Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Northeast Ohio Homeland Security Planning Region Response Mission Capability: Isolation and Quarantine NEO Region Containment Plan Northeast Ohio Homeland Security Planning Region Response Mission Capability: Isolation and Quarantine NEO REGION COMMUNITY CONTAINMENT PLAN Version 1.0 1/30/2007 1 Document Revision Page Review and Maintenance of the Plan This plan was approved on___________________ by ______________________________________________. This document will be reviewed annually unless additional updates are required. The reviewer will add the review date and any changes in the table below and maintain a printed copy of the plan in a binder, replacing pages as needed. The binder will be located _______________________________________ Date Revision number Description of Change NEO Regional Epidemiologist Group Response Mission Capability: Isolation and Quarantine NEO REGIONAL COMMUNITY CONTAINMENT PLAN Version 1.0 1/30/2007 Pages Affected Reviewed or Changed by 2 Table of Contents Purpose Assumptions Plan Maintenance Legal Authority Concept of Operations Command and Control Key Considerations Types of Containment Measure Containment measures for individuals Community-based containment measures International Travel Restrictions Coordination of Community Containment Measures References NEO Regional Epidemiologist Group Response Mission Capability: Isolation and Quarantine NEO REGIONAL COMMUNITY CONTAINMENT PLAN Version 1.0 1/30/2007 3 Appendices Delegation of Authority to Quarantine and Isolate to the Health Commissioner Cuyahoga County Board of Health Public Health Emergency ICS/Unified Command System (UCS) Ohio Department of Health’s Limitation of Movement and Infection Control Practices CDC Interim Pre-pandemic Planning Guidance: Community Strategy for Pandemic Influenza Mitigation in the United States – Early, Targeted, Layered Use of Nonpharmaceutical Interventions CDC Smallpox Response Plan and Guidelines (Version 3.0), Guide C, Part 1 – Infection Control Measures for Healthcare and Community Settings and Part 2 – Quarantine Guidelines CDC Smallpox Response Plan and Guidelines (Version 3.0), Guide F – Environmental Control of Smallpox Virus Interim Mask Guidance Definitions Acronyms NEO Regional Epidemiologist Group Response Mission Capability: Isolation and Quarantine NEO REGIONAL COMMUNITY CONTAINMENT PLAN Version 1.0 1/30/2007 4 Annexes [to be developed] 1 2 3 4 5 6 Standard Operating Guidelines for Implementing Isolation and/or Quarantine Standard Operating Guidelines for Monitoring Persons/Groups in Isolation and/or Quarantine Traveling Population SOG – Renee School Closure Standard Operating Guidelines Standard Operating Guidelines for Closing Businesses Standard Operating Guidelines for Implementing NEO Regional Epidemiologist Group Response Mission Capability: Isolation and Quarantine NEO REGIONAL COMMUNITY CONTAINMENT PLAN Version 1.0 1/30/2007 5 Purpose This document outlines the plan and procedures for the Northeast Ohio (NEO) Homeland Security Region to initiate non-pharmaceutical interventions (NPI) in response to an incident or outbreak of a communicable disease. The overall goal of community containment is to reduce transmission of disease by limiting contact among people. Community containment measures fall into two major categories: 1) individual level measures (e.g. isolation and quarantine) and 2) community level measure (e.g. suspension of public gatherings). Scope This plan will outline a range of approaches that may be used in relation to various levels of threat represented by different communicable diseases. This plan does not cover procedures used for mass prophylaxis. The distribution of mass prophylaxis is covered elsewhere. Assumptions 1. A surveillance system is in place that provides the following epidemiological information on the disease in question: number of cases and contacts, characteristics of transmission, morbidity and mortality, and high risk groups. 2. In the absence of clear scientific data, community containment measures will be implemented based on public health judgment and historical information. Containment measures will be assessed on an ongoing basis for effectiveness and feasibility. 