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