Los Angeles County Department of Public Health

Emergent Disease Annex Briefing

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Emergent Disease AnnexAll-Hazards

Emergency Plan(Feb. 2013)

- Overarching Departmental emergency plan and response framework

- Not specific to any hazard

Emergency Operations Annex

(Feb. 2014)

- Preparation, response and recovery from emergent disease threat

- Courses of Action (COAs) and Options

- Activation and operation emergency management system (ICS)

- Not specific to any hazard Emergent Disease Response Playbooks

(Fall 2014)

- DOC and Field Specific- ICS section specific- Key objectives, policies, COAs and decision points

Emergent Disease Annex

(Sept. 2014)

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Situation and Scenario Emergent Disease• Could be caused by a number of organisms

• Unique disease transmission and severity profile• No vaccine or treatment• Sustained, human-to-human transmission

Scenario (p.3)• A novel, SARS-like coronavirus has emerged on the global stage. Early

epidemiology and clinical reports from the country/region of origin suggest high transmissibility (Ro~3.0), and there is limited information on disease severity (i.e. hospitalizations, mortality)

• The disease rapidly progresses from emergence in a foreign country to some other major metropolitan areas in the U.S. before reaching Los Angeles County. Local outbreaks first occur at a school and hospital. Additional clusters then quickly emerge within the County. Each cluster is characterized by high severity in certain populations.

• The outbreak rapidly evolves through widespread transmission of the disease throughout the County.

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Mission AreasDPH Mission (p.6) Save and sustain human life, minimize disease transmission, support public health and healthcare infrastructure and support community recovery.

Mission AreasOperational planning in nine (9) key focus areas of responsibilities

- Epidemiology and Surveillance - Non-Pharmaceutical Interventions- Public Health Lab - Healthcare Support- Public Information and Warning - Fatality Management- Emergency Management - Mass Care- Intel and Information Management

• Based on PHEP (CDC), HPP (ASPR) and FEMA Capabilities

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TimelineTimeline (p.12)• Key operational response actions

Phase 1a:Pre-Incident(Level Green)

Phase 1b:Minimal Cases

(Level Yellow/Orange)

Phase 2a:Initial Response

(Level Orange/Red)

Phase 2b:Continued Response

(Level Black)

Phase 3:Recovery

(Level Yellow/Orange)

No Cases <10 Cases <100 Cases >100 Cases <100 Cases

• Monitor Situation• Investigate Possible

Cases• Distribute CDC

Guidance

• Investigate Possible Cases

• Isolate Cases• Assess Severity• Distribute CDC

Guidance

• Isolate Cases • Quarantine Contacts• Community NPIs• Assess Severity &

Transmissibility • Distribute CDC Guidance

• Cohort Cases• Community NPIs • Distribute CDC

Guidance

• Demobilization• Support Community

Recovery

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Objectives and Key Actions Epi & Surveillance [Appendix B1]

– Develop critical information and inform DPH/DOC decision making– Cases; Efficacy of interventions/COAs; Forecast potential impacts

Public Health Lab [B2]

– Facilitate rapid detection and confirmation of cases

Emergency Public Info & Warning [B3]– Develop, coordinate and disseminate warnings and notifications– Many audiences: Healthcare, First responders, Media, Community– At-risk, vulnerable populations

Objectives and Key Actions Emergency Management [B4]

– Manage, sustain DPH response– Coordinate with local, state and federal response agencies

Intelligence and Information Management [B5]– Collect, analyze and depict incident information

Non-Pharmaceutical Interventions [B6]– Control spread, limit effect of disease– Centerpiece of Annex– Isolation, Quarantine, Community NPI– Efficacy v. Resources

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Objectives and Key Actions Healthcare Support [B7]

– Coordination; Communication; Facilitation– Guidance; PPE; Infection control practices

Mass Care [B8]– Support health, medical, mental health and social needs of impacted

individuals– Coordination of services with partner agencies

Fatality Management [B9]

– Support recovery, identification and handling of decedents– Surge in death certificates– Support in family assistance centers

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Mission Area ResponsibilitiesMission Area Public

HealthCEO/Emergency

ManagementSheriff’s

DepartmentFire

DepartmentHealth

ServicesMental Health

Social Services Coroner

Epi and Surveillance P S

Public Health Lab P S

Public Information and Warning S S P S R

Emergency Management S P S S

Intelligence and Information

ManagementP S S S R R R

Non-Pharmaceutical Interventions P S R S S

Healthcare S R S P R

Mass Care S R S S S P

Fatality ManagementS R S S R P

P = Principal AgencyS = Support Agency

R = Resource Agency

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Assess & Prioritize Hazards

Determine Goals &

Objectives

Develop the Annex

-Planning Directive-Form Core Planning Team-Define Scenario, Assumptions, Goals and Mission Area Objectives

-Form Dept. planning workgroups-Develop and analyze COAs and tasks-Write Annex-Vet with Executives for approval

Prepare, Review & Approve Annex

-Present plan to: -Key government agencies -Healthcare partners-Community stakeholders

-Approval by DPH Executives -Submit approved plan to ECO/OEM for County inclusion & adoption

Train, Exercise and

Maintain Annex

Engage the Community

-Develop and conduct trainings-Develop and conduct exercises-Review/revise approved plan (every 3 years)

 

Whole Community: FEMA Process in LACDPH