FIGURE 1. HENRICO ZIKA UNIFIED COMMAND … Supplemental...SMART Objective(s): ... Incident Action...

FIGURE 1.

HENRICO ZIKA UNIFIED COMMAND ORGANIZATIONAL CHART 2016

Henrico Zika Unified Command Org Chart 2016

POSITION ACRONYMS:PIO = Public Information OfficerLOFR = Liaison OfficerOSC = Operations Section ChiefPSC = Planning Section ChiefLSC = Logistics Planning ChiefFSC = Finance Section ChiefDOCL = Documentation Unit Leader

FIGURE 2. HENRICO ZIKA PREPAREDNESS AND

RESPONSE PLAN/INCIDENT ACTION PLAN (IAP) PHASE 2

FOR OFFICIAL USE ONLY (FOUO)


HENRICO ZIKA PREPAREDNESS AND

RESPONSE

Henrico County Health Department

Operational Period: (Phase 1: Preparedness and Phase 2: Mosquito Season) Date From: 4/1/2016 Date To: 10/31/2016

Time From: 0700 Time To: 0700

Date and Time Prepared: 22 June 2016 1530



INCIDENT OBJECTIVES (ICS 202)

1. Incident Name:

Henrico Zika Preparedness and Response

2. Operational Period: Date From: 4/1/2016 Date To: 10/31/2016


3. SMART Objective(s):

Provide for the safety of Henrico County residents and responders

Reduce the impact of Zika in Henrico County

Maintain constant situational awareness using scientific resources from local and regional partners, VDH and the CDC

Educate the Henrico community about Zika disease transmission and prevention

Enhance outreach to vulnerable populations

Support integrated mosquito management efforts

4. Operational Period Command Emphasis:

Develop comprehensive communications strategy, addressing internal and external efforts to share information and resources.

Identify potential areas that are at high-risk for developing vector habitats to shape communications and response efforts.

Develop response model for addressing reported habitats or high-risk locations, including legal implications and restrictions.

Maintain situational awareness as knowledge of Zika virus changes and mosquito season progresses.

General Situational Awareness:

Be sensitive to the fear and emotion that surround this virus, particularly for young or developing families.

Consistent and accurate information are the best tools to combat Zika. A unified message is critically important during this phase of the incident.

Mosquito season, in general, begins around May 1. However, it is expected that the Asian Tiger mosquito population will begin to grow around June 1.

5. Site Safety Plan Required? Yes No X

Approved Site Safety Plan(s) Located at:

6. Incident Action Plan (the items checked below are included in this Incident Action Plan):

ICS 203

ICS 204

ICS 205

ICS 205A

ICS 206

ICS 207

ICS 208

Map/Chart

Weather/Tides/Currents

Other Attachments:

ICS 230 Schedule of Events

ICS 214 Activity Log

ICS 201 Map/Briefing

_215, 215A________________________

7. Prepared by: Name: A.

Oughton/D. Calkins Position/Title: DPSC/PSC Signature:

8. Approved by UC – Health : S. Fischer Davis, MD Signature:

ICS 202 IAP Page Date/Time: 6/22/2016 3:35 PM



ORGANIZATION ASSIGNMENT LIST (ICS 203)

1. Incident Name:




3. Incident Commander(s) and Command Staff: 7. Operations Section:

IC/UCs Susan Fischer Davis, M.D. (HCHD) Chief Lane Carr (HCPW)

Randy Buchanan (Henrico County Public Works) Deputy Paul Johnson (Community Maintenance)

Group Public Outreach and Education

Safety Officer Supervisor Jasmin Johnson (HCHD)

Public Info. Officer Steve Knockemous (Henrico Public Relations & Media Services) Karen Carter, Ext. Office

Asst. PIO Cari Tretina, Henrico County

Liaison Officer Rob Rowley (HMRC), Anna McRay (HFD)

4. Agency/Organization Representatives:

Group Surveillance/Investigation

Supervisor Laura Young (HCHD)

5. Planning Section:

Chief David Calkins (HCHD)

Deputy Alec Oughton (HFD)

Situation Unit Group Mosquito Control

Documentation Unit Jernelle Hilliard (HCHD) Supervisor Wes Robertson (HCPW)

Resources Unit Leader

6. Logistics Section:

Chief Anne Powell (HCHD)

Deputy

Supply Unit Leader

Facilities Unit Leader

8. Finance/Administration Section:

Chief Charlie Lintecum (HCHD)

Deputy

Procurement Unit

9. Prepared by: Name: David Calkins Position/Title: PSC Signature:




ASSIGNMENT LIST (ICS 204)

1. Incident Name:


2. Operational Period: Date From: 4/1/2016 Date To: 10/31/2016 Time From: 0700 Time To: 0700

3.

