Continuity of Operations (COOP) Pandemic Flu Tabletop Exercise

1. KC Pandemic Regional Interagency COOP Exercise KC PRICE ‘07 DETERMINED ACCORD Continuity of Operations (COOP) Pandemic Flu Tabletop Exercise

2. Rules of Engagement Brad Scott,Exercise Director

3. Ground Rules Brainstorming techniques and free, non-attribution discussions are highly encouraged. The following rules apply while brainstorming: REMEMBER, • non-attribution is in effect • Promote maximum group interaction • Keep issues on a high level • Offer inputs based on facts; avoid hearsay • Do not engage in Non-constructive criticism is not permitted • Focus on solutions, not blame • Respect all ideas and comments • PARTICIPATE FEMA

4. Action Item/MSEL Protocol • Evaluators/Facilitators each have a set of Action Items that will be introduced during Exercise Play. • Evaluator should give the Action Item to their Agency Lead Players at the table, that individual should read it out loud for their team, and then discussions should take place.

5. Action Item/MSEL Protocol • Evaluators – There are Easels strategically placed in the room that will reflect the current Action Item in Play. In addition Exercise Staff will come around to the tables instructing you which Action Item should be introduced. • Once an Action Item is completed it should be returned to the Evaluator, which can later be used to facilitate your Hotwash discussions.

6. Animal Outbreak Overseas (today) • National and international health organizations continue to track the occasional transmission of H5N1 avian influenza from an infected bird to a human • Human cases appear about one per week • Rare human-to-human transmission reported Dept. of Agriculture

7. Animal Outbreak Overseas (today) • H5N1 influenza in birds or humans not yet been identified in North America, however 59 countries report bird cases and 185 deaths have occurred in third-world countries

8. Animal Outbreak Overseas (today)

9. Animal Outbreak Overseas (today) • The U.S. is working with an international partnership to contain outbreaks beyond its borders • Vaccine research is ongoing • The need for planning and preparedness is stressed • CDC and WHO continue to monitor and investigate human cases worldwide, except in nations who refuse to cooperate internationally CDC

10. KFEB - 1 Segment 1 – Feature Story

11. WHO Global Pandemic Phases, Federal Government Response Stages, and Triggers WHO Worldwide Phases Federal Government Response Stages No Triggers INTER-PANDEMIC PERIOD Phase 1. No new influenza virus subtypes have been detected in humans. An influenza virus subtype that has caused human infection may be present in animals. If present in animals, the risk of human infection or disease is considered to be low Phase 2. No new influenza virus subtypes have been detected in humans. However, a circulating animal influenza virus subtype poses a substantial risk of human disease PANDEMIC ALERT PERIOD Phase 3. Human infection(s) with a new subtype but no human-to-human spread or at most rare instances of spread to a close contact Phase 4. Small cluster(s) with limited human-to-human transmission but spread is highly localized, suggesting that the virus is not well adapted to humans Phase 5. Larger cluster(s) but human-to-human spread is still localized, suggesting that the virus is becoming increasingly better adapted to humans but may not yet be fully transmissible (substantial pandemic risk) PANDEMIC PERIOD Phase 6. Pandemic phase: increased and sustained transmission in the general population • Stage 0New Domestic Animal Outbreak in At-Risk Country • Stage 1Suspected Human Outbreak Overseas • Stage 2Confirmed Human Outbreak Overseas • Stage 3Widespread Human Outbreaks in Multiple Locations Overseas • Stage 4First Human Case in North AmericaStage 5Spread throughout United StatesStage 6Recovery and Preparation for Subsequent Waves Immediate Actions Triggers Animal OutbreakNorth America (AONA) Human OutbreakOverseas (HOO) Human OutbreakNorth America (HONA) Pandemic Waves

12. Action Item #1 • Headquarters calls and wants to know what essential functions in addition to the ones already identified in your Agency COOP Plan need to be considered during a pandemic? • Are there any functions that will need to be suspended?

13. Action Item #2 • Headquarters calls and wants to know what Human Capital flexibilities are being considered to maximize workforce capabilities? • What does your plan suggest, and is there a need to develop or modify existing labor relations plans?

14. ACTION ITEM #3 Headquarters calls and asks if the current Delegations of Authorities and Succession Plan contained within your COOP will be sufficient enough for a Pandemic Outbreak?