3. In the absence of pharmaceuticals (e.g. vaccine, antivirals, antibiotics), nonpharmaceutical intervention (NPI) community containment measures may be the principal means of disease control. Plan Maintenance This document should be reviewed at least annually and after every applicable exercise. Review dates and changes should be documented (see page 2). Updated pages will be replaced as needed. An electronic copy of this plan is located on the CCBH network at: N:disease/community containment. The file is titled NEO Regional Community Containment Plan. Printed copies of this document are in a binder titled NEO Regional Community Containment Plan in Epidemiology, Surveillance, & Informatics. This plan will be exercised to identify operating challenges and promote effective implementation. Legal Authority1 The containment measures outlined below must be supported by legal authority. An official act may be authorized by law, but the act cannot violate an individual right without a compelling state interest. When considering containment measures, it is important for the government NEO Regional Epidemiologist Group Response Mission Capability: Isolation and Quarantine NEO REGIONAL COMMUNITY CONTAINMENT PLAN Version 1.0 1/30/2007 6 official to carefully weigh the situation to ensure there is sufficient data indicating a need. Containment measures need to utilize the least restrictive means of achieving the public good. Similarly, the government official needs to ensure the order is sustainable and logistically supportable. To this end, the government official should be familiar with the appropriate scope of authority and fully engage the appropriate legal counsel early in the process. Federal Authority Under the authority of Section 361 of the Public Health Service Act (42 USC 264), the Health and Human Services (HHS) Secretary may make and enforce regulations as necessary to prevent the introduction, transmission or spread of communicable diseases from foreign countries into the United States of from one state or possession into another. The CDC (under authority delegated by the HHS Secretary) Director may isolate and quarantine persons who have been exposed to or are infected with certain specified communicable diseases and are arriving in the United States from a foreign country or traveling from one state or possession into another. CFR Title 42, Chapter 1, Part 70 - Interstate Control of Communicable Disease. http://www.access.gpo.gov/nara/cfr/waisidx_03/42cfr70_03.html CFR Title 42, Chapter 1, Part 71 - Foreign Quarantine. http://www.access.gpo.gov/nara/cfr/waisidx_03/42cfr71_03.html State Authority http://onlinedocs.andersonpublishing.com/oh/lpExt.dll?f=templates&fn=main-h.htm&cp=PORC ORC § 3701.13 - ODH has ultimate authority in matters of quarantine. ORC § 3701.56 - Provides for law enforcement and public health officials to enforce isolation and quarantine orders. ORC § 3701.14 - General powers of the Director. ORC § 3701.81- Requiring persons to limit spread and inform the health authorities of known contagions. ORC § 5923.21 - Governor may call-up Ohio National Guard (ONG) to enforce the laws of Ohio. ORC § 5923.27 - ONG called up by Governor is considered a law enforcement officer. ORC § 5923.27 - Arrest and detention by ONG is for purposes of escorting to civil authorities. Local Authority http://onlinedocs.andersonpublishing.com/oh/lpExt.dll?f=templates&fn=main-h.htm&cp=PORC ORC § 3707.04 - Authority to promulgate quarantine regulations. ORC § 3707.05 - Local health department (LHD) may not close highway without ODH permission and in compliance with regulations. ORC § 3707.08 - Isolation of persons exposed to communicable diseases; placarding of premises. ORC § 3707.09 - Establishment of quarantine guard. ORC § 3707.16 - Attendance at gatherings by quarantined persons prohibited. ORC § 3707.17 - Quarantine in place other than that of legal settlement. NEO Regional Epidemiologist Group Response Mission Capability: Isolation and Quarantine NEO REGIONAL COMMUNITY CONTAINMENT PLAN Version 1.0 1/30/2007 7 ORC § 3707.21 - Isolation of affected persons in institutions. ORC § 3707.23 - Examination of common carriers by board of health during quarantine. ORC § 3709.20 & 3709.21 LHD and Boards of Health may make such orders as necessary to protect public health. ORC § 3707.26 – Board shall inspect schools and may close them. Ohio Attorney General Opinion 926 (1949) - A LHD may impose a quarantine if reasonable. On March 24, 2004, the CCBH signed a resolution granting the Health Commissioner authority to act on behalf of the board in enforcing provisions of Ohio Revised Code Section 3707.04 – 3707.32 (Appendix X). [Each Jurisdiction will insert own] Concept of Operations Command and Control As per the NIMS guidance, the Incident Command System (ICS) will be the structure utilized for implementing this plan as the established response to an event. This provides a uniform system by which all involved organizations can respond at any level of management using common terminology, goals, and responsibilities. The NEO Homeland Security Planning Region Emergency ICS/Unified Command System (UCS) will be implemented for the duration of the event (Appendix X). Add info about DOCs Key Considerations Table 1 presents data elements that will be analyzed when making decisions about when to use community containment measures. As information about specific disease transmission becomes known, the data listed below will be used to make decisions about appropriate disease control measures. NEO Homeland Security Planning Region will also utilize guidance