AVIAN INFLUENZA: POST CONTINGENCY PLANNING AND TRIPWIRES

UNCLAS SECTION 01 OF 04 WELLINGTON 000112

SIPDIS

SIPDIS

STATE FOR S/ES-O/CMS/ EAP/EX AND EAP/ANP

E.O. 12958: N/A
TAGS: AMGT ASEC CASC AMED KFLO AEMR
SUBJECT: AVIAN INFLUENZA: POST CONTINGENCY PLANNING AND TRIPWIRES

REF: A) 05 STATE 219189; B) 05 Apia 00150

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1. In response to reftel, Embassy Country Team met to discuss New
Zealand Government (GNZ) preparations against Avian Influenza
pandemic.


2. Llywelyn Graeme will input tripwire data into the Tripwire
Reporting and Integrated Planning System (TRIPS).


3. New Zealand's Ministry of Health (MOH) will take the lead if
there is a pandemic in-country. The MOH has a national pandemic
plan, and District Health Boards have local plans. An intersectoral
group from other Government Ministries is considering non-health
issues that are directly affected by a pandemic, such as potential
school closures, border management, and the maintenance of critical
infrastructure, including supply of food and water and law and
order.

The GNZ is considering setting a target of 3 weeks for persons to be
reasonably (not completely) self-reliant during an advanced event or
outbreak. This 3-week period would be one in which persons made
only limited trips to restock food items, water supplies and things
of that nature -- i.e. not sustained social contact. This target
figure may change depending on New Zealand's ongoing assessment of
risk and readiness.

- New Zealand is not on the regular migratory pathways of any
waterfowl. The small number which do reach New Zealand mostly
originate from southern Australia. Other migratory birds visit
estuaries along the Asian coastline, Philippines and Australia on
their annual migrations south from arctic Russia. However, they are
not "waterfowl" and are not regarded as a high risk for introducing
avian viruses into New Zealand. The Ministry of Agriculture and
Forestry (MAF) is currently undertaking surveillance in wild birds
to assess the influenza status of waterfowl and shore birds.

- The New Zealand Government (GNZ) is following the advice of the
WHO by stockpiling anti-viral medicine for use in a volume
equivalent to approximately 20% of the population. No decision on
the best use of the stockpile will be made until the nature of the
pandemic is known.

The MOH has set up a Pandemic Influenza Technical Advisory Group
which advises the Ministry on the international situation and
provides recommendations on the appropriate nature of New Zealand's
responses.

In the event of a pandemic, public announcements would be made
through TV, the radio, and other media channels. Some workplaces
and schools may close.

- Available host country medical treatment facilities in the event
of an outbreak: In the event of an outbreak, hospitals and primary
care practitioners may not be able to deal with the potential large
numbers of affected individuals. The MOH is considering and
planning for other possible options, such as community assessment
centers or calling a national free health advice number staffed by
registered nurses and designating specific quarantine stations.
Citizens could be expected to care for themselves and others at
home.

The Ministry of Health has a formal arrangement with Australia's CSL
Ltd--the only influenza vaccine manufacturer in the Southern
Hemisphere--which should give New Zealand a supply if they need a
pandemic vaccine. However, the vaccine is currently not available
since the manufacture of a vaccine can only start once the strain of
the virus causing the pandemic is known.

Mission facilities have adequate emergency food and water supplies
to allow American employees and family members to shelter in place
for approximately 1-2 weeks. Small stockpiles are distributed at
centrally-located residences in neighborhoods with large
concentrations of Embassy staff.


4. Preparedness Measures Taken/To Be Taken
--------------
(a) Briefings: In November, the Embassy distributed to Mission
personnel the Department's cable on "Frequently asked questions on
Avian Influenza." An Avian Flu Warden Message is posted on the
Embassy web site and includes hyperlinks to WHO, CDC, State Dept,
and GNZ web pages.

(b) Medical Expertise: Mission New Zealand has no in-house health
unit operation but depends on a local Post Medical Advisor for all
medical assistance. We virtually have no staff with medical
background and skills; our canvassing identified one employee with a
general nursing background at ConGen Auckland.