Public Information Officer (PIO)/Assistant PIO

4. Personnel: Name Contact Number(s)

Public Information Officer: Steve Knockemus 804.501.4476

Assistant Public Information Officer: Cari Tretina 804.501.4276

5. Resources Assigned:

# o

f

Pers

ons

Contact (e.g., phone, pager, radio frequency, etc.)

Reporting Location, Special Equipment and Supplies, Remarks, Notes, Information Resource Identifier Leader

6. Work Assignments:

Develop Zika “Pick-a-Day to Fight-the-Bite” flier for distribution to Henrico County residents.

Translate Zika “Pick-a-Day to Fight-the-Bite” flier into Spanish and Arabic.

Develop Zika “Pick-a-Day to Fight-the-Bite” poster (see additional information below). Coordinate with Department of General Services to distribute.

Translate Zika posters into Spanish and Arabic.

Develop Talking Points (3-5) to be distributed to inspectors and call centers, as appropriate.

Approve press release developed by Mosquito Control Group.

Coordinate with VDH Regional PIO to create Henrico Zika speaking team.

Update Henrico County website, to include link to Health Department and/or a dedicated Zika page, with instructions for making Zika pregnancy kits. Links to CDC and VDH should be accessible on this site.

Develop “press kits” for first confirmed locally-transmitted case.

Coordinate with VDH Central Region PIO and RIC Airport marketing manager to display Zika-related information on display screens at Richmond International Airport.

Use social media to promote Zika resources on Henrico County website.

Coordinate display of Zika information on bulletin board on first floor of County Administration building during the month of August.

Work with Zika Unified Command and Zika Working Group to write an article for publication in “County Connection.”

7. Special Instructions:

Coordinate with Unified Commanders and Zika Working Group to develop Zika “Pick-a-day to Fight-the-Bite” flier

Zika posters should be one-sided and should use information from both sides of the flier.

“Press kits” for first confirmed locally-transmitted case should include pre-scripted messaging and/or press release to quickly share accurate information with the media when a case of locally-transmitted Zika has been confirmed.

The press release developed by the Mosquito Control Group should include a link to the updated Henrico County website.

8. Communications (radio and/or phone contact numbers needed for this assignment):

Name/Function Primary Contact: indicate cell, pager, or radio (frequency/system/channel)

Steve Knockemus, PIO Office: 804.501.4476 Cell: 804.370.6072

Cari Tretina, Assistant PIO Office: 804.501.4276 Cell: 804.456.8906


ICS 204 IAP Page Date/Time: 3 June 2016 3:30 PM




1. Incident Name:



3.

Liaison Officer (LOFR)

4. Personnel: Name Contact Number(s)

Liaison Officer: Rob Rowley 804.363.2930

Liaison Officer: Anna McRay 804.501.7183


# o

f

Pers

ons




Serve as point of contact for Unified Command members and partner agencies.

Share information with and facilitate dialogue between Unified Command and partner agencies or organizations.

Identify appropriate points of contact (POCs) for - and facilitate dialogue with - organizations and resources, such as faith-based or community groups, that will become involved in Zika preparedness and response.

Reach out to Henrico County Public Schools and Henrico County Recreation & Parks for involvement in Zika education and outreach.




Rob Rowley, LOFR Phone: 804.363.2930

Anna McRay, LOFR Phone: 804.501.7183 (office) 804.822.6201 (cell)






1. Incident Name:



3.

Group: Public Outreach & Education

4. Operations Personnel: Name Contact Number(s)

Operations Section Chief: Lane Carr 804.727.8359

Deputy Ops Chief: Paul A. Johnson 804.501.7622

Group Supervisor: Jasmin Johnson 804.912.4827


# o

f

Pers

ons



Medical Reserve Corps (MRC) Volunteers

Jasmin Johnson 25+ Cell: 804.912.4827


Identify Medical Reserve Corps (MRC) volunteers interested in participating in Zika outreach and education.

Recruit volunteers from other organizations, including CERT, to participate in Zika outreach and education.

