CDE Planning Template- working copy€¦ · Web viewOutbreaks, such as pertussis, influenza or...

V e r s i o n 2 - S e p t e m b e r 2 0 2 0 P a g e | 1

Date last updated: _______________________

Disclaimer: The information contained in this document is confidential, privileged and only for the information of the Community stated in this document and FNHA team members who support the Community’s development of this plan. For further information please contact [email protected].

Updated: INSERT DATE INSERT COMMUNITY NAME

Response Plan

EMERGENCYCOMMUNICABLE DISEASE

Insert Community Name

mailto:[email protected]


Record of Amendments

Date Subject Page Amended By Plan Created All

"CDER planning starts with writing down what you are currently doing and filling in any gaps." -CDE team



ContentsRecord of Amendments............................................................................................................................................2

Checklist.....................................................................................................................................................................5

1. INTRODUCTION..............................................................................................................................................7

2. PURPOSE.........................................................................................................................................................7

3. BACKGROUND................................................................................................................................................7

4. OBJECTIVES AND CONSIDERATIONS OF THIS PLAN..........................................................................8

4.1 The objectives of Communicable Disease Emergency Response (CDER) planning..........................8

4.2 The considerations of CDER planning................................................................................................8

Before a Communicable Disease Emergency...............……………………………………………………………….……………...8

5. COMMUNITY RESPONSIBILITES ..............................................................................................................8

6. EMERGENCY OPERATIONS CENTRE WITH INCIDENT COMMAND SYSTEM ….……......................9

6.1 Sample CDE EOC Structure ...............................................................................................................9

6.2 Roles.................................................................................................................................................... 9

7. PLANNING INFORMATION REGARDING CDE COMMUNICATIONS.................................................10

8. MEAUSRES TO REDUCE THE SPREAD OF COMMUNICABLE DISEASE.......................................11

9. COMMUNITY-BASED DISEASE CONTROL STRATEGIES..................................................................11

9.1 General IPC Measures During a CDE …………………………………………………………………… 1110. SURVEILLANCE...........................................................................................................................................12

11. INFECTION PREVENTION AND CONTROL MEASURES.....................................................................12

12. VACCINES OR MEDICATIONS TO REDUCE THE SPREAD OF DISEASE........................................13

During a Communicable Disease Emergency................................................................................................13

13. COMMUNITY RESPONSIBILITIES............................................................................................................14

14. PLAN FOR MASS TRIAGE/TREATMENT CENTER’S............................................................................14

15. HEALTH SERVICES DELIVERY................................................................................................................15

15.1 Implement Infection Prevention and Control Measures..........................................................................14

16. ISOLATION....................................................................................................................................................15

17. ESTABLISHING ALTERNATE SITES FOR PROVIDING MEDICAL CARE.........................................15

18. ARRANGE FOR TRANSPORTATION OF POSITIVE CASES...............................................................16

19. DISCUSS FUNERAL ARRANGEMENT ISSUES.....................................................................................16

20. SURVEILLANCE...........................................................................................................................................17

21. COMMUNICATION.......................................................................................................................................17

21.1 Have a Clearly Identified Communication/Information and Community Liaison..................................17

After a Communicable Disease Emergency...................................................................................................18

22. COMMUNITY RESPONSIBILITIES............................................................................................................18

Appendix 1: Contact Information of Emergency Operation Centre..................................................................20



Appendix 2: RHA MHO/CD Team Contact List for Surveillance Reporting...................................................25

Appendix 3: CDE Public Messaging.....................................................................................................................26

Appendix 4: Public Hand Hygiene/Cough Etiquette Messaging......................................................................27

Appendix 5: Infection Prevention and Control Measures...................................................................................28

Appendix 6: Sample Point of Care Risk Assessment (PCRA)..........................................................................29

Appendix 7: Priority Community Members List..................................................................................................31

Appendix 8: Community Member Resource Inventory Template.....................................................................33

Appendix 9: CDER Plan Written Answers...........................................................................................................34



ChecklistNote: Please use checklist to identify areas of the template needing further planning information. Items on the checklist are ordered as they appear on the template. Space is provided in Appendix 9 for written answers to questions below (for a quick reference).

Section Question/Comment

Title Page Fill in date last updatedTitle Page Fill in Community nameTitle Page Fill in date updated and Community name in footer2. Purpose Fill in Community name5. Community Responsibilities

Complete a Community member resource inventory. See Appendix 8

Review the Community’s all-hazard emergency preparedness and response plan (EPR) and business continuity plan (BCP), and be familiar with their content. Please complete location and name of leads.

6.1 EOC Complete EOC table and charts in Appendix 17. Planning Information Regarding CDE communications

How will CDE-related information be communicated to Community staff and members (See Appendix 3 - Communication plan template)?

How will CDE-related information be received and/or disseminated to external partners, including province, FNHA Regional offices, ISC, while respecting confidentiality and privacy laws?

Review public health messaging resources in Appendix 4

8. Measures to reduce spread

Check off most applicable RHA contacts for your Community in Appendix 2

9. Community-based disease control strategies

List prioritized Community programs/services, including health services during a CDE

12. Vaccinations or Medications to Reduce the Spread of Disease

Assess current vaccine and medication delivery processes, and determine if modifications need to be made to allow for quick delivery of these during a CDE event

Provide the name and address (include map as needed) of the alternate site/facility for a mass immunizationHow will mass immunization be executed?

13. Community Responsibilities

Which neighboring Communities will we open communication with?

