Identify Resources and Needs

Begin planning by assessing the community’s existing resources. Identify resource gaps and needs the community might face in a smallpox emergency. The scope of the outbreak will determine the level of response each community will need to mount. Communities with smallpox patients will have different response needs than those without smallpox patients. Depending on the severity of the outbreak, local response teams may need to:

• Isolate and care for suspect cases.
• Institute enhanced surveillance of acute, febrile rash illnesses.
• Coordinate with state public health officials and CDC to diagnose patients with smallpox and receive shipments of medical countermeasures.
• Activate an Emergency Operations Center, following jurisdictional standards and practices within the National Incident Management System.
• Designate one or more healthcare facilities to treat only patients with confirmed smallpox. This may require designating other facilities to monitor suspected, febrile patients, and others to handle routine medical care.
• Launch contact tracing efforts and contact monitoring systems.
• Work with law enforcement if the emergency is considered a deliberate act.
• Rapidly vaccinate healthcare workers, first responders, public health officials, and other people who will interact with smallpox patients.
• Execute vaccination strategy or strategies, depending upon the circumstances of the event.
• Monitor and report adverse events that may have resulted from vaccination.
• Communicate effectively and regularly with the media and the public.
• Provide information and data to state and federal public health officials to inform state and national response decisions.

Identify circumstances that will affect local response plans:

• Review state and local laws and regulations that govern different aspects of an emergency response to smallpox, including, but not limited to:
  • Quarantine laws
  • Hazardous waste disposal and transportation regulations
  • Credentialing requirements for healthcare workers in vaccination clinic
• Identify the availability of healthcare facilities with Airborne Infection Isolation Rooms (AIIRs) to isolate smallpox patients.
  • Encourage healthcare facilities to enter into Memoranda of Understanding (MoU) to allow for easy patient transfers. Review existing MoUs to ensure they would be effective in a smallpox emergency.
  • If the community is small and does not have multiple healthcare facilities, seek out regional partnerships in order to give community members clear instructions on where to seek care in an emergency.
• Determine the number and type of staff required to conduct different response activities, such as:
  • Managing the response and leading the Incident Management team
  • Contact tracing and monitoring
  • Vaccination, both ring and community-wide vaccination efforts
  • Collecting, reporting, and analyzing data
  • Communicating with the public and with other authorities involved in the response
  • Lab testing