ࡱ> ~}M &Xbjbj== "WW&Tl        ((((( O2`)`)`)`)`)`)`)`)/O1O1O1O1O1O1O$P SUO `)`)`)`)`)UO/  `)`)jO///`)" `) `)/O/`)/O//4L  /O`)T) jC '()BM/OO0OMS-TS/O/      Exercise Island Flu Pandemic NAME OF TOWN: -______________________ GOALS To help local government officials and department heads understand the challenges that a Flu Pandemic poses to Public Health, Continuity of Government, and Infrastructure To suggest questions to the towns to help them to design tools to solve these challenges. To exercise these tools in a collaborative effort with other towns To use the lessons learned to build a Flu Pandemic Cooperative Agreement among all the Island Towns EXERCISE OBJECTIVES Town Government: To deliver health related and other information to the general public To establish a method to protect human health within the community To establish a surveillance method and perform surveillance of flu cases To establish a system that would maintain town employee health and reduce absenteeism To maintain a towns Critical Infrastructure and maintain the delivery of the towns essential government services through Continuity of Operations Planning (COOP) To provide or arrange for emergency food, water, shelter To maintain order among the populace To maintain communications with the general public To protect human health, establish a surveillance method, and to deliver health related and other information to the general public To provide a means of transporting and storing human remains EXERCISE DESCRIPTION The exercise is divided into five SIMULATED DEVELOPMENTS sections which are labeled Start of Month 1, Start of Month 2, Start of Month 4, Start of Month 5, Start of Month 6 These SIMULATED DEVELOPMENT sections are designed to simulate actual events as they would naturally occur in the development of a pre-pandemic and a full pandemic event. The accompanying time periods are designed to simulate an approximate timeline as it would naturally occur in the development of a pre-pandemic and a full pandemic event The simulation of the first 5 months of the exercise are designed as preparation months, to be used by town planners to get ready for the simulated Pandemic outbreak on Marthas Vineyard that starts in Month 6. At the start of Month 6, when the island portion of the pandemic begins, the exercise is separated into weekly increments Weeks 1 through 5 are designed to gradually increase the severity of the Pandemic with a peak in week 5, after which, the effects of the pandemic subside for the remainder of the 12 week period. The scenarios presented within the each SIMULATED DEVELOPMENT are presented from the viewpoints of the two state governmental bodies that would be giving direction to town government in the event of a flu pandemic, the Massachusetts Department of Health and the Massachusetts Emergency Management Agency. ------------------------------------------------------------------------------------------------------------------------------ INSTRUCTIONS: Participants will be given this exercise several weeks before the actual exercise (Pre-Exercise Period). During the Pre-Exercise Period: Participants will take this exercise back to their individual towns and develop actions based upon the situations listed in the exercise. Participants will prepare a town plan for each of the SIMULATED DEVELOPMENT sections that are presented. Participants can use only those assets that they currently have. Participants can use assets from other towns that have been designated in existing MOUs. Participants can share the assets of another town for the exercise if they can acquire a temporary exercise MOU from the other town for this exercise. Actions will be prepared in a cooperative manner between the listed agencies of the town. Actions will be assembled in a manner that can be used in the actual exercise. --------------------------------------------------------------------------------------------- During the Exercise: Each town will share their solutions of the SIMULATED DEVELOPMENTS with the other towns. After the Exercise: The solutions from each town will be sorted by SIMULATED DEVELOPMENTS categories into one document and delivered to each town for review. This will give each town the option of using another towns ideas, revising their own results, and/or collaborating with another town on certain issues. All this information can be used for making a final Flu Pandemic Town Plan. ASSUMPTIONS CURRENT SITUATION: The World Health Organization (WHO) and the CDC will keep the U.S. health community apprised of the progress of the Pandemic. The Massachusetts Department of Public Health will keep the Massachusetts health community apprised of the progress of the Pandemic. The world is currently at Phase 3 (No or limited human to human transmission) A limited number of instances of probable human-to-human transmission have been reported; although none appears to have spread in a sustained way. Phase 3 will not be downgraded to Phase 2 in the foreseeable future EXERCISE ASSUMPTIONS: The exercise is simulated to have a timeline of approximately six months. There is no right or wrong way to handle the situations presented. Participants can add more