UNS-Belize-IPP - Avian Influenza

UNS-Belize-IPP - Avian Influenza UNITED NATIONS SYSTEM – BELIZE CONTINGENCY PLAN FOR INFLUENZA PANDEMIC May, 2006 UNITED NATIONS SYSTEM – BELIZE CONTINGENCY PLAN FOR INFLUENZA PANDEMIC I. INTRODUCTION The United Nations System (UNS) has the responsibility to protect and safeguard the health and safety of staff and their dependents in the event of crisis situations. In addition the UNS must maintain essential functions to assist the country in responding to such situations. Considering the threat of a potential Influenza Pandemic, the UN Secretary General directed all UN Offices to develop plans on how to protect staff, continue operations and support national efforts during a pandemic (UN, March 2006). The UNS in Belize therefore developed this plan to guide a coordinated and systematic preparedness and response of all UN Agencies in the country for a potential influenza pandemic. The plan was developed using the United Nations Medical Services Staff Contingency Plan for an Influenza Pandemic (UNSMD, March 2006), the Pandemic Planning and Preparedness Guidelines for the United Nations System (UN, March 2006) and the WHO Global Influenza Preparedness Plan (WHO, 2005). The plans will be implemented according to the phases established by the World Health Organization. II. OBJECTIVES The objectives of this plan are to: - Minimize the impact of the influenza pandemic on the health and safety of staff and their dependents. - Ensure a timely and effective response of the UN system that will enable the Organizations to fulfill their mandates in supporting the national preparedness and response III. THE UN IN BELIZE The UN system in Belize consists of 4 UN Agencies (UNDP, UNICEF, UNFPA and PAHO/WHO) with a total of 38 staff members (4 international and 34 national) and 96 dependents (6 international and 90 national) (Annex III). Of the four agencies only UNDP is based in Belmopan while the others are in Belize City. The majority of the staff lives in or around Belize City, with some residing in Belmopan City and San Ignacio/Santa Elena Town, Cayo District (Figure No.1) Over that last few years the UNS in Belize has had experience in responding to natural disasters, mainly hurricanes and floods, and therefore it is expected that these experiences will be very useful in preparing and responding to the Influenza Pandemic. 1 Figure No.1 - Map of Belize IV. NATIONAL PREPAREDNESS AND RESPONSE TO INFLUENZA PANDEMIC A national Avian/Influenza Pandemic Preparedness and Response Committee has been established under the National Emergency Management Organization (NEMO). This Committee is responsible for the coordination of preparedness and response activities for Avian Influenza and/or Influenza Pandemic according to the threat level in the country. PAHO/WHO is the UN representative for emergency preparedness and response, and therefore represents the UNS on this national committee. In addition there is a Health Committee responsible for the human health aspects of the Pandemic and an Agricultural Committee responsible for animal health (avian influenza). PAHO/WHO is also a member of the Health Committee in its own right and functions as a representative of the UN Agencies as well. V. ROLES AND RESPONSIBILITIES The Designated Official and the Security Management Team (SMT): 2 Given the small number of UN Agencies operating in Belize it is not considered necessary to establish a separate Crisis Management Team (CMT) for Influenza Pandemic. The SMT will therefore undertake the functions of CMT and will be strengthened with a UN physician. The DO in coordination with the SMT/CMT will be responsible for coordinating the response actions, according to the operational plan outlined in Annex I. Once a Pandemic Phase (Table 1), the SMT/CMT will activate the UNS Operational Contingency Plan accordingly. The DO will activate the different phases in country and the Heads of Agencies will ensure that preparedness and response actions are implemented in their individual agencies. Essential functions, as defined by the SMT/CMT will be coordinated from the UN Crisis Coordination Center (UNCCC). These functions are outlined in Section VI. The SMT/CMT will take operational decisions and inform UN