Situation Manual

Time Allotted / Minutes
Dispensing Dilemma – Exercise Play
Exercise Briefing
During this exercise it will be important to remember and comply with the following statements:
·  Prior to beginning today’s Point of Dispensing (POD) Exercise please watch the short Influenza Pandemic in America video. By viewing the video you and your team members will gain additional insight into the importance of this exercise.
·  For the purpose of this exercise designers have developed a scenario that will require the health department to open, manage and close a single Drive-Thru Point of Dispensing (POD). While some health departments, based on the size of the population they server, may open more than a single POD in response to a Phase 6 Influenza Pandemic the focus of this exercise are the processes associated with opening, managing and closing a single POD.
·  You should only use Internet Explorer as your internet browser for today’s Exercise.
·  It is important NOT to jump ahead in the exercise scenario. In other words don’t focus on what might happen, focus on the Common Operating Picture that is presented during the exercise to make informed decisions.
·  In any exercise a number of assumptions and artificialities may be necessary to complete play in the time allotted. During this exercise, the following apply:
1.  The scenario is plausible, and events occur as they are presented.
2.  There is no “hidden agenda”, nor any trick questions.
·  Exercise Basics:
1.  This exercise contains a total of 23 scenario and inject pages.
2.  The exercise is self-paced and it should take approximately three hours to complete. However, based on the time spent on each scenario and inject the exercise may be completed in under three hours or it may take much longer than three hours to complete the exercise.
3.  There is a scheduled 15 minute break approximately half way through the exercise.
4.  All videos embedded within this exercise can be enlarged to FULL SCREEN by simply clicking on the full screen icon in the lower right hand corner of the video.
5.  Thoroughly review all scenario information and injects as they are presented during the exercise.
·  At the end of the exercise you will need to complete an evaluation (Hotwash) on how your team performed during the exercise. The Hotwash will consist of your team providing comments on three areas in which it performed well (Strengths) and three areas your team will need to improve upon (Areas for Improvement) to enhance its preparedness, response and recovery capabilities. Found below are Hotwash examples:
Strengths – During the exercise our team consulted our disaster plans and procedures and found them to be complete.
Areas for Improvement – During the exercise our team consulted our disaster plans and procedures and found portions of the plans and procedures that need to be revised.
·  After the exercise each registered participant who took part in the exercise will receive an e-mail to log into the ONX System to complete their Individual Hotwash to access their Certificate of Participation.
·  If you need assistance anytime during the exercise please call the Help Desk at:
Phone Number – 605-475-4700
Account Number – 1076890#
Time Allotted / 20 Minutes
Dispensing Dilemma – Inject – # 001 / Image of Rural China and Health Alert Network Icon
Day 1
An outbreak of unusually severe respiratory illness has been identified in a small village in southern China. At least 25 cases have occurred affecting all age groups; 20 patients have required hospitalization, five of whom have died to date.
Day 11
Surveillance in surrounding areas has been increased resulting in new cases being identified throughout the province. Viral cultures collected from several of the initial patients are positive for type A influenza virus.
Samples of the virus have been sent to the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) for further characterization. The CDC has determined that the samples are type A H5N1, a subtype never before found in humans.
Day 29
The findings from the CDC have been transmitted back to the Ministry of Health in China and throughout the WHO network. The CDC, in collaboration with the WHO, has dispatched a team of epidemiologists and laboratory personnel to further evaluate the outbreak and disseminates a Health Alert Network (HAN) advisory notifying clinicians and health departments in the United States to be on the alert for patients with severe respiratory illness and a history of travel to the region of Asia where the human cases occurred.
Samples of the H5N1 influenza virus are sent to the United States Food and Drug Administration (FDA), Novartis, Sanofi Pasteur, MedImmune and GlaskoSmithKline so that work can begin on vaccine production.
Identify the name and title of the individual(s) at the health department that will receive the HAN advisory.
Assuming that the chance of health department staff encountering patients that may have been exposed to the virus is very remote will the information contained in the HAN be shared with all of the health department’s staff? / Yes / No
If the above answer is yes. – Briefly explain how this information will be disseminated to all of the health department’s staff.
If the above answer is no. – Briefly explain why the information in the HAN will not be shared at this time.
Time Allotted / 15 Minutes
Dispensing Dilemma – Inject – # 002 / Image of Phase 4 Pandemic Alert
Day 37
The WHO has issued a Phase 4 Pandemic Alert.
Influenza vaccine manufactures have been placed on alert and have begun to prepare for the production of a vaccine to combat the H5N1 influenza virus.
The outbreak caused by the novel influenza virus is headlined in every major newspaper and has become the lead story on CNN, MSNBC and Fox News.
Day 46
Key United States government officials continue to be briefed on a daily basis as surveillance is intensified throughout Southeast Asia and the Pacific Rim.
The CDC has issued a Level 3: Warning for those traveling to and from China and Indonesia, and a Level 1: Watch for most of the other Southeast Asian countries.
Human cases of the H5N1 influenza virus have been reported in Hong Kong, Singapore, South Korea and Japan.
Based on the current information from the CDC and WHO will the health department activate any of the components of its Emergency Operations Plan (EOP)? / Yes / No
If the above answer is yes. – Identify the components of the EOP that will be activated and briefly describe the actions that will be undertaken at this time.
If the above answer is no. – Briefly explain why the health department will not activate any of the components of its EOP.
