Ebola preparedness and Response in Lao PDR

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Ebola preparedness and Response in Lao PDR
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Outline

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

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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
• .

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The preparedness contingency plan
Phase 1 Preparedness
Phase 2 Contingency for response

• 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

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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

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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

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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/decontamin
  ation 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

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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.

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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

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The preparedness contingency plan (Cont )

• Phase 1 Preparedness (Cont)
• Communication to public
• Designate spoke person
• Develop talking points and QA for the public
• Prepare 166 for EVD information
• Raise awareness among clinicians on Ebola and on
  recording travel history
•  

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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

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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

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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,

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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

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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

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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