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Simulation tests Fla., federal response during pandemic

By JOHN W. ALLMAN
Tampa Tribune (Florida)

TAMPA, Fla. — It was a first in U.S. disaster planning Wednesday, as local emergency management and health officials, working alongside a federal disaster team, simulated conditions expected if an avian flu pandemic were to occur.

The exercise brought employees from 22 local, state and federal agencies together, working to identify variables that might hinder Hillsborough County’s ability to deal with such a crisis.

The drill, in another first, was transmitted via satellite to the U.S. Centers for Disease Control and Prevention in Atlanta and Washington so health officials could watch in real time.

“We didn’t know how it would work, bringing in so many different groups of people who had never worked together before,” said Dennis LeMonde, spokesman for Hillsborough’s emergency management office. Overall, the effort was viewed as a success.

The main challenge that arose — providing better management of patients and their needs — was met by opening additional triage stations at an alternate treatment facility at the Florida State Fairgrounds, he said.

Local emergency rooms were flooded early Wednesday with 550 Armwood High School students, each exhibiting different symptoms associated with avian flu. At the fairgrounds, 250 more students arrived by bus in groups of 30 to the Special Events Center, each carrying a card with information specific to his or her condition.

Some students played older patients with long medical histories. Some were pregnant. Others pretended to be with an armed parent demanding medical care for their child.

Paige Palinkas, 16, an Armwood sophomore, played a 28-year-old expectant mother. She said 10 students off each bus were sent to the morgue, a blocked-off area with a black flag and body bags in rows.

“It really could really happen,” she said, sitting on a cot. “That’s the scary thing.”

The H5N1 strain of avian flu has killed 110 people worldwide since 2003, almost all from direct contact with infected wild birds or domestic poultry. It has yet to reach the United States, but officials believe it could arrive this year with migratory birds.

Maurice Brazil, commander for FEMA’s Homeland Security FL-3 Disaster Medical Assistance Team, based in the Tampa Bay area, said his unit was responsible for assisting thousands of hurricane survivors at Louis Armstrong New Orleans International Airport during Hurricane Katrina.

“There’s no way we’ll know what a pandemic will do,” Brazil said, as his crew assisted local doctors in treating patients. “What you’re seeing today is a picture of what we saw at Katrina.”

The exercise assumed conditions expected six weeks into a national outbreak. Hospitals would be at capacity and turning patients away. Alternate sites would be established. Security would be increased to quell panic and deal with the “walking worried,” people who might fear they are infected but really aren’t sick.

Catherine Carrubba, the county’s mass casualty director and an ER doctor at Tampa General Hospital, said the Disaster Medical Assistance Team’s experience is invaluable.

“They know how to do this,” she said. “As a community, we don’t how to do this. We’re learning from them today.”

Area hospitals have monitoring systems in place to gauge spikes in flulike symptoms being diagnosed, LeMonde said. Once those spikes reach a certain level, Wednesday’s drill becomes real.

“That’s a good thing for people to know,” he said. “There is a plan.”

County health and emergency management officials said the avian flu exercise helped identify areas needing attention while they continue to plan for a possible pandemic.

Hospitals: Area hospitals reported overwhelmed switchboards and security staffing and problems with patient management.

Alternate Treatment Center: A makeshift medical unit set up at the Florida State Fairgrounds experienced delays due to many patients arriving at once. Additional triage stations were created, allowing officials to better track and update the condition of patients during treatment.

Staffing: Estimates say as much as 30 percent of an area’s work force might be absent or sick in an outbreak. First responders — public safety and medical personnel — could be infected early on. Agencies such as the health department must maintain enough people to work multiple disaster locations.