ALMATY AVIAN INFLUENZA PREPAREDNESS UPDATE

UNCLAS SECTION 01 OF 03 ALMATY 000925 SIPDIS SENSITIVE BUT UNCLASSIFIED DEPT FOR NEA/SA/EX PMO FRANK LEDAHAWSKY; SCA/CEN; S/ES- O/CMS - OFFICE OF CRISIS MANAGEMENT SUPPORT E.O. 12958: N/A TAGS: APER AMGT AEMR AMED KPAO KFLU KZ ECONOMIC SUBJECT: ALMATY AVIAN INFLUENZA PREPAREDNESS UPDATE REFS: A) ALMATY 0001; B) STATE 219189; C) DOS/MED DRAFT PANDEMIC INFLUENZA PLAN ¶1. (SBU) Summary: The Embassy Almaty Emergency Action Committee Pandemic Influenza (PI) Subcommittee has re- convened to discuss and execute the "Preparedness Checklist" (Ref C). Participants in the PI Subcommittee include the DCM and representatives from MED, CDC, ADM, PAS, RSO, Principal Officer Embassy Branch Office (EBO) Astana, USAID and Peace Corps. For the purposes of PI planning, the current plan for EBO Astana is included in the overall preparedness plan for the Mission. End Summary. ¶2. (SBU) Introduction: - Host Country AI/PI update: There have been no reported cases in Kazakhstan of Avian Influenza in bird populations since summer 2005. Migratory birds are expected to reappear in the region during the spring northward migratory season, and may bring H5N1 influenza strains to domestic flocks. The Government of Kazakhstan (GOK) Ministry of Health has a surveillance program in place to test for H5N1 strains when suspicious avian deaths are reported. There have been no confirmed human cases of Avian Influenza in Kazakhstan. ¶3. (SBU) Preparedness Checklist - 1. Structure for planning and decision making: The multidisciplinary planning committee has been created and consists of the Emergency Action Committee Pandemic Influenza (PI) Subcommittee. The coordinator is RMO Monte Makous with alternate coordinator CDC Country Director Michael Favorov or his designee from CDC. Members of the planning committee include representatives from Management, DCM, GSO, HR, RSO, IT, PAS, DAO, CA, POEC, USAID, PC, Foreign Commercial Service, MED Astana, PO Astana, GSO Astana, ECON Astana, and USAID Astana. The committee liaison in the GOK Ministry of Health is Dr. Kenes Ospanov of the Republican Sanitary and Epidemiology Station. Dr Ospanov also provides linkage with the host country emergency preparedness group. ¶4. (SBU) Preparedness Checklist - 2. Development of a post specific written pandemic influenza plan: Ref A delineates Post tripwires and actions and includes elements as listed in the Pandemic Influenza Plan. The organizational structure to operationalize the plan and �0A;the responsibilities of key personnel will reflect what currently is in place for the post EAP. Post plans on conducting a tabletop simulation exercise per further guidance on this from M/MED. ¶5. (SBU) Preparedness Checklist - 3. Elements of a Pandemic Influenza Plan: Surveillance Plan: Per guidance of the DOS/MED Pandemic Influenza Plan, the Health Unit has established surveillance procedures for influenza-like illness, and has criteria in place to distinguish pandemic influenza. A system for internal review of pandemic influenza activity is in place. ¶6. (SBU) Preparedness Checklist - Communication Plan: - External communication has been assigned as follows: Public health reporting to DOS/MED - RMO Monte Makous, CDC country Director Michael Favorov, or designee; Clinical spokesperson - RMO Monte Makous or designee; Media spokesperson - PAS Information Officer Jacqueline McKennan. - Key points of contact: Local health ministry - Dr. Ospanov of the Republican Sanitary and Epidemiology Station; Local CDC contact - Michael Favorov, CDC Director; Newspaper and radio contact - PAS Officer; Public official contact through the Embassy front office or PAS Officer. - The list of other healthcare facilities with whom it is necessary to maintain communication: The International SOS Clinic, International Medical Clinic, and Peace Corps Medical Officers. - Due to the substandard medical facilities in Kazakhstan, a meeting with local healthcare facilities is not applicable. (Ref A, para 2) - A plan for updating key facility personnel daily has been established. It will entail the RMO or designee briefing the COM or DCM by telephone or in person. - A strategy for regularly updating