from the CDC and ODH when determining thresholds. Table 1. Threshold determinants for use in decisions about disease control measures2 Parameter Data Element Case and Contacts Number of cases (absolute or estimated) Age of cases Location of cases Estimated number of work, school, daycare, household or other social contacts per case Rate of incident cases Number of hospitalized cases Morbidity/Mortality Number and percentage of cases with no identified epidemiological link Number of cases occurring among contacts NEO Regional Epidemiologist Group Response Mission Capability: Isolation and Quarantine NEO REGIONAL COMMUNITY CONTAINMENT PLAN Version 1.0 1/30/2007 8 Public Health Resources Community Cooperation, mobility and compliance Number of cases under surveillance and/or quarantine Investigator to case and contact ratios Number of contacts under active surveillance Number of contact under quarantine Ability to rapidly trace contacts (# untraced/interviewed contacts) Ability to implement and monitor quarantine (staff member/volunteer to contact ratio) Ability to provide essential services Degree of compliance with voluntary individual isolation Degree of compliance with active surveillance and voluntary individual quarantine Degree of movement out of the community Degree of compliance with community-containment measures Types of Containment Measures3 Containment measures for individuals 1. Isolation - A table ODH’s Limitation on Movement and Infection Control Practices (Appendix X) provides a list of type and duration of precautions recommended for selected diseases. 2. Quarantine - The contact remains separated from others for a specified period (incubation period), during which s/he is assessed on a regular basis (in person or by phone at least once daily) for signs and symptoms of the disease. Persons with disease specific symptoms will require immediate evaluation by a trained healthcare provider. Restrictions may be voluntary or legally mandated; confinement may be at home or in an appropriate facility. No specific precautions are required for those sharing the household with a person in quarantine as long as the person remains asymptomatic. Application: Situations in which the risk of exposure and subsequent development of disease is high and the risk of delayed recognition of symptoms is moderate Benefits: Reduces risk of spread from persons with sub acute or sub clinical presentations or from delayed recognition of symptoms Challenges: May infringe on personal movement May lead to a feeling of isolation from family and friends May lead to loss of income or employment Requires plans/protocols for provision of essential services Requires plan for provision of mental health support Risk of noncompliance, particularly as duration increases May require enforcement for noncompliance Resources Required: Staff for monitoring and evaluation Appropriate facility if home setting is unavailable or inadequate NEO Regional Epidemiologist Group Response Mission Capability: Isolation and Quarantine NEO REGIONAL COMMUNITY CONTAINMENT PLAN Version 1.0 1/30/2007 9 Staff, funding, and goods for provision of essential services Hotline for notification of symptoms or personal needs Mechanisms to communicate with family members outside the household or facility Mental health and social support services Delivery systems for food and other essential supplies Partners: Professional and lay healthcare workers to perform assessments on behalf of the health department Community volunteers/workers to assist with provision of essential services Potential need for law enforcement to assist with noncompliant persons Forms/Templates: Checklist for active monitoring Template for recording results of clinical evaluation Checklist and guidelines for evaluation of homes for quarantine Checklist and guidelines for evaluation of community-based sites for quarantine Guidelines for monitoring compliance with home quarantine Guidelines for monitoring compliance with quarantine in community-based facilities Forms for recording compliance with quarantine 3. Working Quarantine - Employees are permitted to work but must observe activity restrictions while off duty. Monitoring for illness before reporting for work is usually required. This may change based on the clinical presentation of disease. Use of appropriate infection control procedures while at work is required. Application: Persons for whom activity restrictions (home or facility quarantine) are indicated but who provide essential services (e.g., healthcare workers, utilities, etc.) Benefits: Reduces risk of community spread from high-risk contacts while minimizing adverse impact of activity restrictions on provision of essential services. Clinical monitoring at work reduces the staff required for active monitoring at the quarantine site. Challenges: Need for close and consistent pre-shift monitoring at the work site to prevent inadvertent