14. Plan for Mass Triage/Treatment Center’s

Provide the name and address (include map as needed) of the alternate site/facility for a mass triage/treatment centreFill in Community nameWhere can the Community Priority List be accessed?

15.1 Implement IPC measures

Review Appendix 6 for PCRA, PPE and Environmental Cleaning Guidelines



16. Isolation Where can a Community find regular updates/existing information about CDE related Community-level, household, and self isolation practices?

17. Establishing Alternate Sites for Providing Medical Care

Provide the name and address (include map as needed) of the alternate site/facility for a providing medical care

18. Arrange for Transportation of Positive Cases

What form of transportation will be used to transport Community members that are sick (e.g. Ambulance, hospital transfer vehicle, health centers’ vehicle)?

19. Discuss Funeral Arrangement Issues

Provide the name and address (include map as needed) of the alternate site/facility for keeping deceased Community members prior to burial

20. Surveillance What is the plan for reminding Community members to self-identify illness to their health team?

21. Communication What is the common communication platform used in the Community?

Note: Add additional information and appendices to this document as your Community finds appropriate.



COMMUNICABLE DISEASE EMERGENCY RESPONSE

1. INTRODUCTION

Planning the response for a communicable disease emergency (CDE), such as a pandemic, holds many challenges. This document is a collaborative effort of many individuals in Community including the Emergency Management Department, Senior Administration, and other organizational partners. It is a useful tool to support the Community to develop, strengthen and update the Communicable Disease Emergency Response (CDER) plan.

It is important for CDER plans to be flexible in order to scale up or scale down the response activities, depending on the circumstances of the CDE event.

At the start of a CDE event, access the CDER plans and use them to guide response activities during the event. As more information becomes known, the plan(s) may need to be revised.

2. PURPOSE

Completing a CDE plan, distinct from the All Hazards Plan, will facilitate collaboration between the emergency response structures in a Community and the healthcare/public health sector. The unique addition of the Healthcare Representative to the Emergency Operations Centre (EOC) strengthens this collaboration and will support effective Community response. This document has been developed to provide guidance for Community Name to prepare for and respond to CDEs.

3. BACKGROUND

A CDE may present as an outbreak, epidemic or a pandemic.

• An outbreak is an unusual occurrence of an illness and is declared by the Medical Health Officer (MHO)

• An epidemic is an outbreak of an illness within a defined geographical location• A pandemic is an outbreak of the same illness in a number of countries at the same time, and can

only be declared by the World Health Organization (WHO).

There have been a number of documented pandemics, with the most recent being COVID-19, affecting British Columbia (BC) in 2020. Outbreaks, such as pertussis, influenza or measles, occur more frequently. At some point in the future BC will face another epidemic or pandemic, although it is difficult to predict exactly when this will happen. It is also difficult to predict if it will bell caused by influenza or some other pathogen, however, experts believe that the most pandemic prone organism is the influenza virus. In a CDE, the Provincial Health Officer or MHO will make a declaration of an outbreak or pandemic, in response Health Authorities and Local Governments will activate their CDER plans. Local Governments, jurisdictions or First Nations may declare a state of emergency at that time to facilitate response and movement of resources.

First Nations Health Authority’s (FNHA) role in a CDE is to provide support to Communities in all aspects, clinical and practical, of their response. The FNHA Communicable Disease Population and Public Health (CDPPH) team will be directly involved, providing a direct information link between federal, provincial and local partners, education and resources for health care staff and facilitation of resource flow/ relationships between Communities and partners. FNHAs Crisis Response team is involved in supporting Communities



in their disaster response activities including psycho-social and cultural supports as well as practical issues of transportation etc.

4. OBJECTIVES AND CONSIDERATIONS OF THIS PLAN

4.1 The objectives of Communicable Disease Emergency Response (CDER) planning• To create a document that is rooted in culture, taking into account Community strengths,

resilience and incorporating historical lessons in disaster response. • To minimize suffering, serious illness and overall deaths.• To facilitate communication between CDE response partners.• To increase Community readiness and Community member awareness. • To develop a plan that is a living document, changing to meet future needs.

4.2 The considerations for CDER planning

• To review the regional/Community governance structure. • To integrate the CDER plan with other local and regional plans (e.g. Community Emergency

Response Plan, Regional Health Authority (RHA) plan and plans from other local and regional jurisdictions), and ensure its preparedness and response activities are complementary.

• To review emergency plans from neighboring towns if available.• To review Appendix 8 for example of planning assumptions for a past pandemic.• To establish linkages with emergency preparedness and response partners such as FNHA,

Indigenous Services Canada (ISC) and provincial/regional/local Emergency Preparedness Plan (EPP) personnel.

"We already use unofficial plans, it's the official plans that are hard to make."

-Anonymous

5. COMMUNITY RESPONSIBILITES

• Complete a Community member resource inventory as a first step for CDER planning. See Appendix 8 for sample template.

• Review the Community’s all-hazard emergency preparedness and response (EPR) plan and business continuity plan (BCP), and be familiar with its content.

• Community leadership and health team members will be responsible for supporting the preparation of a CDER plan which is a part of the Health and Wellness Plan, and can be added as an appendix to their emergency preparedness plan. They should also coordinate with their RHA to ensure it is integrated with the RHA’s pandemic/CDER plan (contact the Infection Prevention and Control Program [IPC] of your local RHA).


Before a Communicable Disease Emergency


• Community leadership is responsible to support the work required to review, revise and exercise (tabletop exercises) this CDER plan annually, or as needed.

• Community health team members are responsible to ensure that Community Leaders, senior administration and Community members are kept apprised of any updates or information as it relates to health emergencies, such as localized outbreaks, epidemics or pandemics.

