by Senior Airman Zachary Cacicia
436th Airlift Wing Public Affairs
12/4/2015 - DOVER AIR FORCE BASE, Del. -- Every
year, thousands of air mobility missions traverse Dover AFB; meaning
that tens of thousands of people who have travelled to and from all
parts of the globe touch down in Delaware, potentially bringing foreign
The 436th Medical Group teamed up with the State of Delaware and
off-base medical partners to conduct an Ebola Response Plan and
Transport exercise that tested the 436th Medical Clinic's and Delaware's
response capabilities in the event that a possible Ebola (or other
highly infectious disease) patient is identified Nov. 3, 2015, at Dover
Lt. Col. (Dr.) Douglas Riley, 436th Aerospace Medicine Squadron public
health flight commander, was the primary facilitator and organizer for
the 436th MDG Clinic's role in this first in the nation joint
collaboration between the military and state exercise.
"You never know what is or is not going to occur in the future," said
Riley. "Is there going to be another infectious disease pandemic? If you
look at the Centers for Disease Control and Prevention, it's not 'if,'
it is 'when.'"
This exercise brought together the 436th MDG and several off-base
agencies, including: the Delaware Health and Social Services: Division
of Public Health, St. Francis Healthcare and the Christiana Care Health
Though this was an Ebola Response Plan and Transport exercise, the Ebola
virus was not the primary focus. According to Riley, the primary focus
was on the response and transport of a patient, including all of the
procedures conducted. The Ebola virus was used because it is currently
well-known and on everyone's radar.
"This drill was not for the Ebola, it was for the response," Riley said.
"To find out where we are lacking and how we can synergize our
activities with the state."
The exercise ran a realistic scenario where an Airman returned to Dover
AFB from an overseas deployment. Senior Airman Peter Cannizzaro, 9th
Airlift Squadron loadmaster, volunteered to play the role of this
Airman. In the scenario, Cannizzaro had just spent the last several
months deployed to West Africa, the ground zero of the ongoing Ebola
epidemic. During his deployment, he may have come into contact with
individuals who later succumbed to an unknown illness, presumed to be
Ebola, but it had not been verified. When Cannizzaro went to a regular
scheduled appointment at the medical clinic days after he returned from
Africa, he presented the early stage symptoms of the Ebola virus and
acknowledged that he just returned from West Africa to the medical
personnel. Once Cannizzaro was identified as a possible Ebola patient,
he was isolated.
This was the start of the exercise, and Riley acknowledged that all
participants played their roles completely. They wore proper personal
protective equipment (PPE) and went about their business and procedures
as they had practiced countless times.
To properly care for the patient, Cannizzaro had to be moved to a
treatment facility capable of handling a possible Ebola patient.
Currently, the only such facility in the state is Christiana Care's
Wilmington Hospital in Wilmington, Delaware. But to get the patient
there safely, they needed the help from another healthcare provider, St.
Francis Healthcare, who operates the only special operations team with a
single patient bio-containment unit (isolation pod) in Delaware, and
only one of 18 in the country. This team who would normally be stationed
in Wilmington, but for the sake of this exercise was prepositioned
nearby at an EMT center in Dover.
According to Joe Leonetti, St. Francis Healthcare senior director of
operations, this team is designed to be completely self-contained. A
specialized ambulance and two support vehicles, manned by seven highly
trained emergency medical technicians made up the team.
"This was a no-notice drill," said Leonetti. "They asked us to
participate and it has been fantastic. You can't put a price on these
types of drills; the hands-on training is really valuable; everybody
Several officials from the State of Delaware observed the exercise,
including Betty Decker, Delaware Health and Social Services: Division of
Public Health, Public Health Preparedness Section training
"The joint venture is just wonderful work, we are very pleased to be
able to participate with the base," said Decker. "This is a realistic
scenario; we have a lot of people who come back from that area in
The St. Francis team, completely donned in PPE, brought the isolation
pod into the medical clinic and placed Cannizzaro into it. Once this was
completed, they placed it into a specialized ambulance and drove
Cannizzaro to Wilmington Hospital to undergo treatment. Once at the
hospital, the nurses, doctors and other medical personnel there jumped
into action, going through with their own infectious disease response
Speaking on the exercise as a whole, Riley was pleased with its results.
"We knew what the process was, but we had never run it before," he said.
"Nowhere in the country that I know of has it been run to this level,
we executed what was supposed to be a drill, which turned into a full
blown exercise with all of the key players."
According to Riley, this exercise is required to be conducted by Delaware at a minimum of once a year.
"Its purpose was to identify gaps in the plan of the process," he said.
"It did; it identified gaps here in the Med Group, and in the state's
plan. We went back to the table and we are retooling to minimize the
He also explained that they plan on changing the name of the exercise to
the Highly Infectious Disease Response Plan. This will ensure that
individuals are aware that it is not just the Ebola virus that they are