The Eagle Package Has Landed

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1 The Eagle Package Has Landed Zerlyn Ladua RN, FNP, MSN BT/Public Health Emergency Preparedness Director Division of Communicable Disease Control Alameda County Public Health Department Ron Seitz BT/Public Health Emergency Preparedness Disaster Preparedness Coordinator Division of Communicable Disease Control Alameda County Public Health Department

2 Objectives Briefly discuss past RSS Exercises and Planning Identify Key Action to be taken to receive the Eagle Package-include lessons learned along the way. Discuss strengths and weaknesses learned during the Bay Area EMSA Exercise Identify critical issues and potential solutions Next Steps

3

4

5 National Pharmaceutical Stockpile Strategic National Stockpile Multiple Locations In USA Local Points Of Dispensing (PODs) are designated sites 5 throughout the state that would be set up to quickly to dispense emergency pharmaceuticals. (Vaccines, Antibiotics, Antidotes)

6

7 Operation Rough and Ready

8 Bay Area City Readiness Initiative (CRI) Full Scale Exercise Operational Area Alameda County* City and County of San Francisco Contra Costa County* Marin County Napa County San Benito County San Mateo County Santa Clara County Sonoma County* Local City of Berkeley * Exercise included some aspect of warehouse operations

9 Regional Activities Bio Watch Regional Call *RSS Warehouse Activation Alameda- Received Eagle Package Sonoma-Received Eagle Package Contra Costa-Received State Exercise Supply Joint Information Center Emergency Operation Activation Points of Dispensing Sites

10 Tabletop (TTX) Exercise Scenario Aerosolized Anthrax Release Understanding BioWatch Understand how health alerts are shared in various agencies Priority Prophylaxis

11 Goal each City will received meds from the Eagle package Incorporated Cities Alameda Albany Berkeley Dublin Emeryville Fremont Hayward Livermore / Pleasanton Newark / Union City Oakland Piedmont San Leandro

12 Alameda County RSS

13 Planning Challenges CDC/State Assets are rarely provided to counties ( confirmation received one month before exercise) Made it hard to finalize Ex Plan Commercial Warehouse Near Christmas, space at warehouse C-POD» Parking lot model» Weather issues? Additional Challenges Staff untrained Used JAS and JIT Outdated Inventory management system Dug system out of mothballs New Staff at the City level Orientation Getting buy in Higher level approvals Necessity of activating a POD Transportation Coordination Contractors (3 Drivers) County GSA (1 Driver) Limited capabilities Limited contract arrangements Maps vs. GPS Simulation of Security Drivers would normally follow

14 CDC Resources DSNS Exercise Team (Only single person could attend) 8 member on the deployment team All Team members have SNS expertise Can review documents Act as controllers (not evaluators) Most are MEPPs Other resources include Pandemic Influenza supplies SNS 12hr Push packets Trucks Size 53 ft. Trailer» No lift gate» No pallet jacks Two tractor-trailer loads (40 to 44 pallets total) Each trailer holds pallets Exercise material from managed Inventory is referred as Eagle Packets Pallets Size 48x48 with 6 levels of 16» Cannot double stack pallets» 96 cases per pallet» Pallets have shrink wrap» Very few pallets < 96 cases» BAR Codes: No

15 Dana Grau, Al Hendrickson and Gregg Hand, CDC

16 Let the Fun Begin - Briefing

17 Primary POD locations City Model One City requests delivery to a central warehouse For Exercise purposes some cities elected to use an alternate site for convenience

18 TourSolver Routing

19 Trucks at the door

20 Breaking the seal

21 Signing for Delivery

22 What s inside

23 Receiving Assets

24 Inventory

25 Accountability Inspection Damage QA Verification Lot Numbers NDC Number Product Count Packing Slip

26 Staging

27 Delivery

28 Lessons Learned Inventory 80% Doxycyline and 20% Ciprofloxacin Each pallet had the same lot#, same NDC # and same expiration date Majority of our POD nonmedical supplies are pre positioned at the City PODs We generated the inventory and pick list based on the list received from the state. Future Avoid repallitization Consider a staging in the parking lot Consider sending entire medication pallets to one POD site to avoid multiple lot #s at the site Consider additional supplies such as screening forms to be sent separate from mediations Need more computers-current inventory management system is adequate

29 Communications / Field Tracking

30 Communications / Four Routes

31 Routing Pre-Plan

32 Lessons Learned Reality Communications Issued County Radios JIT All contract drivers had cell phones Local drivers are familiar with the area Language Barriers Security Security briefing for truck drivers Future TourSolver did not come up with better routes TourSolver sent drivers on freeways that prohibit trucks CHP was contacted and made allowances Start Ex 0830 Delivery completed 1530 End EX

33 Recovery

34 More Lessons Learned The Good Coordination of all phases of the operations: Receiving staff, JAS Warehouse Staff, Drivers-Use professionals Equipment, Supplies, Personnel Product Deployment Plan Created a Loadmaster Position (Last on First off) Pre-printed Form Back-up IAP Template for RSS Operations What Data Matters? / When? The Bad Paperwork can create delays Technology is not always your friend Took time to enter data Processing Orders Printing/Verifying Pick List Communications Always have a back-up Routing /Vehicle Restrictions

35

36 The Ugly: Stuff Happens!!

37 Next Steps GSA indicated they could do it! More Computers Contract improvements ACPH and GSA Law Enforcement Changes over the years Followed our Plan Used Job Action Sheets Staff minimum training Used our own PHEP Staff Annual Exercises Testing Certain Facets Checklists

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