6. EMERGENCY OPERATIONS CENTRE (EOC) WITH INCIDENT COMMAND SYSTEM (ICS)

A standardized emergency management concept specifically designed to allow its user(s) to adopt an integrated organizational structure equal to the complexity and demands of single or multiple incidents, without being hindered by jurisdictional boundaries.

Unique aspects of the CDE EOC are the inclusion of a Health Representative with direct communication to the Incident commander. In the case of CDEs, decisional input from health representation is vital as CDEs are unique and have significant differences from environmental hazards.

The EOC specifies clear roles and responsibilities for both the planning and response phases for all partners.

6.1 Sample CDE EOC Structure

6.2 Roles

Incident Commander (or EOC Director) • This individual is responsible for the management and coordination of all operations at the

Incident Command Post during an emergency/disaster• Setting Response Objectives and Undertaking Coordination• Communications with Staff • Monitor the situation• Responsible for overall emergency policy and coordination through the joint efforts of government

agencies and private organizations• Sets objectives and priorities



• Has overall responsibility

Health Representative• Provides direct input to Incident Commander on unique aspects of Communicable Disease

Emergencies, which differ from environmental hazard plan• Has knowledge of Public Health system, existing relationships, and resource access points

Operations- “the doers”• “The Doers” Responsible for coordinating all jurisdictional operations in support of the emergency

response through implementation of the jurisdiction’s action plan • Likely role for Health Director• Directs resources • Carries out the response activities described in the plan • Directs operations and ensures safety of staff

Planning- “the thinkers”• “The Thinkers” Responsible for collecting, evaluating, and disseminating information; developing

the jurisdiction’s action Plan in coordination with other functions; maintaining documentation• Assess Impacts• Create priority based plans ensuring BCEMS Response Goals are addressed• Prepare to support long-term recovery• Collects and evaluates information • Develops incident action plans • Maintains resource status (personnel, equipment) • Maintains incident documentation

Logistics- “the getters”• Provides support to meet the incident needs • Provides resources • Provides other services to support the incident

Finance/Administration- “the payers”• “The Payers” Responsible for financial activities and other administrative aspects• Track and keep accurate records of expenditures• Submit records for reimbursement• Monitors costs related to the incident • Provides accounting, procurement, time recording and cost analysis

(See Appendix 1- Fillable EOC structure and contacts)

7. PLANNING INFORMATION REGARDING CDE COMMUNICATIONS

The goal of CDE communications is to build trust through the delivery of timely, clear, transparent and consistent messaging to the Community during a CDE event. To ensure plan effectiveness, it should specify communication processes with Community members, health care partners and other stakeholders (e.g. – neighboring Communities, other organizations) as well as align with the provincial communication plan.



• Develop a plan to determine how CDE-related information will be communicated to Community staff and members. See Appendix 3 - communication plan template.

• Develop a plan to determine how CDE-related information will be received and/or disseminated to external partners, including province, FNHA Regional offices, ISC, while respecting confidentiality and privacy laws.

• See Appendix 4 for sample messaging for Communities on how to reduce spread of respiratory and other pathogens. Regional Health Authorities or FNHA may provide direction or sample messaging for Communities.

8. MEASURES TO REDUCE THE SPREAD OF COMMUNICABLE DISEASE

One of the strongest factors to successfully address a CDE is the existence of responsive, trusted, well-developed Community health programs with policies and procedures which can be built on in a CDE. These include:

• Providing care to Community members with chronic health concerns to strengthen their resilience.• Existing trusted Public Health immunization programs, including annual influenza and

pneumococcal programming.• Maintaining Community Health Nurse (CHN) knowledge and skills in IPC Best Practices,

Communicable Disease (CD) Surveillance, follow-up and response.• Strong public health messaging regarding IPC measures, such as:

- Handwashing, hand sanitizer- Covering cough- Voluntarily staying home when sick - Cleaning hard surfaces with Public Health approved disinfectants in public spaces (i.e.

bleach)

• Developing a relationship with RHA CD teams, MHOs, and other health teams to facilitate information flow and mutual understanding in CDE events (See Appendix 2 RHA MHO/CD Team Contact List).

• Developing and using Community and Health Care Centre IPC policies and procedures to reduce the risk of spread of pathogens.

Note: Health Directors/Employers are responsible for ensuring provincial IPC best practices are followed. For information regarding environmental cleaning, please refer to the Housekeeping Manual for First Nations Community Health Facilities in Appendix 5. CHNs and OH&S can be utilized as additional resources.

9. COMMUNITY-BASED DISEASE CONTROL STRATEGIES

Public health Infection Prevention and Control (IPC) measures are measures that seek to reduce the spread of disease. These measures may also include the availability and use of an effective vaccine or other treatments, if available, however, the following are recommendations for Community-based strategies which can be part of slowing disease spread.

9.2 General IPC Measures During a CDE

• Voluntary self-isolation is strongly recommended when sick.Advise Community members to stay home when sick.



• EOC team to review the need to cancel public gatherings (schools, potlatch, feasts, sport events), due to illness, or staffing levels.

• Risk of spread of disease at Community events is higher when events are crowded, held indoors and without access to sufficient hand hygiene (washing and alcohol-based sanitizer stations).

• Risk should be balanced against need for Community and cultural connection to strengthen resilience. The FNHA CDPPH team, FNHA OCMO and Regional MHO are resources available for Communities looking for support in finding a reasonable balance.

• Alcohol-based hand sanitizing stations are recommended in public buildings (Band Office, Community recreation center, Nursing Station, day care and school).

