Avian Influenza: Lithuania tripwires and contingency

UNCLAS SECTION 01 OF 03 VILNIUS 001347 SIPDIS E.O. 12958: N/A TAGS: AMGT ASEC CASC AMED AEMR LH SUBJECT: Avian Influenza: Lithuania tripwires and contingency planning REF(S): A. STATE 219189; B. VILNIUS 1239 ¶1. Embassy Vilnius has reviewed the preparedness steps and tripwire guidance in ref A. As requested, we have developed our own readiness measures against avian influenza, including tripwires for possible drawdown requests and shelter-in-place plans. ¶2. Per paragraph 6 of ref A, Post has attempted to place the following information on the TRIPS website. We are having technical problems logging in, but we will keep trying until we succeed, and confirm as soon as the information is uploaded. ¶3. Introductory paragraph: The GOL has plans in place to manage a possible outbreak of avian influenza or human pandemic influenza. An outbreak of extremely virulent human pandemic influenza would undoubtedly strain Lithuania's capabilities, but the GOL likely would report its situation truthfully and seek assistance from both its allies and international organizations. Vilnius has two hospitals that are designated for use in an AI outbreak. Infected adults will be treated at State TB and Infectious Diseases University; infected children will be treated at Santariskiu Children's University Hospital. Treatment at both hospitals is on a first-come, first-served basis, with no discrimination between a national and a foreigner. Once an epidemic is declared in Vilnius, Post cannot shelter in place for more than three days. Once quarantine is declared for the country or for Vilnius, Post will be able to shelter in place for no more than 48 hours. Post does not have the funds to purchase medication, hand sanitizers, masks and food to provide 100% coverage for all personnel or for sustaining a long-term period of sheltering in place. MGMT Officer Cheryl Johnson and IMO David McCrane are Post's POCs for coordinating Post's AI plan. Ms. Johnson and Mr. McCrane are also tasked with inputting Post Tripwires into TRIPS. ¶4. Tripwires: Tripwire One: A spike in the number and/or broadening geographic spread of animal-to-human cases or sustained human- to-human transmission in the Baltics or a neighboring country. Tripwire One Responses: a) EAC meets to confirm tripwire has been crossed. b) Provide Mission briefings for American and LES employees and dependents. c) Restrict official and unofficial travel to suspected areas. d) Ensure that any public announcements or travel warnings issued relating to the neighboring country are disseminated to American citizens in Lithuania. e) Consider requesting authorized departure of non-essential staff and family members. Note: Under certain scenarios, drawdown of personnel may not be possible, safe, or medically advisable due to factors such as closure of borders and other travel restrictions; establishment of quarantines at ports of entry; rapid curtailment of commercial travel; and surge in demand for medicine and related services. f) Consider recalling all employees who are currently in remote areas. Tripwire Two: A spike in the number and/or broadening geographic spread of animal to human cases or sustained human- to-human transmission in rural areas of host country. Tripwire Two Responses: a) EAC meets to confirm tripwire has been crossed. b) Provide Mission briefings for American and LES employees and dependents. c) Restrict official and unofficial travel to suspected areas. d) Consider requesting ordered departure of non-essential staff and family members. Note: Under certain scenarios, drawdown of personnel may not be possible, safe, or medically advisable due to factors such as closure of borders and other travel restrictions; establishment of quarantines at ports of entry; rapid curtailment of commercial travel; and surge in demand for medicine and related services. e) In coordination with the Department, issue public announcement, warden message, or travel warning cautioning American citizens against nonessential travel to the affected region and to suspected areas. f) In coordination with the Department, prepare press guidance. g) Institute mandatory sick leave for employees who exhibit flu-like symptoms or has a family member exhibiting flu-like symptoms. h) Implement use of protective equipment (gloves, masks, etc.) according to MED guidance. i) Limit consular services as necessary, such as instituting an appointment-based system for all non-emergency services so as to reduce crowds in the waiting room. Posts should consult with CA prior to taking such steps. Tripwire Three: A spike in the number and/or broadening geographic spread of animal to human cases or sustained human- to-human transmission near or within the capital city. Tripwire Three Responses: a) EAC meets to confirm tripwire has been crossed. b) Provide Mission briefings (perhaps by phone or email) for American and LES staff and dependents. c) Cancel incoming official travel to host country, except for personnel involved in investigative/containment efforts, or as otherwise deemed necessary by COM. d) Coordinate with CA/OCS on issuance of guidance (public announcement or travel warning, as appropriate) urging American citizens to defer all non-emergency travel to host country and particularly the affected regions. e) In coordination with the Department, prepare press guidance. f) 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. g) 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. h) Implement social distancing (limit movements of all personnel and dependents in the city). i) Plan for home visits to sick individuals who receive care under the Embassy health unit. j) Consider relocating Embassy personnel to designated residences. k) Consider delivery service of groceries and other essential items to residences. l) 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 options. m) Reduce consular operations to emergency consular services only. n) Divide 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. o) Restrict visitor access to Mission. p) Consider prophylactic Tamiflu treatment only for staff who are required to be in direct contact with potentially infected persons. Alternate Tripwire: Mission employee or eligible family member develops AI infection. Alternate Tripwire Response: a) Employee or eligible family member begins Tamiflu treatment. b) Medevac if possible. ¶5. Post's principal point of contact for AI contingency planning is Management Officer Cheryl Johnson (370 5 266 5561). KELLY