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Pages 22-54

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From page 22...
... 22 chapter four Where the rubber hits the tarmac: six case examples introduction Six case examples of communicable disease response planning at U.S. and Canadian airports are presented here.
From page 23...
... 23 Pearson International is Canada's busiest airport in terms of total passengers, international passengers, total flight operations, and cargo tonnage. In 2002, just before the SARS outbreak, the airport served more than 14.5 million international passenger trips [Greater Toronto Airports Authority (GTAA)
From page 24...
... 24 In the surveys, Pearson, PHAC, and TPH noted having prepared for or dealt with the diseases shown in Table 11 in the past 15 years. Under the Quarantine Act, there are 25 diseases of concern; PHAC is prepared to deal with all 25 (S.
From page 25...
... 25 and Travel Health (an agency of the PHAC) had a focused public health campaign for MERS-CoV that included: (1)
From page 26...
... 26 Stakeholder Airport PHAC TPH Airport senior management X X Airport planning X Airport media/public relations X X Airport operations X X X Airport emergency management X X X Airport law enforcement Airport rescue and firefighting X X X Airport training X Airport maintenance Airport human resources Airlines, air cargo companies, charter operators, and air taxi operators X X Concessionaires Mobility services (wheelchairs, carts) Airport sponsor/certificate holder General aviation aircraft owners and pilots Local health department X X Provincial health department X X PHAC–quarantine station X X X Other public officials (elected officials, etc.)
From page 27...
... 27 • Provide guidance regarding appropriate PPE and infection control measures; and • Provide guidance regarding treatment or prophylaxis that may be needed for ill/exposed individuals. For responses to potential health problems with international travelers, PHAC is developing a surge capacity framework.
From page 28...
... 28 PHAC reported: 1. Challenges of the federal Quarantine Act because it does not pertain to domestic flights; 2.
From page 29...
... 29 medical grade mask, and with emergency personnel in tow, escorted him from the plane. Another announcement followed a few minutes later, informing passengers that the patient had active tuberculosis, was highly contagious, and had exposed everyone aboard the flight.
From page 30...
... 30 many opportunities to improve our response planning." It occasioned vast local and national media attention. The airport's emergency preparedness coordinator convened every stakeholder to a hotwash, an immediate after-action review (AAR)
From page 31...
... 31 TABLE 14 STAKEHOLDERS INVOLVED IN COMMUNICABLE DISEASE PLANNING PROCESS AT PHOENIX SKY HARBOR INTERNATIONAL AIRPORT Stakeholder Airport Health Department Airport senior management X X Airport planning X X Airport media/public relations X X Airport operations X X Airport emergency management X X Airport law enforcement X X Airport rescue and firefighting and EMS X X Airport maintenance X X Airlines, air cargo companies, charter operators, and air taxi operators X X Mobility services (carts, wheelchairs) X Airport sponsor/certificate holder X General aviation aircraft owners and pilots X Local health department X State health department X X CDC -- Quarantine Station X X Other public officials (elected officials, etc.)
From page 32...
... 32 • Liaising with state health department/CDC as needed to identify disease agent and arrange for laboratory testing; • Instituting control measures (isolation and quarantine or other measures necessary to control disease spread) ; • Collecting environmental samples; • Providing guidance on environmental cleaning measures/waste disposal; • Providing guidance regarding appropriate PPE and infection control measures; • Providing guidance regarding treatment or prophylaxis that may be needed for ill/exposed individuals; and • Leading any public information/messaging efforts in partnership with the airport.
From page 33...
... 33 activated in sequence or in series, as the situation dictates. The sources include available public health staff; activation of public health volunteers; requests for staffing assistance through the health care coalition; requests for staffing assistance through the fire/EMS automatic aid system; and requests for staffing assistance to adjoining counties and/or the state.
From page 34...
... 34 in 2014. By the end of the first quarter of that year, 13 U.S.
From page 35...
... 35 the plans and how developed Portland International maintains a communicable disease response plan, which is a stand-alone plan referenced in the AEP. The plan was developed in 2001 after 9/11 with help from the airport's fire department/EMS, the Multnomah County Health Department, the Port of Portland's Communication Center, CDC, and the regional hospital consortium.
From page 36...
... 36 TABLE 16 STAKEHOLDERS INVOLVED IN COMMUNICABLE DISEASE PLANNING PROCESS AT PORTLAND INTERNATIONAL AIRPORT Stakeholder Airport Health Department Airport senior management Airport planning X Airport media/public relations X X Airport operations X X Airport emergency management X X Airport law enforcement X Airport rescue and firefighting and EMS X X Airport maintenance Airlines, air cargo companies, charter operators, and air taxi operators X Concessionaires X Mobility services (wheelchairs, carts) Airport sponsor/certificate holder General aviation aircraft owners and pilots Local health department X State health department X X CDC -- Quarantine Station X X Other public officials (elected officials, etc.)
From page 37...
... 37 in which the health department participated was in 2014. The airport drills on communicable disease response at least every 2 years, but it also schedules a drill or exercise when regulatory requirements change; new procedures are introduced; or when the airport authority becomes aware of a new threat, such as a novel influenza or other communicable illness.