• Prioritize Community programs/services, including health services depending on the CDE. • During a CDE the Regional MHO has the authority to require and compel cases and contacts to

self-isolate or accept treatment. There may be potential in some remote areas to delay the pandemic strain until after the antivirals or vaccines become available by introducing:

- Strict Public Health measures.- Monitoring and if necessary restricting access to Communities during a pandemic.

*Please see Appendix 3 and Appendix 4 for public health messaging resources

10. SURVEILLANCE

Through disease surveillance the spread of disease is monitored in order to establish patterns of progression. The main role of disease surveillance is to predict, observe, and minimize the harm caused by an outbreak, epidemic, and pandemic. Surveillance is also an important tool for supporting informed and strategic decision making with regard to the delivery and transformation of health and wellness programs and services for First Nations Communities in British Columbia (BC) before, during and after a CDE.

First Nations Communities and individuals living in BC receive public health and primary care through programs and services from both the FNHA and the Provincial health care system. Data are captured and created through both systems to make sure the information is collected, analyzed and used to monitor and report on the health and wellness of BC First Nations. FNHA CD management collaborates with RHA CD teams and other FNHA departments to support CHNs to ensure timely and equitable CD management in BC First Nations Communities.

11. INFECTION PREVENTION AND CONTROL MEASURES

Implementation of infection prevention and control (IPC) measures help create a safe environment for health care providers and Community members. The goal of IPC is to prevent and/or reduce the risk of transmitting infection. IPC protects staff and Community members from preventable infections and promotes wellness through implementing best practices into daily routine.

A hierarchy of infection prevention and control measures for CD describes the measures that can be taken to reduce transmission. Control measures at the top of the diagram seen below are more effective and protective than those at the bottom. By implementing a combination of measures at each level, risk of transmission is substantially reduced


https://en.wikipedia.org/wiki/Pandemic

https://en.wikipedia.org/wiki/Epidemic

https://en.wikipedia.org/wiki/Outbreak

https://en.wikipedia.org/wiki/Disease


IPC is an integral component of a workplace’s Occupational Health and Safety (OHS) program and effective strategies need to be in place for the safety and protection of staff and Community members accessing healthcare. Implementation and maintenance of a best practice IPC program and a Respiratory Protection program (RPP) are the responsibility of the Health Centre/Nursing Station. PPE and annual N95 mask fit testing are an occupational health employer requirement for healthcare staff. For further information and support contact [email protected]

Maintaining an adequate supply of PPE for Health Centres/Nursing Stations in Community is a part of their regular operations. Please refer to your regular process of ordering PPE supplies. In the event of a pandemic declaration, supplies will be made available by provincial and federal partners, coordinated by FNHA CDPPH. A tool called the Burn Rate Calculator is available on the FNHA website. It is a spreadsheet-based model that will help healthcare facilities plan and optimize the use of PPE for response to a CDE.

The selection and use of PPE will be dependent on point of care risk assessments (PCRA- see Appendix 6). Knowing correct handling procedures of PPE before and after use is also important. If there is an airborne spread illness, PPE requirements will differ from other modes of transmission, such as droplet and contact. Routinely check supplies for expiration dates and store PPE in a clean and dry environment for access by healthcare staff. Refer to the recommendations from BC Centre for Disease Control (BCCDC) and FNHA for up to date information on precautions and PPE necessary with each CDE.

Note: For Burn Rate Calculator and instructions please refer to https://www.fnha.ca/what-we-do/communicable-disease-control/coronavirus/health-professionals

12. VACCINES OR MEDICATIONS TO REDUCE THE SPREAD OF DISEASE

In response to a CDE there may be vaccines, antivirals or other treatments that become available to protect individuals and reduce disease spread. During a CDE the current practices of vaccine and medication procurement and administration can be utilized.

• Assess current vaccine and medication delivery processes, and determine if modifications need to be made to allow for quick delivery of these during a CDE event (e.g. mass immunization plan, identification of high risk individuals and provision of home or Community treatment, linking with neighboring Communities for support, who to contact for supplies/stock etc.).

• Health teams must maintain their immunization competency.


https://www.fnha.ca/what-we-do/communicable-disease-control/coronavirus/health-professionals



• Considerations for immunization:

- Weather- Location- Measures to reduce transmission risk (e.g. social distancing, pre-booked appointments)- Logistics (e.g. supplies, vaccines, transportation)

13. COMMUNITY RESPONSIBILITIES

Each Community is responsible for initiating response of their CDE guided by their CDER plan.

• The Community’s EOC will activate and meet, using an appropriate platform or venue, as soon as possible to action this plan and any local control measures with direction and consultation from healthcare services. Each local control measure (such as individual isolation or cancelling events) will need to be discussed and decided upon separately before being implemented.

• Health team members will need to establish communication links with RHA and FNHA and coordinate CDE responses including practices for identifying and treating cases (i.e. testing, treatment, isolation, etc.). See contact information in Appendix 1.

• Communication will open with other Communities in the area as they will likely be affected. This will also be important in the event any Community is severely affected by the CDE and needs additional support.

14. PLAN FOR MASS TRIAGE/TREATMENT CENTER’S

In the event the number of suspected and confirmed cases requiring treatment or prophylaxis is beyond the capacity of existing healthcare facilities, the EOC will designate a site/facility to establish a mass triage/treatment centre.

• The Planning and Logistic team will ensure there is a designated facility and it is open with sufficient supplies and equipment to support the health team. See Appendix 4 for Public Health Flu, Hand Hygiene, and Cough Etiquette Resources.