Headquarters in New York of precautionary and security measures being implemented for the safety and well being of UN staff and dependents. The individual agencies will inform their own headquarter offices. The SMT/CMT will be responsible to adjust and update the operational guidelines for the Contingency Plan for Influenza Pandemic as required under the guidance of PAHO/WHO. It should be noted, that the Security Phase will be determined according to the developing situation in the country at the time. The DO in consultation with the SMT and UNDSS will determine increasing the Security Phase, as necessary. Heads of Agencies (HOAs): The HOAs will ensure that the preparedness and response actions, as set out in Annex I are carried out in their individual agencies. It is the responsibility of each head of agency to ensure that their respective staff is properly informed about the developments in relation to the Pandemic. Each agency will also be required to acquire a prescribed amount of protective equipment and supplies for their staff (Annex VIII), which will be distributed upon the advice from the SMT/CMT Each Agency must also ensure that there is an updated staff list, including emergency contact numbers. Influenza Pandemic Focal Point (IPFP): The IPFP will support the DO and SMT in the implementation of the different components of the plan, including training of staff and preparation of guidelines and staff awareness materials. The IPFP will also provide technical assistance to the National Influenza Preparedness and Response Committee and will function as the liaison officer between the SMT/CMT and the National Avian Influenza/Pandemic Preparedness and Response Committee. Influenza Pandemic Technical Group (IPTG) 3 This group will be comprised of technical personnel from each UN agency and will be responsible to work closely with the IPFP to ensure the plan activities are implemented in the respective UN Agencies. Recommendations from the group will be submitted to the SMT/CMT for approval and follow-up. Staff Members: While it is the responsibility of the UNS to ensure the safety and security of the UN Staff and dependents, each staff member has the responsibility to take the necessary precautionary and preventive measures for their own health and safety, and that of their families. Staff members must comply with the guidelines set out in this plan and with instructions provided by the respective heads of agencies, or any other action deemed necessary by the SMT/CMT for the protection of staff members, dependents or the entire UNS. VI. OPERATIONAL CONTINGENCY PLAN The Operational Contingency Plan will be implemented according to the alert and response phases established by WHO (Table No.1). In light of the fact that Pandemic Response Plan is now in Phase 3, this plan does not address Phases 1 and 2. The specific activities of the plan along with the responsible agencies/individuals are outlined in the Operational Response Matrix in Annex I. Table No. 1 – WHO Pandemic Phases Inter-pandemic Phase 1 No new influenza virus detected in humans. If a new influenza period virus presents in animals, the risk of human infection is considered to be low Phase 2 No human infections, but a circulating animal influenza virus poses a risk to humans Pandemic alert Phase 3 Human infection(s) with a new virus, but no (or very infrequent) period human-to-human spread. Phase 4 Small human-to-human cluster(s) - less than 25 people, lasting less than 2 weeks, highly localized - virus is not well adapted to humans Phase 5 Larger human-to-human cluster(s) - between 25-50 people, lasting from 2-4 weeks, still localized but virus increasingly better adapted to humans Pandemic period Phase 6 Significantly increased and sustained transmission in general population Post Pandemic Post Return to Inter-pandemic period period Pandemic 4 Independent of the Pandemic Phases, seasonal influenza vaccination is recommended for staff and dependants who are at high risk of complications from influenza. The vaccine can be obtained from one of the UN physicians. Command and Control The response will be managed from the UN Crisis Coordination Center (UNCCC). The incident commander is the DO who, with the support from the SMT will