From page 38...
... 38 Multnomah County Health Department reported: 1. There are a lot of regulations (federal, airline, port, first responder)
From page 39...
... 39 federal government was equally unprepared. When calls were placed to the CDC, the agency reportedly did not initially consider Mr.
From page 40...
... 40 recent experiences The Ebola outbreak began in West Africa (Guinea, Sierra Leone, Liberia, and Mali) in March 2014 and was declared controlled in mid-2016.
From page 41...
... 41 ity plan. The plan also is incorporated into the airport's public safety standard operating procedures manual.
From page 42...
... 42 TABLE 19 STAKEHOLDERS INVOLVED IN COMMUNICABLE DISEASE PLANNING PROCESS AT DALLAS/FORT WORTH INTERNATIONAL AIRPORT Stakeholder Airport Health Department Airport senior management X Airport planning Airport media/public relations X X Airport operations X Airport emergency management X X Airport law enforcement X Airport rescue and firefighting and EMS X X Airport training Airport maintenance Airport human resources X Airlines, air cargo companies, charter operators, and air taxi operators X Concessionaires X Mobility services (wheelchairs, carts) Airport sponsor/certificate holder General aviation aircraft owners and pilots Local health department X State health department X CDC -- Quarantine Station X X Other public officials (elected officials, etc.)
From page 43...
... 43 In addition, a real-world incident can substitute for a drill or exercise required by regulations. Tarrant County Public Health conducted a drill on its plan in 2016.
From page 44...
... 44 3. Discuss contamination risks and decontamination procedures faced by first responders, public health, and medical care professionals in the prehospital environment.
From page 45...
... 45 fever, all of which are symptoms of Ebola infection (Massport 2014; Tradani and Feathers 2014)
From page 46...
... 46 On January 26, 2015, North America's first documented case of H7N9 avian influenza was confirmed when a Chinese national living in British Columbia's Lower Mainland became sick after returning from a trip to China, where she was infected with the virus. Although the risk to other Canadians was considered low because there is no evidence that H7N9 transmits easily from person to person (its primary vector of transmission is from infected poultry to humans)
From page 47...
... 47 senger with H5N1 influenza and one with H7N9 influenza, another who arrived with untreated TB, and an outgoing sick 3-year-old child. The influenza cases were summarized earlier.
From page 48...
... 48 the plans and how developed Vancouver Airport maintains an airport pandemic plan that includes • Communicable disease plan, • Communicable disease response plan, • Business continuity plan, and • Quarantine plan. The pandemic plan and its component plans are part of the AEP and a part of the airport's business continuity plan.
From page 49...
... 49 TABLE 23 STAKEHOLDERS INVOLVED IN COMMUNICABLE DISEASE PLANNING PROCESS AT VANCOUVER INTERNATIONAL AIRPORT Stakeholder Airport PHAC Airport senior management X X Airport planning X X Airport media/public relations X X Airport operations X X Airport emergency management X X Airport law enforcement X X Airport rescue and firefighting and EMS X X Airport training X Airport maintenance X Airport human resources X Airlines, air cargo companies, charter operators, and air taxi operators X X Concessionaires X Caterers X Mobility services (wheelchairs, carts) Airport sponsor/certificate holder X General aviation aircraft owners and pilots Local health department Provincial health department X PHAC -- quarantine station X X Other public officials (elected officials, etc.)
From page 50...
... 50 Vancouver Airport schedules a classroom session, seminar drill, tabletop exercise, functional exercise, or live exercise 1. Monthly (seminars, tabletop exercises)
From page 51...
... 51 2. A clear point of contact (leadership)
From page 52...
... 52 TABLE 24 COMMON THEMES IN CASE EXAMPLES YYZ PHX PDX DFW BOS YVR Disease Incident SARS TB Measles Ebola Suspected Ebola H5N9 influenza Year 2003 2013 March 2014 September 2014 October 2014 2015 Common Themes Scenario(s) 3 1a 3 3 1 3 How airport learned of ill passenger LHD/PHAC LHD network LHD CDC/LHD ATC, MedLink, airline LHD, PHAC Main airport role Assist LHD in epidemiology, screening incoming passengers Assist LHD in epidemiology; care to caregivers Assist LHD in epidemiology Assist LHD in epidemiology EMS services; report symptoms; liaison with LHD; liaison with pilot; isolation of plane Assist LHD in epidemiology Isolation used in response at airport Nob No No Yes Yes No Quarantine used in response at airport No No No No No No Specific airports designated as points of entry for enhanced screening of passengers from affected countries or areas No No No Yes No No Main LHD role SME, epidemiology, medical coordination, PIO SME, epidemiology, medical coordination, PIO SME, epidemiology, medical coordination, PIO SME, medical coordination, PIO SME, medical coordination, PIO SME, epidemiology, medical coordination, PIO CDC/PHAC used as resource Yes Yes Yes Yes Yes Yes Airport EOC activated ?
From page 53...
... 53 for temporal trends across 2003 through 2016. The data were gathered from July 2016 through February 2017.
From page 54...
... 54 3. During communicable disease events, the designated public health partner is the lead to ensure that the risks to the population are managed as quickly as possible.

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