15. INTERLUDE – AOO • Share agency pandemic plan with staff. • Re-affirm emergency contact information and accountability procedures. • Institute employee education for infection control, hand-washing, cough etiquette, and social distancing. • Advocate for seasonal influenza vaccination and pneumonia vaccinations for at-risk employees. • Advise staff what a “safe haven” is. • Direct staff to OPM website about leave policies, safe haven, employee assistance and other benefits. • Identify those who have the capability to telecommute, and with security software, on home computers. • Hold one-day work-at-home exercise for employees.

16. KFEB - 2 Dozens dead Birds in south & southwestern States – AONA Dead Birds – Iowa CDC Alerts local Health Monitoring Hospital Respirator cases and over the counter flu medication purchases

17. Animal Outbreak in North America • USDA is monitoring spot reports of possible animal outbreaks of H5N1 in the United States • The introduction of avian influenza into North America has occurred • USDA officials are concerned about the possible effects of the virus on the chicken population • USDA & Dept. of Interior intensely monitor domestic and wild bird populations

18. Action Item #4 • Headquarters calls and knows that through your COOP planning, you have the ability to account for our workforce. • But it wants to know if you have identified procedures to track who is sick and who has been exposed, recovered or died during a pandemic?

19. Action Item #5 • Headquarters calls and wants to know if you have been proactive in educating the workforce on pandemic hygiene and preparedness. • Have you posted educational material and conducted training for your workforce?

20. KFEB – 3 - HOO WHO confirms H5N1 flu is spreading from human to human throughout Vietnam Federal Stage – 2 Incident of National Significance OPM alerts Federal Agencies to be prepared to track employee health State Dept. recommend overseas travel restriction

21. Human Outbreak Overseas • H5N1-related human deaths are reported in the villages in northern Vietnam • This new strain is able to move from human-to-human • The Federal Government Response Stage is raised to Stage 2 • DHS declares an “Incident of National Significance”

22. Human Outbreak Overseas • Within days, 12 Vietnamese villages report influenza deaths and tests indicate the same virus • The WHO issues a global health report saying a new strain of influenza exists, based on avian H5N1, that is able to move from human-to-human • Public health workers struggle to track and contain spread of the virus throughout Vietnam • Travel restrictions to and from Vietnam are set in place • CDC requests human tissue samples from Vietnam to determine if there has been a change in the virus. Vietnam refuses, citing a concern that it won’t receive any manufactured vaccine for its population • Federal agencies are asked to begin tracking employee health

23. Action Item #7 • The Headquarters calls and wants to know what percentage of your current workforce has the ability to work from home? • Because of the nature of a pandemic, work at home or telework is a viable social distancing measure. • Are there plans in place to increase the amount of telework and work at home employees during a pandemic? • Has an assessment been done to see what the infrastructure will allow for considering the possibility of increased work at home and telework protocols. • Are there security concerns and if so, how are you addressing them?

24. Action Item #8 • Headquarters calls and wants to know what social distancing techniques are being considered

25. Action Item 9 • Your Contract workforce supervisor calls the Contracting Officer’s Representative, he has heard that the agency is planning for a pandemic and might require different working hours for the building population. He is concerned and request a meeting to discuss their current contract terms and conditions. • Are you prepared to discuss this issue?

26. KFEB - 4 Human to Human – Thailand, Cambodia & Austria WHO has Elevated to Phase 6 US Public Health Service has been place on Alert Status

27. Human Outbreak Overseas (cont.) • Cases of human-to-human influenza begin to appear in Thailand, Cambodia, Australia, and elsewhere in the region • The WHO declares Pandemic Phase 6 and the Federal Response Stage is raised to Stage 3 • Isolated cases begin appearing in other countries

28. Human Outbreak Overseas (cont.) • Domestic emergency medical personnel plans are activated and hospitals begin to implement surge plans • National Disaster Medical System placed on Alert Status • U.S. Public Health Service placed on Alert Status • Medical Reserve Corp Units asked to roster volunteers FEMA

29. Action Item #10 • An employee calls his supervisor and inquires about what his family would need to do and who to contact in the event of his death during a pandemic? • What is the agency’s policy when dealing with a death of a federal employee?

30. Action Item #11 • Headquarters calls and wants to be sure we are prepared and have procedures in place to deal with large numbers of deaths related to a pandemic. • Does your agency’s bereavement policy address multiple deaths and notification protocols?

31. Action Item #12 • Headquarters Public Affairs is calling its Regional Public Affairs Officers. • It wants to know what steps are being taken to ensure that the Federal Government is conveying the same message on awareness, preparedness and protection during a pandemic that the State and Local Authorities are announcing?