coordinate and monitor the response activities of all UN Agencies, concentrate and disseminate all relevant information to UN staff and dependents and report to Headquarters, New York. In addition, constant liaison with relevant host government agencies and continuous monitoring of the host government?s response to the crisis will be maintained by the SMT. Monitoring and Evaluation The primary responsibility in this area will fall upon the SMT to meet regularly, as the situation warrants at the UNCCC to monitor the developing crisis, assess current operations, and identify gaps in the current plan and areas that may require additional attention. VII. ANNEXES I. Operational Preparedness and Response Matrix II. SMT/Essential Staff List and Emergency Numbers III. National Authorities Contact IV. NY/HQ Contact List V. Staff and Dependents List VI. Priority groups for Pandemic Vaccine VII. List of Essential Supplies VIII. Personal Protective Equipment VIII. REFERENCES - UNSMD (2006). United National Medical Services Staff Contingency Plan Guidelines for an Influenza Pandemic. United Nations Medical Directors. - UN (2006). Pandemic Planning and Preparedness Guidelines for the United Nations System. United Nations, New York. - WHO (1995). WHO Global Influenza Preparedness Plan, the role of WHO and recommendations for national measures before and during pandemics. World Health Organization, Geneva. 5 ANNEX I OPERATIONAL PREPAREDNESS AND RESPONSE MATRIX PHASE 3: Human infection(s) with a novel subtype, but no human to human spread, or at most rare instances of spread to a close contact ACTION RESPONSIBILITY PLANNING AND Familiarize with national preparedness and response plan DO/SMT/CMT, ITG and COORDINATION Essential Staff Establish a UN technical group for IP (IPTG) SMT/HOAs Strengthen SMT with UN doctor to serve as the Crisis Management Team DO (CMT) Assess preparedness status and identify gaps and develop plans to address these IPTG/SMT/CMT gaps Identify critical functions and the associated staff needed to maintain the HOAs following functions: , Physical security of staff , Medical care of staff , Maintenance of computers and telephone services , Ability to communicate with other Organizations and Governments , Maintenance of Utilities (electricity, water and sanitation) , Ability to make important operational and policy decisions related to the pandemic , Ability to make important operational and policy decisions related to critical operations and programs continuity Identify hospitals in the country and region where critically ill staff may be sent SMT/CMT/UN Doctors and develop specific plans for facilitating their rapid hospitalization, for example via a Memorandum of Understanding Identify location from which UN Agencies will operate in the event of IP affects HOAs/SMT the country Advise staff to remain alert and to procure basic supplies to sustain them and HOAs their families in the event of a national emergency Distribute the UN IP plan to all Agencies and UN Doctors IPFP Provide technical support to national authorities in preparing national plans IPFP and other technical staff, as necessary PREVENTIVE & Prepare list and submit to WHO headquarters on medication needs for UN Staff DO/HOAs/IPFP MEDICAL and dependents. INTERVENTIONS “Pandemic” Identify high risk group who will receive the „Pandemic Vaccine? once it SMT along with UN Vaccines becomes available (Annex VI) doctors Antiviral Acquisition of Oseltamivir (Tamiflu) to treat 30% or more of staff and DO/SMT dependents. Ensure availability of Oseltamivir to provide to essential staff as prophylaxis for DO/UN Doctor 6 weeks. Antipyretics Encourage staff members to stock enough paracetamol for their own needs. Individual staff members Antibiotics Identify sources of antibiotics for the relief of secondary infections for Staff DO/SMT/CMT members and dependents. 6 ACTION RESPONSIBILITY Protective Procure: Equipment and HOAs with advice from , Surgical masks in numbers sufficient to provide all staff and dependents with other preventive UN doctors. 