exposures May require means of transporting persons to and from work site to minimize interactions; persons in working quarantine should wear appropriate Personal Protective Equipment during transport. Must maintain close cooperation and communication between work site and local health authorities Need to provide mental health services to address concerns about isolation from family and friends Resources Required: Appropriate facility for off-duty quarantine if home is unavailable or inadequate Staff, funding, and goods for provision of essential services Personal protective equipment Hotline for notification of symptoms and personal needs System to track results of work-site monitoring and location(s) of off-duty quarantine NEO Regional Epidemiologist Group Response Mission Capability: Isolation and Quarantine NEO REGIONAL COMMUNITY CONTAINMENT PLAN Version 1.0 1/30/2007 10 Mental health, psychological, and behavioral support services Partners: Work-site administrators and infection control personnel Community volunteers/workers Staff/volunteers to assist with transportation to and from work Mental health professionals Potential need for law enforcement to assist with noncompliant persons Forms/Templates: Guidelines and instructions for persons in working quarantine Instructions for supervisors of persons in working quarantine Checklist to evaluate homes for quarantine Guidelines for monitoring compliance Checklist for active monitoring at work site Template for recording results of clinical evaluation Forms for recording compliance 4. Passive Monitoring - The contact is asked to perform self-assessment periodically and to contact authorities immediately if symptoms occur. Application: Situations in which 1) the risk of exposure and subsequent development of disease is low, and 2) the risk to others if recognition of disease is delayed is also low Benefits: Requires minimal resources Places few constraints on individual movement Challenges: Relies on self-reporting Affected persons may not perform an adequate self-assessment Resources Required: Supplies (thermometer; symptom log; written instructions) Hotline to notify authorities about symptoms or needs Staff to receive telephone reports and provide in-person evaluation and care Plans and procedures for rapid isolation of persons who develop symptoms Partners: Household members Forms/Templates: Symptom logs Instructions for patients and healthcare workers 5. Active Monitoring without Explicit Activity Restrictions - A healthcare or public health worker evaluates the contact on a regular (at least daily) basis by phone and/or in person for signs and symptoms. Application: Situations in which 1) the risk of exposure to and subsequent development of disease is moderate to high, 2) resources permit close observation of individuals, and 3) the risk of delayed recognition of symptoms is low to moderate Benefits: Places few constraints on individual liberties Challenges: Requires adequate staffing NEO Regional Epidemiologist Group Response Mission Capability: Isolation and Quarantine NEO REGIONAL COMMUNITY CONTAINMENT PLAN Version 1.0 1/30/2007 11 Requires a system to track information and to verify monitoring and appropriate actions based on findings Resources Required: Trained staff to provide in-person and/or telephone evaluations Plans and procedures for rapid isolation of persons who develop symptoms Contingency plans for managing noncompliant persons Hotline to notify authorities about symptoms or needs Partners: Professional and lay healthcare workers to perform evaluations on behalf of the health department Possible need for law enforcement to assist with management of noncompliant persons Forms/Templates: Checklist for assessment of active monitoring Template for recording results of clinical evaluation Community-based containment measures If disease transmission is significant and sustained, the implementation of community-based containment measures will be considered. Community-based containment measures can be grouped into two broad categories: measures that affect groups of exposed or at-risk persons and measures that affect entire communities. Measures that affect groups of exposed or at-risk persons include quarantine of groups of exposed persons and containment measures that apply to use of specific sites or buildings. These measures should be considered when: 1) there is limited disease transmission in the area, 2) most cases can be traced to contact with an earlier case or exposure to a known transmission setting (e.g., a school or workplace where a person has fallen ill) and 3) the intervention is likely to either significantly slow the spread of infection or to decrease the overall magnitude of an outbreak in the community. Measures that affect whole communities should be considered when: 1) there is moderate to extensive disease transmission in the area, 2) many cases cannot be traced to contact with an earlier case or known exposure, 3) cases are increasing among contacts of infected patients, and 4) there is a significant delay between the onset of symptoms and the isolation of cases because of the large number of ill persons. 