the Health Unit staff on the status of pandemic influenza has been established and will consist of daily briefings in person or by telephone. - A plan for informing patients and the Mission community about the level of pandemic influenza activity has been established and will entail announcement at Country Team Meetings, the issuance of Administrative Notices, emails to the appropriate staff, use of unofficial email distributions, use of radios, and use of the Mission telephone tree. ¶7. (SBU) Preparedness Checklist - Education and Training Plan: - Language and reading level-appropriate materials have been identified by utilizing the PowerPoint program available on the DOS/MED intranet website with translation into the Russian language. - Means for accessing DOS/MED and federal web-based PI training programs have been identified. This includes links to the Pandemic Influenza materials on the Office of Medical Services website and the HHS Pandemic Influenza website. - A system for tracking personnel who have completed pandemic influenza training has been set up. - Post plans on issuing an administrative notice to recruit and train non-health unit personnel when the health unit reaches surge capacity. ¶8. (SBU) Preparedness Checklist - Health Unit Personnel Training: LES nursing staff, laboratory technician and receptionist have received training on Post's Pandemic Influenza Plan. Those providers with CERT training will be informed of the Post PI Plan. ¶9. (SBU) Preparedness Checklist - Triage Plan: Patient triage will be primarily by telephone contact followed by home visit by a medical provider if deemed appropriate. Those entering the facility seeking care will be directed to the HU and examined immediately in a separately designated room. Signage to instruct those with possible PI is under development. Criteria for determining which patients need evaluation are based on Ref C. ¶10. (SBU) Preparedness Checklist - Facility Access: Criteria and protocols to limit public gatherings, closing the mission to outside visitors and limiting visitors to the HU have been established. RSO has been a key partner in designing procedures for enforcing facility access controls. ¶11. (SBU) Preparedness Checklist - Occupational Health Plan: - A system for delivering vaccine or prophylaxis to healthcare personnel has been developed, and has been tested during the non-pandemic influenza season. Prioritization based on risk has been established. - Thermometers have been procured for all Mission employees to be used for self-screening at home. Those with fever or respiratory symptoms will be required to stay at home. This has been tested as a table-top exercise. - A policy for managing healthcare personnel with symptoms of PI or documented PI has been established. - Developing alternative worksites for those with high- risk medical conditions will be done as needed on a case- by-case basis. - Mental health resources at Post are minimal, and will be identified on an ad hoc basis. - Post will accommodate personnel with child care responsibilities on a case-by-case basis. ¶12. (SBU) Preparedness Checklist - Vaccine and Antiviral Use: - A prophylaxis priority list of patients and healthcare personnel has been developed. Exact forecasts cannot be determined due to the inherent fluctuations of counting these individuals. There are approximately 20 first priority personnel, 150 second priority personnel, and 550 remaining personnel. - A system for distributing the prophylaxis has been developed. ¶13. (SBU) Preparedness Checklist - Issues Relating to Surge Capacity: Persons responsible for assessing day-to- day clinical staffing needs during an influenza pandemic are RMO Makous, LES Nurse Almaty, and LES Nurse Astana. When necessary, an announcement will be made to the Mission community to recruit those with medical background. Post awaits further guidance from DOS/MED and DOS legal counsel regarding liability issues and credentialing. ¶14. (SBU) Preparedness Checklist - Needs for Anticipated Durable and Consumable Resources: Post is developing a plan to address supply shortages to "shelter in place" that is subsumed into the current emergency disaster plan. ORDWAY