AVIAN INFLUENZA: EMBASSY PORT-AU-PRINCE

UNCLAS SECTION 01 OF 03 PORT AU PRINCE 000220 SIPDIS SIPDIS DEPT FOR S/ES-O/CMS DEPT PASS TO USAID/GH/RCS/KELLY WOLFE AND LAC/PEG MARSHALL E.O. 12958: N/A TAGS: AMGT ASEC CASC AMED KFLO AEMR HA SUBJECT: AVIAN INFLUENZA: EMBASSY PORT-AU-PRINCE CONTINGENCY PLANNING AND TRIPWIRES REF: 2005 STATE 219189 ¶1. This cable is in response to reftel. ¶2. SUMMARY: Post's Avian Influenza Working Group (AIWG) met on January 23 and began developing preparedness measures to meet the threat of a possible AI human pandemic. The AIWG members have inventoried medical supplies, identified medically trained staff, and identified staff at medical risk in a pandemic scenario. AIWG members also began making plans for mission briefings, social distancing measures, communication with wardens, and continued operations under reduced staff in a drawdown situation. AIWG members formulated AI-specific trip wires coupled with Embassy response measures. END SUMMARY. ¶3. Post convened on January 23 its first AIWG to develop preparedness measures against the threat of a possible AI human pandemic. The AIWG discussed AI-specific preparations, contingencies, and tripwires. KEY ASSUMPTIONS -------------- 1) The risk to USG personnel in Haiti is currently low. It is unlikely that Haiti would be at the center of any outbreak of human-to-human H5N1 infection, thus providing some advanced warning. However, if AI would arrive in Haiti, it could spread unchecked throughout the country, as the nation's health and security infrastructure are inadequate to enforce a quarantine. 2) An animal or human infection in the Dominican Republic should be treated as an infection in Haiti and vice versa. The likelihood of rapid spread between the countries is very high. Neither Haiti nor the Dominican Republic has sufficient resources to control the border. 3) By the time an H-2-H outbreak occurs in Haiti, it likely will have already occurred in the United States, limiting the potential benefit of evacuation. However, as Haiti has no medical facilities that would be able to handle AI cases at an international standard of care, evacuation would be the best option, if still feasible. 4) Depending on the speed of a human-to-human outbreak, U.S. citizens could be quickly cut off from air evacuation routes. Evacuation by sea might also become impossible. 5) An outbreak in Port-au-Prince could engender even further instability in this volatile city. 5) The Mission would be unable to obtain essential medical and basic supplies locally in the event of a crisis and should stockpile adequate provisions. 6) Post should prepare for a long-term shelter-in-place contingency. Post believes it could sustain a shelter-in-place for a maximum of four (4) weeks. AI-SPECIFIC PREPARATIONS -------------- ¶4. Concerning AI-specific preparations, AIWG members have inventoried and ordered/received pandemic preparedness medical supplies, including medications and protective gear. Embassy staff at potential medical risk during a pandemic has been identified and a mission drawdown list is being updated. Mission staff with medical skills that could assist Post's medical unit in a pandemic has been identified. Mission management is inventorying and stockpiling fuel, food, water, and other emergency supplies and planning mission drawdown procedures coupled with shelter-in-place and social distancing measures. ¶5. AIWG member discussions resulted in the following list of AI-specific tripwires and post responses: TRIPWIRE ONE: Pathogenic virus strain H5N1 infects an animal in Haiti, the Dominican Republic or Caricom country, but without human-to-human (H-2-H) transmission; or there is sustained pathogenic-H5N1 H-2-H transmission anywhere in the world. PORT AU PR 00000220 002 OF 003 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. -- If applicable, provide town hall and other briefings to American and LES employees and eligible family members. c. -- If applicable, bar travel into areas suspected to have H-2-H transmission. d. -- If applicable, disseminate public announcements and travel 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 Haiti or the Dominican Republic, but without H-2-H transmission; or there is sustained H-2-H transmission in a Caricom country; or there is quickly spreading H-2-H transmission anywhere in the world. 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 H-2-H transmission, 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 the Dominican Republic or Haiti, but not in Port-au-Prince; or there is quickly spreading H-2-H transmission in Caricom countries. 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. -- 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). e. -- If medically advisable, request authorized departure of all non-essential staff and family members. Begin planning to implement medically advisable authorized departures. 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 protective equipment (gloves, masks, etc.) according to MED guidance. k. -- 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 in Port-au-Prince or in any location where USG personnel are stationed. PORT AU PR 00000220 003 OF 003 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. -- Coordinate with CA/OCS on issuance of guidance (public announcement or travel warning) urging Americans to defer all non-emergency travel to Haiti and particularly the affected regions. d. -- In coordination with the Department, prepare press guidance. e. -- 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. f. -- Instruct all non-emergency American and LES staff to remain home on administrative leave. g. -- Implement social distancing measures: Children should remain home from school, and all personnel should avoid crowds and social gatherings. h. -- Plan for medical home visits for sick individuals who receive care from Post's health unit. i. -- Consider relocating Embassy personnel to designated residences. j. -- Consider delivery service of groceries, medical supplies, and other essential items to residences. k. -- Depending on level of public inquiries, 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. l. -- Reduce consular operations to emergency consular services only. m. -- Ensure the Marine Security Guard detachment and local guards take appropriate precautions when working in close proximity to decrease the risk of spread of the disease while maintaining proper security coverage to Mission. n. -- Restrict visitor access into Embassy buildings. o. -- Consider prophylactic Tamiflu treatment (or other appropriate anti-viral agent) for staff who are required to be in direct contact with potentially infected persons. p. -- Continue convening AIWG on an ad hoc basis to monitor AI-related activities in host countries. AIWG, in coordination with Post's EAC, continues to monitor and guide Post's AI-related activities. CARNEY