32. INTERLUDE - HOO • Continue employee education for infection control, social distancing, cough etiquette, and hand washing. • Review Sick Leave and Absentee Policies. • Require that all employees become familiar with agency pandemic plan. • Prepare and utilize cross-trained employees to increase staffing capabilities. • Hold a second work-at-home exercise. • Re-affirm Succession Planning among employees. • Remind staff to review family preparedness plan. • Consider evaluation of employee Risk Level and purchase of Personal Protective Equipment. • Re-affirm employee access to health-care, faith based resources, employee assistance; incorporate requirements of special-needs employees.

33. KFEB - 5 International Traveler – Sick arrives in KC from Seattle CDC attempting to track down passengers KC and Seattle Hospitals preparing for rush of flu victims

34. Human Outbreak North America (1st Case) • Traveler arrives in Kansas City from Seattle with what appears to be the human form of H5N1 flu virus • CDC attempts to track down other passengers

35. INTERLUDE - HONA • Publish relevant information for key stakeholders. • Continue employee education for infection control and social distancing. Cancel face-to-face meetings. Remind staff to stay home if ill. • Ensure that all employees have full information related to personal preparedness, employee assistance, health insurance, survivor benefits. • Reconfirm employee contact information. • Conduct regularly scheduled employee accountability and tracking reports • Encourage critical employees to regularly copy vital records needed to carrying out missions, store in a secure location or ensure accessibility from various worksites. • Monitor local and state guidance.

36. KFEB - 6 Local Communities acting independantly Some Social Distancing measures – cancelling public events – closing scholls GOVERNORS MO/KS urge local Mayors not to overact. KS Medical Center –Closed biosciences lab, both KU and Univ of MO remain Open

37. STOP PLAY • A majority of school districts in the Kansas City metro area have closed schools due to the pandemic. • Anyone with children under the age of 15, please stand up. • WORKFORCE IMPACT !!!

38. Human Outbreak North America (1st Case) • KCMO and Independence close public schools

39. KFEB - 7 2-Weeks since 1st Case of Avian in US Outbreaks reported in a Major US Cities Trucking Resources short supply Airline Industry in crisis Commuters avoiding public transporation Absentee Rate 20 40 percent Shortage of Vaccine

40. Human Outbreak North America • All major cities reporting cases of the avian flu • Federal government response stage is increased to 5 indicating a national outbreak • Shipping resources are reduced and the air line industry begins to suffer from a shortage of passengers • Commuters avoid public transportation • Employee absentee rates rise significantly

41. INTERLUDE - HONA • Initiation of plan for carrying out agency mission with up to 40% absentee rate. • Consider safe-haven work sites and alternative work schedules. • Employees who continue to report to work must have their risk level assessed and addressed. • Employees still at work – aggressive infection control & social distancing. • Initiation of procedure to contact all employees daily. • Agency tracks and reports # employees working from safe haven, reporting sick, exposed, recovered and employee deaths. • Refer staff to county health department websites.

42. KFEB - 8 KC Public Schools and Day Cares Closes Colleges Closed Gas rationing - ATMs out of money Drinking water – Non Functioning – Boil Orders issued

43. Action Item #13 • Several Supervisors are reporting that a number of their employees are experiencing flu like symptoms. • They want to know what the policy is to make these employees leave the worksite?

44. Action Item #14 • You are a member of management. • You overhear a fellow manager discussing an employee’s pandemic sickness with office workers. • Does this violate the Health Insurance Portability Accountability Act (HIPAA)? • Is this addressed in your pandemic policy plan under management education issues?

45. Action Item #15 • The nurse’s office is beginning to administer anti-viral shots. • You have several contract workforce employee requesting shots. • Can you legally give contract workforce flu shots?

46. Action Item # 16 • Several of your employees have called and are healthy but because of the gasoline shortages, they can’t get fuel for their vehicles to report to work. • They figure the Government Fleet may have better luck getting gasoline. • Can the Government provide transportation?

47. KFEB - 9 Outbreaks spreads uncontrollably through US Deaths Sky Rocketed – 1.6 million, with at least 8,000 in KC 45% of Deaths - People between ages of 15 -0 35 150 Local Physician Dead 1200 Nurses Dead Bodies in temporary burial sites

48. Human Outbreak North America • All schools, licensed child care centers, universities, and colleges are now closed • Most stores are closed, grocery stores are experiencing shortages and ATMs are out of money • Some places are without power

49. Nation-Wide Pandemic • 45 percent of flu-related deaths have occurred in people between 15 and 35 years old • Ban implemented on public funerals

50. Action Item # 17 • The President indicated in a recent National news report that there may be a need to activate any and all National Guard troops to help in the Federal Response to the Pandemic. • What impact will this have on your workforce?