Identifier
Created
Classification
Origin
05BUENOSAIRES3110
2005-12-20 21:18:00
UNCLASSIFIED//FOR OFFICIAL USE ONLY
Embassy Buenos Aires
Cable title:  

Embassy Buenos Aires Avian Influenza Tripwires and

Tags:  AMGT ASEC CASC AMED KFLO AEMR AR 
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VZCZCXRO1674
PP RUEHRG
DE RUEHBU #3110/01 3542118
ZNR UUUUU ZZH
P 202118Z DEC 05
FM AMEMBASSY BUENOS AIRES
TO RUEHC/SECSTATE WASHDC PRIORITY 2828
INFO RUCNBEH/BRASILIA ENVIRONMENTAL HUB COLLECTIVE
UNCLAS SECTION 01 OF 04 BUENOS AIRES 003110 

SIPDIS

SENSITIVE, SIPDIS

STATE FOR S/ES - O/CMS - Office of Crisis Management Support

E.O. 12958: N/A
TAGS: AMGT ASEC CASC AMED KFLO AEMR AR
SUBJECT: Embassy Buenos Aires Avian Influenza Tripwires and
Contingency Planning

Reference: (A) State 219189
(B) State 220047
(C) Buenos Aires 2914

UNCLAS SECTION 01 OF 04 BUENOS AIRES 003110

SIPDIS

SENSITIVE, SIPDIS

STATE FOR S/ES - O/CMS - Office of Crisis Management Support

E.O. 12958: N/A
TAGS: AMGT ASEC CASC AMED KFLO AEMR AR
SUBJECT: Embassy Buenos Aires Avian Influenza Tripwires and
Contingency Planning

Reference: (A) State 219189
(B) State 220047
(C) Buenos Aires 2914


1. Sensitive But Unclassified - Not For Internet
Distribution.


2. (SBU) Summary: Embassy Buenos Aires has created an
Avian Influenza (AI) Mission Task Force (MTF),chaired by
the DCM and composed of a program coordinator and
representatives from MED, CON, RSO, MGMT, FAS and ESTH. The
MTF recently met to explore Post's current posture, the
Argentine health care environment and the advance planning
necessary to confront a possible AI epidemic. The GOA has
created an extensive AI Contingency plan based on Pan
American Health Organization (PAHO) and U.S. practices and
may be capable of implementing it, depending on the severity
of an AI outbreak. However, a lack of resources makes it
probable that a sustained AI epidemic would overwhelm the
Argentine healthcare system within a short period.


3. (SBU) The MTF identified steps that should be taken
immediately, created an implementation action plan and
developed a series of tripwires and corresponding responses.
Of particular concern to the MTF is the lack of a stockpile
of antivirals at Post and the unavailability of the drugs on
the local market.


4. (SBU) In determining appropriate tripwires, the MTF
factored a fast transmission rate, especially if the virus
develops the ability to spread directly from human-to-human,
into all assumptions concerning AI due to the historically
rapid geographical dispersion of pandemics, the pace of
modern air travel and Argentina's location as a major
migratory bird flyway. The tripwires also consider likely
civil unrest and the probability that basic services and
business organizations would either cease functioning or
dramatically cut back services in the event of a pandemic.
End Summary.


5. (U) Embassy Buenos Aires has created an ongoing Avian
Influenza (AI) Mission Task Force (MTF),chaired by the DCM
and composed of a program coordinator and representatives

from MED, CON, RSO, MGMT and ESTH. The purpose of the MTF
is to explore Post's current posture, the Argentine health
care environment in the event of a pandemic and coordinate
the advance planning necessary to confront a possible AI
epidemic, and develop emergency response procedures.


6. (SBU) The MTF observed that Post currently does not have
a supply of antiviral drugs and recommends obtaining enough
of the drugs to ensure 100% coverage of all Embassy staff
(including contract personnel) and EFMs in order to ensure
continued Embassy operations.


7. (SBU) There are a number of high-quality hospitals and
clinics in the greater Buenos Aires area. The quality and
number of facilities outside of the capital varies greatly
depending on the region, with healthcare in the northern
provinces of a particularly low quality.


