Pre-Event
Planning
Coordinating
Resouces
When planning
for any public health emergency, public health planners need to
consider several factors: (Knowing these details will affect the
strategy you plan for.)
- What personnel
and skills are available at the local and national level to assist
in the outbreak?
- What kind
of communications exist to work with these people?
- What kinds
of medicines, vaccines, and supplies are available?
- How will
all these resources be transported?
Identify
Staff
When identifying
staff, the person designated to manage this activity should consider
the population size and language(s) of their given area and estimate
the number of teams that could respond to a case. They should also
consider the number of supervisors and support staff they will
need to support these teams. This would include case interviewers.
Estimates should take into account whether or not there will be
enough contact tracing teams to conduct face-to-face interviews,
which will take longer, or work via telephone. Support staff, secretaries,
telephonists, data entry, contact team supervisors all need to
be identified.
Train
Staff
After the teams
have been identified, they should be trained in smallpox diagnosis
so that they can evaluate contacts for suspect cases of smallpox.
They should also receive training in contact interviewing methods,
skills, and how to evaluate those contacts for level of risk. They
should also have a thorough understanding of the vaccination arrangements
to be used, how to screen for contraindications to the vaccine,
how to monitor for severe adverse events, and how to evalucate
a patient for a vaccination “take.” An essential to
good epidemiology, they should understand all forms and databases
that will be used.
Materials
Public health
authorities should also develop forms before an event occurs. Forms
should be developed that will track case information and contact
information. And to further assist the case managers, educational
materials will need to be developed that help in the description
of the disease, as well as various vaccination issues. Some important
forms in pre-event planning are Case forms, Contact forms and VAERS
forms. Educational materials required for pre-event planning are:
- Smallpox
recognition card.
- Vaccination
Status recognition card.
- Vaccine contraindication
sheet.
- Vaccine Information
Statement (VIS).
- Vaccination ‘ticket’.
Emergency
Operations Center
A central entity
that can help to coordinate the response and review how things
are going will be essential. Response teams in the field will need
to confer on issues of all aspects of the investigation, including
surveillance, laboratory issues, and vaccine safety. A central
location will also need to be identified to monitor the availability
of resources and get them out to those in need. And other members
will be necessary to provide basic support to those in the field.
A National headquarters with specialists for supporting field teams
would include:
- Operations
coordinator and operations staff
- Specialists
in smallpox investigations, surveillance, lab, vaccine safety.
- Specialists
in contact tracing, vaccine supply, policy and procedures.
- Communications,
training, and hot line advisors.
- IT and computer
support.
Creation
Smallpox Response Teams
In order to
quickly contain a smallpox outbreak, you will need teams that are
already trained in smallpox disease and how to control it. Local
resources could become quickly overwhelmed, not to mention concerned
about the safety of their own families. With national-level response
teams available, they could go in to assist when necessary.
A central leader
should be identified to coordinate contact tracing activities.
This person will be key if the outbreak should get so large that
contact tracing will need to be prioritized. This person should
also be responsible for identifying the number of teams that would
be needed to do appropriate contact tracing, given the geography
and population of the area, as well as getting those teams prepared
to respond.
Additional considerations
will be what other staff can be quickly mobilized from other parts
of public health or the medical community to help in outbreak control
and how the health and safety of the team members will be assured.
Well functioning teams would have:
- Spirit of
team work and sharing of information.
- “Get
the job done” mentality.
- Recognize
and utilize local experts.
- Share credit
broadly, particularly with local counterparts. Make others look
good.
- Use brief,
succinct, and positive communications.
- Keep messages
consistent among all team members.
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