1. Focused Measures to Increase Social Distance - Intervention applied to specific groups, designed to reduce interactions and thereby transmission risk within the group. When focused, the intervention is applied to groups or persons identified in specific sites or buildings, most but not necessarily all of whom are at risk of exposure Examples: Quarantine of groups of exposed persons Cancellation of public events Closure of office buildings, schools, and/or shopping malls; closure of public transportation such as subways or bus lines Application: Groups or settings where transmission is believed to have occurred, where the linkages between cases is unclear at the time of evaluation, and where restrictions placed only on persons known to have been exposed is considered insufficient to prevent further transmission NEO Regional Epidemiologist Group Response Mission Capability: Isolation and Quarantine NEO REGIONAL COMMUNITY CONTAINMENT PLAN Version 1.0 1/30/2007 12 Benefits: Applied broadly, reduces the requirement for urgent evaluation of large numbers of potential contacts to determine indications for activity restrictions May enable reductions in transmission among groups of persons without explicit activity restrictions (quarantine) Challenges: May be difficult to solicit cooperation, particularly if popular buildings are closed or popular events are cancelled Requires excellent communication mechanisms to notify affected persons of details and rationale May need to provide replacement for affected activities (e.g., school, essential services) Generally relies on passive monitoring Resources Required: Systems to communicate relevant messages May require enforcement, particularly if closure of buildings or gathering places is necessary Requires resources for passive monitoring Hotlines to report symptoms and obtain follow-up instructions Transportation for medical evaluation, with appropriate infection control precautions Partners: News media and communication outlets Community groups Law enforcement Forms/Templates: Messages for affected persons Messages for employers of affected persons Messages for persons supplying essential services 2. Community-wide infection control measures - Throughout a public health emergency or even yearly public health events, CCBH will encourage all persons with signs and symptoms of a disease utilize measures to protect themselves and others. This includes, cough etiquette and hand washing. In other situations where the magnitude of a threat might be more consequential, individuals might be advised to avoid public gatherings (e.g., movies, religious services, public meetings). Depending upon particular circumstances, individuals might also be warned avoid going to other public areas (e.g., food stores, pharmacies); the use of other persons who are recovered or not infected might be encouraged. 3. Community-Wide Measures to Increase Social Distance – Intervention(s) applied to an entire community or region, designed to reduce personal interactions and thereby transmission risk. The prototypical example is implementation of a “snow day,” in which offices, schools, and transportation systems are cancelled as for a major snowstorm. Examples: Snow days Closure of office buildings, shopping malls, schools, and public transportation NEO Regional Epidemiologist Group Response Mission Capability: Isolation and Quarantine NEO REGIONAL COMMUNITY CONTAINMENT PLAN Version 1.0 1/30/2007 13 Application: All members of a community in which 1) extensive transmission of disease is occurring, 2) a significant number of cases lack clearly identifiable epidemiologic links at the time of evaluation, and 3) restrictions on persons known to have been exposed are considered insufficient to prevent further spread Benefits: Reduces need for urgent evaluation of large numbers of potential contacts to determine indications for activity restrictions May enable reductions in transmission among groups without explicit activity restrictions (quarantine) “Snow days” are familiar concepts and thus are easy to implement on short notice Challenges: May be difficult to solicit cooperation Requires excellent communication mechanisms to notify affected persons of details and rationale May need to provide replacement for affected activities (e.g., school, essential services) May need to address mental health and financial support issues When an entire community is involved, requires cooperation with neighboring jurisdictions that may not be using a similar intervention, particularly in situations where persons live in one city and work in another and only one locale is affected by the intervention Generally relies on passive monitoring Social and