• The Nursing Station/Health Centre/health services will have lists of population groups within the Community that may be especially vulnerable to the CD and/or may need to be prioritized for medical treatment/prophylaxis (e.g. Elders, prenatal/postnatal clients, children under one year, Community members with a chronic disease). These lists should be available annually. See Appendix 7- Community’s Priority Lists for more information.

• Band members list of those living on reserve is updated annually.

• If a Community member is unable to travel to the facility a member of the Logistics team will coordinate transportation.

• As appropriate, health teams may be asked to communicate with their RHA regarding vaccine utilization in their Communities. If access to vaccine from the Regional Health Authority becomes difficult, contact [email protected] for assistance with coordination of supplies.


During a Communicable Disease Emergency


Note: Consider if Community members are willing to go to mass triage centers and hospitals as needed.

15. HEALTH SERVICES DELIVERY

Delivering health services requires two main components: implementing IPC measures and providing healthcare services on a priority basis.

• Outbreaks and Pandemics may be caused by any known or unknown diseases and therefore, it is important that IPC measures and processes be in place to prevent its spread in all Health Care Centers and Nursing Stations.

• It is also important to be able to identify vulnerable Community members to provide timely support. Consent will need to be considered.

15.1 Implement Infection Prevention and Control Measures

Healthcare workers identified as being at risk for exposure to communicable diseases, will wear the appropriate PPE identified by their point of care risk assessment. See Appendix 6 for PCRA.

• PPE equipment selected will vary depending on how the organism is spread (transmission). It is recommended to follow higher level precautions if mode of transmission is unknown.

It will be the responsibility of the health team to consult with either RHA and/or FNHA to ensure these precautions are appropriate and there are adequate supplies and instruction on proper storage and disposal of PPE for all modes of transmission:

• Airborne (through the air) • Droplet (through respiratory secretions)• Contact (on surfaces)

It will also be the responsibility of the health team to ensure best practices for their IPC processes at each level of the hierarchy. For IPC program questions and support, please contact [email protected].

For environmental cleaning, refer to Environmental Cleaning Best Practice Guidelines: Housekeeping Manual (Appendix 5) to determine the appropriate cleaning methods and materials to be used.

16. ISOLATION

There are 3 levels of CDE related isolation which may be used to help prevent the spread of disease to our Community members: individual, household, Community.

These different levels are based on symptoms, exposure risk, or diagnosis.

• In the case of individuals or households who are isolated due to the CDE, regular check ins and communication may be recommended to ensure they are not getting sicker, or require supplies such as food or medication.

• For Community level isolation consider:

- A meeting/communication should take place explaining the reasons for the isolation and any restrictions that are in place because of it.

- Expected timelines of the isolation.




- Inform Community members where to refer to for regular updates/established information (e.g. website, newsletter, communication board, etc.).

17. ESTABLISHING ALTERNATE SITES FOR PROVIDING MEDICAL CARE

Alternate care sites can be established in the event that one or many Community members are unable to remain at home, due to not being able to care for themselves or it not being safe for loved ones to care for them.

Guided by what is known about the disease these sites may possess the following:

• An area large enough for more than 5 people to be cared for, running water, washroom facilities, a place to cook/plans for delivering food, large sinks, heat, and enough room to isolate patients from each other as well as for patient care.

• Other considerations include: beds, bedding, buckets, lights, patient care and medical equipment, PPE, washcloths, sponges, paper towels, scissors, water, soap, oxygen, patient record keeping material.

18. ARRANGE FOR TRANSPORTATION OF POSITIVE CASES

If a member of the Community has been identified as being too sick to be cared for within the Community, the health team will arrange for transportation to the closest health facility.

Note: it is the responsibility of the health team to ensure communication to transport teams regarding the condition of the sick Community member, updates to the possible mode of disease transmission, and the IPC measures to be implemented.

19. DISCUSS FUNERAL ARRANGEMENT ISSUES

Large gatherings and rituals for the preparation of the deceased Community member can be high risk events for transmission. For this reason certain considerations need to be made for funeral arrangements depending on the disease and its transmission.

• Chief and Council of the deceased’s community will be consulted along with the family to determine the best method of funeral arrangements, given the medical situation.

• During a CDE consider connecting with RHA/FNHA for current guidelines and additional support.

• When a Community member passes away as a result of the CD, attempt to send them to the hospital, Coroner’s office, or funeral home as you would normally do when a Community member passes away.

• Depending on the disease and its transmission certain things may need to be considered when handling those who have passed as a result of the disease.

• If there is a need for persons sitting with the deceased Community member (no contact) or attending the funeral to wear PPE or follow distancing protocol, the MHO or FNHA will notify the Community.

• It is recommended only direct family members attend the funeral as a way to limit the number of persons at the funeral (minimize large gatherings).



• The Community will make every effort to provide supporting arrangements for the deceased as soon as appropriate and possible.

In the case where the number of deaths as a result of the pandemic are so overwhelming that the hospital, Coroner’s office, or funeral homes cannot receive a deceased person immediately, they may be required to stay in the Community. This period of time may be for hours, days or in extreme cases, the Community may be advised to keep the deceased person on site and to make direct funeral arrangements.

Updated information on correct protocols and IPC measures for handling the deceased person during the CDE will be provided by FNHA. This will be updated as new information emerges. For questions/information please email [email protected].

