Situation Manual

Time Allotted / 135 Minutes
Ebola Express – Start Exercise
During the exercise it will be important to remember and comply with the following statements:
·  It is important NOT to jump ahead in the exercise scenario. In other words don’t focus on what might happen, focus on the current scenario that is presented during the exercise to make informed decisions.
·  In any exercise a number of assumptions and artificialities may be necessary to complete play in the time allotted. During this exercise, the following apply:
1.  Assume the scenario is plausible, and events occur as they are presented. Remember the primary focus of the exercise is Continuity of Operations.
2.  There is no “hidden agenda”, nor any trick questions.
3.  This is a no-fault learning environment. Have fun!
·  Exercise Basics:
1.  The exercise is self-paced and should take approximately two hours to complete.
2.  Thoroughly review all scenario information and injects as they are presented during the exercise.
·  At the end of the exercise you will participate in a group Hotwash to identify strengths and areas for improvement for your section / branch. Found below are Hotwash examples:
Strengths – During the exercise our team consulted our disaster plans and procedures and found them to be complete.
Areas for Improvement – During the exercise our team consulted our COOP plans and procedures and found portions of the plans and procedures that need to be revised.
·  After the exercise each registered participant who took part in the exercise will receive an e-mail to log into the ONX System to complete their Individual Hotwash to access their Certificate of Participation.
Time Allotted / 25 Minutes
Ebola Express – Scenario – # 001 / Image of Ebola
March 2016
In early March, the World Health Organization (WHO) is busy investigating wide-spread reports of a new illness in Western Africa.
On March 30, the WHO announces the identification of a new hemorrhagic viral disease, Ebola Virus Disease - B (EVD-b).
EVD-b is not airborne but symptomatic individuals are more contagious within the first 3 days of symptom onset and can continue to transmit the virus for up to 21 days. EVD-b has an incubation period of 8 to 21 days.
Symptomatic individuals may only have a low-grade fever.
Time Allotted / 10 Minutes
Ebola Express – Scenario – # 002 / Image of SNS
Summer / Fall 2016
In mid-June, the Centers for Disease Control and Prevention (CDC) begin clinical trials for a vaccine for EVD-b.
By late August, the Food and Drug Administration (FDA) has approved a post-exposure-prophylaxis (PEP) for EVD-b. The vaccine can be administered to individuals up to 14 days after exposure and has been shown to be 95% effective in reducing the possibility of becoming infected with EVD-b.
Following approval by the FDA, the CDC begins to add the PEP for EVD-b to the Strategic National Stockpile (SNS) cache by mid-October.
As with other SNS pharmaceuticals, the PEP for EVD-b can be shipped from the SNS within 12 hours of being requested by State Health Departments.
Time Allotted / 10 Minutes
Ebola Express – Scenario – # 003 / Image of Returning Missionaries
December 2, 2016
On December 2, 173 members of the Modern Missionary Movement return from a mission trip to the east African country of Ethiopia. The focus of the trip was to staff a small village health clinic and to help construct an addition to the village’s school.
As trained healthcare workers, the missionaries took the standard precautions while working in the village’s health clinic.
Ethiopia is not considered an EVD-b affected country.

Upon returning to the United States, the missionaries visit family members and friends, and return to work and church.

Time Allotted / 10 Minutes
Ebola Express – Scenario – # 004 / Image of Emergency Department
December 8, 2016
Early in the evening nine, of the missionaries begin feeling ill with a low-grade fever, nausea and bloody diarrhea. They seek treatment at Okaloosa Medical Center’s Emergency Department (ED).
The attending physician obtains the medical history from each missionary and learns that all have recently returned from Ethiopia. The doctor calls DOH-Okaloosa’s on-call epidemiologist to report an outbreak of unknown cause.
Since the nine missionaries arrived at the ED within several hours of one another, have similar symptoms and traveled together, DOH-Okaloosa – Epidemiologists (EPI) begin an investigation to rule out malaria, foodborne and waterborne illnesses and any other potential causes.
As their conditions continue to worsen, all nine missionaries are admitted to the hospital.
Time Allotted / 10 Minutes
Ebola Express – Scenario – # 005 / Image of Sick Missionaries
December 9, 2016
A Health Alert Network (HAN) is released by the CDC indicating that EVD-b has been confirmed in an individual in Ethiopia. The CDC adds Ethiopia to the list of EVD-b advisory countries.
DOH-Okaloosa EPI alerts the Okaloosa Medical Center of the change in EVD-b affected countries and recommends collecting stool and blood samples from the nine missionaries and sending these to the State of Florida lab for rapid EVD-b testing.
Throughout the day 48 additional missionaries report signs and symptoms similar to those reported by the original nine missionaries.
December 10, 2016
DOH-Okaloosa EPI and the Okaloosa Medical Center receive positive laboratory results for EVD-b for all nine of the original missionaries.
By the end of the day another 38 missionaries report signs and symptoms of EVD-b.
Time Allotted / 10 Minutes
Ebola Express – Inject – # 006 / No Image
Based on the fact that 95 missionaries are symptomatic for EVD-b, describe in detail the actions that will be taken by DOH-Okaloosa – EPI.
(Note: Review What Would EPI Do document that has been provided to your group.)
CLICK ON VIDEO TO PLAY

