LONDON - LESSONS LEARNED FROM PANDEMIC INFLUENZA

UNCLAS SECTION 01 OF 02 LONDON 003525 SIPDIS SENSITIVE SIPDIS STATE FOR A/MED, OES/IHB, EUR/WE, CA/OCS, S/ES-O/CMS, EUR-IO/EX, AND G/AIAG LANGE FSINFATC FOR FSI/LMS/CMT E.O. 12958: N/A TAGS: KFLU CASC TBIO AMED AMGT UK SUBJECT: LONDON - LESSONS LEARNED FROM PANDEMIC INFLUENZA EXERCISE LONDON 00003525 001.2 OF 002 ¶1. (SBU) SUMMARY: Post held a Pandemic Influenza Tabletop Exercise (PI TTX) on September 7 with members of the Embassy's Pandemic Influenza Working Group (PIWG) and officials from the U.S. Department of Defense's (DOD) 3rd Air Force in the UK, and U.S. Air Force Europe (USAFE),located at Ramstein Air Base, Germany. Key topics in the exercise that need further attention include 1) coordinating communication among the Embassy, American citizens and DOD, 2) shelter-in- place guidelines, and 3) distribution of prophylaxis. Embassy tripwires will be revised based on feedback from participants in the exercise. ¶2. (SBU) BACKGROUND: The purpose of the PI TTX was to use recently revised Embassy tripwires in the scenario, and identify areas that required additional review. The PI TTX consisted of a fictional scenario in three segments, covering approximately one and half months in time. The scenario began at World Health Organization (WHO) Phase 3 (no or very limited human- to-human transmission) and ended at WHO Phase 6 (pandemic underway). Participants in the exercise included all members of the PIWG: Medical; Environment, Science, Technology and Health Section; Consular; Community Liaison Office; Public Affairs; Management, Human Resources; Regional Security Office; Defense Attach Office. In addition, staff members from the 48th Medical Group at RAF Lakenheath participated in the PI TTX to ensure coordination between their personnel, who are not in the Embassy Chief of Mission (COM) chain of command, and the Embassy. ¶3. (SBU) COORDINATING COMMUNICATION: The key issue identified from the PI TTX was coordinating communication. Throughout the scenarios, participants realized that significant coordination was required to ensure a consistent message was being delivered inside the Embassy, with Amcits, to the media and with DOD personnel in the UK not under COM authority. In addition, coordination with HMG policy and outreach would be essential to avoid conflicting guidance. ¶4. (SBU) SHELTER-IN-PLACE GUIDELINES: Throughout the scenarios, significant discussion focused on when shelter-in-place would be appropriate and the subsequent impact on essential operations. DOS and DHS recommendations to maintain a stockpile of food and water for 12 weeks are not generally practical given small housing in the UK. Participants believe that the water supply in the UK will not be affected in the event of a pandemic, so purifying water (e.g. using bleach) would be better than storing it. MGMT and HR emphasized that limited tele-work options currently exist and could be used if needed. In addition, the Embassy alert system via mobile text messaging (SMS) will be a valuable tool to keep employees informed. ¶5. (SBU) DISTRIBUTION OF PHARMACEUTICALS: Participants discussed the issues surrounding the distribution of prophylaxis, including the physical distribution, who gets it, how to evaluate potential recipients (e.g. telephonic vs. in person),security measures during distribution, and when it should be administered. It is expected that in the event of an outbreak, Embassy employees and Amcits will be seeking prophylaxis even before symptoms arise. Participants accepted that we will need to primarily rely on the host country for medical care in the event of a pandemic. Consular (American Citizen Services) has discussed this issue with HMG, including the question of Amcits visiting the UK, and was told that HMG would be prepared to assist anyone with medical care regardless of nationality or residence status, in the event of a pandemic affecting the UK. ¶6. (SBU) NEXT STEPS: 1) Embassy tripwires will be revised based on input from the PI TTX and reviewed at LONDON 00003525 002.2 OF 002 the next working group. 2) The next working group meeting will focus on establishing communication POCs, particularly focused on sharing Embassy information with DOD not under COM authority. 3) MED will continue to review its pharmaceutical distribution method to Embassy staff in the event of a pandemic. 4) Post will continue to work with HMG to better understand host nation capabilities, based on the questions and issues raised during the PI TTX. Visit London's Classified Website: http://www.state.sgov.gov/p/eur/london/index. cfm TUTTLE