CORRECTED COPY: AI REPORT #7: POST'S AI-SPECIFIC

UNCLAS SECTION 01 OF 04 BRIDGETOWN 000338

SIPDIS

SIPDIS

DEPT PASS TO USAID/GH/RCS/KELLY WOLFE AND LAC/PEG MARSHALL

E.O. 12958: N/A
TAGS: AEMR AMED AMGT ASEC CASC EAGR EAID ETRD KFLO
KSCA, SENV, SOCI, TBIO, BB, GJ, XL
SUBJECT: CORRECTED COPY: AI REPORT #7: POST'S AI-SPECIFIC
CONTINGENCY PLANNING AND TRIPWIRES

REF: STATE 219189


1. This is a corrected cable in response to reftel. See
additional information in para 2 about Embassy's activities
and constituent Post in Grenada, changes in para 3 on Post's
geographic areas of responsibility and concern, and
tripwire-related changes in para 5.


2. Summary: Post's Avian Influenza Working Group (AIWG) met
on November 23 and January 27 to develop preparedness
measures to meet the threat of a avian influenza (AI) human
pandemic. Consequent to these meetings, AIWG members
inventoried medical supplies and identified medically trained
and medically at-risk staff in a pandemic scenario. AIWG
members also began making plans for mission briefings, social
distancing, warden messaging, and continued operations in a
drawdown situation. AIWG members formulated and refined
AI-specific tripwires and tripwire responses. Post's AI
preparations and plans also apply to constituent-post Embassy
Grenada. Because Post's geographic area of concern is
diverse, extensive, and consists of many small-island states,
Post prefers to maintain its AI-specific tripwires and
tripwire responses as general guidelines rather than trying
to outline a particular Post response for every possible
scenario. End Summary.


3. Post's AIWG met on November 23 and January 27 to develop
preparedness measures against the threat of a AI human
pandemic. The AIWG formulated AI-specific preparations,
contingencies, and tripwires, and followed up with
AI-specific preparatory activities. (Note: Because of the
high level of human interaction in the Caribbean, the AIWG is
taking the whole region as its area of concern. Post covers
the seven Eastern Caribbean islands of Antigua and Barbuda,
Barbados, Dominica, Grenada, St. Kitts and Nevis, St. Lucia,
and St. Vincent and the Grenadines. Post's consular
district, however, extends beyond these seven countries to
the islands of Martinique, (French) St. Martin, St.
Barthelemy, Montserrat, Guadeloupe, the British Virgin
Islands, and Anguilla. There are also several Dutch island
countries in the Lesser Antilles. Because the small U.S.
State Department mission in Grenada is a constituent Post,
all tripwires and tripwire responses enumerated in this cable
apply to that mission as well. End Note.

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Early AI-Specific Preparations
--------------


4. Concerning AI-specific preparations, AIWG members have
inventoried and ordered medical supplies, including
medications and protective gear; identified staff who would
be medically at-risk during a pandemic; and identified staff
with medical skills who can assist Post's nurse in a
pandemic. AIWG members also continue to plan for smooth
AI-related information flow to American staff, LES, and
Americans in the consular district through mission briefings
and warden messaging respectively. Post has begun to
inventory and stockpile fuel, food, water, and other
emergency supplies. The AIWG members are also weighing
options for Mission drawdown and social distancing.

--------------
AI-Specific Tripwires and Tripwire Responses
--------------


5. AIWG discussions have generated the following list of
AI-specific tripwires and post responses:

Tripwire One: Pathogenic virus strain H5N1 infects an animal
in a Caribbean country; or there is human infection with
pathogenic H5N1 in the non-Caribbean Western Hemisphere, but
without sustained human-to-human (H-2-H) transmission
anywhere in the world.

Tripwire Responses:

a. Convene Emergency Action Committee (EAC) to confirm
tripwire has been crossed. AIWG makes report to EAC
concerning contingency plans and AI-related activities in
host countries. EAC issues recommendations.

b. Provide town hall and other briefings to American and LES
employees and dependents.

c. If applicable, bar travel into areas suspected to have
H-2-H transmission.

d. If applicable, disseminate public announcements and travel

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warnings about H-2-H regions among American citizens in
Post's Consular District.

e. Continue convening AIWG to review contingency plans,
survey medical supplies, and monitor AI-related activities in
host countries.

Tripwire Two: Pathogenic H5N1 infects a human in a Caribbean
country, but without H-2-H transmission; or there is
sustained H-2-H transmission anywhere in the world.

Tripwire Responses:

a. Convene EAC to confirm tripwire has been crossed. The
AIWG makes its report to EAC concerning AI-contingency
preparations and AI-related activities in host countries.
The EAC issues recommendations.

b. Provide town hall and other briefings to American and LES
employees and dependents.

c. Disseminate public announcements and travel warnings about
H-2-H regions among American citizens in Post's Consular
District.

d. Bar USG travel into H-2-H suspected areas.

e. Consider recalling all employees from remote areas.

f. In the case of human AI illness in a Caribbean country,
consider requesting authorized departure of non-essential
staff and family members, and begin implementation planning.

g. Continue convening AIWG to refine contingency plans and to
monitor AI-related activities in host countries.

