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Appendix 5 Outbreak/Epidemiologic Response Plan

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Alice Hughey Acting Agency Director Karen L. Smith, M.D., M.P.H. Public Health Officer 2344 Old Sonoma Road Building G Napa, California 94559 HHSA EMERGENCY OPERATIONS PUBLIC HEALTH PLAN (EOP) – APPENDIX 5 DIVISION OUTBREAK/EPIDEMIOLOGIC RESPONSE PLAN NAPA COUNTY HEALTH AND HUMAN SERVICES AGENCY (HHSA) ANNEX H - APPENDIX 5: OUTBREAK /EPIDEMIOLOGIC RESPONSE PLAN Revised October 2013 Intentionally Blank Page NAPA COUNTY HHSA PUBLIC HEALTH DIVISION page ii ANNEX H - APPENDIX 5: OUTBREAK /EPIDEMIOLOGIC RESPONSE PLAN Revised October 2013 RECORD OF CHANGES, UPDATES AND REVISIONS Plan Description of Change Date Signature Section and Page #. Updated to reflect the State of California’s June 2012 Dr. Jennifer Medical/Health Emergency Operations Manual Henn and related guidance for the MHOAC program and to reflect the recently developed Napa County Mass Casualty Incident Plan Overall The wording in various sections of the September 2013 Dr. Jennifer document was simplified to provide concise Henn instructions or clear descriptions. 2.1, 2.2, 2.4, Updated the “Outbreak Investigation” section to September 2013 Dr. Jennifer 2.6 better reflect the steps undertaken during the Henn investigation process. 3 Deleted the “Outbreak Investigation Kit” September 2013 Dr. Jennifer Henn 3.5.2 Deleted Table 2 – Community Containment September 2013 Dr. Jennifer Issues Henn 3.6 Deleted section, “Community Mitigation Dr. Jennifer Strategies (Community Containment CDPH Henn Alert System)” 3.8.8 Deleted entire section, “Staffing for Monitoring September 2013 Dr. Jennifer Teams” Henn 3.8.18, Deleted Sections: September 2013 Dr. Jennifer 3.8.20, Henn “EOC Public Information Officer”, 3.8.21, 3.9 “Daily Briefings For Law Enforcement”, “HHSA DOC Operations” and “Risk Communications and Public Education.” 4.4.5 Inserted verbiage on Data Security” September 2013 Dr. Jennifer Henn 4.4.7 Added an entire section on “Surveillance” September 2013 Dr. Jennifer Henn Overall Applied the following standard language October 2013 Dr. Karen NAPA COUNTY HHSA PUBLIC HEALTH DIVISION page iii ANNEX H - APPENDIX 5: OUTBREAK /EPIDEMIOLOGIC RESPONSE PLAN Revised October 2013 throughout the document: Smith “Health Officer” (not Public Health Officer) “Public Health Division (PHD)” instead of “Napa County Public Health” Used the term “case” or “cases” instead of “patient” or “patients”, where appropriate 2.4 Added the Health Officer roles and October 2013 Dr. Karen responsibilities Smith 2.6.3 Updated the Confidentiality for clarity October 2013 Dr. Karen Smith Cover Page Updated Alice Hughey’s name as the Acting October 2013 Dr. Karen Agency Director Smith 3.7.3 Inserted language describing information December 2013 Dr. Jennifer sharing of epidemiologic surveillance Henn information with MHOAC program 4.4.4 Inserted language describing descriptive December 2013 Dr. Jennifer statistics to be shared with MHOAC program Henn during outbreak investigation NAPA COUNTY HHSA PUBLIC HEALTH DIVISION page iv ANNEX H - APPENDIX 5: OUTBREAK /EPIDEMIOLOGIC RESPONSE PLAN Revised October 2013 CONTENTS 1. OUTBREAK RESPONSE PLAN INTRODUCTION................................................ 1 1.1 Purpose ..................................................................................................... 1 1.2 Scope ........................................................................................................ 2 1.3 Related Plans ............................................................................................ 3 1.4 Legal and Procedural Framework .............................................................. 4 2. OUTBREAK INVESTIGATION .............................................................................. 5 2.1 Outbreak Investigation Purpose ................................................................. 5 2.2 Outbreak Investigation Objectives .............................................................. 5 2.3 24/7 Communicable Disease Reporting ..................................................... 6 2.4 Outbreak Investigation Roles and Responsibilities ..................................... 6 2.5 Outbreak Action Planning .......................................................................... 8 2.6 Action Planning Team Triggers ................................................................ 11 2.6.1 Infection Control and Case Management Actions ........................... 11 2.6.2 Epidemiology and surveillance surge capacity ............................... 12 2.6.3 Confidentiality................................................................................. 12 3. OUTBREAK RESPONSE WITHIN ICS STRUCTURE ......................................... 