ࡱ> ` ?bjbjss .d7%BBBBBBBV>>>8vDLVn2("JJJ"""2n4n4n4n4n4n4n$ohMrXnB6!"66XnBBJJymn8886dBJBJ2n862n88hlBB&mJ }>g6Jj*2nn0ntjs7sT&msB&m "[)8.1"""XnXn7d"""n6666VVVDVVVVVVBBBBBB Mora Pandemic Influenza Medical Surge Capacity Plan 9-06 Final Draft Purpose: The purpose of the Pandemic Influenza-Medical Surge Capacity Plan is to promote an effective Mora County response to a pandemic influenza or medical surge capacity event should it arise in New Mexico. Legal Authorities: On April 6, 2003, the New Mexico Public Health Emergency Response Act (PHERA) ( HYPERLINK "http://www2acdc.gov/phip/docs/nmhb0231.pdf" http://www2acdc.gov/phip/docs/nmhb0231.pdf) was signed into law. [Citation: 12-10A-1 to 12-10A 19 NMSA 1978] This law provides the State of New Mexico with the ability to manage public health emergencies; prepare for a public health emergency; and access to appropriate care, if needed, for an indefinite number of infected, exposed or endangered people in the event of a large scale public health and medical emergency. The PHERA authorizes the NMDOH Secretary in coordination with the New Mexico Secretary of Public Safety and the Director of the Office of Homeland Security (OHS) to utilize health care facilities for public use and to inspect, regulate or ration medical resources, and sets forth procedures for isolation or quarantine. Beginning with the incident identification, all response is local. Prevention, protection, response and recovery planning must be coordinated at the State and County level according to the New Mexico All Hazards Operations Plan and in the Department of Healths Emergency Operations Plan. Planning must also be coordinated with Local County and Tribal Emergency Operations Plans. The Incident Command System (ICS) is the management system that will be used in the event of a pandemic or medical surge in order to coordinate emergency response. [Occurs in conjunction with the National Response Plan (NRP). The system is expanded to include the National Incident Management System (NIMS)]. Although a single Incident Commander handles the command function for some emergencies, an Incident Command System (ICS) organization may be expanded to include a Unified Command (UC). Unified Command is a structure that brings together the Incident Commanders of all major organizations with particular response functions in order to coordinate an effective response, while at the same time maintain their distinct organizational responsibilities. The UC links the organizations responding to the incident and provides a forum for these entities to make consensus decisions. Under the UC, the various jurisdictions and/or agencies and non-governmental responders may blend together throughout the operation to create an integrated response team. It is highly likely that the response to a pandemic-medical surge will require a Unified Command Structure. Situations and Assumptions: For Pandemic Influenza: A new strain of influenza will evolve and the usual influenza vaccines will not be effective for the virus. There is a potential of 20,000 to 25,000 deaths in New Mexico, overwhelming mortuary resources. There is a potential for a clinical disease attack rate of 30% in the overall population (30% of 5,180 = 1,554 ill Mora County residents). (Year 2000 census data) The initial Pandemic Influenza event will likely last 8 to 17 weeks and will likely be followed by a series of waves each lasting weeks to months. This could continue up to two years. Medical and public health surge may quickly overwhelm the systems resources resulting in scarcity of medicine, equipment, personnel, and other healthcare resources. For Medical Surge: Mora County experiences an event that causes the medical infrastructure to become completely exhausted. Identification of the affected residents, their triage and referral must occur to assure that the county residents are taken care of medically. Concepts