2 masks per day for 6 weeks. interventions , Enough Personal Protective Equipment (PPE) including masks, gloves and gowns (Annex VIII) for essential staff involved in high risk response activities. Staff members , One set of needles and syringes per staff member and dependent. , Thermometers COMMUNICATION Update all UN Staff, including UN Physicians on situation and preparedness and DO/IPFP/HOAs response plan. Provide health travel advisory to all agencies PAHO/WHO Provide regular updates to staff on the disease and information on preventive IPFP/IPTG measures, including personal hygiene Provide information on case management and Infection Control Guidelines to all PAHO/WHO UN doctors PHASE 4: Small cluster(s) with limited human to human transmission but spread is highly localized, suggesting that the virus is not well adapted to humans ACTION RESPONSIBILITY PLANNING AND Declare Pandemic Alert Phase 4 PAHO/WHO/DO COORDINATION Convene regular meetings for the SMT/CMT DO Convene regular technical group meetings and ensure response plan is up to date. IPFP Continue monitoring the situation closely and report to UN HQ/NY and IPFP/IPTG individual agencies of developments in country PREVENTIVE & MEDICAL INTERVENTIONS “Pandemic” Review high risk group for „Pandemic Vaccine? and update as necessary IPFP/ITGP Vaccines Antiviral Ensure Oseltamivir (Tamiflu) is available to staff as determined in Phase 3 and HOAs store in secure localtion. Antipyretics Continue encouraging staff members to stock enough paracetamol IPFP Antibiotics Secure sources of antibiotics for the relief of secondary infections for Staff DO/SMT/CMT members and dependents. Distribute PPE to essential staff HOAs Conduct emergency simulation exercises HOAs – Individual Agencies Confirm contractual medical care agreements with health care providers and SMT/CMT facilities Protective Ensure supplies listed in Phase 4 haven been procured HOAs/IPTG Equipment and other preventive interventions COMMUNICATION Issue health travel advisory PAHO/WHO Advise staff to prepare for staying at home for 6 and to stock supplies for at least DO/SMT/CMT/HOAs 6 weeks Inform staff of local healthcare arrangements HOAs - Individual Agencies Issue advice on personal protection and hygiene IPFP/IPTG 7 ACTION RESPONSIBILITY Ensure guidelines on management of suspected/probable cases are distributed to IPFP/IPTG each UN Doctors PHASE 5: Larger cluster(s) but human to human spread still localized, suggesting that the virus is becoming increasingly better adapted to humans, but may not yet be fully transmissible (substantial pandemic risk). ACTION RESPONSIBILITY PLANNING AND Declare Pandemic Alert Phase 5 PAHO/WHO COORDINATION Monitor the situation closely and maintain NY/HQ and individual agencies SMT/CMT – IPFP/IPTG updated. Instruct staff to stay at home ensuring that that they have sufficient food, water, DO/HOAs prescribed medication and supplies, medical kits and other essentials to last for at least 6 weeks (Annex VII), until the pandemic wave has passed. Report suspected case to UN HQ/NY and individual agencies HQ. DO/HOAs Follow up treatment with UN Doctors and maintain UNSMT/CMT updated on HOA/DO the situation. Defer all non- critical UN and activities in the country. DO/SMT Defer all non- critical travel according to UN Travel Advisories DO/SMT Defer all travel of UN staff presenting with influenza-like symptoms HOA/UN Doctors PREVENTIVE & MEDICAL INTERVENTIONS Treatment Provide treatment as necessary following case management guidelines UN Doctors “Pandemic” Provide to high-risk groups and essential staff UN Doctors on the Vaccine advise on DO/SMT Antivirals Provide antiviral within 48 hours to symptomatic persons who meet the clinical UN Doctors case definition criteria in accordance to Case Management Guidelines to be provided later Provide antivirals as prophylaxis to essential staff with high risk of exposure UN Doctors (Annex VI) and those in contact with symptomatic persons Antipyretics Use as prescribed As above Antibiotics Use as prescribed As above Protective Reinforce the promotion of the use of PPE and hygiene guidelines Individual UN Agencies Equipment and other preventive Home confinement of symptomatic persons (seven days since resolution of fever HOAs interventions or as recommended by physician). COMMUNICATION Inform staff of travel restrictions DO/HOAs Instruct family members of a symptomatic person not to come to work to ensure UN