Develop Train-the-Trainer program for MRC, CERT, Master Gardeners, and other volunteers with emphasis on training the Neighborhood Leader

Implement the Train-the-Trainer/Neighborhood Leader program by training volunteers to provide a pre-scripted Zika presentation to communities throughout Henrico County.

Track events where Zika information was provided to the public, including presentations and/or events involving or led by volunteers.

Identify community groups, faith-based groups, homeowners associations, civic associations, and other groups for public outreach and education opportunities.

Distribute door hangers in at-risk neighborhoods as directed by Unified Commanders.

Distribute Zika pregnancy tool kits through HCHD maternity clinic, Family Planning Clinic, and WIC clinics.

Support the distribution of Zika “Pick-a-day to Fight-the-Bite” fliers to Henrico County residents through mail and other means.

Work with Master Gardeners to set up Zika booth at Henrico Community Day (July 30, 2016).

Set up and staff a table with Zika information during WIC clinics at West WIC office of Henrico County Health Department.

Assist with operating a Zika point of dispensing (POD) clinic.

Assist with development of Zika messaging for Kroger pharmacy bags (this task has been completed by Finance Section Chief)


Maintain a spreadsheet to track Zika education and outreach events in Henrico County to include the name of the event, the date and time, the number of people reached (estimated if necessary), and the number of MRC or other volunteers that participated.

A Zika POD may involve dispensing mosquito repellant, condoms, and prevention information.

Coordinate with Standing Water Initiative to develop and implement the Zika Train-the-Trainer program.

As applicable, incorporate the use of social media, such as “Next Door,” in the Zika Train-the-Trainer program to help volunteers organize and empower their neighbors.



Jasmin Johnson, Group Supervisor Cell: 804.912.4827

Karen Carter Office: 804.501.5160






1. Incident Name:



3.

Group: Surveillance/ Investigation

4. Operations Personnel: Name Contact Number(s)


Deputy Ops: Paul A. Johnson 804.501.7622

Group Supervisor: Laura Young 804.339.1929 (cell)


# o

f

Pers

ons



District Epidemiologist Laura Young 1 804.339.1929 (cell) 804.501.5216 (office)


Respond to calls from citizens and providers with questions about testing and possible exposure

Approve or deny testing requested by providers per VDH testing algorithm

Coordinate specimen submission to the state laboratory o Ensure paperwork is complete and correct o Pick-up and/or delivering specimens from providers offices to DCLS, as needed

Maintain a line list and hardcopy file on patients for whom Henrico HD has submitted specimens and on patients who are Henrico residents submitted by other districts.

Enter information into VEDSS for patients for whom Henrico HD has submitted specimens

Ensure that providers and other districts receive results in a timely manner

Conduct patient interviews/investigations in the event of any positive lab results for Henrico residents. 7. Special Instructions:



Laura Young, Group Supervisor Cell: 804.339.1929






1. Incident Name:



3.

Group: Mosquito Control 4. Operations Personnel: Name Contact Number(s)


Deputy Ops: Paul Johnson 804.501.7622

Group Supervisor: Wes Robertson 804.727.8358


# o

f

Pers

ons



Standing Water Initiative Randy Buchanan

3 804.349.3201 (Cell)


Create consent form for permission to access to analyze, neutralize, and treat, if necessary, the patient’s property.

Distribute Zika “Pick-a-Day to Fight-the-Bite” flier to 93,000 Henrico County households through public utility bills.

Work with Community Maintenance to distribute Zika flier to additional households as well as libraries.

Coordinate with PIO to develop door hangers using Zika “Pick-a-Day to Fight-the-Bite” fliers. These door hangers will be strategically distributed in at-risk neighborhoods prior to a confirmed locally-transmitted case.

Prepare and print door hangers for targeted outreach to Zika-affected neighborhoods. These door hangers will be used during the next operational period (if and when a locally-transmitted case is confirmed, and if and when the patient agrees to share address with Mosquito Control).

Develop language for a press release to be used if and when a locally-transmitted case is confirmed.

Work with Community Maintenance to develop GIS map with layers showing neighborhoods most at risk. Continue mosquito trapping and collection activities. Continue answering calls from citizens. Conduct property inspections as requested and provide treatment as necessary. 7. Special Instructions:

The press release mentioned above should include a link to the new Henrico County website and should be approved and distributed to media by PIO.