8. (SBU) The GOA has created an extensive plan based on Pan
American Health Organization (PAHO) and U.S. practices to
deal with a possible outbreak of AI and coordinated the plan
with the Ministries of Health in Chile, Uruguay and Brazil.
The Ministry of Health (MOH) is active and involved and the
GOA may be capable of implementing the plan depending on the
severity of the outbreak and the availability of antivirals
and vaccines from outside sources.


9. (SBU) A lack of resources makes it probable that a
sustained AI epidemic would overwhelm the Argentine
healthcare system within a short period. The GOA would need
assistance with personnel, detection laboratories and
medical equipment such as respirators and isolation wards if
a pandemic outbreak occurred in Argentina. The GOA does not
currently have a supply of antiviral drugs, such as Tamiflu,
although the GOA claims it is currently negotiating for a
stockpile of the drugs.


10. (SBU) Post has sufficient resources to shelter essential
personnel in place at the Embassy for two weeks.


11. (SBU) Post management has tasked two U.S. citizen
employees, ESTH Officer Tim Hall and Post Medical Officer
Dr. Michael Heald, with responsibility for inputting the
tripwire data. Both possess secret clearance or higher.


12. (U) All DoD personnel are under COM authority.


BUENOS AIR 00003110 002 OF 004




13. (SBU) In determining appropriate tripwires, the MTF
factored a fast transmission rate, especially if the virus
develops the ability to spread directly from human to human,
into all assumptions concerning AI due to the historically
rapid geographical dispersion of pandemics, the pace of
modern air travel and Argentina's location as a major
migratory bird flyway. Post's plan also addresses the civil
unrest and breakdown of basic services that could result
from a pandemic outbreak in Latin America. It is highly
possible that basic services and business organizations
would either cease functioning or dramatically cut back
services.


14. (SBU) All tripwire responses have been made under the
assumption that an effective human vaccine will not be
available. Any of the tripwires discussed below could occur
independently of each other. It is also possible that two
or more tripwires could occur sequentially or
simultaneously.


15. (U) In the course of discussions, it was apparent that
certain actions need to take place now, before any tripwires
are met, in order to be fully prepared in advance. This
report lists A) actions that require immediate attention,
and B) tripwires and responses.


16. (SBU) A) Actions to be taken immediately:

- As deemed necessary by Post management, provide Mission
briefings for both American and LES employees and
dependents. Topics will include General AI info, MED
guidance, Post's contingency plans and the address of the
Embassy website containing information about avian
influenza. (Action: MGMT and MED)

- After briefing Mission (see above),provide American
Citizen Community with information presented during briefing
via email. (Action: MGMT and MED)

- Identify Staff with medical background and skills.
(Action: MED)

- Train non-medical personnel in caring for those suffering
from AI and to supplement the health unit staff in the event
of a pandemic. (Action: MED)

- Request sufficient Tamiflu to cover all staff (including
contract employees) and EFMs. Conduct inventory of personal
protective equipment (gowns, gloves, protective eyewear,
alcohol-based cleaners and N95 respirators). In
coordination with Consular Section, determine quantities
needed in the section. Procure needed supplies. (Action:
MGMT and MED)

- Provide proper security measures for Tamiflu supply in
mission. (Action: RSO)

- Stockpile emergency supplies for a period of at least
several weeks. This should include a practice of
maintaining full tanks of fuel in all vehicles. (Action:
MGMT and GSO)

- Plan for continuation of operations with reduced staff and
prepare for conducting work from home or other locations
under conditions of a pandemic limiting access to mission
offices. This includes the ability to disseminate warden
messages from an alternate location. (Action: DCM and CONS)

- Identify essential staff to remain through possible
authorized or ordered departure. This list will likely
mirror that in the Emergency Action Plan (EAP). (Action:
DCM)

- Identify staff with medical issues or risk for severe
disease to depart when authorized. (Action: MGMT and MED)

- Prepare pre-planned packets - including travel orders -
for potential Mission evacuees under an authorized
departure. (Action: MGMT and GSO)

- Engage host country officials, including NGOs, to keep
abreast of host country's AI response strategy and health
care capabilities. (Action: ESTH)

- Update list of alternative local physicians in case the
Post doctor is unavailable. Alternative doctors should be
briefed by Post medical staff on AI procedures. (Action:
MED)

- Inspect MRE and bottled water supplies. Determine if

BUENOS AIR 00003110 003 OF 004


additional MREs and other supplies should be ordered to
sustain Mission operations and for unforeseen contingencies.
(Action: MGMT and GSO)

- Conduct periodic meetings of the MTF to review Post's AI
preparedness posture. (Action: DCM and all sections)


17. (SBU) B) Tripwires and Responses:

Tripwire One: A substantial and sustained spike in the
number and/or broadening geographic spread of animal to
human cases or sustained human-to-human transmission
anywhere in the world.