town departments as they see fit RELAVANT PLANNING ASSUMPTIONS: Influenza Pandemic will result in the rapid spread of infection with outbreaks throughout the world. Communities across the state and the country may be impacted simultaneously After the first few weeks of an Influenza Pandemics, Federal and State Governments will be overwhelmed Absenteeism from local government entities, the business community, and the public health community will be significant. There will likely be significant disruption of public and privately owned critical infrastructure including transportation, commerce, utilities, public safety and communications. Social distancing strategies aimed at reducing the spread of infection such as closing schools, community centers, and other public gathering points and canceling public events will likely be implemented during a pandemic START OF EXERCISE SIMULATED DEVELOPMENT #1 (START OF MONTH 1 (5 months remaining until the start of the Pandemic on Marthas Vineyard ) DEVELOPMENT DESCRIPTION: The World Health Organization (WHO) and the Center for Disease Control (CDC) has declared that the world has changed from Phase 3 ( no or limited human to human transmission of the H5N1 virus) to Phase 4. This means that there is now evidence of increased human-to-human transmission of the H5N1 flu virus. Several cases of this increased human-to-human transmission have occurred in Indonesia and several cases have occurred in China. It is believed that both countries are underreporting the number of cases. News Organizations have begun to report this issue but it is a Page 2 item. Television feature programs are doing in-depth stories on the effects of a Pandemic, especially the disruptions to transportation, energy, finance, utilities, food supply, etc. from absenteeism by workers. YOUR EXERCISE CHALLENGES: 1. The Massachusetts Department of Health has communicated to your Board of Health Agents (BOH) that they estimate that there is a moderate degree of likelihood that the H5N1 flu will occur in the major cities of the U.S., within 4 months. The MDPH is unable to determine, at this time, if the H5N1 virus will affect a few random cases or if it will become a full Flu Pandemic. They are suggesting that the BOH establish a public information program to educate your citizens on good health practices in the event that the health situation deteriorates into a full flu pandemic. 2. The Federal Emergency Management Agency (FEMA) and the Massachusetts Emergency Management Agency are suggesting to your Chief Municipal Officer (CFO) and your Emergency Management Director (EMD) that you establish a Continuity of Operations Plan. The Massachusetts Emergency Management Agency is offering special courses for the CFO and the EMD. The Government is suggesting that you put special emphasis on lines of succession for both your department heads and your line workers because of the expected high incidence of absenteeism from illness and other causes. They believe that, if the virus becomes a full flu pandemic, each department will have at least 1 and in some cases 2+ absences/deaths from both the ranks of management and line workers. They suggest that this could have a significant effect the ability on your Town Government to continue to provide services due to the contagious nature of the disease. a. What measures will you institute to ensure that all departments have a replacement department head? What measures will your department heads institute to provide additional workers to continue providing services? Would you continue to provide all the services that you provide now? Where will the additional workers come from? How long will it take you to set up this system? What training will they require? What will it cost? 3. From your towns citizens: The Board of Health is being asked for more information about how citizens can protect themselves. What will your answer be? Who will answer? How will the answer be disseminated? b. Your selectmen are being asked if food needs to be stockpiled. What will you tell them? Who will answer? How will the answer be disseminated? 4. (ADD ADDITIONAL CHALLENGES HERE) YOUR RESPONSE: The local Board of Health will . The local Board Selectmen will . The local Town Administrator (or comparative official) will . The local Police Chief will . The local Emergency Manager will . Add other Departments here: SIMULATED DEVELOPMENT #2 (START OF MONTH 2) (4 months remaining until the start of the Pandemic on Marthas Vineyard ) DEVELOPMENT DESCRIPTION: The World Health Organization (WHO) and the Center for Disease Control (CDC) has declared that the world is now at Phase 5. This means that there is evidence of significant human to human transmission of the H5N1 flu virus. Large localized clusters of human to human transmission have occurred in Indonesia and China. The countries of Japan, India, and South Korea have also seen significant human to human transmission of the H5N1 virus. The World Health Organization (WHO) and the Center for Disease Control (CDC) believe that it is possible that the H5N1 virus could reach the U.S. News Organizations have begun to report this issue and are beginning to treat it with increase attention. Television feature programs are focusing on the state of preparedness of the U.S. health care system with emphasis on the shortness of supplies and trained personnel YOUR EXERCISE CHALLENGES: 1. The Massachusetts Department of Health has communicated to your Board of Health Agents (BOH) that they believe that all towns should establish a surveillance system to determine the extent of the disease in the community. a. How would you establish this surveillance system? Who would collect the data? Will the BOH agent be overwhelmed by the additional duties required during a pandemic? Is there an alternative to decreasing the agents workload? 