Doctor/HOA containment at early stage. Update and disseminate infection control guidelines for cases and exposure to IPTG/IPFP cases Keep staff informed and updated on developments HOAs 8 PHASE 6: Increased and sustained transmission in the general population. ACTIONS RESPONSIBILITY PLANNING AND Declare Pandemic Phase 6 PAHO/WHO COORDINATION Acquire pandemic vaccine once available DO/SMT/CMT/UN Doctors Convene SMT/CMT meetings DO Monitor the situation and maintain all levels informed. IPFP/IPTG MEDICAL Provide treatment following the case management guidelines UN Doctors INTERVENTIONS „Pandemic Apply vaccination according to priority groups already identified DO/UN Doctors Vaccine? Antivirals Provide antivirals as prophylaxis to essential staff with high risk of exposure DO/UN Doctors and those in contact with symptomatic persons Protective As in Phase 5 Equipment and other preventive interventions COMMUNICATION Maintain staff updated See Phase 5 Post Pandemic Period: The pandemic wave has passed ACTIONS RESPONSIBILITY PLANNING AND Assess status of staff and provide support, as necessary DO/SMT/CMT COORDINATION Focus on recovery but maintain a level of readiness in the event of re-occurring outbreaks. Continue monitoring, and where necessary implement containment of activities 9 ANNEX II UNS BELIZE – SMT AND OTHER ESSENTIAL STAFF Security Management Team Name Agency/Title Home Address Office Tel. # Emergency Tel. # Dr. Kathleen Israel PAHO/WHO #12 St. Mathews St, Belize (501) 224-4885/5536 Home: 223 6230 Representative, Designated Official City Mobile: 610 3404 Mrs. Rana Flowers UNICEF #6217 seashore Drive, (501) 223-3864/3609 Home: 223 4515 Representative, Alternate Designated Official Buttonwood Bay, Belize City Mobile: 610 2201 Mr. Joseph Hendrikx UNDP #9 Lubaantun Street, (501) 822-0689/2688 Home: 822 0674 Program Director Belmopan City Ms. Jewel Quallo-Rosberg UNFPA, Liaison Officer #1591 Seashore Drive 501) 223-1644 Home: 223 1889 Belize City Essential Staff Mr. Rony Maza PAHO/WHO #9 Morrison Alley, Belize City 224-4885/5536 Home: 227 1355 Technical Advisor/Influenza Focal Point Mobile: 601 7879 Dr. Guillermo Troya PAHO/WHO Benny’s Apartments, Town 224-4885/5536 Home: 223 6714 Technical Advisor – Health Services House # 1, Mile 3 Northern H. Mobile: 600 9987 Way. Ms. Ruby Dominguez PAHO/WHO # 1161 Coral Drive, Vista del 224-4885/5536 Home: 225 3377 Mar, Ladyville Mobile: 601 8449 Ms. Claudette Hulse UNDP Buena Vista Street, San 822 - 2688 Home: 824 2690 Finance/ Admin Officer Ignacio Mobile: 621 4047 Mr. Philip Balderamos UNOPS- Small Grants Program 19/21 Turneffe Avenue, 822- 2462 / 2688 Home: 822 3523 National Coordinator Belmopan City Mr. Roy Bowen UNICEF #92 Lake Garden, Ladyville 223-3864/3609 Home: 225 2594 Project Officer Mrs. Agnelia Constantino UNICEF #11 Dolphin Drive, 223-3864/3609 Home: 203 6996 Operations Officer Buttonwood Bay, Belize City Mobile: 600 1050 UN Doctors Name Specialty Work Address Office Tel. # Emergency Tel. # Dr. Pedro Arrigaga Internist 8 Handyside Street Office:223-5479 Home: 223 2594 Belize City Mobile: 601 9275 Dr. Filiberto Cawich Internist Belize Medical Associates, Office: 223-0303 St. Thomas St, Belize City Sesha Meenavalli General Practitioner #17 Unity Blvd. Belmopan Office: 822-2565 Mobile: 602 5339 City 10 ANNEX III NATIONAL AUTHORITIES CONTACT LIST NAME TITLE ADDRESS WORK TEL # EMERGENCY # Col. George Lovell National Emergency Ministry of Foreign Affairs Defence and 822 0995/822 2054 Mobile: 605 1877 Coordinator, NEMO NEMO, New NEMO Building, Belmopan Hon Jose Coye Minister of Health, East Block, Independence Plaza, 822-0589 Home: 223 1501 Communications and Belmopan Mobile: 610 5001/1183 Transport Ms. Margaret Ventura Chief Executive Officer, East Block, Independence Plaza, 822-2326 Home: 822-3145 Ministry of Health, Belmopan Mobile: 610-3735 Communications and Transport Dr. Jorge Polanco Director of Health Services Ministry of Health, Belmopan 822 2325/2363 Home: 203 3575 (a.i) Mobile: 600 9961 Dr. Paul Edwards Deputy Director of Health Ministry of Health, Belmopan 822-2325/2363 Mobile: 605 3599 Services (a.i)/ National Influenza Focal Point Mr. Godswell Flores Principal Public Health Ministry of Health, Belmopan 822 2325/2363 Home: 225 1077 