Small Group Learning Activity – Emergency Preparedness and Response
January 11, 2011
10:00 am-11:00 am
Your working group has one hour to discuss the following potential local
community-based interventions that could potentially minimize the impact of
Pandemic 2011 on the greater Durham community. You will be presenting your
recommendations to a panel of local leaders including elected officials from Durham
County, the State of North Carolina and the Duke University Board of Trustees.
Community-wide emergencies require swift and coordinated action. Community
leaders have limited options to stem a rapidly evolving pandemic and all have major
social and financial implications. Your group’s recommendations will help leaders
create a prompt, measured and coordinated response to the pandemic. The
overarching goal for the community response is to limit transmission of the
flu virus to vulnerable populations until a vaccine strategy targeting the new
virus is underway.
Please remember that you each individually represent a key-stakeholder entity in
the local community and it is imperative to ensure your organization’s perspectives
are fully expressed in your group’s presentation.
Highlighted below are the interventions that require your consideration and rank
ordering. Your group’s local health director should have a few points that highlight
potential pros and cons of each individual intervention. There are relevant
assumptions and discussion points presented with each intervention.
Instructions:
1. You will be assigned a team member personality profile. Please try to adhere
to the spirit of that personality. Also don’t judge your team members
harshly.
2. Discuss each of the possible recommendations below.
3. Be prepared to present which of these interventions need to be initiated (i)
NOW – i.e., within 24hrs, (ii) shortly – i.e., within 72hr, and (iii) not urgent,
just whenever possible.
4. Have a team member rank order the 15 potential interventions (marked by
an “*”). A worksheet is provided at http://goo.gl/AbBFL
5. Consider other interventions you would like your team to consider…be creative.
1. Recommend Governor Perdue declare a ‘State of Emergency’ to include:
a. *Mobilization of the National Guard to assist with planning and
establishing mass vaccinations clinics for seasonal flu
b. *A State Health Department mandate that citizens wear a mask when
in public areas.
c. *Recommend immediate closure of non-essential government aligned
services (i.e., DMV, County sponsored childcare).
2. Recommend school closure effective immediately to prevent rapid
community transmission.
a. *Close public schools
b. *Cancel Duke classes
c. Information points
i. Durham County public schools enroll approximately 33,000
students.
ii. Case-fatality rate has been initially reported as possibly up to
30% - though early indicators locally do suggest the same
virulence. Local mortality figures are not available but there
seems to be less serious illness than initially reported.
iii. Vaccination rates during a routine flu season for students and
staff equal roughly 35%.
3. Recommend local government officials cancel all public gatherings
(including those held at private venues).
a. *Campus activities
i. Major scheduled local gatherings include NCAA Division I
athletics,
b. *Community activities
i. E.g., religious services and performances at the Durham
Performance Arts Center.
4. *Recommend discontinuation of public transportation within County,
except services running to and from hospital.
5. *Recommend local government to create an automatic isolation policy
for suspected cases (individuals with symptoms) in community for 5-7
days.
6. *Recommend conversion of Cameron into temporary isolation facility
for Duke University students (and staff) deemed sick (but well enough
to be out of hospital) and School of Science and Math for the Durham
community.
7. *Recommend that local government create a voluntary quarantine
policy for exposed individuals (asymptomatic) within the community
for 3-5 days.
8. *Recommend cancellation of Duke non-essential travel for students and
faculty.
9. *Recommend enforcement of ‘No Visitation’ policy within the hospital
systems.
10. *Recommend cancellation of all elective surgery in preparation for
‘surge’ of patients.
a. Information points:
i. Roughly 50% of hospital admissions are for non-emergent
conditions (i.e. surgery to remove a gall bladder, hip
replacement or back operations for ‘pinched nerves’).
ii. Currently Duke University Health Systems averages 90+
percent in-patient bed occupancy.
11. *Recommend mandatory attendance for Duke Hospital/County critical
services, unless sick, with threat of dismissal.
Each group is comprised of the following members:
 Durham Public Health Director**
 Director of Durham County Emergency Management
 Chairperson for Chamber of Commerce
 Durham Deputy Mayor
 Duke University Student Affairs Director
 Duke University Health System Chief Medical Officer
 Duke University Human Resources Senior Vice President
 Durham Public School Superintendent
 Duke University/Health System Risk Management Director
 Duke University Student Government/International Student
Association Representative
** Denotes designated group spokesperson.
Durham Public Health Director**
You oversee the local county health department. Your mission is to preserve,
protect and enhance the general health and environment of the community. You work
closely with the NC Division of Public Health and the CDC. The health department will play
a major role in all policy decisions executed by local government and will be responsible for
coordinating mass vaccination clinics. Your department will work collaboratively with the
local hospitals and clinics to ensure healthcare providers are delivering consistent and
accurate information. Elected officials, citizens and the media will expect you will
determine the direction and pace of the local response. Decisiveness is key. Difficult
decisions need to made and your leadership must be absolute.
Director of Durham County Emergency Management
You are responsible for coordinating the execution of the County’s emergency
response plan. The County Board of Commissioners and the Durham City Council have
powers vested to them during disasters and your department is responsible to ensure the
local response is implemented in a timely and coordinated fashion. You work
collaboratively with the Public Health Director and other department heads of local
government. You will potentially have to enforce unpopular decisions
(quarantine/isolation orders). It is imperative that you have clear direction and a
pragmatic approach.
Chairperson for Chamber of Commerce
Your role is to ensure that local, state and federal government make policies around
the pandemic that do not unduly cripple the business climate of the region. School closure
and social distancing decisions can have catastrophic effects on small businesses that are
particularly sensitive to operating with a limited workforce. Likewise, restaurants and
storeowners are unlikely to be compensated for lost revenue due to implementation of
public health and usually due not carry insurance to financially protect them during
pandemics.
Durham Deputy Mayor
The Mayor serves as the presiding officer of the City Council and you are his trusted
deputy. The Mayor’s primary goal is to ensure the safety and wellbeing of residents and
visitors to the city of Durham. 2011 is a very tough financial climate and the Mayor wants
to ensure the pro-business climate is preserved. The constituents are looking for leadership
and swift but appropriate action. ‘At risk’ populations including those will limited financial
resources are dependent on the Mayor’s office to ensure their needs and interest receive
appropriate consideration.
Duke University Student Affairs Director
Your office oversees much of the campus. You are responsible for the dorms, the
student health services and generally the advocate to ensure the health and safety of the
student body. You are the student’s parent away from home and very much answer to
those parents who are at home! You report to the University President and most ensure the
academic year continues in a safe and reasonable fashion. Undergraduate students only
spend a brief four years on campus and you want to ensure the experience optimized (but
safe).