Tripwire Three: There is sustained H-2-H pathogenic H5N1
transmission in a Caribbean country, but not yet in the
Lesser Antilles; or someone in the Lessor Antilles becomes
infected with pathogenic AI, but without H-2-H transmission.
Tripwire Responses:

a. Convene EAC to confirm that tripwire has been crossed.
The AIWG makes its report to the EAC concerning
AI-contingency plans and AI-related activities in host
countries. The EAC issues recommendations.

b. Provide town hall and other briefings to American and LES
employees and dependents.

c. Bar USG travel into H-2-H suspected areas.

d. If medically advisable, request authorized departure of
all non-essential staff and family members. Begin planning
to implement medically advisable authorized departures.

e. Consider canceling incoming official travel to host
country, except for personnel involved in investigative or
containment efforts, or as otherwise deemed necessary by the
Chief of Mission (COM).

f. In coordination with the Department, issue public
announcements, warden messages, and travel warnings
cautioning American citizens against nonessential travel to
suspected areas.

g. In coordination with the Department, prepare press
guidance.

h. Institute mandatory sick leave for employees who exhibit
flu-like symptoms, or who have a family member exhibiting
flu-like symptoms.

i. In consultation with CA, limit consular services as
necessary.

j. Implement use of personal protective equipment (PPE -
gloves, masks, etc.) according to MED guidance.

k. Plan for home visits to sick individuals who would receive
care and medications under Post,s health unit.

l. Plan for the delivery of food, water, medical supplies,
and other essential items to residences.

m. Plan for the implementation of social distancing measures

n. Provide, in consultation with medical staff, prophylactic
Tamiflu or other antiviral treatment for staff who are

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required to be in direct contact with potentially infected
persons.

o. Convene AIWG to refine contingency plans, including plans
for social distancing, quarantines, emergency delivery of
food and supplies. AIWG continues to monitor AI-related
activities in host countries.

Tripwire Four: Sustained pathogenic H5N1 H-2-H cases occur
on any Lesser Antilles island or a USG employee becomes ill
with pathogenic AI. (Note: Besides U.S. Embassy personnel
in Barbados and its constituent post in Grenada, there are
115 Peace Corps volunteers and administrative staff
distributed among the islands of Antigua, Dominica, Grenada,
St. Kitts and Nevis, St. Lucia, and St. Vincent. There is
also a seven-person U.S. Air Force tracking station and a
Consular Agent in Antigua, as well as a Consular agent in
Martinique. End Note.)

Tripwire Responses:

a. Convene EAC to confirm that tripwire has been crossed.
The AIWG makes its report to the EAC concerning
AI-contingency plans and AI-related activities in host
countries. The EAC issues recommendations.

b. Provide Mission briefings, some perhaps by phone or
e-mail, for American and LES staff and dependents.

c. Cancel incoming official travel to host country, except
for personnel involved in investigative or containment
efforts, or as otherwise deemed necessary by the Chief of
Mission (COM).

d. Coordinate with CA/OCS on issuance of guidance (public
announcement or travel warning) urging Americans to defer all
non-emergency travel to host countries 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 procedures as
needed.

g. Instruct all non-emergency American and LES staff to
remain home on administrative leave.

h. Implement social distancing measures: Children should
remain home from school, and all personnel should avoid
crowds and social gatherings. Consider moving well people
out of AI-endemic areas to safehavens.

i. Implement home visits to sick individuals receiving
medications or care under Post,s health unit.

j. Relocate Embassy personnel to designated residences.

k. Deliver food, water, medical supplies, and other essential
items to residences as needed.

l. Depending on level of public enquiries, Embassy staffs and
equips a situation room. Consular officers establish a
database tracking quarantined, hospitalized, or ill-at-home
American citizens. Post issues guidance for American
community on treatment options.

m. Reduce consular operations to emergency consular services
only.

n. Divide Marine Security Guard detachment and local guard
squad into two separate and independent entities respectively
to decrease the risk of spread of the disease and ensure
proper coverage to Mission.

o. Restrict visitor access into Embassy buildings.

p. Provide, in consultation with medical staff, prophylactic
Tamiflu or other antiviral treatment for staff who are
required to be in direct contact with potentially infected
persons.

q. Continue convening the AIWG on an ad hoc basis to monitor
AI-related activities in host countries. The AIWG, in
coordination with Post's EAC, continues to monitor and guide
Post,s AI-related activities.


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6. Comment: Post's area of concern (the Caribbean) is
diverse and geographically extensive. Although the countries
of Lesser Antilles are coordinating their AI preparations
with the Pan American Health Association (PAHO) and the
Trinidad-based Caribbean Epidemiology Center (CAREC),Post
anticipates that, beyond protocols for tissue sampling, the
countries in the region may respond to an AI pandemic in
various and unpredictable ways. To assure maximum
flexibility of action, Post therefore believes it is best to
use the above tripwires and tripwire responses as general
guidelines, instead of trying to outline a list of particular
Post responses for every possible scenario. End Comment
KRAMER