2. The Federal Emergency Management Agency (FEMA) and the Massachusetts Emergency Management Agency are suggesting to your Chief Municipal Officer (CFO) and your Emergency Management Director (EMD) that you educate your workers in health and work practices that will keep them from becoming infected from both their co-workers and the public that they deal with. The Government is suggesting that you start this training early before the Flu Pandemic arrives in order that your workers will feel safe enough to come to work during the pandemic. a. What measures will you institute to educate your workers. When will you begin? How long will it take you to set up this system? What will it cost? 3. From your towns citizens a. The selectmens office, the Board of Health office, and the Police Department are being asked if their department has a plan for a Flu Pandemic. What will you tell them? 4. Both local newspapers are asking about your towns flu pandemic plan. a. What will you tell them? 5. A few citizens are coming forward to volunteer to help. a. What will you do? 3. (ADD ADDITIONAL CHALLENGES HERE) YOUR RESPONSE: The local Board of Health will . The local Board Selectmen will . The local Town Administrator (or comparative official) will . The local Police Chief will . The local Emergency Manager will . Add other Departments here: SIMULATED DEVELOPMENT #3 (START OF MONTH 4) (2 months remaining until the start of the Pandemic on Marthas Vineyard ) DEVELOPMENT DESCRIPTION: International spread of the flu has begun. Several large clusters of cases have appeared in London, Paris, Moscow, and Johannesburg The World Health Organization (WHO) and the Center for Disease Control (CDC) has declared that the world is now at Phase 6. This means that the worldwide flu pandemic has begun. The World Health Organization (WHO) and the Center for Disease Control (CDC) believe that the risk of the Flu reaching the U.S., in the near future, is now acute . It is estimated by the European Union that within 5 weeks, the Pandemic will cause severe disruptions to transportation, energy production, finance, utilities, etc. from absenteeism by workers and to food supply because of a slowing of transportation due to border screening. The News Media is now on full alert, graphically depicting scenes of frantic activity in hospitals in Europe, Asia, and Africa. Talk shows are rife with discussions by politicians of both parties on the state of US preparedness YOUR EXERCISE CHALLENGES: 1. The Massachusetts Department of Health and the Massachusetts Emergency Management Agency has communicated to your Board of Health Agents (BOH) and your Emergency Management Directors that they estimate that there is a high degree of likelihood that the H5N1 flu will occur in the major cities of the U.S., within 1 month and in 2 months. Both agencies believe that this will have a significant effect the ability on your Town Government to continue to provide services due to absenteeism or death of your workers. You can expect that each department will have at least 1 and in some cases 2+ absences/deaths from both the ranks of management and line workers. The MDPH estimates that the flu Pandemic can last as long as 12 weeks (3 months) and absences can be as long as 2 to 3 weeks throughout the 12 weeks. a. What measures will your department heads institute to provide additional workers to continue providing services? Will you continue to provide all the services that you provide now? Where will the additional workers come from? How long will it take you to set up this system? What will it cost? 2. The Federal Emergency Management Agency (FEMA) and the Massachusetts Emergency Management Agency are suggesting to your Chief Municipal Officer (CFO) and your Emergency Management Director (EMD) that Schools and public gatherings may have to be closed to limit the spread of infection. a. What program will you institute to communicate, implement, and control this policy? 