Emergency Operations Center Activation COVID19 Considerations The mark

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Emergency Operations Center Activation: COVID-19 Considerations The mark “CDC” is owned by the US

Emergency Operations Center Activation: COVID-19 Considerations The mark “CDC” is owned by the US Dept. of Health and Human Services and is used with permission. Use of this logo is not an endorsement by HHS or CDC of any particular product, service, or enterprise. cdc. gov/coronavirus

Objectives § Discuss the Emergency Operations Center (EOC) activation process during the COVID-19 response

Objectives § Discuss the Emergency Operations Center (EOC) activation process during the COVID-19 response § Describe the function of the Preliminary Assessment Team (PAT) § Explain EOC activation modes § Define EOC activation levels

EOC Activation § Activation of the EOC enhances Department/Ministry ability to provide immediate response

EOC Activation § Activation of the EOC enhances Department/Ministry ability to provide immediate response in the event of a public health emergency. § An activated EOC supports rapid response through various activities, including: – Mobilization of staff and resources – Organization of response actions – A centralized location of technical expertise and subject matter experts (SME) for decision making and the drafting of plans

EOC Activation Process § The activation of an EOC for a public health emergency

EOC Activation Process § The activation of an EOC for a public health emergency can occur under the direction of the Department/Ministry Director or the recommendation for activation obtained from a Preliminary Assessment Team (PAT). § The exact process for activation should be described in the Emergency Response Plan for the responsible health authority as well as the EOC’s own plan or handbook.

Preliminary Assessment Team

Preliminary Assessment Team

Preliminary Assessment Team Process § The Preliminary Assessment Team (PAT) is a group of

Preliminary Assessment Team Process § The Preliminary Assessment Team (PAT) is a group of SMEs who are responsible for conducting an initial assessment of an incident or event. – The PAT includes the involvement and input of SMEs from the scientific community and the EOC general staff. § The process is initiated in response to a potential public health threat.

Preliminary Assessment Team Process: Objectives § Achieving a preliminary assessment of the situation. §

Preliminary Assessment Team Process: Objectives § Achieving a preliminary assessment of the situation. § Identifying response activities and operations. § Recommending the activation (if necessary) of the EOC to support response activities for the potential public health threat, impact, and/or need for centrally managed response.

Preliminary Assessment Team Process: Discussion Topics for Infectious Diseases like COVID-19 What are the

Preliminary Assessment Team Process: Discussion Topics for Infectious Diseases like COVID-19 What are the known facts, unknown facts, and assessments? How was the disease detected? Has the information been validated? Where is the outbreak located and/ or which areas is it impacting? Are there deaths, serious cases requiring hospitalization, or other urgent impacts? § What are the most common, less common, and serious symptoms? § What actions have been taken? What actions need to be taken? § Are national or local media aware of the threat? § §

Preliminary Assessment Team Process: Discussion Topics for Infectious Diseases like COVID-19 continued § Is

Preliminary Assessment Team Process: Discussion Topics for Infectious Diseases like COVID-19 continued § Is there information that the international community and/or authorities can contribute to the assessment? § Are there unfilled critical intelligence or information needs? § Should the public be notified? § Should international authorities be notified? § When does leadership need to be briefed, and by whom? § Information on future meetings and next steps.

Activation Criteria § Each country should have an established pre-determined criteria to consider if

Activation Criteria § Each country should have an established pre-determined criteria to consider if EOC activation is necessary, and at what level. § These criteria should be consistent with the International Health Regulations 2005 (IHR) § The following criteria are examples of what may trigger EOC activation: – National-level interest and priorities – Number of reported cases and/or deaths (based on previous threshold values; for high-priority diseases like COVID-19, the threshold could be one case) – International impact/Geographical dispersion – Public health threat – Exceeds the management/staffing capability of coordinating Department/Ministry

Preliminary Assessment Team (PAT) Process Not to activate The PAT discussion will consider if

Preliminary Assessment Team (PAT) Process Not to activate The PAT discussion will consider if the available data on the threat meet the criteria previously established by the country to activate the EOC, and at what level of response. Determination is made based on assessment

EOC Activation Modes

EOC Activation Modes

EOC Activation Modes § After determining that the activation of an EOC is necessary,

EOC Activation Modes § After determining that the activation of an EOC is necessary, an activation Alert Mode mode should be implemented based on the results of the assessment (i. e. , the PAT Process). Watch Mode Alert Mode Watch Mode Response Mode

EOC Activation Modes § The EOC is activated based on the needs of the

EOC Activation Modes § The EOC is activated based on the needs of the public health Alert Mode emergency. § The activation modes and levels of an EOC can vary through the course of the emergency. Watch Mode – An EOC can be active (i. e. , in watch mode) before reaching response mode, where the deployment of an Incident Management System (IMS) is required. – Not all emergencies will experience three activations modes.