of Operations: Summary of WHO Global Pandemic Phases Interpandemic 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 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. NM Specific: Activation of the New Mexico State Unified Command (UC) NMDPS, NMDOH, NM Emergency Managers Association (NMEMA). Phase 4. Small cluster(s) with limited human-to-human spread transmission but spread is highly localized, suggesting that the virus is not 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 human but may not yet be fully transmissible (substantial pandemic risk). Pandemic Period Phase 6. An increased and sustained transmission in the general population. Postpandemic Period Return to the Interpandemic period (Phase 1) The governments of Mora County and the Village of Wagon Mound will respond and comply to the State Unified Command (NMDPS, NMDOH, and NMEMA) when they adjust the alert level upon notification of change of the pandemic phase by CDC and WHO. Specific Response Areas: Community Preparedness Leadership and Networking NMDOH and Local PHO  County Manager-Village Manager  County Emergency Manager  Public Safety Medical Volunteers Fire and Police MVCHS Faith Community EMS Agnes Martinez Clinic Volunteers Red Cross El Centro (Wagon Mound) Schools Utilities Home Health Agencies Counselors (phone,electric,gas) Media Communication Postmaster NMDOH and the Local PHO will provide accurate information to the involved communities and follow the established plan. The County Manager and Village Manager will act as the fiscal agents. The County Emergency Manager will coordinate and implement the plan. Public Safety Public Safety will provide traffic control, quarantine support, crowd control, security, and usual customary duties. EMS will provide all available staff and will follow recommended practice for quarantine. Red Cross will provide coordination of food and shelter for healthy residents. Utilities will provide phone service; electricity and gas, assuring systems remain functional. Assure that there is enough staffing. Media Communication will be used to disseminate current information and call in HAM radio communication if necessary. Medical MVCHS will treat and triage. PHO will provide current information and triage El Centro Family Health will treat and triage. Agnes Martinez Clinic will treat and triage. Home Health will treat and shelter in place. Volunteer Faith Community will disseminate information and provide pastoral guidance. Volunteers report to logistics in NIMS structure for assignments. School will be used to disseminate information and their facilities will be used for shelters or PODS. Postmaster and post offices will be used to disseminate information. Counselors will be used to provide psychosocial support to residents of the county as well as the medical teams working. They will also be used as a referral service. Mora County has a Pandemic Influenza Medical Surge Capacity Operational Plan that included Memorandum of Agreements (MOA) within and outside the County to carry out the Plan. (See appendix #1 for MOA list) Mora County will comply with the New Mexico House Bill 219 IMAS Intrastate Mutual Aid System that will generate MOAs between counties that request assistance through the Emergency Operations Center for adjacent counties in a time of emergency. Surveillance The surrounding counties that have hospitals and biological laboratories, Santa Fes St. Vincent Hospital, Ratons Miner Colfax Hospital, Taoss Holy Cross Hospital and Las Vegass Alta Vista Hospital will perform influenza surveillance on residents of Mora County as a part of the agreed upon surveillance process and the Notifiable Disease Reporting System. Hospitals detecting positive influenza cultures will report these to the Mora County Public Health Office. The Mora County Public Health Office will be a part of the process to perform concurrent surveillance on