Time Allotted / 15 Minutes
Dispensing Dilemma – Scenario – # 003 / Image of Phase 5 Pandemic Alert
Day 66
Although cases are reported in all age groups, young adults appear to be the most severely affected with a case-fatality rate approaching 9% of those individuals stricken with the virus.
Public unease grows because a vaccine is not yet available and supplies of antiviral drugs are severely limited.
The WHO issues a Phase Five (5) Pandemic Alert.
Day 89
CLICK ON VIDEO TO PLAY
Video Library – Public Health – Video # 1 – Influenza Pandemic Overview - GNN
State and local public health agencies are asked by the CDC to intensify influenza surveillance.
Time Allotted / 10 Minutes
Dispensing Dilemma – Inject – # 004 / Image of Health Surveillance
Day 91 / Wednesday / 9:21AM
Briefly describe the enhanced health surveillance processes and procedures that will be employed by the health department based on the current public health emergency.
Time Allotted / 15 Minutes
Dispensing Dilemma – Inject – # 005 / Image of ICS
Day 92 / Thursday / 10:35AM
With guidance from the State Department of Health the decision has been made to fully activate the health department’s EOP.
Will the health department utilize the Incident Command System to effectively and efficiently manage the response to this public health emergency? / Yes / No
(Note: At this point the decision to open a Point of Dispensing (POD) has not been made.)
If the above answer is yes. – Identify the individuals by name and title that will be responsible for fulfilling the various ICS roles that will be staffed for this incident.
(Example: ICS Position: Incident Commander / Responsible Individual: John Harper – Environmental Health Coordinator)
If the above answer is no. – Briefly explain why ICS will not be used and describe in detail how the health department will manage this incident.
(Note: For future reference you may want to access the Just In Time Disaster Training Library for additional information on the Incident Command System. These videos are too long to view during today’s exercise. Incident Command System) – OPTIONAL
Time Allotted / 15 Minutes
Dispensing Dilemma – Inject – # 006 / Image of Partners
Day 93 / Friday / 1:47PM
The health department fully understands that it will need the support of various government agencies as well as community and faith based organizations (Community Partners) to successfully respond to the current public health emergency.
List each of the Community Partners the health department plans to rely upon in the days and weeks to come. Then identify the point of contact (POC) information (name and phone number) for each partner. Finally list the kind support the health department expects to receive from the identified partner.
(Example: Community Partner: County Sheriff’s Office / POC: Thomas Highsmith – 555-555-5555 / Support: Provide site security for the POD once it has been opened.)
Using the phone contact two of the Community Partners identified above to confirm that they fully understand their role in supporting the health department during the current public health emergency.
Begin the conversation with “THIS IS AN EXERCISE” and end the conversation with “THIS IS AN EXERCISE”.
(Note: Continue to call Community Partners until you actually talk with two Community Partners.)
Did the Community Partner’s that were contacted fully understand their role in supporting the health department during a public health emergency? / Yes / No
If the above answer is no. – Describe the actions the health department will take to better educate its Community Partners on their expected role(s) during a public health emergency.
Time Allotted / 15 Minutes
Dispensing Dilemma – Inject – # 007 / Image of Volunteers
The health department’s Community Partners are ready to step-up and assist during this public health emergency. However most indicated that their paid and volunteer staff members do not have the training to assist with response activities such as helping to open and manage a POD.
Explain in detail how the health department will provide “Just In Time” training for individuals that would like to assist but have no training. This includes health department staff members that have not previously received the necessary training.
(Note: Access a set of Point of Dispensing (POD) Operations - Just In Time Training videos.)
When paid and volunteer staff members from Community Partners assist the health department during a public health emergency are they covered by the health department’s:
Liability Insurance? / Yes / No
Workers Compensation Insurance? / Yes / No
Describe in detail how the health department will effectively manage volunteers from the community that are willing and able to assist.
(Note: Access the Medical Reserve Corps Guide to Managing Spontaneous Unaffiliated Volunteers.)
(Note: For future reference you may want to access the Just In Time Disaster Training Library for additional information on Volunteers Reception Center (VRC) Operations. These videos are too long to view during today’s exercise. Volunteers Reception Center (VRC) Operations) – OPTIONAL
Time Allotted / 15 Minutes
Dispensing Dilemma – Scenario – # 008 / Image of Antiviral Medications
Day 96 / Monday / 6:47PM
With MSNBC, CNN, Fox News, USA Today along with other news organizations continuing to report on the effects of the current public health emergency individuals and families throughout the United States begin to panic. In an effort to prepare, individuals begin to purchase and hoard food, medication and other supplies that they believe will be needed to survive a pandemic.
Due to panic buying before the onset of the worst of the influenza pandemic, retailers such as grocery stores, drug stores and even gas stations begin to feel the strain and are unable to maintain adequate supplies for normal daily consumption.
Based on the idea of supply and demand, many stores begin to raise prices for basic supplies.
In consultation with the State Department of Health the decision has been made for the health department to activate its plan to open and manage a POD for the distribution of antiviral medications.
Time Allotted / 10 Minutes
Dispensing Dilemma – Inject – # 009 / Image of IAP
Day 97 / Tuesday / 8:21AM
Based on current information and the health department’s POD Plan develop a prioritized checklist known as an Incident Action Plan (IAP) that focuses on INITIAL RESPONSE ACTIVITIES associated with opening and staffing a POD.