Wes Robertson, Group Supervisor Phone: 804.727.8358





COMMUNICATIONS LIST (ICS 205A) Incident Name: Henrico Zika Preparedness and Response



3. Basic Local Communications Information:

ICS Position Name (Alphabetized) Method(s) of Contact

(phone, pager, Phone, etc.)

UC – Health Susan Fischer Davis Phone: 804.382.2908 / [email protected]

UC – Public Works Randy Buchanan Phone: (c) 804.349.3201 / [email protected]

Pub Info Officer Steve Knockemus Office: 804.501.4476 / Cell: 804.370.6072 / [email protected]

Asst. PIO Cari Tretina Phone: 804.501.4276 / [email protected]

Liaison Officer Anna McRay Phone: 804.822.6201 / [email protected]

Liaison Officer Rob Rowley Phone: 804.363.2930 / [email protected]

Planning Chief David Calkins Phone: 804.338.4424 / [email protected]

Dep Plans Chief Chief Alec Oughton Phone: 804.332.4955 / [email protected]

Doc Unit Leader Jernelle Hilliard Phone: 804.380.0050 / [email protected]

Operations Chief Lane Carr Phone: 804.727.8359 / [email protected]

Deputy Ops Chief Paul Johnson Phone: 804.501.7622 / [email protected]

Pub. Outreach Group Supervisor

Jasmin Johnson Phone: 804.912.4827 / [email protected]

Pub. Outreach Group Karen Carter Phone: 804.501.5160 / [email protected] ; [email protected]

Surv./Inv. Group Supervisor

Laura Young Phone: 804.339.1929 / [email protected]

Mosquito Control Group Supervisor

Wes Robertson Phone: 804.727.8358 / [email protected]

Fin-Admin Chief Charlie Lintecum Phone: 804.432.7075 / [email protected]

4. Prepared by: Name: D. Calkins Position/Title: PSC Signature:

ICS 205A IAP Page Date/Time: 6/22/2016 3:35 PM

mailto:[email protected]



















3. Organization Chart

INCIDENT ORGANIZATIONAL CHART (ICS 207)

1. Incident Name: Henrico Zika Preparedness and Response



ICS 207 IAP Page 4. Prepared by: Name: D. Calkins Position/Title: PSC Signature: Date/Time: 6/22/2016 3:35 PM


SAFETY MESSAGE/PLAN (ICS 208)

1. Incident Name:




3. Safety Message/Expanded Safety Message, Safety Plan, Site Safety Plan:

Ensure that responders, volunteers, and other personnel participating in breeding site elimination efforts take all necessary precautions to avoid mosquito bites.

4. Site Safety Plan Required? Yes No X

Approved Site Safety Plan(s) Located At:

5. Prepared by: Name: D. Calkins Position/Title: PSC Signature:



1. Incident Name: Henrico Zika Preparedness and Response 2. Operational Period (Date/Time)

From: 4/1/2016 0700

To: 10/31/2016 0700

ICS 230

3. Schedule of Events (Meetings & Operational Schedule)

Date/ Time Meeting Name Purpose Attendees Location

2/18/2016 1400-1600 Zika Technical Information Meeting

Situational Awareness, Sharing Information

HCHD, VDH Entomologist, HCPW

HCHD Large Conference Room, Human Services Building 8600 Dixon Powers Drive Henrico, VA 23228

3/3/2016 1430-1630 Zika Working Group Meeting

Situational Awareness HCHD, VDH, OEM, HCPW, HC PR&MS











4/18/2016 1030-1200 Zika Unified Command Objectives Meeting

Identify UCs, agree to UC org structure, develop incident objectives, identify key tasks for UC

HCHD, OEM, HCPW, Henrico Fire





5/6/2016 1430-1630 UC Tactics Meeting Develop tactics and strategies for meeting incident objectives

HCHD, VDH, OEM, HCPW, HC PR&MS








DPW Woodman Road Maintenance Building Training Center 10431 Woodman Road, Henrico, VA

6/2/2016 Zika Unified Command Planning Meeting

Develop and finalize IAP; obtain approval of IAP from UC

HCHD, VDH, OEM, Extension Office, HCPW, HC PR&MS


6/9/2016 Zika Working Group Meeting

Zika Tabletop Exercise, Situational Awareness

HCHD, VDH, OEM, HCPW, HC PR&MS


6/23/2016 Zika Working Group Meeting



4. Prepared by: D. Calkins Date/Time: Position/Title: PSC Date/Time: 6/22/2016 3:35 PM

5. Approved by: S. Fischer Davis Position/Title: UC - Health Date/Time:


ACTIVITY LOG (ICS 214)