the newly diagnosed cases of influenza, newly hospitalized cases, newly quarantined cases, and number of deaths within the county. Laboratories Mora Public Health Office will be the extension of the New Mexico Department of Health and New Mexico Scientific Laboratory for rapid testing, information systems and tests orders for viral testing for influenza. Mora County local providers are aware of protocols for safe specimen collection and testing per OSHAs Bloodborne Pathogen Precautions and Standard Precautions. D. Health Care, Medical and Mortuary Surge Mora County will follow the specific recommendations of the Office of the Medical Investigator (OMI) pertaining to a large surge of deaths related to influenza or any event. Mora will create MOAs with the Mortuaries in Taos, Las Vegas, Raton and Santa Fe to process the deceased appropriately. Mora County will follow the recommendations provided by the CDC and the NMDOH for quarantine, use of PPE, and prevention and treatment of a pandemic influenza strain. The Nodes Pandemic Influenza Policy will be the main document to refer to. The medical team of the Mora Valley response will consult the OHEM Targeted Out- Reach Plan in Phase 2. This will help identify the special needs and vulnerable population for the county and how they will be accessed. Mora County will hook into the OHEM database to credential volunteer health care professionals. Mora can also use recommendations from the medical reserve corp. and the citizens corp. identified in Mora County. They will also access the Northern New Mexico VOAD (Volunteers Organizations Active in Disasters) for resources for volunteers. E. Infection Control and Clinical Guidelines Mora County will adhere to CDCs, OSHAs, and NMDOHs guidelines for infection control to prevent the transmission of influenza. The Association for Professionals in Infection Control and Epidemiology (APIC) recommend that precautions needed for influenza include droplet precautions to be used for the duration of the illness while draining. The definition of droplet precautions includes: Practices that reduce the risk of droplet transmission of infectious agents. Droplet transmission involves contact of the conjunctivae or the mucous membranes of the nose and mouth of a susceptible person with large-particle droplets (larger than 5 microns in size) containing microorganisms generated from persons who have clinical disease. Droplets are generated from the source person by sneezing, coughing, or by fomites (like tissues) that are used on this area of the face. Transmission requires close contact between source and recipient persons, usually 3 feet or less. Because droplets do not remain suspended in the air, special air handling equipment is not needed. F. Vaccine and Antiviral Drug Distribution and Use Mora County will rely on the Mora Public Health Office, the Mora Valley Community Health Service, and the Agnes Martinez Family Health Center to receive, store and maintain all influenza vaccine and antiviral medications per each institutions pharmacy policy. The distribution and administration of these medications during the pandemic phase will be dependent on the State of New Mexicos Public Health Order that will be issued per statement of the NMDOH policy. G. Community Disease Control and Prevention The Mora County Medical Community will enlist the faith based and school communities in the Inter-pandemic Phase to educate residents on the Pandemic Influenza/Medical Surge Plan and its components for Mora County. During the Pandemic Phase, the Mora County Medical Community will enlist the local media (radio, newspaper and television), the volunteer fire departments, grocery stores, post offices and other businesses to educate residents. Group gatherings will be allowed until they are deemed unsafe by the NMDOH. Mora County will comply with the NMDOH plan. H. Health Communications and Information