Inspector/Disaster Focal Mobile: 601 8371 Point 11 ANNEX IV UN HQ – CONTACT INFORMATION Name Post Office Tel # Emergency Tel # E-mail Dr. David Navarro UN System Influenza david.nabarro@undp.org Coordinator Dr. Carissa Etienne PAHO/WHO Regional 1-202-974-3404 etiennec@paho.org Coordinator for Influenza Pandemic Ms. Diana Russler Deputy United Nations Security 1-212-963-7584 1-646-473-0458 russler@un.org Coordinator 1-917-402-9762 Mr. Chris Maxfield UNDSS - Chief of the 1-917-367-9189 maxfieldc@un.org Europe/Americas Section Mr. Stefano Palazzi UNDSS – Responsible for 1-917-367-4273 1-917-208-0604 palazzi@un.org Central America 12 ANNEX V STAFF AND DEPENDENTS LIST Agency International International National National Staff TOTAL Staff Staff Staff Dependants Number of Dependants persons per agency and for UNS Belize UNICEF 2 3 6 14 25 PAHO/WHO 2 3 18 41 64 UNDP - - 5 22 27 UNFPA - - 2 4 6 UNOPS - - 3 9 12 TOTAL 134 4 6 34 90 13 ANNEX VI PROPOSED PRIORITY GROUPS FOR PANDEMIC VACCINE Proposed priority groups for pandemic vaccine (as per UNMDS guidelines) Group 1. Health professionals (healthcare providers and relevant public health specialists) 2. Staff performing critical functions with high risk of exposure 3. Remaining staff performing critical functions 4. Persons at high risk of severe or fatal outcomes following influenza infection , staff and dependents with high risk medical conditions , immuno-compromised individuals , >65 years of age , children between 6 – 23 months of age , pregnant women 5. Children 24 months to 18 years 6. Healthy adults Even though the recommended priority groups are determined, they will be continually revised in light of new information that is learnt about the pandemic virus. When sufficient pandemic influenza vaccine is available, the entire staff population will be offered vaccination. 14 ANNEX VII RECOMMENDED LIST OF 6-WEEK SUPPLIES TO BE STOCKED Water Stock bottled water or other safe drinking water in secure plastic containers (with proper cover) – At least 4 liters (1 gallon) of water per person per day for at least six weeks. Water purification kits or filters are readily available and should be purchased as a back up. Food Store a six-week supply of non-perishable foods. Select foods that require no refrigeration as electricity supplies may not be available. Consider ready to eat foods and those that require little or no water to prepare. Foods that you may consider are: , Ready-to-eat canned meats and soups, fruits and vegetables , Dry goods such as noodles (remember that you will need water to cook these items), dry cereal, granola, dried fruits and crackers , Canned juices , Peanut butter or nuts , High energy foods such as protein or fruit bars , Food for infants – canned or jarred baby food and formula , Pet food Other supplies: , Buy extra garbage bags and cleaning supplies; viruses such as Avian Influenza are easily cleaned away with formalin and iodine-based disinfectants. , Plastic containers and plastic wrap to store food. , Buy extra provisions of candles, kerosene/gas lamps , Personal hygiene items such as soaps, tooth paste, tissue, wipes, etc. , Portable radio , Fire extinguisher (make sure you all know how to use it) , A battery operated clock that , Flashlight , Extra batteries , Manual can opener Food Storage Advice , Keep food in the driest and coolest spot in the house – a dark area if possible. Make sure that it is sealed off from possible vermin , Keep food covered at all times 15 , Open food boxes or cans carefully so that you can close them tightly after each use. , Wrap cookies and crackers in plastic bags, keep them in tight containers, this will stop them from going stale and prolong shelf life , Empty opened packages of sugar, dried fruits and nuts into screw-top jars or airtight cans to protect them from pests , Inspect all food containers for signs of spoilage before use , If you lose power, minimize waste by using the food in your fridge first, then the freezer and then finally your non-perishable items Shelf Life of Foods for Storage , Use within six months: Powdered milk (boxed), dried fruit (in metal container), dry, crisp crackers (in metal container), and potatoes , Use within one year: Canned condensed meat and vegetable