Note: If the death was a direct result of the CDE, the Coroner’s office will determine if the deceased person needs to be examined by the Coroner’s office or family physician. If the deceased person is remaining in the Community the Nurse Practitioner or Medical Practitioner needs to complete a ‘Registration of Death’ (form number HLTH 406 REV 92/12) Province of British Columbia – Ministry of Health, et al.

20. SURVEILLANCE

Establish local surveillance (monitoring sick people) during a CDE with the purpose of being able to provide additional support for treatment, management, and prevention.

The health team plays a key role in disease surveillance. Their responsibilities include:

• Encouraging Community members of their responsibility to inform the health team when they are sick during a CDE. When a Community member (or caregiver) suspects having symptoms of the current illness of concern or those being monitored by Public Health, they will notify a member of the health team and be triaged as per the triage section above.

• Supporting dissemination of public health information for the Community, including symptoms to monitor based on the CDE.

• Informing the Communities’ RHA to support timely and effective monitoring and management of outbreaks.

Note: The BCCDC website has health professional information and updates as well as other resources related to CDE. For example, with influenza please see http://www.bccdc.ca/health-info/diseases-conditions/influenza.

21. COMMUNICATION

Prioritizing timely communication during pandemic will support Community needs and can help reduce the spread of misinformation.

Immediately after Community leadership is made aware of the health emergency the communication plan to inform all Community members will be implemented. Community members who do not reside in the Community will also be informed and encouraged to attend any information sessions.

The following information will be provided via the commonly used media, such as radio, Community Facebook page, telephone calls and written Community notices:

• What an outbreak or pandemic is.


http://www.bccdc.ca/health-info/diseases-conditions/influenza

http://www.bccdc.ca/health-info/diseases-conditions/influenza


• The current state/status update of transmission in Community Name.• Getting vaccinated if it is an option (this is very important to Community members who do not live

in the Community full time, especially if travel is limited into the Community). • Detailed protective measures for those who have declined or are unable to receive the vaccine or

if disease has no vaccine option.• Antiviral information if applicable.• Self-monitoring (if a Community member becomes sick, they must inform the health team of their

illness to get quick and proper treatment). • Personal hygiene (importance of hand washing, cough etiquette).• Travel restrictions.• Infection control measures (i.e. the use of PPE, cleaning recommendations, etc.).

Note: Experts from our RHA, FNHA or consultants are available to assist with communications.

21.1 Have Clearly Identified Communication/Information and Community Liaison

Identify a Communication/Information person within the Community to coordinate public and internal communication. In the EOC this role is called Communication or Information.

Identify a Community Liaison acting as the point of contact as the external agencies. This person will conduct any media interviews, or communications required on behalf of the Community. In the EOC this role is called Community Liaison. See Appendix 1.

22. COMMUNITY RESPONSIBILITIES

An outbreak or pandemic is over when the local, provincial, and federal public health authorities formally declare it being over.

The Community Incident Command Team shall meet and complete the following:

• Deactivate the plan.

• Hold a critical incident debriefing session for all team members; provide or arrange grief counselling to staff members as needed (see Appendix 1 for counsellor information).

• In a timely manner, the Incident Command team will assess the effectiveness of this plan, and revise the plan as necessary (i.e. hot wash, debrief, after action).

• Inform Community members of the pandemic being over and discuss how it affected the Community. This could be done in a Community gathering, as this would be a good time to support each other.


After a Communicable Disease Emergency


• Crisis counselling services will available. For Mental Health and Wellness support for staff and Community members refer to https://www.fnha.ca/what-we-do/communicable-disease-control/coronavirus/health-professionals.

• Arrange for the return of any Community members who may have been out of the Community, in hospital, or at other care sites.

• Document lessons learned by the Community and update CDER plan accordingly.

• If the Community was financially impacted by the health emergency seek financial redress. For information or support please contact FNHA.

• The health team will complete the surveillance report with the information required by our RHA and FNHA.

• Resume regular surveillance activities.

Note: There are only a few times in history where there is an opportunity to improve response for future pandemics. It is important to write down and pass along how the Community did during the outbreak, what worked, and what could have worked better. Encourage planning for future pandemics.



Appendix 1: Contact Information of Emergency Operation Centre*TO BE REVIEWED/UPDATED TWICE PER YEAR or as needed*

Fillable EOC (ICS Structure)


Incident Commander_____________________

Operations"the doers"

________________

Planning Section"the thinkers"

________________

Logistics Section"the getters"

_________________

Finance / Admin"the payers"

_________________

Health Rep__________________

Community Liaison____________________

Information___________________

Communication___________________

Risk Mgt / Safety____________________


INCIDENT COMMAND SYSTEM (ICS) STRUCTURE in EOC:

ICS ROLESRole Position in Community

Incident Commander

Health Representative

Community Spokesperson(s): -Community Liaison -Communication -InformationOperations- “the doers”Planning- “the thinkers”Logistics- “the getters”Finance/Admin- “the payers”Worker Counsellor/Support

EOC CONTACT INFORMATIONTEAM MEMBER PRIMARY CONTACT BACKUP CONTACTIncident CommanderSets objectives and priorities. Has overall authority during emergency event.

Name: Name:Work: Work:Home #: Home #:Cell #: Cell #:Email: Email:Preferred Communication:

Preferred Communication:

Position: Position: Health RepresentativeRepresentative from health clinic/hospitalProvides direct input to Incident Commander on unique aspects of Communicable Disease Emergencies which differ from environmental All-hazards response.



Position: Position:

Community Spokesperson(s)Community member/elder with deep connections to Community and traditions.



Position: Position: Community Liaison Name: Name:



Point person for all communications decisions including media requests. Can be outside support such as RHA communications or FNHA spokesperson if no available representative within Community.