Video Library – EETE – EPI – Exercise Support

Time Allotted / 15 Minutes
Ebola Express – Inject – # 007 / No Image
Based on current information and the need to potentially dispense EVD-b PEP, identify and briefly describe the actions that will be taken by DOH-Okaloosa.
(Note: Review the Incident Action Plan that has been provided to your group.)
Time Allotted / 15 Minutes
Ebola Express – Scenario – # 008 / Image of POD
DOH-Okaloosa (Department) activates the Department’s Strategic National Stockpile Plan (AKA: All Hazards Plan – Annex 5).
DOH-Okaloosa – EP&R contacts FDOH – ESF-8 requesting activation of the Strategic National Stockpile (SNS). This request will alert the CDC to ship an appropriate quantity of EVD-B PEP to DOH-Okaloosa to meet the current public health emergency needs of the EVD-b contacts.
As the public health emergency continues to intensify the Department activates the Mass Prophylaxis and Immunization Plan (AKA: All Hazards Plan – Annex 5 – Tab – 1). As part of this activation, EP&R begins preparing a plan to staff a Point of Dispensing (POD) to provide the EVD-b PEP to what could be a large number of EVD-b contacts.
Multiple Department employees are being re-assigned to support POD operations and EPI’s contact tracing investigation. Supervisors are being advised that emergency re-assignments may extend past two weeks and they should plan accordingly.
Time Allotted / 10 Minutes
Ebola Express – Inject – # 009 / Image of Management
December 11, 2016 – 9:27AM
With Department employees being re-assigned to support POD and contact tracing operations, identify and briefly describe the immediate actions that will need to be taken by the Department’s senior leadership.
(Note: Review DOH-Okaloosa All-Hazards Plan Table of Contents that has been provided to your group.)
In addition to the activation of the Department’s Strategic National Stockpile Plan and Mass Prophylaxis and Immunization Plan identify any additional plans that will be activated under the current conditions.
Describe in detail how the activation of the identified plans will affect your section / branch.
Time Allotted / 15 Minutes
Ebola Express – Inject – # 010 / Image of Management
As Department employees continue to be re-assigned to response operations, senior leadership has activated the Department’s Continuity of Operations Plan (COOP).
(Note: As part of describing the following plans, identify the primary, secondary and tertiary person by name and title that will fill various leadership roles.)
Describe in detail the Department’s senior leadership line of succession plan.
Describe in detail the line of succession plan for your section / branch.
Identify and briefly describe training gaps that currently exist in regards to your section / branch line of succession.
(Note: In other words, what training is needed to ensure that an individual assigned additional responsibility will be successful?)
Time Allotted / 15 Minutes
Ebola Express – Inject – # 011 / Image of ICS
In conjunction with activating its COOP the Department must also focus efforts on the public health emergency occurring within the County.
Will an Incident Command System (ICS) be established to manage the public health emergency? / Yes / No
If the above answer is yes. – Describe the ICS organizational structure that will be used then identify the roles and responsibilities of each ICS section.
(Note: Review the ICS chart and definitions that have been provided to your group.)
If the above answer is no. – Briefly describe how the Department will coordinate the public health emergency if no formal incident management structure is established.
Time Allotted / 15 Minutes
Ebola Express – Inject – # 012 / Image of MEF
December 11, 2016 – 3:47PM
Currently your section / branch is experiencing a manpower shortage of between 10% and 25% and the personnel shortage is expected to rise over the next several days. The Department is no longer able to maintain normal day to day operations and your section / branch must now focus on CRITICAL and PRIORITY Mission Essential Functions.
(Note: Review your section / branch COOP Profile that has been provided to your group.)
As you review the COOP Profile for your section / branch list each CRITICAL Mission Essential Function (MEF) and identify the individual that is primarily responsible for maintaining the MEF.
As you review the COOP Profile for your section / branch list each PRIORITY MEF and identify the individual that is primarily responsible for maintaining the MEF.