economic impact of public transportation closures Resources Required: Communication outlets Enforcement Resources for passive monitoring Hotlines and other communication systems to report symptoms and obtain follow-up instructions Partners: News media and other communication outlets Law enforcement and transportation officials to enforce restrictions (e.g., closure of bridges, roads, or mass transit systems) and plan for provision of critical supplies and infrastructure Forms/Templates: Messages for affected persons Messages for employers of affected persons Messages for persons supplying essential services 4. Widespread Community Quarantine, Including Cordon Sanitaire - Legally enforceable action that restricts movement into or out of the area of quarantine of a large group of people or community; designed to reduce the likelihood of transmission of among persons in and to persons outside the affected area. When applied to all inhabitants of an area (typically a community or neighborhood), the intervention is referred to as cordon sanitaire (sanitary barrier). Examples: Quarantine (cordon sanitaire) of a city or town NEO Regional Epidemiologist Group Response Mission Capability: Isolation and Quarantine NEO REGIONAL COMMUNITY CONTAINMENT PLAN Version 1.0 1/30/2007 14 Quarantine of occupants of a housing complex or office building Application: All members of a group in which 1) extensive transmission is occurring, 2) a significant number of cases lack identifiable epidemiologic links at the time of evaluation, and 3) restrictions placed on persons known to have been exposed are considered insufficient to prevent further spread. Widespread quarantine is unlikely to be necessary because other less restrictive measures (e.g., snow days) may be equally effective. Cordon sanitaire is not recommended unless a community is in a setting where it is likely to be applied effectively and has been planned with neighboring jurisdictions and state and federal input. Benefits: Reduces need for urgent evaluation of large numbers of potential contacts to determine indications for activity restrictions Challenges: Controversial because of the degree that individual movement is restricted Difficult to solicit cooperation for extended periods, particularly if the rationale is not readily apparent or was not clearly explained Requires excellent communication mechanisms to inform affected persons and to maintain public confidence in the appropriateness of the chosen course of action Need to ensure continuation of essential services Need to provide financial support and mental health support services for the affected population When an entire community is involved, requires cooperation with neighboring jurisdictions that may not be using a similar intervention, particularly in situations where persons live in one city and work in another and only one locality is affected by the intervention Need to provide mechanisms for isolating symptomatic persons with minimal delay Resources Required: Systems to communicate relevant messages Enforcement to maintain security at borders Transportation for persons requiring medical evaluation, with appropriate infection control precautions Staff and supplies to maintain access to and availability of essential services and goods, including food, water, medicine, medical care, and utilities Psychological support staff Plan to divert flow of critical infrastructure supplies and materials that normally transit through quarantined area Partners: News media and other mass communication outlets Public and private groups, industries, and officials to coordinate supply and provision of essential services to affected area Law enforcement to maintain security at borders and to enforce movement restrictions Transportation industry Forms/Templates: Messages for affected persons Messages for employers of affected persons Messages for persons supplying essential services NEO Regional Epidemiologist Group Response Mission Capability: Isolation and Quarantine NEO REGIONAL COMMUNITY CONTAINMENT PLAN Version 1.0 1/30/2007 15 International Travel Restrictions At the federal level, the Health and Human Services (HHS) Secretary has statutory responsibility for preventing the introduction, transmission and spread of communicable diseases from foreign countries into the United States and would be expected to set guidelines for international travel. However, local authorities may be responsible for quarantine of passengers of incoming flights from designated countries. The Listed below are elements included in the federal plan: Expanded reporting of ill passengers on board interstate air carriers as well as air and sea carriers arriving from foreign countries. Requirements that air and sea carriers arriving from foreign countries as well as certain interstate air carriers maintain passenger and crew lists for 60 days and can submit lists electronically to CDC upon request. Explicit