14 3.1 Introduction .............................................................................................. 14 3.2 Operations Centers .................................................................................. 15 3.3 HHSA Department Operations Center (DOC) .......................................... 16 3.4 Response Activations .............................................................................. 18 3.5 Mass Prophylaxis ..................................................................................... 19 3.6 Risk Communication ................................................................................ 19 3.7 Non-Pharmaceutical Interventions (NPI) .................................................. 19 3.7.1 Procedure For non-pharmaceutical interventions ........................... 21 3.7.2 Isolation and Quarantine – Introduction and Legal Definitions ........ 22 3.7.3 HHSA DOC Operations Branch Actions Related to Isolation and Quarantine ............................................................................ 23 3.7.4 Locations for Isolation .................................................................... 24 3.7.5 Locations for Quarantine ................................................................ 25 3.7.6 Isolation and Quarantine Monitoring ............................................... 27 3.7.7 Monitoring Teams .......................................................................... 28 3.7.8 Monitoring Documentation.............................................................. 29 3.7.9 Actions in the Case of Non-Compliance ......................................... 30 3.7.10 Hospital and Congregate Care Response ...................................... 30 3.7.11 Hospital Resource Requests .......................................................... 31 3.7.12 Napa County Medical Surge Capacity for Isolation and Quarantine 32 3.7.13 Alternate Care Sites and Field Treatment Sites .............................. 32 3.7.14 Support Services ............................................................................ 33 3.7.15 Mental Health Support .................................................................... 34 3.7.16 Environmental Health Support ........................................................ 34 3.7.17 Triage and Transport in Isolation/Quarantine ................................. 35 3.7.18 EOC Legal Officer – County Counsel ............................................. 35 3.7.19 EOC Operations Section – Law (Enforcement) Branch .................. 36 3.7.20 Amended Laws Relating to First Responders and Isolation Orders 36 3.7.21 Mass Fatalities ............................................................................... 37 NAPA COUNTY HHSA PUBLIC HEALTH DIVISION page v ANNEX H - APPENDIX 5: OUTBREAK /EPIDEMIOLOGIC RESPONSE PLAN Revised October 2013 4. EPIDEMIOLOGY AND SURVEILLANCE RESPONSE PLAN .............................. 38 4.1 Introduction ...........................................................................................................38 4.2 Concept of Operations ........................................................................................38 4.3 Plan Activation .....................................................................................................39 4.4 Epidemiological Response.................................................................................39 4.4.1 Consultation And Confirmation ....................................................... 40 4.4.2 Notification ..................................................................................... 41 4.4.3 Coordination ................................................................................... 41 4.4.4 Communications ............................................................................ 42 4.4.5 Investigation ................................................................................... 43 4.4.6 Contact Tracing .............................................................................. 45 4.4.7 Surveillance ................................................................................... 46 4.4.8 Recovery and Evaluation ............................................................... 47 4.4.1 Consultation and Confirmation .......................................................... 40 4.4.2 Notification .......................................................................................................41 4.4.3 Coordination ..................................................................................... 41 4.4.4 Communication ................................................................................. 51 4.4.5 Investigation ..................................................................................... 52 4.4.6 Contact Tracing ................................................................................ 55 4.4.7 Recovery
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