questions for all Participants 1. What actions are critical at Level 2 in your plan? What is the trigger for that level? 2. What are your unit s capabilities, procedures and possible issues regarding faculty and staff who want to work-at-home? 3. What information about self-protection from the H5N1 flu needs to be communicated to your unit s students, staff and faculty? 4. What should your unit do to report possible flu cases in any unit staff/faculty? 5. With the possibility of the University suspending classes and operations, what are the priority steps your unit needs to take at this time to get ready? 11

13 MODULE 3: Suspension of Classes November 24 to December 27, 2006 Nov. 24 National media are reporting hundreds of avian flu cases in nearly all parts of the country. To date, the Washington State Department of Health has reported more than 150 confirmed cases in the state with 85 deaths. No cases of the flu have been confirmed within 50 miles of Pullman, yet. Students still in town that can leave are leaving campus and heading home. The President s Office is deluged with calls demanding that WSU suspend classes. Governor Gregoire holds a press conference and orders the public school system (K-12) be closed and recommends that all public and private colleges and universities also close. The President calls an emergency meeting. WSU suspends classes. Discussion first centers on how to inform students scattered throughout the state and country to not come back from Thanksgiving Break. Students living in on-campus residences will be asked to leave by Dec. 6. The Housing Office estimates approximately 10% of the resident undergraduate students and 30% of the resident graduate students will be left on campus without the means or ability to leave. Dec. 5 Area hospitals and the Student Wellness Center are reporting that they are getting many calls from people who are worried if they have the pandemic flu. Student Health and local emergency rooms are at full capacity. Student Health and Pullman Regional identify the first suspected cases of H5N1 in the county. Other cases in the county are also suspected. The Housing Office is receiving calls from the students remaining in on-campus residences demanding to be able to stay in the residence halls. Although Housing and Student Affairs try to get as many students as possible to leave, they have expected there would be many students who could not or would not leave. Housing implements its plans for 12

14 accommodating the remaining students as best as they can. Dec. 6 Dec. 8 The first suspected cases of H5N1 in the county are confirmed. WSU goes to Response Level 3 Additional outbreaks and more deaths are reported along the I-5, I-90 and I-82 corridors. Human Resources indicates that the regional WSU campuses and research sites are reporting that as many as 60% of essential employees are not coming to work, either because of self-shielding, caring for young children, or ill family members. The first student from WSU dies at Pullman Regional. Also reports of many more ill in the residence halls as well as throughout Pullman and the county. Several other fatalities occur over the next few days. WSU students still in Pullman are hard hit by the flu. WSU struggles to care for the remaining students in campus residences who are becoming ill at an accelerating rate. Dec. 13 Essential personnel on the Pullman campus are required to continue to come to work; only 75% report. More students, faculty and staff are confirmed to have the H5N1 virus and over half of these are seriously ill. Pullman Regional Hospital s resources began to be overwhelmed. Dec. 14 Shipments of food and other essentials begin to be delayed because the national transportation network has been decimated by absenteeism. Food supplies for WSU Dining Services are running critically low with only a few days supply on hand of a very limited menu. Dining halls may have to be closed and students are complaining of the lack of food. Parents and students are demanding refunds of tuition and fees. Dec. 16 The Hospital is full of critical cases and is establishing triage sites and alternative care facilities around town and at the Veterinary 13

15 Teaching Hospital. A call for volunteers with any type of medical training to assist with care of the ill students in the residence halls goes out. Several Veterinary Medicine and Pharmacy faculty and students volunteer to help the Health and Wellness staff. Dec. 24/25 Santa Claus stays home at the North Pole to avoid getting sick. Children everywhere are disappointed. 14

16 Discussion Based on the above information, the Participants will have 20 minutes to consider these questions. Questions for the Participants 1. What should your unit be doing at Level Three that is different than the other levels? 2. Identify all the resources needed to support your units mission-critical and essential functions? Where might those resources be found if normal sources are unable to provide them? 3. Should your unit supply essential personnel with N95 masks? 4. What are the issues regarding essential personnel who refuse to show up for work? 5. What do you think the most critical issue is facing your unit at this stage in the Pandemic? 6. Could Santa Claus use an N95 mask for protection so he could still make his rounds? 15

17 MODULE 4: Business Continuity and Recovery December 28, 2006 to March 1, 2007 Dec deaths have been reported in Pullman. Most of these are students, and over a 150 students lie ill within their on-campus residences. Quarantine and isolation doesn t seem to help much and is difficult to enforce. Local newspapers and KRFA/KWSU are reporting that nearly 6,000 people have died in Washington State and 600,000 nationwide. At WSU-Pullman, fewer than half of the essential employees are showing up for work and the number of available personnel for some critical operations threatens the ability of those operations to continue. Human Resources attempts to identify those employees who may have recovered from the flu in order to fill vacant essential positions. Pullman Regional is refusing to accept any more patients since the hospital and all alternate care facilities are overwhelmed. They have asked the state for permission to utilize more facilities to expand their capacity. Jan. 8 The Strategic National Stockpile has received the newly created H5N1 flu vaccine to be distributed through a point of dispensing (POD), mass medication dispensing/vaccination site. After healthcare workers and essential emergency personnel receive theirs, the Whitman County Public Health department has asked WSU to designate additional personnel who may receive the vaccination before it is dispensed publicly through a POD. Jan. 17 Over the next two weeks the number of new cases of the flu dwindles. A few more people including some students die. Even though new cases are becoming rare, many of the severe cases who developed complications from the symptoms of the disease still are hospitalized and require critical care. 16

18 Feb. 1 National media are reporting that the first wave is subsiding in most parts of the world and throughout the country. Hospitals throughout the state are reporting a rapid decline in the number of new cases. Local hospitals report no new cases in over a week. Feb. 23 Health and Wellness and the Whitman County Health Department report no new cases of the flu at WSU or in the county for the last four weeks. Fatalities in the county, including WSU, total 46. WSU announces WSU will return to full operations by March 5 and units are to begin phasing in restoration of all services and operations now, to be fully ready by the 5 th. Non-essential employees are recalled to work. WSU also decides to re-open classes at all campuses for a special shortened spring semester that will run from March 12-June 1. Additional distance education classes are organized to maintain educational continuity for those that cannot return. March 1 President Bush goes on national television to announce that the CDC and the WHO have concluded that the First Wave is over, but warns that a Second Wave could appear in two to three months. March 12 The special session of classes at all WSU campuses begins. Only about 30% of the students return for classes on the Pullman campus. Numbers are higher at the regional campuses. Distance education works hard to keep up with the demand for the on-line courses. Questions for this Module 1. Do you think your unit has personnel that should be included in a special essential personnel priority vaccination list? Why? 2. How can your unit assist Human Resources to identify those who have recovered from the flu and are again available for work? 3. What does your unit have to do at this stage to recover, restore operations and prepare for full startup of the University again? 17

19 EXERCISE WRAP-UP 1. In your opinion, what is the number one issue this exercise identified that your unit needs to address to be prepared for a pandemic? 2. What weaknesses did the exercise expose in your unit emergency planning and readiness? Explain. 3. What suggestions would your unit like to make to WSU to enable WSU to quickly make the best decisions regarding emergency response to a pandemic? 4. What should be your next steps to improve your units preparedness, planning or response to a pandemic or any other major emergency? 18