soups: canned fruits, fruit juices and vegetables; ready-to-eat cereals and uncooked instant cereals (in metal containers); peanut butter, jams; hard candy, chocolate bars and canned nuts , May be stored indefinitely (in proper containers and conditions): Wheat: vegetable oils; corn; baking powder, soybeans, instant coffee, tea, vitamin C and cocoa, salt, non-carbonated soft drinks, white rice, bouillon products, dry pasta, powdered milk (in nitrogen-packed cans) Fuel , Purchase and store in safe containers an emergency supply of gasoline/diesel for your car , Ensure to have a back up supply of cooking gas (butane/propane) Disposal of Wastes Remember that if there is movement restrictions imposed in an area, the collection of waste may not be possible. It is important that you consider alternative arrangements such as composting food wastes. If you live in a multiple storey building, ask the building manager if there are emergency plans in place to deal with not only waste disposal but also possible disruption to water and electrical supplies Medical Kits Emergency services may be limited during time of crisis, therefore make sure your home emergency medical kit is not out-of-date, check all supplies for expiry dates and replace any items that are out-of-date or nearing expiration date. You may wish to consider the following items: , Glucose and blood pressure monitoring kit , Adhesive bandages, different sizes , Sterile dressings, small and large , Sterile gauze pads, large and small , Adhesive tape, 2” width , Medical grade non-latex gloves 16 , Waterless alcohol-based hand sanitizer , Antiseptic wipes , Anti-bacterial ointment , Cold pack , Scissors , Tweezers , Thermometers – remember to have a spare , CPR breathing barrier, such as a face shield , Face masks, 3-ply simple surgical masks , Pain and fever reliever – remember to include both children and adult supplies , Anti-diarrhea medication , Anti-acid (for stomach upset) , Vitamins , Fluids with electrolytes (oral rehydration solution (ORS)) , Stock up on prescription medications that you might need, for example, if one of your family members is diabetic, ensure that you have enough supplies for at least 6 weeks, or if someone has a heart condition, ask your doctor for an extra prescription so that you can have an emergency supply of all the medications your family members need. , You may need extra bedding if a family member becomes sick, such as sheets, towels, plastic mattress covers, etc. Consider where you could make up a sick bay which could be isolated from the rest of the house and how would you ventilate this room. It is important that air from the room is expelled to the outside of the house and not back into the house, consider how this might be done 17 ANNEX VIII PERSONAL PROTECTIVE EQUIPMENT (PPE) *FOR ESSESNTIAL STAFF WITH HIGH-RISK EXPSURE This is an average supply that has been worked out for this category of staff, calculating 2 changes per day for each person for 6 weeks. Quantity Quantity for 6 Item Description Unit Per day weeks 1 Protective goggles, polycarbonate, reusable Each 3 N/A 2 Face mask grade P2 (or N95), disposable Box of 20 2 84 3 single use gloves, small, anatomically shaped, PAIR 10 420 latex, non-sterile 4 Single use gloves, medium, anatomically PAIR 10 420 shaped, latex, non-sterile 5 Single use gloves, large, anatomically PAIR 10 420 shaped, latex, non-sterile, 6 Single use plastic apron, EACH 2 84 7 Rubber Gloves (reusable for environmental PAIR 10 N/A cleaning) 8 Coverall, disposable, non sterile EACH 2 84 **9 Alcohol rub disinfectant – Dangerous bottle/ 1 N/A goods – UN code 1987, Class 3 1000ml 10 Disposable bag for bio-hazardous waste – EACH 1 N/A 1 bag per day for 6 weeks. 42 bags 11 Disposal bag for bio hazardous waste, small, EACH 1 N/A with “Bio-Hazard” print, polypropylene – 42 bags 1 bag per day for 6 weeks * This PPE kit is not adequate for veterinarian purposes including for culling. ** This should be procured locally to avoid problems with shipping of dangerous goods. If it cannot be supplied locally, order separately. Alternatively, chlorhexidine gluconate 4% solution in bottles of 250 ml each (that means 4 bottles per kit to equal the liter requirement per kit), could be procured. 18