1. Incident Name: Henrico Zika Preparedness and Response



3. Name:

4. ICS Position:

5. Home Agency (and Unit):


Name ICS Position Home Agency (and Unit)

7. Activity Log:

Date/Time Notable Activities

8. Prepared by: Name: Position/Title: Signature:

ICS 214, Page Date/Time:

FIGURE 3. PICK-A-DAY TO FIGHT-THE-BITE

ZIKA VIRUS FLYER

Zika Virus Disease (Zika)

What is it?Zika is a disease spread primarily by mos-

quitoes. Some infected people get mild symp-toms such as fever, rash, red eyes or joint pain for about a week. However, four of every five people who get Zika won’t have symptoms and won’t know they have it. There is no vac-cine or medicine for Zika.

Where is it? Zika is widespread in South and Central

America, Mexico and the Caribbean. It has the potential to become established in the United States.

One of the mosquitoes that is capable of spreading the virus, the Asian tiger mosquito, is found throughout Virginia and Henrico County.

Special concerns for pregnant women

Zika can be spread from mother to child if a woman becomes infected with the virus while pregnant. Infection during preg-nancy has been linked to micro-cephaly, a serious birth defect, and other problems in babies. Zika also can be transmitted through unpro-tected sex with an infected man.

If you or your partner is preg-nant and you have traveled to a Zika-affected area, please talk to your doctor or call the Henrico County Health Department at (804) 501-5216.

Info: search "Zika" at henrico.us

Step 3: Wear insect repellent!

Use Environmental Protection Agency (EPA)-registered products.

Step 1: Pick-a-Day to Fight-the-Bite!

Once a week, inspect your property and empty, dump, turn over or throw out items that hold water such as tires, tarps, buckets, birdbaths and toys.

Pick-a-Day to Fight-the-Bite!

Step 2: Cover up!

Wear long-sleeved loose fitting shirts and long pants.

Zika potentially could be spread by the Asian tiger mosquito, the most common nui-sance mosquito in Henrico County. For this to happen, a local mosquito would need to bite a person infected with Zika.

Asian tiger mosquitoes, marked by distinc-tive black and white striping, prefer to bite during the day and will enter homes through open doors and windows or holes in screens. They lay eggs only in containers of water, not in ponds, puddles, ditches or swamps.

If Asian tiger mosquitoes are biting you, they likely hatched on or near your property. Take steps to control their spread and prevent bites.

Info: (804) 226-6453 or search "mosquito" at henrico.us

FIGURE 4.

KROGER PHARMACEUTICAL BAG

FIGURE 5. FIGHT-THE-BITE TODAY EVENT ADVERTISEMENT

FIGURE 6. HENRICO ZIKA UNIFIED COMMAND

SITUATION REPORT

Revised 9/30/2016

Henrico County Zika Unified Command SITUATION REPORT #20

Time: 1100 Date: 10/28/2016

Incident: 2016 Zika Preparedness and Response Operational Phase 2 – Mosquito Season

New information in bold

Item #

Item As of 10/28/2016

Location/brief synopsis of issue (elaboration to be

located in NOTES)

1 Confirmed and probable cases of Zika

In U.S.

In Virginia

In VDH Central Region

4,091 (+75)*

87 15

*139/4,091 (+2) are locally-acquired cases in Florida

2 Requests approved for testing in Virginia

Pregnant

Non-pregnant

1,859 (+55) 1,395 (+45) 464 (+10)

3 Specimens submitted for testing

By HCHD based on provider location

For Henrico County residents

158 (+2) 95 (+1) 63 (+1)

4 Zika Outreach Events/Efforts 61 (+2) See notes below

5 MRC Volunteers Participation 92 (+8)

410 hours

$10,696.90

This number reflects the number of times MRC volunteers have participated in outreach events. Individual volunteers may be counted multiple times. This is the number of hours MRC volunteers worked on Zika outreach and education efforts. This number reflects the monetary value of MRC volunteer support. This total is calculated using an hourly rate of $26.09 over a total of 410 volunteer hours.

6 Asian Tiger Mosquitoes Collected 17,808 (+307)

Report filed by: David Calkins, Planning Section Chief NOTES:

146 pools of mosquitos from Henrico have been delivered to date to DCLS for Zika testing. All have come back negative. One pool will be retested next week because of invalid sample processing.