Work: Work:Home #: Home #:Cell #: Cell #:Email: Email:Preferred Communication:


Position: Position:

Operations- “the doers”Establishes strategies and actions to complete the goals and objectives set by the Incident Commander.Example Function Branches:- Health Services- Land Management- Emergency Social

Services- Economic Development- Public Works



Position: Position:

Planning- “the thinkers”Coordinates support activities such as determining venues for triage centres and mass immunization clinics. Supports Incident Command and Operations in processing incident information such as collating data.Example Function:- Situation- Resources- Documentation- Advance Planning- Demobilization - Recovery



Position: Position:

Logistics- “the getters”Supports Incident Commander and Operations Lead in their use of personnel, supplies, equipment, and transportation.- Example Functions:- Info Technology- Communications- OC Support- Facilities - Security- Clerical- Supply- Personnel- Transportation



Position: Position:

Finance/Administration- “the payers”Supports Incident Commander

Name: Name:Work: Work:Home #: Home #:



Cell #: Cell #:Email: Email:Preferred Communication:


Position: Position: Name: Name:Work: Work:Home #: Home #:Cell #: Cell #:Email: Email:Preferred Communication:


Position: Position: EXTERNAL CONTACTSRegional Health Authority

MEMBER PRIMARY CONTACT BACKUP CONTACTName: Name:Work: Work:Cell #: Cell #:Email: Email:Position: Position: Name: Name:Work: Work:Cell #: Cell #:Email: Email:Name: Name:Phone #: Phone #:

FIRST NATIONS HEALTH AUTHORITYName: Dr. Shannon McDonald

Name:

Work: 1-877-376-0691 or 604-357-4554. The service will text the doctor on call.

Work:

Cell #: Cell #:Email: [email protected]

Email:

Name: Name:Work: Work:Cell #: Cell #:Email Email:Name: CDPPH Name:Work: 1-844-364-2232 (option #3)

Work:

Email: [email protected] Email:Name: Emily Dicken Name:

Work: Work:

Email: [email protected]

Email:





In-Community Volunteer

Support Volunteer Role (eg. Meal prep for emergency/health staff)

Contact Information

Health Department / Emergency contact

Name: Work: Home: Email:

Emergency Coordination / Spokesperson


Messaging


Meal Preparation coordinator


Note: For up to date information please refer to https://www.fnha.ca/what-we-do/communicable-disease-control/coronavirus/health-professionals.




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Appendix 2: RHA MHO/CD Team Contact List for Surveillance ReportingCheck off most applicable RHA contacts for your Community

Check Off Applicable Contacts

Agency Position Contact

☐ Fraser Health Authority Central Communicable Disease Intake Line – Health Protection

1-866-990-9941

☐ Fraser Health Authority Medical Health Officer (MHO) on call after hours

604-527-4806

☐ Interior Health Authority Communicable Disease Unit 1-866-778-7736☐ Interior Health Authority MHO on call after hours 1-866-457-5648☐ Island Health Authority South Island Communicable Disease Hub 1-866-665-6626☐ Island Health Authority Central Island Communicable Disease Hub 1-866-770-7798☐ Island Health Authority North Island Communicable Disease Hub 1-877-887-8835☐ Island Health Authority MHO on call after hours 1-800-204-6166☐ Northern Health Authority Central Communicable Disease Hub 1-855-565-2990☐ Northern Health Authority MHO on call after hours 250-565-2000☐ Vancouver Coastal Health Communicable Disease Control 604-675-3900☐ Vancouver Coastal Health MHO on call after hours 604-527-4893

Note: For updated information please refer to CD Management Resources: FNHA Regions


https://www.fnha.ca/Documents/FNHA-Communicable-Disease-Management-Resources-Regions.pdf

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Appendix 3: CDE Public Messaging Key message components:

1. Expression of empathy2. Clarification of facts and/or call to action

a. Who b. What c. When d. Wheree. Whyf. How

3. What we do not know4. How leadership is going about getting answers5. Statement of commitment 6. Referrals for more information or supports7. Next scheduled communication

Check messaging for the following:

• Positive action steps, honest/open tone, message clarity and congruence with other messaging from partner organizations, simplicity, avoidance of jargon or judgmental phrases, humor or extreme speculation.

• Refer to CDE Communication at https://www.fnha.ca/what-we-do/communicable-disease-control/coronavirus/health-professionals for FNHA public communication.





https://www.fnha.ca/what-we-do/communicable-disease-control/coronavirus/health-professionals%20

https://www.fnha.ca/what-we-do/communicable-disease-control/coronavirus/health-professionals%20

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Appendix 4: Public Hand Hygiene/Cough Etiquette Messaging

- Infection Prevention and Control Canada (IPC) http://www.ipac-canada.org/links_handhygiene.php

- Health Link BC http://www.healthlinkbc.ca/healthfiles/hfile85.stm

- Provincial Infection Prevention and Control Network of British Columbia

https://www.picnet.ca/resources/posters/infection-control-posters/

- BC Centre for Disease Control http://www.bccdc.ca/health-info/prevention-public-health/hand-hygiene

Note: For up to date information please refer to https://www.fnha.ca/what-we-do/ communicable-disease-control/coronavirus/health-professionals.


https://www.fnha.ca/what-we-do/%20communicable-disease-control/coronavirus/health-professionals

https://www.fnha.ca/what-we-do/%20communicable-disease-control/coronavirus/health-professionals

http://www.healthlinkbc.ca/healthfiles/hfile85.stm%20

http://www.ipac-canada.org/links_handhygiene.php%20

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Appendix 5: Infection Prevention and Control Measures