administrative due process provisions for persons subject to quarantine. Explicit authority to offer vaccination, prophylaxis, and other appropriate medical interventions on a voluntary basis to individuals in quarantine.1 The proposed regulations are available at www.regulations.gov The CDC maintains a system of U.S. Quarantine Stations that serves to limit the introduction of infectious diseases into the United States and to prevent their spread. CDC has the legal authority to detain any person who may have an infectious disease that is specified by Executive Order to be quarantinable. These diseases are cholera, diphtheria, infectious tuberculosis, plague, smallpox, yellow fever, and viral hemorrhagic fevers. SARS was added in April 2003, and new types of flu (influenza) that could cause a pandemic were added in 2005. If necessary, CDC can deny ill persons with these diseases entry to the United States. CDC also can have them admitted to a hospital or confined to a home for a certain amount of time to prevent the spread of disease. The CDC Detroit Quarantine Station has jurisdiction over all ports in Michigan, Kentucky and Ohio. Contact information is as follows: Location/Inside Deliveries (FedEx): CDC Detroit Quarantine Station 2613 World Gateway Place Detroit Metro Airport McNamara Terminal, Bldg. 830 Detroit, MI 48242 U.S. Mailing Address: 2613 World Gateway Place McNamara Terminal, Bldg. 830 Detroit, MI 48242 Phone: 734-955-6197 (24 hour access) Fax: 734-955-7790 NEO Regional Epidemiologist Group Response Mission Capability: Isolation and Quarantine NEO REGIONAL COMMUNITY CONTAINMENT PLAN Version 1.0 1/30/2007 16 Coordination of Community Containment Measures ODH first becomes aware of an infectious disease through notification by local health jurisdictions, in accordance with OAC reporting rules. However, there will be times when ODH is the first to hear of an infectious disease. When an infectious disease is identified which requires a limitation on movement, ODH will consult with the LHD as needed to determine the extent of disease spread and whether other LHDs are involved or whether transportation routes are involved. If disease crosses jurisdictional boundaries or transportation routes, issuance of an order to limit movement by a local board of health (or the health commissioner acting for the board) will be done in coordination with other LHDs and the Ohio Department of Health.1 When illness reports and surveillance data or information from state and national public health authorities leads a LHD in the NEO region to determine that community containment measures may be needed, the LHD will contact the other NEO Region health jurisdictions and the ODH to schedule a conference call. If needed, ODH will notify the CDC to have a representative to attend the call. Attendees on this conference call should include: Local Health Commissioners Local Epidemiologists State Director of Communicable Disease Epidemiology Regional Public Health Coordinator Local Public Information Officers State Public Information Officer CDC representative as appropriate Other LHD staff as appropriate, (e.g. Directors of Nursing, Directors of Environmental Health).SKK The conference call will be facilitated the Lead Epidemiologist of the LHD that identified a need for community containment measure. Topics of discussion will include: Current disease surveillance data within local health jurisdictions, the region and the country Available information and guidance regarding the efficacy and adverse impacts of community containment measures already in effect nationally and internationally Specific community containment measures under consideration and the criteria for the timing and duration of implementation Implementation of community containment measures and emergency staffing plans within State and Federal agency facilities concurrent with local decisions Whether State or Federal authorities will be invoked regarding any or all social distancing measures within the State Timing of notifications to response partners and the public Establishing consistency regarding the timing and public announcement of community containment measures between all local jurisdictions.SKK Each LHD will notify its emergency response partners when community containment measures will be issued and enforcement by law enforcement entities is needed (state or local law enforcement and emergency responders). NEO Regional Epidemiologist Group Response Mission Capability: Isolation and Quarantine NEO REGIONAL COMMUNITY CONTAINMENT PLAN Version 1.0 1/30/2007 17 References 1. Ohio Department of Health’s Limitation of Movement and Infection Control Practices 2. Santa Clara County Pandemic Flu Plan – Critical Capacity Module IV. Limiting the Spread of Disease NEO Regional Epidemiologist Group Response Mission Capability: Isolation and Quarantine NEO REGIONAL COMMUNITY CONTAINMENT PLAN Version 1.0 1/30/2007 18