Supplemental dispensing of mosquito repellant continues. Standing Water Initiative will be providing insect repellant free-of-charge to Henrico residents that file mosquito complaints.

This will be the final situation report for this operational period.

Revised 9/30/2016

As noted in #4 and #5 above, Henrico County has coordinated or participated in the following Zika Outreach Events/Efforts:

No. Date Event/Effort Audience

Materials Disseminate

d

Approx. Population Reached

MRC Volunteers Participati

ng

4 Ongoing Zika Train-the-Trainer MRC/CERT Outreach PPT 36

5 Ongoing Zika Outreach for Henrico WIC – East End

Henrico County WIC Clients – East HHD (Laburnum Ave.)

Zika Flyers and Education

80 2

6 Ongoing Zika Outreach for Henrico WIC – West End

Henrico County WIC Clients – West WIC Office (Shrader Road)

Zika Flyers and Education

80 2

Ongoing Supporting Chickahominy Health District

Chickahominy Health District partners

Outreach PPT

60 10/22/2016 Health Fair for Asian American Society of Central Virginia

Henrico County residents

Zika Flyers, Education, and mosquito repellant

100 6

61 10/25/2016 Zika Presentation at Marywood Apartments

Residents of Marywood Apartments

Zika Presentation and Flyers

2 2

TOTALS Est. 331,381*

92**

*Total may include overlap among various outreach events and efforts. **This number reflects the number of times MRC volunteers have participated in outreach efforts. Individual volunteers may be counted multiple times.

FIGURE 7.

HENRICO COUNTY ZIKA TASK FORCE PERMISSIONS AND LOGISTICS

TABLETOP EXERCISE

Henrico County Zika Task Force (ZTF) Permissions and Logistics Tabletop

Exercise

Presented by: Standing Water Initiative July 1, 2016

1 | P a g e

In order to meet the overall expectations and goals of our Zika Response Plan, clear,

consistent, and frequent communication with our citizens must be a top priority. To ensure

public safety and prevent further spread of Zika, due to local transmission, citizens living within

a 150-to-200 yard radius of an infected person’s home must receive and understand information

as well as the control procedures necessary to reduce Asian tiger mosquito numbers and

limit/eliminate any risk of further transmission. A large part of this equation is ensuring that the

mosquito control operations team has access to as many homes within the risk radius without

violating local directives, laws, or constitutional rights.

The Henrico County Zika Task Force (ZTF) Permissions and Logistics Tabletop Exercise is

designed to address how the operation teams can safely, efficiently, and effectively gain access

to individual properties, conduct inspections, and abate target mosquito populations all within

the virus’s viremic phase (See Appendix I pg. 7).

The goals of this exercise are as follows:

A. Determine the most efficient way to gain permission from citizens to access their

property following a confirmed locally-transmitted case of Zika virus.

B. Identify procedures, materials, and information needed to canvas targeted

neighborhood.

C. Investigate how to maintain team, volunteer, and resident safety during the permission,

inspection, and treatment phases of response.

D. Test the handling of questions, concerns, complaints, and requests for service from

outside the target response area.

E. Determine Response Team deployment procedures.

F. Identify gaps in the Response Team structure and supervision.

Projected definitions of Mosquito Control Response Teams based on Zika Task Force

outline:

(Number of volunteers/interns & supervisors is subject to change)

Permission Team A team composed of ~5 volunteer/interns and ~1 SWI supervisor whose responsibility

will be to disseminate agreement and authorization forms (See sample on page 3) for

private property access following confirmation of a target area. Each team member will

be provided with reference and literature based materials to justify the need for

authorization.

Inspection Team A team comprised of ~10 volunteers/interns and ~1 SWI supervisor whose responsibility

will be to conduct mosquito (Asian tiger) site inspections. Inspections will follow normal

SWI inspection protocol with the caveat that all potential egg-laying habitat (i.e.

containers) will be removed or dumped during the time of the inspection.

2 | P a g e

Treatment Team A team comprised of ~3 certified pesticide applicators and/or contractor teams whose

responsibility will be to provide mosquito abatement via chemical applications on

predetermined and qualifying residential/business/community properties. Treatments

will be based on permissions and Centers for Disease Control (CDC) recommendations.

Scenario 1: Confirmed Local

Transmission Part A: Developing Permissions Protocol

A case of locally transmitted Zika virus has been confirmed. The infected household

grants consent for the Henrico Department of Health to share his/her address with Henrico

County Standing Water Initiative. The resident also allows full access to their property.

