Ebola preparedness and Response in Lao PDR

Outline Objective The preparedness contingency plan Phase 1: Preparedness Phase 2: Contingency for response Challenge

Objective To prepare for detect, investigate and manage Ebola cases in Lao PDR To ensure appropriate the capacity to manage travellers originating from known Ebola-infected.

The preparedness contingency plan Leadership, coordination and information Point of entry ( POE ) Health care system preparedness Laboratory and biosafety Surveillance and contact tracing Communication and public Travel and trade policy Phase 1: PreparednessPhase 2: Contingency for response

The preparedness contingency plan (Cont ) Phase 1: Preparedness Leadership, coordination and information: DCDC daily briefings to the Minister of Health on the EVD situation, the risk for Lao PDR and the level of preparedness IHR focal point to update DCDC daily on EVD situation Weekly coordination meetings at DCDC on EVD situation including an updated

The preparedness contingency plan (Cont ) Phase 1: Preparedness Point of entry (PoE) preparedness : Staff working at “points of entry”, especially airport operators, aircraft operators and port health authority are trained to recognise early and advanced symptoms of viral hemorrhagic fever Approval and activation of the PoE contingency plan Assessment of capacity and equipment at the PoEs Development of passenger declaration form and passenger guidance Development of SOPs for appropriate referral of symptomatic travellers from affected areas including notification to relevant authorities Increase of staff capacity at PoEs

The preparedness contingency plan (Cont ) Phase 1: Preparedness (Cont) Health care system preparedness: Train staff working in healthcare settings to recognize early and advanced symptoms of viral hemorrhagic fever Designation of a central referral hospital with isolation facilities Designation of an experienced IPC team Assessment of capacity needed for IPC including review of isolation and treatment protocols, handling of human remains, disinfection/decontamination procedures, waste disposal, supply and equipment Identify supplier and procure sufficient supplies of PPE for isolation unit Awareness raising of hospital and health care staff

The preparedness contingency plan (Cont ) Phase 1: Preparedness (Cont) Laboratory testing capacity and biosafety: Designate BSL 3 laboratory for EVD testing Establish protocols for EVD testing, including testing for differential diagnosis Procure /acquire necessary reagents and supplies including positive controls. Perform assay with positive control to verify operational capacity. Identify international referral laboratories (WHO collaborating center) and establish a mechanism for shipment of clinical samples for confirmatory testing.

The preparedness contingency plan (Cont ) Phase 1: Preparedness (Cont) Surveillance and contact tracing: Collate and review daily information from different surveillance systems, e.g.: Event based surveillance including 166, WHO EIS, IHR focal point, Media reporting Disseminate daily information to DCDC Conduct regular risk assessment Use FET as surge capacity

The preparedness contingency plan (Cont ) Phase 1: Preparedness (Cont) Communication to public: Designate spoke person Develop talking points and Q&A for the public Prepare 166 for EVD information Raise awareness among clinicians on Ebola and on recording travel history

The preparedness contingency plan (Cont ) Phase 1: Preparedness (Cont) Travel and trade policy Determine travel and trade policy, e.g. travel advice for travelling to affected areas

The preparedness contingency plan (Cont ) Phase 2: Contingency for response Leadership, coordination and information DCDC daily briefings to minister on the EVD situation Activate MoH EOC Share information with WHO and other stakeholder Mobilize resource Regular risk assessment

The preparedness contingency plan (Cont ) Phase 2: Contingency for response (Cont) Health care system response Contact tracing among staff and patients who have been in direct contact with the suspected patient. Setting up medical monitoring of identified contacts (fever and prodromal symptoms); Ensuring barrier management in all areas where the suspected patient has been treated (contaminated zone, transition and “clean” zone). Ensure continuous proper use of PPE by all medical staff. Medical staff in isolation area should be monitored with to donning and doffing PPE and with respect to time on duty in the isolation ward,

The preparedness contingency plan (Cont ) Phase 2: Contingency for response (Cont) Lab testing and biosafety Ensures reagents available and biosafety practice applies Share and ship the specimen with WHO reference lab Conduct testing

The preparedness contingency plan (Cont ) Phase 2: Contingency for response (Cont) Surveillance Contact tracing among staff and patients who have been in direct contact with the suspected patient. Setting up medical monitoring of identified contacts (fever and prodromal symptoms); Conduct regular risk assessment Use FET as surge capacity

Challenge Quarantine facility is not appropriated at International Airport Lack of Medical staff working at Airport Laboratory testing IPC-PPE usage and practicing for Health Care workers Information sharing Financial support