Mora County Medical Community has to identify a communications system that will be effective in the rural part of the County. In the Mora All-hazard Emergency Operations Plan, there is an identified communication process between law enforcement, fire, emergency medical response, New Mexico Forestry and Mora County Roads Department. Where exactly the Mora County Medical community will fit into this process is unknown. Cell phones are available and functioning, but should the electricity go out, medical communication may be completely out. I. Psychosocial Support Services Mora County does not have a cohesive psycho-social plan, but will utilize the plans in place in organizations that exist in the County. They include: Mental Health counseling at MVCHS Mental Health counseling at AMFHC Mental Health and bereavement counseling within the faith-based communities. Mental Health counseling provided from Community Based Services out of New Mexico Behavioral Hospital Mental Health counseling from Helping Hands Mental Health referral and guidance counseling from the Mora School System Mental Health and social counseling from the Mora Valley School Based Health Center Contact List of Organizations and Resources The telephone and resource list is part of the Community Health Councils Targeted Outreach Plan Phase 2. It will be maintained and kept current by the Mora Valley Community Health Council and added to this annex. Gaps Ham Radio Operators Cots Portable toilets Water Supplies Portable water containers, water buffalos Storage of PPE and equipment Medical supplies Community shelter operations guidelines Generators and fuel Animal health develop a services plan Have access to rapid flu testing kits Education of PPE use Counselors and lack of external psychosocial resources Long Term Goals Teach first aide and CPR at the high school Educate Mora valley residents about the plan Drill on the plan     PAGE  PAGE 4 7:FGHPQ  , . / } ~   | #$ǿǻdzLJLJǃ{sokheZ?hLhWhZL5hWhL5hWhhIJh|n0JjhIJh|n>*U h|n>*jh|n>*Uh|nh|n>*h 7h|nh|n5h|n hr5hrhr5hrhx05>*CJ$aJ$hF)5>*CJ$aJ$hrhr5>*CJ$aJ$*GHQ  . / #$^a & FgdLh^hgdW & Fgd 7gdr$a$gdr??HI`a:;RW~   "#xyQRTcd 0ȼȸĸȸ԰ԟԓ}hj.hj.5hqt hq5 hqt5hqthqt5hJCh@1hF)hK5 hF)5hqhq5hKhqhk 5hF)hk hqhy5hqhF)hy5hyheZ?hd`hWhd`hW5hZLhL1;  "#YySTdgdK^gdK^gdk `gdk ^gdF)`gdqgdy & Fgdd`h^hgdW12FHgi/0]st@ ^@ gdJC & FgdMgdgdK012FGgh&.0=Q\qstű|xtpph{bhjh!hd`hj.hX6 hJChj.heZ?hKhX6hK5hX6hX65heZ?hX65>*&jheZ?hX65>*UmHnHu&jheZ?heZ?5>*UmHnHuhj.hJC5jhJC5UmHnHu hJC5 h5 hj.5,W y P!!!!"J"w""""<###$ & F gdF) & F gdF) & FgdF)h^hgdF) & FgdF)gdK7GVWtxy    " 1 4 M { !!%!M!O!!!!!!!!"$"C"H"I"J"p"u"v"w""""""#####$% %@%C%hhG hMhch!hyn5h!hynhF]h!h{b5h!h!5hKrhhF)heZ?hjh{bG$$Y&Z&g&;(<(()))6)7)***,,,,--0/1/^/8^8gd*m`gd*mgd*mgd1p & Fgd1pgdG  & FgdG gdKgdF)C%Z%c%%%%%%%%%&*&Y&Z&f&g&&&&&&&&&&''d''':(;(f(i((&)))5)6)7)) ******,,,־ֺh(gh5Qw hp5hphp5hph1p h1ph1p h1p5 h5h1ph1p5hM+hh y hG hG hG 5hG hG 5hG hei hfshMhfshfs6 hfshfshfshMhqn82,,,-e.u.z....0/4/]/^/p/v//000011112Q2]23333333555555778ƾʣ{sksh1Rh*5h1RhSg5h1Rh1R5hSghUlZhhSg5hh5h*mh*m5 h*mhO-ha ha ha 6ha hO-6ha hIS6hIShO- hSg5h*mhSg5 h*m5h*mhO->*h*mh*m>*h*mh5Qwh(gh1R*^/_/03333555667788+8N:O:p:;*;L; & F gdbgdSg`gdgd1R`gd1R8^8gdSggdUlZ`gdgd*m8888 88*8+878I8{888M:N:O:R:p:{:;;;*<-<<<<<========C?E?U??????ļббؔzrjhGU hphSg heih5Qwh5Qwh5Qw5h5QwheiheihSg5 hU$Z5 h5 hbhF)hF) hbhbhhSg5hh5hSghbh hSg5h1Rh*5h1RhSg5h1Rh1R5h1R h1Rh1R+L;;;-<x<<<<==========>A>^>o>>>>> ? & FgdF)h^hgdgdSg & F gdb ?C?D?E?U??????????????????h^hgdSggdSg8^8gdSg 8^8gd & FgdU$Z & Fgd5Qwgd5QwgdF) & FgdF)???????????????????????? hphSghfs0JmHnHuh(hU$Z hU$Z0JjhU$Z0JUjhGUhG?????????????h^hgdSg &`#$gd( ,1h/ =!"#$% !DyK +http://www2acdc.gov/phip/docs/nmhb0231.pdfyK Vhttp://www2acdc.gov/phip/docs/nmhb0231.pdf@@@ NormalCJ_HaJmH sH tH DA@D Default Paragraph FontRiR  Table Normal4 l4a (k(No List6U@6 |n Hyperlink >*B*ph4 @4 U$ZFooter  !.)@. 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