(c) Tamiflu/PPE: Post has no/no supply of Tamiflu on hand as we

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were not among the initial high-risk post identified for first
shipments. Post currently has disposable gloves, soap, and bleach
on hand. A supply of masks, soap and gloves are available at ConGen
Auckland, primarily for consular personnel. To be Done: We need to
determine amounts of Tamiflu and other supplies needed if tripwire
number 2 is reached.

(d) Security: When the Tamiflu arrives, it will be locked securely
in a well-protected area within the Chancery.

(e) Emergency Stockpiles: Management has minimum numbers of
emergency supplies (food, fuel, water, blankets, medicines)
pre-positioned at several locations in Wellington and Auckland.

(f) Continuity of Operations: EAC discussed possibility of
mini-command centers in Wellington in connection with other natural
disasters (earthquake, land slides) that would preclude all
personnel being able to gather at one alternate point. These
mini-centers would require staff to travel shorter distances, or
work from home.

With reduced staffing, ConGen Auckland would likely suspend NIV and
IV operations; ACS services could be continued with one consular
officer and reduced ACS staff. If required to work from home,
Consul would use post's emergency ACS laptop with its CD of AmCit
names to communicate with American community. Additional CDs would
be positioned in ACC to ensure dissemination of info to AmCits. RSO
maintains up-to-date lists of staff home and cell phone numbers. TO
DO: Up date personal e-mail addresses.

(g) Drawdown Planning: Mission sections are reporting to
Management their minimum staffing requirements to ensure continuity
of operations. We are working closely with Embassy Apia in the
event that small island community were to be affected. Given their
limited access to travel, and limited health facilities, COM likely
would request authorized or ordered departure for Embassy and Peace
Corps Americans sooner than for New Zealand staff.

(h) Medical Issues: No staff medical issues have been reported;
but one EFM is pregnant and one dependent child has respiratory
problems.

(i) Pre-planned Packets: The Management Office has prepared travel
orders for American DH staff and EFMs.

(j) Strategies for Airport Closures: As an island nation, airport
closing sends a fairly definitive message that no one enters or
exits the country. This is an option that the MOH definitely would
consider, but we believe would require some advance notification
before implementation.

(k) Town Hall Briefings: In meetings with AmCits in Wellington and
Christchurch in December, consular staff responded to avian flu
inquiries. ConGen will continue to address avian flu in all
subsequent outreach visits to AmCits throughout New Zealand. With
the recent installation of ACS+ software, ConGen is also able to
disseminate AI-related news and updates more easily. CA outreach
materials have been shared with major expat American organizations,
such as the American Chamber of Commerce. An AI warden message is
posted on the Embassy website.

TRIPWIRES AND RESPONSES
--------------


5. Tripwire One:
--------------
A spike in the number and/or broadening geographic spread of animal
to human cases or sustained human-to-human transmission in a
neighboring country.
-------------- ---
Tripwire One Responses:
- EAC meets to confirm that tripwire has been crossed. ConGen
Auckland, USAP (U.S. Antarctic Program) Christchurch, and Embassy
Apia participate by DVC or are notified by telephone.
- Provide Mission briefings for American and LES staff and
dependents (for Embassy and constituent posts).
- ConGen to notify Amcits via warden system, Embassy web site and
local media.
- Restrict official and unofficial travel to suspected areas.
- Given New Zealand's island separation, and depending on the
specific neighboring country affected, authorized departure of non-
essential staff and family members may not be considered essential
at this time. Ensure travel orders for all personnel are prepared
in event of further evacuation necessity.
- Monitor public announcements from New Zealand Government.


