Wisconsin Department of Health Services
Ebola TTX
INSERT DATE/LOCATION HERE
Division of Public Health, Public Health Preparedness
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Wisconsin Department of Health Services
To provide participants an opportunity to evaluate current response concepts, plans and capabilities in response to a possible outbreak of a viral disease with high mortality.
Ebola TTX Division of Public Health, Public Health Preparedness 2

Wisconsin Department of Health Services
The current Ebola Viruses Disease outbreak continues to evolve and guidance from the Centers for Disease
Control and Prevention (CDC) and the Department of
Health Services (DHS) frequently changes. The information presented in this exercise may be quickly outdated. Check the CDC and DHS websites for up-todate information.
Ebola TTX Division of Public Health, Public Health Preparedness 3

Wisconsin Department of Health Services
Critical Transport: Discuss how critical transportation would occur in region/jurisdiction in the event of an
Ebola case.
1. Determine criteria and process for transport to local hospital
2. Determine criteria for inter-hospital transport
3. Discuss responder safety as it relates to: Personal Protective
Equipment (PPE), transport from one facility to another, decontamination of ambulance, etc. . .
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Wisconsin Department of Health Services
Operational Communications (Information Sharing and Emergency Public Information and Warning):
Ensure timely, accurate, internal and external communication throughout response
1.
Identify internal communication and info sharing needs
2.
Identify external communication needs
3.
Develop risk communication strategy for public
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Wisconsin Department of Health Services
Medical Services: Determine the ability to provide appropriate, safe care to an Ebola Virus Disease patient.
1. Provide lifesaving medical treatment to an Ebola Virus
Disease patient
2. Ensure responder safety and health throughout the course of providing treatment
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Wisconsin Department of Health Services
Public Health Functions:
1. Surveillance and Epi Investigation:
• Investigate case and identify contacts to patient
• Assemble appropriate screening tools/forms/resources to ensure consistent data collection
• Identify/activate local, regional, state and/or federal resources for surge capacity in contact tracing
2. Quarantine (if needed):
• Ensure the ability to appropriately quarantine those who may have been exposed to Ebola in alignment with recommended guidance
• Ensure isolation/quarantine plans are updated and ready to be operationalized
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Wisconsin Department of Health Services
Fatality Management Services: Discuss the coordination of fatality management services as it pertains to a fatality caused by Ebola.
1. Ensure responder health and safety throughout processing of the deceased
2. Ensure most current guidance is followed as it relates to handling Ebola contaminated remains
3. Provide mental/behavioral health services for those impacted by event
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Wisconsin Department of Health Services
This is an exercise based on a possible event.
Process the information just as you would in a real-life incident. Avoid the temptation to “solve” the entire scenario.
There is no “hidden agenda” or any trick questions.
Participation is the key to making this exercise a success.
Feel free to make valid assumptions based on the information provided.
Respond based on your knowledge of current plans and capabilities (you may use only existing assets).
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Wisconsin Department of Health Services
• This is an open, low-stress, no-fault environment.
• Offer any suggestions or recommended actions that could improve response and preparedness efforts.
• Be respectful of others, as varying viewpoints, even disagreements, may occur.
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Wisconsin Department of Health Services
• At 7 pm on Friday a 23-year-old male who is ill presents at the local emergency department.
• Vitals/Symptoms:
• Temp 101.5
• Headache
• Muscle pain
• Abdominal cramps
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Wisconsin Department of Health Services
Emergency Department:
• How would ER registration handle a patient that has flu-like symptoms or says “I think I have
Ebola”?
• What symptom-related questions would you ask this patient?
• What travel history questions would you ask this patient? NOTE:
Patient NOT being actively monitored.
15 minutes for discussion
How would this scenario change if the patient had called 9-1-1?
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Wisconsin Department of Health Services
Patient was in Liberia 11 days ago. Traveled from Africa to
Germany, where spent a few days with friends. Upon return to United States, he did not end up on the Active
Monitoring list.
Assumption: Substantial patient history info needed from the time period of return to US.
NOTE: Patient worked for the
American Red Cross teaching healthcare workers about infection control practices. He was considered low-risk.
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Wisconsin Department of Health Services
A unified command teleconference is held between the local hospital, state public health, local public health, and the CDC.
Based on policy and criteria, what would the likely recommendation be for initial management?
• Should the patient remain where he is or be transferred?
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Wisconsin Department of Health Services
Unified Command decision that patient should be seen at the nearest Category II facility.
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Wisconsin Department of Health Services
• What testing should be performed in a rule-out scenario?
• What lab capabilities and employee protections need to be in place to perform this testing?
• Is the facility able to perform this testing (Category II) or only screen and isolate the patient (Category III)?
• How about YOUR hospital?
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Wisconsin Department of Health Services
• Patient arrives at the nearest Category II facility for monitoring/assessment/initial care.
• Discuss the process of specimen collection, packaging, transport.
• Ensure permission is received to transport.
• Is there a written protocol?
• What technical support might be needed?
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Wisconsin Department of Health Services
• The EMS unit that transported the patient from home to the Category II hospital is requesting guidance on how to properly decon the rig.
• What is your guidance to them?
• Where would you turn for technical support?
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Wisconsin Department of Health Services
• Please discuss your internal hospital response plan to ensure the following:
• Appropriate patient care
• Appropriate isolation
• Appropriate PPE to ensure Responder Safety and Health
• Appropriate monitoring of healthcare workers and coordination with public health
Ebola TTX
• NOTE- Include specific names of policies/procedures where appropriate
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Wisconsin Department of Health Services
• Due to media and public interest, activate your Risk
Communication Plan.
• Do you have one? If so, describe it.
• How will the messaging be consistent between:
• Hospital
• Local public health
• Local government
• State government
• CDC
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Wisconsin Department of Health Services
• While at the hospital and awaiting test results, the patient begins to deteriorate.
• A decision is made between Unified Command at all levels to transport to a Category I facility.
• INJECT: INITIAL TEST FOR EBOLA POSITIVE
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Wisconsin Department of Health Services
• How would this process occur?
• Has the EMS that would be transporting already been identified?
• If not, which EMS would transport the patient?
• Where would you turn for technical support?
Ebola TTX
• Once patient is transported:
• Who monitors staff?
• How is waste handled?
• How does hospital return to normal operations?
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Wisconsin Department of Health Services
• How is contact tracing/investigation occurring?
• Who is the lead?
• Where can you get surge capacity for contact tracing?
• How are you handling the ‘worried well?’
• Is there a hotline/phone bank option?
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Wisconsin Department of Health Services
• Extensive contact tracing has identified three close contacts (girlfriend and two co-workers).
• There are other possible contacts that are being investigated.
• How would you monitor these contacts? What restrictions would you put on their movements?
• Who handles contact tracing and monitoring? Who can assist?
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Wisconsin Department of Health Services
• Patient dies at your facility
• Activate fatality management plan for an Ebola victim
• How are Ebola infected remains handled?
• What is the guidance?
• What is your recommendation to the Medical
Examiner/Funeral Home Director?
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Wisconsin Department of Health Services
• Frequently updated by DHS Incident Command structure to reflect the most current guidance:
• Go to: http://www.dhs.wisconsin.gov/communicable/diseasepag es/ebola.htm
• OR http://www.cdc.gov/vhf/ebola/index.html
• These are the two most current, up-to-date sites
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Wisconsin Department of Health Services
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