However, in order to effectively begin CDC based protocol the Zika Task Force (ZTF) is

charged with determining a target radius surrounding the infected resident’s home and

obtaining property access permissions for all houses within the target radius. In order to

identify a target radius Geographic Information Systems (GIS) is used. The resulting map

portrays a radius which intersects corners and/or bisects some properties. The ZTF

Permission Team begins distribution and collection procedures in order to gain property

authorization.

3 | P a g e

1. Does ZTF include all properties touched by the target radius? What about

properties outside the target radius but in the same neighborhood?

2. How are authorization forms disseminated and collected? How are permissions

posted and collected for absent residents? Or those unwilling to grant immediate

permission? (i.e. indecisive)

3. What materials and information will each resident be provided to justify the need for

authorization? How will residents be able to ask questions or find out more

information?

4. What forms of identification will ZTF staff be required to present to residents?

5. How will the ZTF begin mobilization?

6. Are there enough team volunteers/interns and supervisors provided in the

Permission Team definition to handle authorization dissemination and collection? If

not how will ZTF determine the necessary number?

4 | P a g e

Part B: Vacant Properties

During community canvassing it is suspected there are some vacant homes.

7. How does the ZTF handle inquires, inspections, treatments, and complaints

regarding abandoned homes, facilities, businesses, and properties where quick

authorization is not feasible? Do you adopt a treat now deal with repercussions later

attitude?

8. What message will be conveyed to concerned citizens of adjacent properties

regarding ZTF’s pursuit of corrective action? What message will be provided to

citizens if abandoned property owner refused cooperation?

9. Should the ZTF have an active call center during operations to aid in the contact of

property owners?

Part C: Inquiries from Residents Outside the Target Area

A ZTF staff member is approached by a citizen living outside the target area. The citizen heard

from a neighbor within the target area that the county is looking to conduct inspections and/or

provide treatments of properties for Asian tiger mosquitoes. The citizen questions why ZTF

members have only targeted houses across the street. After a brief explanation, and despite

being outside the target area, the resident becomes nervous and requests a permission form to

have his/her property inspected and treated if necessary. The resident claims that his/her close

proximity to those houses receiving inspections is reason enough to warrant addition to the

inspection schedule.

10. What message will be provided to curious and/or concerned citizens living adjacent

to, within, or across from target area homes? Should this message be a unified

response or specific to resident proximity or situation?

11. How does ZTF staff handle citizens (outside the target area) who insist on an equal

and immediate provision of services?

Part D: Safety Concerns

After the formation of the target radius, ZTF Command indicates a history of criminal activity

within the target boundaries. Command confirms this speculation through communication with

the Henrico County Police Department. Given the time of day or length of time required to

canvas the area several ZTF staff become concerned about potential safety issues.

12. What safety protocols are necessary to ensure the protection of all working ZTF

Teams within the target area?

13. What personal protection equipment (PPE) will be necessary to increase visibility

and safety during team operations in the field? How many PPE units will be

available? Where will teams and staff pick up PPE units? What will be provided in

each PPE unit?

14. What steps will the Police and other public safety departments take in order to

ensure adequate coverage during Zika operations? How will ZTF communicate with

public safety departments and personnel during operations?

5 | P a g e

Part E: After Hours

Local transmission has been confirmed at 5pm on a Friday. ZTF Command begins mobilization

procedures. However, over the course of these procedures it becomes apparent that a majority

of the ZTF volunteers and interns are unavailable. It is also realized that several supervisors

have left town for the weekend.

15. How will after hours and/or weekend events be initiated and mobilized?

16. What additional resources does ZTF have in terms of manpower? Are there reserve

volunteers?

17. What protocol is in place to substitute for absent supervisors and/or members of the

command structure?

Part F: Refusal

Community canvassing also revealed several homes where residents granted authorization and

agreed to inspections but during those inspections refused dumping and treatments. One such

resident is a hoarder and has hundreds of containers in their backyard. Actively perusing a

citation is not part of the ZTF protocol nor is it feasible in terms of time. Educational materials

passed out during the permission phase of operations informed neighbors that excessive

containers can exacerbate the threat of transmission via harboring Asian tiger mosquitoes

therefore, several residents demand immediate action.

18. At this point, are there any further options for addressing the resident hoarding

containers?