6. Tripwire Two:
--------------
A spike in the number and/or broadening geographic spread of animal

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to human cases or sustained human-to-human transmission within the
Auckland consular district but not on North Island (where both
Wellington and Auckland are located),(i.e., Cook Islands, Niue, or
South Island)
-------------- --------------
Tripwire Two Responses:
- EAC meets to confirm that tripwire has been crossed. ConGen
Auckland, USAP Christchurch, and Embassy Apia participate by DVC or
are notified by telephone.
- Provide Mission briefings for American and LES employees and
dependents (for Embassy and constituent posts).
- Restrict official and unofficial travel to suspected areas.
- ConGen to notify Amcits via warden system, Embassy web site and
local media.
- Monitor public announcements and recommended advice from New
Zealand Government. Consider mirroring their actions for Mission
personnel and AmCits, as appropriate.
- Consider requesting authorized departure of non- essential staff
and family members.
- In coordination with the Department, prepare press guidance.
- Institute mandatory sick leave for employees who exhibit
flu-like symptoms or has a family member exhibiting flu-like
symptoms.
- Implement use of protective equipment (gloves, masks, etc.)
according to MED guidance for high-risk-to-exposure personnel.
- AmConGen Auckland to limit consular services as necessary, such
as instituting an appointment-based system for all non- emergency
services so as to reduce visitors in the waiting room.
- Ensure that staff procure additional supplies of food and water
for Embassy and home use. Ensure staff with medical issues have
adequate supplies of required medications if home quarantine becomes
necessary.


7. Tripwire Three:
--------------
A spike in the number and/or broadening geographic spread of animal
to human cases or sustained human-to-human transmission on North
Island:
-------------- --------------
Tripwire Three Responses:
- EAC meets to confirm that tripwire has been crossed. ConGen
Auckland, USAP Christchurch, and Embassy Apia participate by DVC or
are notified by telephone.
- Provide Mission briefings for American and LES staff and
dependents.
- Cancel incoming official travel to host country, except for
personnel involved in investigative/containment efforts, or as
otherwise deemed necessary by COM.
- ConGen Auckland 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.
- In coordination with the Department, prepare press guidance.
- 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.
- If authorized or ordered departure is not permissible, instruct
all non- emergency American and LES staff to remain home on
administrative leave. Children should remain home from school.
- Implement social distancing (limit movements of all personnel
and dependents in the city).
- Implement 24-hour telephone hotline to monitor health of Embassy
staff and families. Encourage self-reporting by employees and their
families of illness and medical developments.
- Consider relocating Embassy personnel to designated residences.

- Depending on level of public inquiries, Embassy staffs and
equips a situation room.
- ConGen Auckland to establish a database tracking American
citizens who have been quarantined, hospitalized, or ill at home.
Direct American citizen community to local treatment facilities.
- ConGen Auckland to reduce consular operations to emergency
consular services only.
- Divide the Marine Security Guard detachment into two separate
and independent entities to reduce the risk of the spread of the
disease and ensure proper coverage of classified materials.
- Restrict visitor access to Mission.
- Consider prophylactic Tamiflu treatment only for staff who are
required to be in direct contact with potentially infected persons.




8. Tripwire Four:
--------------
A spike in the number and/or broadening geographic spread of
animal-to-human cases of human-to-human transmission near or within
Wellington:
-------------- --------------
Tripwire Four Responses:

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- EAC meets to confirm that tripwire has been crossed. ConGen
Auckland, USAP Christchurch, and Embassy Apia participate by DVC or
are notified by telephone.
- Provide Mission briefings for American and LES staff and
dependents.
- ConGen Auckland 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.
- In coordination with the Department, prepare press guidance.
- 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.
- If authorized or ordered departure is not permissible, instruct
all non- emergency American and LES staff to remain home on
administrative leave. Children should remain home from school.
- Implement social distancing (limit movements of all personnel
and dependents in the city).
- Implement 24-hour telephone hotline to monitor health of Embassy
staff and families. Encourage self-reporting by employees and their
families of illness and medical developments.
- Consider relocating Embassy personnel to designated residences
or working from home.
- Depending on level of public inquiries, Embassy staffs and
equips a situation room.
- ConGen Auckland to establish a database tracking American
citizens who have been quarantined, hospitalized, or ill at home.
Direct American citizen community to local treatment facilities.
- ConGen Auckland to reduce consular operations to emergency
consular services only.
- Divide the Marine Security Guard detachment into two separate
and independent entities to reduce the risk of the spread of the
disease and ensure proper coverage of classified materials.
- Restrict visitor access to Mission.
- Consider prophylactic Tamiflu treatment only for staff who are
required to be in direct contact with potentially infected persons.




9. Tripwire Five:
--------------
Mission employee or eligible family member develops AI infection.
-------------- --------------
Tripwire Five Response:
- Employee or eligible family member begins Tamiflu treatment.
- Medevac, if possible.
- Consider Mission closure for all but essential operations.

MCCORMICK