Identify any training that may be needed to effectively maintain the CRITICAL and PRIORITY MEFs for your section or branch.
If your section / branch does not have any MEFs identify the type of assistance your section / branch will be able to provide to support the overall COOP activities of the Department.
Time Allotted / 25 Minutes
Ebola Express – Inject – # 013 / Image of COOP
Your section / branch can now expect 20% or more of its employees to be re-assigned to support POD operations and the ongoing EVD-b investigation.
Identify the parts of your COOP Profile that will be activated then describe in detail the actions that will need to be taken.
(Note: Remember to focus on CRITICAL and PRIORITY MEFs.)
Prepare a list of section / branch employees whose work assignments are so critical that they should not be re-assigned to support response operations. In preparing the list explain what makes the identified staff members work so critical.
Should the critical employees identified above be re-assigned it will be important to have personnel ready to fulfill their work assignment.
Identify a back-up person for each employees listed above.
Identify any additional training that back-up personnel may need to successfully fulfill the additional work assignments.
Time Allotted / 20 Minutes
Ebola Express – Inject – # 014 / Image of MRC
December 13, 2016 – 10:17AM
While the Department is struggling to fill important response roles regarding the current public health emergency, there remains the need to fulfill MEFs which support public health throughout the County.
The Department has activated members of the Okaloosa-Walton Medical Reserve Corps (MRC) to assist and relieve staff working in the POD.
In addition to supporting POD operations many of the MRC members are willing and capable of working within the Department to meet MEFs.
Identify the jobs within your branch / section that MRC members can assist with.
(Note: Review the list of MRC disciplines that has been provided to your group. Also, remember to focus on CRITICAL and PRIORITY MEFs.)
Identify any training that MRC members will need to be able to assist with the above list of jobs.
Time Allotted / 15 Minutes
Ebola Express – Inject – # 015 / Image of Strike Team
FDOH is an integrated agency and ESF-8 manages human resources that are comprised of employees from County based FDOH offices throughout the State that can be re-assigned to assist the Department during this staffing shortage.
Identify the types and / or the kind of Strike Team or support staff assistance that your section / branch will need to fulfill its MEFs.
(Note: Review the list of FDOH – ESF-8 Strike Teams and support staff that has been provided to your group.)
Identify any special training that will be required of Strike Team and / or support staff members assigned to your section / branch from other County based FDOH offices.
If special training is needed identify the individual by job title and name that will be responsible for conducting the training.
Identify and briefly describe any additional section / branch human resource needs that are not covered by the list of available FDOH – ESF-8 Strike Teams and / or support staff.
Time Allotted / 20 Minutes
Ebola Express – Inject – # 016 / Image of Phone
Phone calls regarding the Department’s response to EVD-b and questions about normal services begin to inundate available staff.
(Note: Review the Press Release that has been provided to your group.)
Identify the important public health information (messages) that will need to be provided to Okaloosa County residents.
Identify the resources that will be needed to effectively communicate with the public.
Time Allotted / 15 Minutes
Ebola Express – Inject – # 017 / Image of Demobilization
December 16, 2016 – 1:23PM
Working conditions within the Department begin to improve as FDOH – ESF-8 Strike Team and support staff members continue to arrive to assist with fulfilling MEF responsibilities and support both EVD-b contact tracing and POD response operations.
Over the past day the Department’s workforce has risen to 98% of normal staffing.
At this point will the Department begin to demobilize all or parts of its COOP and return to normal daily operations? / Yes / No
If the above answer is yes. – Identify and briefly describe the tasks associated with demobilizing COOP operations for your section / branch.
If the above answer is no. – Identify the point at which your section / branch will demobilize COOP operations.
Time Allotted / 15 Minutes

Situation Manual – Tabletop Exercise 1 Disaster Resistant Communities Group – www.drc-group.com