Table Top Exercise Measles June 19 2019 Welcome

Table Top Exercise Measles June 19, 2019

Welcome to 1

Information and Introductions Safety and General Information • Emergency Notifications • Emergency Exits • Rest Rooms • Cell Phones Exercise Schedule is found in Appendix A of the Situation Manual Introductions: • Name, Title/Role, Organization Handoff to TTX Facilitator 2

Exercise Overview Purpose: § This specific TTX provides the opportunity to examine response operations related to: § Measles case on campus and College actions, § Partner activities Scope: § This 2. 5 hour -TTX is divided into three Modules with a focus on planning and response to a measles case on campus: – Module 1 Initial Response will examine response to the occurrence of a potential Measles case on campus during the Language School sessions, – Module 2, Extended Response will examine efforts following confirmation of measles and resulting actions on campus and with external partners, – Module 3: Recovery efforts to address media / community relations and return to services. § Each Module will consist of two activities: 1. Scenario Overview 2. Facilitated Discussions surrounding a set of discussion questions 3

Exercise Objectives – Aligned with FEMA Core Capabilities 1. Operational Coordination: a. Test and validate Middlebury College’s response associated with managing a measles case. b. Test and validate Middlebury College’s response associated with managing a case of measles. 2. Public Health, Healthcare and Emergency Medical Services: a. Assess public health system response to a confirmed measles case at the college, integrating with the healthcare system as needed. b. Assess healthcare system response to a confirmed measles case at the college. 3. Public Information and Warning: Enable internal and external partners to coordinate and deliver prompt and reliable information to the community through clear and consistent messaging. 4

Participant Roles and Responsibilities • Facilitator: Provides situation updates and facilitates discussions • Players: Respond to the situation presented based on current plans, policies, and procedures • Support Staff: Performs administrative and logistical support during the exercise (e. g. , registration) 5

Exercise Guidelines • Exercise is being conducted in an open, low-stress, no-fault environment; varying viewpoints are expected • Decisions are not precedent-setting; this is an open discussion • Focus should be on identifying suggestions and recommended actions for improving preparedness and response efforts • Reference the Situation Manual for greater detail and to support your discussions 6

Assumptions and Artificialities • Scenario is plausible and events occur as they are presented • Use existing plans, policies, procedures, and resources to guide responses • No “hidden agenda” • Scenario assumes certain player actions as it moves through each phase 7

Start of Exercise 8

Module 1: Initial Response 9

Module 1: Scenario Overview Date/Time: Monday, July 1, 2019, 12: 15 - 1: 45 pm Location: Parton Health Center, Middlebury College 12: 15: Mr. Patrick Murphy, a Chinese Language School student checks in at Parton Health Center complaining of fatigue, fever and cough. He was transported to Parton by Public Safety Officer. 12: 25 – 1: 45: The nurse assessing Mr. Murphy’s conditions, also noting the beginnings of rash at his hair line, determines he is clinically compatible with a potential measles infection. The College Physician is consulted and he concurs with the diagnosis, and requests the staff to initiate Measles case protocols and plans. • Nasal swab and blood samples are collected and sent to VDH lab, • Isolation / Quarantine protocols are initiated. 7: 05 pm: College received confirmation from VDH lab that Mr. Murphy tested positive for measles. 10

Module 1: Key Issues Mr. Murphy presents at Parton Center and diagnosed as probable for measles infection; protocols need to be initiated Community of ~1, 150 involved in Language School programs Chinese Language School has 135 students enrolled Mr. Murphy and 74 other students are residing in Forest Hall Language School students are dining at Ross Dining facility Multi-agency response has been initiated by Parson Health Center. Porter Medical and VDH notified. VDH responding. At 7: 05 pm, VDH lab confirms measles infection 11

Module 1: Discussion Questions are provided in the Situation Manual. They are broken into two categories • Middlebury College • Health Care Services / Response Partners (Porter, VDH, MREMS) Please take the next 30 minutes to consider the scenario and questions posed. • Consider existing plans and procedures to determine your course of action. • Feel free to divide work effort into appropriate teams to address specific needs or requirements. Select a spokes person to represent your group and brief the collective group. 12

Module 1 Out-briefs Middlebury College External Partners 13

Break • Let’s take 10 minutes • Please be ready to begin again at _______ 14

Module 2: Extended Response – Day 3 and out 15

Module 2: Scenario Overview Wed 3 July, + 1 -2 days after initial presentation • The College and VDH have established an Immunity Verification Clinic and a post-exposure prophylaxis MMR vaccine station. • Identification of exposed sub-population(s) is ongoing. • Selective use of blood draws for titer checks (24 hr. turnaround) for exposed College staff with unverifiable immunity is taking place. • Planning for exclusion and quarantine options are being considered. • Local media is providing coverage of the story. • Worried well are contacting the College, VDH and Porter requesting information and expressing concern for themselves, family and community. 16

Module 2: Scenario Overview, (cont. ) Thursday, 4 July • After spending the past 4 days in the Isolation Residence, Mr. Murphy calls Parton on Thursday morning, and indicates he is feeling dizzy and experiencing diarrhea and experiencing difficulty breathing. • A Parton Health Center staff member responds and assesses Mr. Murphy, and confers with the College Physician. It is decided that Mr. Murphy needs to be transported to Porter Medical Center. Given Mr. Murphy’s conditions, Parton Center contacts MREMS and requests transport of Mr. Murphy. 17

Module 2: Key Issues An Immunity Verification Clinic was established. College community of 1000+ require processing. The results of the epidemiological investigation indicate that ~750 Language School students and college staff were designated as exposed: • 1 person is confirmed infected on campus • 260 individuals were unable to provide documented immunity, of those • 147 individuals received PEP MMR, • 106 Language School students, 6 Faculty and 1 Bilingual do not have viable evidence of immunity to measles, • 12 are within acceptable commuting distance and should be excluded • 94 should be quarantined • Media is actively reporting the situation. The story is capturing national attention 18

Module 2: Discussion Questions are provided in the Situation Manual. They are broken into two categories • Middlebury College • Health Care Services / Response Partners (Porter, VDH, MREMS) Please take the next 30 minutes to consider the scenario and questions posed. • Consider existing plans and procedures to determine your course of action. • Feel free to divide work effort into appropriate teams to address specific needs or requirements Select a spokes person to represent your group and brief the collective group 19

Module 3: Recovery 20

Module 3: Scenario Overview Wednesday, July 3 rd - 4: 15 pm • An initial joint press conference has been set for 3: 30 pm with officials/representatives. Media and press conference cycles have been established for the following days. A JIC has been established with support from VEM based at the xxxx. 21

Module 3: Key Issues • Residents in the community are expressing concern regarding the possible spread of the disease. • Concerned parents and citizens are calling the college, VDH and the Town looking for answers and assistance. At times, there are too many requests for the agencies to effectively manage. • The Media continues to be a presence in the community and they are persistent in their efforts to get any and all information they feel is relevant. Their sources outside of the official channels include patients, staff, families, and local citizens. 22

Module 3 Out-briefs Middlebury College External Partners 23

End of Exercise 24

Exercise Hot Wash 25

Exercise Hot Wash aims to capture the following information based on observations made throughout the exercise: – Overall Strengths – Opportunities for Improvement – Major Takeaways and Action Items 26

Closing Remarks 27