Watch Mode § Watch mode normally aligns with pre-incident activities. – EOC staff monitors

Watch Mode § Watch mode normally aligns with pre-incident activities. – EOC staff monitors conditions for events or incidents that might require a public health response (i. e. , high or unexpected cases of COVID-19). – Core personnel conducts routine operations. Watch Mode

Alert Mode § Alert mode can occur pre-incident, or post-incident. – Generally occurs when

Alert Mode § Alert mode can occur pre-incident, or post-incident. – Generally occurs when preparedness actions require involvement in advance of an event. – Results in an increased level of awareness, increased contact with external agencies, event-specific planning, and/or initial mobilization of assets. Alert Mode

Response Mode § Response mode is associated with the incident activities. – Usually follows

Response Mode § Response mode is associated with the incident activities. – Usually follows the recommendation generated from a Preliminary Assessment Team (PAT) process and/or at the direction of the Department/ Ministry Director or superiors. – Occurs when the Incident Management Systems (IMS) is activated. Response Mode

Response Mode and IMS § The Incident Management System refers to the temporary organization

Response Mode and IMS § The Incident Management System refers to the temporary organization structure that is activated to support a response, regardless of cause, size, location, or complexity. • • It standardizes the response approach between all levels of government, the private sector, and non-governmental organizations. It relies on the deployment of trained personnel to efficiently coordinate the response Response Mode § See the “How do we organize a response” module for more details on IMS.

EOC Activation Levels

EOC Activation Levels

EOC Activation Levels § In Response Mode, the level of effort will change over

EOC Activation Levels § In Response Mode, the level of effort will change over the course of time, resulting in either EOC deactivation or a change in activation levels. § Level of activity often increases as size, scope, and complexity of incident grows. § Transitioning from one EOC activation level to another is based on the level of effort (increase or decrease) required to manage the response. – Does not necessarily refer to total number of personnel involved in response. § Additional details on activities performed by the EOC in support of COVID 19 response are provided in the “How do we operate our EOC” section.

Level III Staffing Increases EOC Activation Levels Significance of the event increases Steady State

Level III Staffing Increases EOC Activation Levels Significance of the event increases Steady State Partial Activation Full Activation onse p s e s/R s e n e Awar Response Alert Watch Normal Operations Critical Information Requirements

EOC Activation Levels – Level III § Level III – The lowest level of

EOC Activation Levels – Level III § Level III – The lowest level of activation (Normal Operations/Steady State) – Is activated by default unless a higher level is specified during the EOC activation process. – The EOC performs normal activities when no incident or specific risk or hazard has been identified.

EOC Activation Levels – Level II § Level II – Requires significant increase in

EOC Activation Levels – Level II § Level II – Requires significant increase in staff (Enhanced Steady-State/Partial Activation) – Augmentation of personnel may be necessary due to the high case counts, multiple state involvement, increased media attention, and/or national leadership interest. – EOC team members/organizations are activated to monitor a credible threat, risk, or hazard and/or support the response to a new and potentially evolving incident.

EOC Activation Levels – Level I § Level I – The highest level of

EOC Activation Levels – Level I § Level I – The highest level of activation (Full Activation) – Is reserved for the largest scale responses, which require an agency- or Ministry-wide effort. – EOC team is activated, including personnel from all assisting agencies, to support the response to a major incident or credible threat.

References § FEMA Emergency Management Institute (2018, June 25) IS-700. B: An Introduction to

References § FEMA Emergency Management Institute (2018, June 25) IS-700. B: An Introduction to the National Incident Management System. Retrieved from https: //emilms. fema. gov/IS 0700 b/curriculum/1. html § WHO (2018) Handbook for Developing a Public Health Emergency Operations Centre. Retrieved from https: //apps. who. int/iris/bitstream/handle/10665/277191/9789241515122 eng. pdf? sequence=1 § WHO (2015) Framework for Public Health Emergency Operations Centres. https: //www. who. int/ihr/publications/9789241565134_eng/en/ § All photos retrieved from CDC's Public Health Image Library (accessed May 2020): https: //phil. cdc. gov/

For more information, contact CDC 1 -800 -CDC-INFO (232 -4636) TTY: 1 -888 -232

For more information, contact CDC 1 -800 -CDC-INFO (232 -4636) TTY: 1 -888 -232 -6348 www. cdc. gov The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.