Drill Tests County's Readiness

Drill Tests County's Readiness

More Volunteers Needed

A smallpox outbreak hit Fairfax County Oct. 25 resulting in the county opening its emergency clinic at Marshall High School in order to vaccinate residents against the disease.

Over the course of four hours, 300 members of BMAT, the Bioterror Medical Action Team, provided transportation to residents, registered and did a basic screening of arriving patients, provided educational information about the outbreak and the course of action, helped with registration forms, did more in-depth one-on-one medical screenings and administered the vaccine to those who were eligible to receive it.

In all, about 104 patients either received the smallpox vaccine or were referred to their personnel doctors for treatment because of exposure to the disease.

It was all part of a test of the county's bioterrorism response plan. The scenario had the county needing to vaccinate more than one million residents within three to five days. In order to reach that goal, the county would have to vaccinate at least 300 people per hour over the course of three days on a 24-hour basis.

"It was our first exercise. We can't test for every scenario, so we wanted to test the basics," said Dr. Gloria Addo-Ayensu, director of the county Health Department. "Did we get the numbers we needed? Is our transportation plan going to work? Is our communication system working? If it were a real-life situation, it would be a lot more chaotic."

ON THE SURFACE, the plan seemed to work without any major complications. A review of the response will determine any problem areas that may need to be addressed and changed in the existing plan. Addo-Ayensu said all of the volunteer BMAT members reported to the clinic and the process of ushering "patients" between the four stations — educational session, completion of registration forms, one-on-one screening and administering the vaccine (oranges and toothpicks were used to simulate the administration of the vaccine) — worked without major problems. In addition, other county and state agencies played a part providing medical assistance, security, transportation and support services. Some neighboring jurisdictions had representatives on hand as observers.

"I've been very pleased. It's gone extremely smoothly and the volunteers are so energetic," said Dr. Daniel Keim, member of the BMAT task force which helped design the emergency plan.

The exercise, however, only attracted 104 volunteer patients, which was less than the health department had hoped for. To test whether the system created could reach its goal of 300 people an hour, the patients were time stamped at each station. With the number of patients less than the required 300, the figures taken will have to be mathematically analyzed to see if the target would have been reached.

"We now have a sense of flow. We're seeing it in 3-D," Keim said. "I really couldn't say much [needed changing]. The general concept, I'm really pleased, worked. There were nit-picky things I noticed. Now, we're going to start looking at the next steps, but the basic concept seems to be sound."

THE DRILL was a culmination of a week-long series of similar exercises held across the state.

"It's part of one big drill. What we've done is look at a large number of aspects of a bioterrorism event," said Dr. Lisa Kaplowitz, deputy commissioner for Emergency Preparedness and Response Programs for the state Health Department. "Starting with what is the threat, Epidemiology confirming the threat and its release into the community, and the local response."

Kaplowitz said the various exercises were tailored to whatever it was that jurisdiction wanted to test, for example some had patients "freaking out," another had a bomb threat and several had patients who were argumentative and battling with the medical personnel trying to provide treatment.

ADDO-AYSENO said Fairfax's drill included people of all ages with the exception of small children, a range of disabilities and various primary languages to test the support services such as interpreters and special-needs assistance. In addition, some patients were asked to "act up," while others were asked to provide details that would be consistent with exposure to smallpox in order to test the screening process.

Kaplowitz said she was impressed with the level of cooperation between the various county agencies at the event, which included fire, police and even the parks and recreation department, which assisted those with special needs.

"There's a lot of security here. One site there wasn't any security," Kaplowitz said.

All of the jurisdictions will be required to submit an action report to the state, which will eventually be presented to the Secure Virginia Panel, said Kaplowitz.

"I was pleased people volunteered and showed up. People sign up and we assume they will show up if we need them," Addo-Ayensu said. "There was a collaboration with the medical community, the other county agencies, the cities of Falls Church and Fairfax. This planning has helped us."