19. What messages are provided to concerned citizens when a neighbor cannot be

forced to eliminate egg-laying habitat?

20. How do you address residents who insist they should not have to spend personal

money for protection from someone who is presenting an obvious public health risk?

Part G: Language Barriers

The Permission Team begins canvassing the neighborhood and initial reports indicate that

some residents were unable to be reached due to language barriers. ZTF staff reports that while

a majority of the foreign residents speak Portuguese, there are also several other households

which appear to speak Russian and Japanese. Homes which are affected by language barriers

equate to approximately 25% of the community. These homes are scattered throughout the

community. The ZTF has no authorization forms translated in these languages.

21. How does ZTF make decisions about which residents require access to translation?

22. Does the ZTF pursue friends and family who could potentially translate?

23. What access does Henrico County have to quick field translation resources? If so

how much time will it take to mobilize or how much advanced notice is required prior

to mobilization?

24. How many translators are accessible?

25. How many languages will the authorization forms cover? Will any of these be pre-

printed?

26. How many regular and translated forms will be required prior to responding to a

locally transmitted case?

6 | P a g e

27. Is there an attempt to contact the HOA to gain permission? Are community meetings

needed to address large complexes such as townhomes and/or apartments?

28. Can ZTF protocol and operations be conducted within a 24 hours window? If not

what level of service, if any, is provided?

29. What is the cutoff point for allocating resources to a particular situation? How do you

prioritize one situation (e.g. local outbreak) over another?

7 | P a g e

Appendix I

From: West, Angela (VDH)

Sent: Tuesday, June 28, 2016 2:26 PM

To: Gaines, David (VDH)

Subject: mosq control questions

Hey David,

As we are starting to recevie emails about doing home visits for patients who have Zika symptoms but

where we do not have lab+ results yet and/or patients who are lab+, a few questions have come up:

1) If the patient is no longer viremic (past 7 days), is there still an expectation to do a home visit and look

for breeding habitats after the viremic time frame has passed?

Yes. If the patient was viremic last week and was bitten by a mosquito at that time, the mosquito

would not be ready to transmit the virus for several more weeks because there is an extrinsic

incubation period of several weeks from when the mosquito took in an infectious blood meal to

when it could actually transmit the virus. Therefore, one would need know whether that infected

mosquito was still around and whether mosquito control would be necessary (i.e., were there

any mosquitoes there in the first place).

2) Will mosquito source reduction after the 7 day viremic time period help to curb potentially infected

mosquitoes or Zika activity?

Yes

3) If yes to #2, then for how long? What is the typical life span of the Asian tiger mosquito? Should home

visits be done for up to 4 weeks after an infected person is identified or just 1 week?

I would say that up to four weeks or one month would be recommended.

4) We are getting emails about doing home visits when someone is symptomatic but testing is still

pending, most people want to know their test results before agreeing to a home visit. But this puts us

back to Q1 above where then it’s often more than 7 days after the viremic period. Any suggestions for

dealing with this time lag for testing vs need for immediate mosquito assessment?

Don’t worry if it is more than seven days after the viremic period. Let us know and we will come

out. If you can’t get the patient to agree to a home visit until lab results are in, we can wait.

David Gaines

Thanks, Angie

FIGURE 8. PICK-A-DAY TO FIGHT-THE-BITE MOSQUITO INSPECTION FORM

Facts about the Asian tiger mosquito

that can transmit the ZIKA VIRUS:

They lay eggs in containers and other man-made items that

collect water

They DO NOT lay eggs in ponds, ditches, streams or swamps

They are persistent daytime biters

They have a short flight range, about 100-200 yards

Homeowners play a primary role in controlling them

If they are biting you, they are breeding nearby

They develop into adults in about 10 days, therefore...

From May through October

PICK ONE DAY A WEEK

to check for breeding sites

on your property!

Over

Boat and Cover Recycling Bins Buckets Drain Pipes

Flower Pots/Trays Items behind your Shed Items under your Deck Rain Gutters Any other man-made items that hold water

For items that cannot be dumped, use an environmentally friendly product labeled for killing mosquito larvae.

Protect yourself from mosquito bites:

Use mosquito repellent Carefully follow the directions

EPA-registered active ingredients include: DEET, Picaridin, IR3535

Wear long-sleeved loose fitting shirts and long pants

For more information, search “mosquito” at henrico.us or call 226-6453 to request a complimentary mosquito inspection.

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