1. From Drill to Reality: Lessons for Future Preparedness
Quan Le
Louisiana Immunization Registry Manager
March 8, 2006

2. Agenda Introduction Drill Experience
Comparison of drill characteristics to the Katrina response
Lessons learned

3. LINKS Field Staff

4. Drill versus an actual event
Pre-event & Post-event Preparations & Activity
Prior to Katrina
Jan 2003 – Smallpox Campaign
LINKS module created to collect professional and responder data, Bio-Prepared Response Professional
PVS compatible
Over 1,400 First Responders inoculated

5. Drill versus an actual event
Pre-event & Post-event Preparations & Activity
Prior to Katrina, cont.
July 2003 – Bio-Terrorism Drill
Combination of BT Response Capacity
Drill & live immunization clinic
Targeted all seven focus areas of LA’s BT grant
Target a cohort to raise immunization rates

6. Drill versus an actual event
Pre-event & Post-event Preparations & Activity
Prior to Katrina, cont.
March 2004 – Strategic National Stockpile (SNS) Drill
Scenario Based (Plague)
One Region in LA (Region 7 – Shreveport)
Planning Period was five months

7. A Levee Breach

8. Devastation of the Ninth Ward

9. Drill versus an actual event
Planning
Drill
Reality
Months of planning, coordination and partnering among multiple organizations
Less than one week for mobilization and deployment

10. Drill versus an actual event
Patient Flow
Drill
Reality
“In-the-front-door” and “out-the-back-door” workflow
Had to work within the “pool” of patients – unplanned workflow

11. Drill versus an actual event
Patient Volume
Drill
Reality
Prepared responders/healthcare personnel to process large numbers of patients in multiple PODs
Required the management of large groups in a clinic/living setting

12. Drill versus an actual event
Post-event Response
Drill
Reality
SNS drill targeted a single threat – plague. No need to review vacc. histories – just track antibiotics dispensed
Vaccination for multiple communicable diseases
- HepA/B, Tetanus, flu
– needed to review vaccination histories

13. Drill versus an actual event
Responder Issues
Drill
Reality
Food, shelter & transportation was controllable & not an issue
Major issue – responders themselves became residents of the shelters

14. Drill versus an actual event
Electronic Tracking
Drill
Reality
Able to use streamlined system interface (Mass immunization Module) to record meds dispensed
Had to review vaccination histories – required use of LINKS

15. Drill versus an actual event
Electronic Tracking, cont.
Drill
Reality
Access to WAN/Internet not an issue.
No WAN/Internet access from the PODs. Required new processes to meet objectives for inventory tracking.

16. Drill versus an actual event
Vaccine Supply & Distribution
Drill
Reality
For BT Drill, supply line was well established
Vaccine distribution center in New Orleans was lost

17. Drill versus an actual event
Facilities & Human Resources
Drill
Reality
Carefully planned and controlled
Facilities & other resources severely impacted –
- Loss of 11 hospitals
- Many responders were themselves victims

18. Drill versus an actual event
Duration
Drill
Reality
Limited in the BT drill to 3 days and ½ day in the SNS/Plague drill
Not clear at the outset

19. Lessons Learned Drills are scripted & controlled
Drills can’t account for all possibilities
Actual events are chaotic
Use the “big picture” gained from drills in preparation
Plan for threat possibilities specific to your region
New York City will be different from the Gulf States