- EAC meets to confirm tripwire has been crossed.
- Provide Mission briefings for American and LES
employees and dependents.
- Restrict official and unofficial travel.
- Ensure that any public announcements or travel warnings
issued are disseminated to American citizens in host
country.
- Recall all employees who are currently in remote areas.
- If the disease has already reached the U.S., consider
sheltering in place of all non-essential personnel in
lieu of authorized departure.
- Begin preparations for actions in Tripwire Two.

Tripwire Two: A spike in the number and/or broadening
geographic spread of animal to human cases or sustained
human-to-human transmission in Latin America or South
Africa.

- EAC meets to confirm tripwire has been crossed.
- Provide Mission briefings for American and LES employees
and dependents.
- Restrict official and unofficial travel to suspected
areas.
- Request authorized departure of non-essential staff and
family members. If this is not possible due to shutdown of
airports or if the disease has already reached the U.S., non-
essential staff and families should shelter in place. (It
is probable that staff and family members will onQ have a
limited time to depart Argentina. This will depend on the
rate of dispersion of the disease and the pandemic
associated shutdown of national and regional airports.)
- Non-essential personnel will be placed on administrative
leave.
- Cancel incoming official travel to host country except for
personnel involved in investigative/containment efforts, or
as otherwise deemed necessary by COM.
- Ensure that staff purchases sufficient supplies of Qod
and water for a shelter in place scenario.
- Social restrictions (restrict movements of all personnel
in the city; restrict dinner parties, participation in
sporting events, etc.)
- Begin preparations for actions in Tripwire Three.

Tripwire Three: A spike in the number and/or broadening
geographic spread of animal to human cases or sustained
human-to-human transmission in Argentina.

- EAC meets to confirm tripwire has been crossed.
- Provide mission briefings (perhaps by phone or email) for
American and LES employees and dependents.
- Cancel incoming official travel to host country except
for personnel involved in investigative/containment efforts,
or as otherwise deemed necessary by COM.
- Coordinate with CA/OCS on issuance of guidance (public
announcement ortravel warning, as appropriate) urging
American citizens to defer all non-emergency travel to host
country and particularly the affected regions.
- In coordination with the Department, prepare press
guidance.
- Implement home quarantine of any staff or dependents who
have been in contact with a person confirmed to have an AI
infection and implement at home monitoring procedure.
- IF AD/OD is not permissible, instruct all non-emergency
American and LES staff to remain home on administrative
leave. Children should remain home from school.
- Implement social distancing (limit movement of all
personnel and dependents in the city).
- Plan for home visits to sick individuals who receive care
under the Embassy health unit.
- Consider delivery service of groceries and other essential
items to residences.
- Depending on level of public inquiries, Embassy staffs and
equips a situation room. Consular officers should establish
a database tracking American citizens who have been
quarantined, hospitalized or ill at home. Also, prepare
guidance for American citizen community on treatment

BUENOS AIR 00003110 004 OF 004


options.
- Reduce consular operations to emergency consular services
only.
- Consider dividing the Marine Security Guard detachment
into two separate and independent entities to decrease the
risk of the spread of the disease and ensure proper coverage
of classified materials.
- Severely restrict visitor access to Mission.
- Consider prophylactic Tamiflu treatment only for staff
that is required to be in direct contact with potentially
infected persons and those at high risk if they develop the
disease.
- In the event of civil unrest, consider increasing the size
of the local guard force and the frequency of patrols to
personal residences. If necessary, consider relocating
personnel sheltering in place to a safer location.

Alternate Tripwire: Mission employee or eligible family
member develops AI infection.

Alternate Tripwire Response:

- Employee or eligible family member begins Tamiflu
treatment.

- Medevac if possible; otherwise home quarantine patient and
anyone who has had direct contact with patient.

GUTIERREZ