3. From your towns citizens: The Board of How will you answer? Your selectmen are being asked. What will you tell them? 4. (ADD ADDITIONAL CHALLENGES HERE) YOUR RESPONSE: The local Board of Health will . The local Board Selectmen will . The local Town Administrator (or comparative official) will . The local Police Chief will . The local Emergency Manager will . Add other Departments here: SIMULATED DEVELOPMENT #4 (START OF MONTH 5) (1 month remains until the start of the Pandemic on Marthas Vineyard ) DEVELOPMENT DESCRIPTION: Cases of the Flu have been discovered in San Francisco, Mexico City, Miami, Chicago, Toronto, New York City, and Boston. Several Deaths have been recorded in all these localities Residents of large cities are beginning to exhibit symptoms of controlled panic. European Countries have begun sealing their borders The US is beginning to limit the transit of persons into and out of the country The News Media is now showing scenes of looting and rioting in Africa and Asia News Media is graphically depicting scenes of hospital and morgue activity in the US. Feature Programs are focusing on how individuals and families can survive a Pandemic Health and Human services are suggesting that if a U.S. Pandemic should become established, it will take about 12 weeks (approximately 3 months to run its course). YOUR EXERCISE CHALLENGES: 1. Your Board of Health Agent is telling you that the expected death rate in your community will be 5% to 10 % more than normal and that it will exceed the capacity of the local funereal homes. a. What measures will you institute to care for the human remains? 2. The Federal Emergency Management Agency (FEMA) and the Massachusetts Emergency Management Agency is informing you that in 1 month, the Flu Pandemic can be expected in your town and it is expected to last for 12 weeks and will probably come again in several waves. During this first 12 week wave, you can expect disruptions to your electrical, phone, and internet service as utility workers will be in short supply and will have to concentrate on only the critical infrastructure and the utility suppliers may have to provide service on a limited time-sharing basis. You can also expect disruptions to the transportation systems (air, truck, rail, and ferry). Slowdowns in these industries will cause delayed delivery times for food, medicines, gasoline, heating oil, and other goods. You can expect civil disruptions at grocery stores and other locations. a. Which of your town services will be most affected by disruptions in electricity service? b. How will phone and Internet disruptions affect your ability to provide town services? c. Can you institute an alternate method of supplying these services? d. How will you handle civil disorder? e. What is your Chain of Command for handling these emergencies f. How long will it take you to set up a system to meet these challenges? g. What will it cost? 3. From your towns citizens: YOUR RESPONSE: The local Board of Health will . The local Board Selectmen will . The local Town Administrator (or comparative official) will . The local Police Chief will . The local Emergency Manager will . Add other Departments here: SIMULATED DEVELOPMENT #5 (START OF MONTH 6) WEEK 1 DEVELOPMENT DESCRIPTION: The Pandemic has now well established itself in all major US cities. The Federal Government has performed the following actions: a. b. c. The State Government has performed the following actions: a. b. c. YOUR EXERCISE CHALLENGES: From your towns citizens: YOUR RESPONSE: The local Board of Health will . The local Board Selectmen will . The local Town Administrator (or comparative official) will . The local Police Chief will . The local Emergency Manager will . Add other Departments here: The local Board of Health will . The local Board Selectmen will . The local Police Chief will . The local Emergency Manager will . Add other Departments here: WEEK 2 DEVELOPMENT DESCRIPTION: The Federal Government has performed the following actions: a. b. c. The State Government has performed the following actions: a. b. c. YOUR EXERCISE CHALLENGES: From your towns citizens: YOUR RESPONSE: The local Board of Health will . The local Board Selectmen will . The local Town Administrator (or comparative official) will . The local Police Chief will . The local Emergency Manager will . Add other Departments here: WEEK 3 DEVELOPMENT DESCRIPTION: The Federal Government has performed the following actions: a. b. c. The State Government has performed the following actions: a. b. c. YOUR EXERCISE CHALLENGES: From your towns citizens: YOUR RESPONSE: The local Board of Health will . The local Board Selectmen will . The local Town Administrator (or comparative official) will . The local Police Chief will . The local Emergency Manager will . Add other Departments here: WEEK 4 DEVELOPMENT DESCRIPTION: The Federal Government has performed the following actions: a. b. c. The State Government has performed the following actions: a. b. c. YOUR EXERCISE CHALLENGES: From your towns citizens: YOUR RESPONSE: The local Board of Health will . The local Board Selectmen will . The local Town Administrator (or comparative official) will . The local Police Chief will . The local Emergency Manager will . Add other Departments here: WEEK 5 DEVELOPMENT DESCRIPTION: The Federal Government has performed the following actions: a. b. c. The State Government has performed the following actions: a. b. c. YOUR EXERCISE CHALLENGES: From your towns citizens: YOUR RESPONSE: The local Board of Health will . The local Board Selectmen will . The local Town Administrator (or comparative official) will . The local Police Chief will . The local Emergency Manager will . 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