- Point of Care Risk Assessment, Routine Precautions, Additional Precautionshttps://www.picnet.ca/wp-content/uploads/PHAC_Routine_Practices_and_Additional_Precautions_ 2013.pdf

- Environmental Cleaning Best Practice Guidelines: Housekeeping Manualhttps://www.fnha.ca/WellnessSite/WellnessDocuments/HP_Housekeeping-Manual.pdf#search =housekeeping

• Chapter 1, Section 1, page 69-Procedure for mixing Surface Cleaner/Disinfectant• Chapter 1, Section 2-Preventing Infection in Special Situations• Chapter 2, Section 7-Housekeeping Supplies and Chemicals





https://www.fnha.ca/WellnessSite/WellnessDocuments/HP_Housekeeping-Manual.pdf#search%20=housekeeping

https://www.fnha.ca/WellnessSite/WellnessDocuments/HP_Housekeeping-Manual.pdf#search%20=housekeeping

https://www.picnet.ca/wp-content/uploads/PHAC_Routine_Practices_and_Additional_Precautions_%202013.pdf

https://www.picnet.ca/wp-content/uploads/PHAC_Routine_Practices_and_Additional_Precautions_%202013.pdf

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Appendix 6: Sample Point of Care Risk Assessment (PCRA)

Example 1


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Example 2





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Appendix 7: Priority Community Members List

Certain population groups should be prioritized for medical intervention and transfers to higher level of care due to their vulnerability and susceptibility to Communicable Diseases. It is highly recommended that these individuals in your Community be identified so a plan of care can be incorporated into your Communicable Disease Emergency Response Planning.

• Vulnerable population groups may include:- Seniors (>65 years of age)- Those with pre-existing chronic conditions (i.e. Cancer, HIV/AIDS, Diabetes, Asthma,

Renal disease, Heart disease, etc.)- Immunocompromised (due to disease and/or treatment)- Young Children (<60 months) and Infants

• The Priority Community Members List (see next page for template) should only be maintained and held by the Community Health Nurse (CHN). Please see the CHN for updated lists. This list should be treated as a confidential record and kept in a secure location (example: locked filing cabinet in records room).

• FNHA recommends the Priority Community Members list be updated quarterly.

Note: This list is confidential and should not be saved into your CDER Plan. To maintain client confidentiality, information in the priority/evacuation lists should be adapted to contain client information pertinent to transportation when provided to the EOC.

For up to date information please refer to https://www.fnha.ca/what-we-do/communicable-disease-control/coronavirus/health-professionals.




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Priority Community Members List

Name AddressContact Number/Radio

Condition/Health Concern/Health Vulnerability

Dependents Other Information


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Appendix 8: Community Member Resource Inventory Template

Community Member Resource Inventory Template: Updated xx/xx/xxxxName of Community Member/Contact information

Able to help during a CDE*

Current role Formal skills Additional skills Willing to be reassigned/relocated

*Note: Consider if the Community member is themselves or is in proximity to a person considered vulnerable.


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Appendix 9: CDER Plan Written Answers

Planning information regarding CDE information How will CDE-related information be communicated to Community staff and members?

How will CDE-related information be received and/or disseminated to external partners, including province, FNHA Regional offices, ISC, while respecting confidentiality and privacy laws?

Community-based disease control strategiesList prioritized Community programs/services, including health services during a CDE (e.g. Health Centre, medical transfer services, etc.):

1.2.3.4.5.6.7.8.9.10.

Vaccines or Medications to reduce the spread of diseaseProvide the name and address of the alternate site/facility for a mass immunization:

Name of facility___________________________________________________

Address (if available) _______________________________________________

Note: Print map and attach to this document.

How will mass immunization be executed?

Considerations:

- Weather- Measures to reduce transmission risk (e.g. social distancing, pre-booked appointments)- Logistics (e.g. supplies, vaccines, transportation)


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Community ResponsibilitiesReview the Community’s all-hazard emergency preparedness and response plan (EPR) and business continuity plan (BCP), and be familiar with their content.

Location of all-hazards plan: ___________________________________

Location of BCP: _____________________________________________

Lead for all-hazards plan: ______________________________________

Lead for BCP: ________________________________________________

Which neighboring Communities will we open communication with? Who could you contact in a neighboring Community to discuss sharing resources in case of a Communicable Disease Emergency (name and number)?

Community Name Contact Name Contact Number

Plan for mass triage/treatment center’sProvide the name and address of the alternate site/facility for a mass triage/treatment centre:

Name of facility___________________________________________________



Where can the Community Priority List be accessed?

IsolationWhere can a Community find regular updates/existing information about CDE related Community-level, household, and self isolation practices?

Establishing Alternate Sites for Providing Medical CareProvide the name and address of the alternate site/facility for a providing medical care:

Name of facility___________________________________________________


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Arrange for Transportation of Positive CasesWhat form of transportation will be used to transport Community members that are sick (e.g. Ambulance, hospital transfer vehicle, Health Centers’ vehicle)?

Discuss Funeral Arrangement IssuesProvide the name and address of the alternate site/facility for keeping deceased Community members prior to burial (the area must be kept cool and dry):

Name of facility___________________________________________________


Note: Print map and attach to this document. If this location is unavailable or unfit to be used as a location for the deceased Community member, the CHN will notify the MHO.

SurveillanceWhat is the plan for reminding Community members to self-identify illness to their health team?

CommunicationWhat is the common communication platform used in the Community?


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