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 infectious diseases.
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 AFB, Delaware.
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 System.
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 learns."
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 administrator.
"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 Africa."
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 procedures.
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 gaps."
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 preparing for.
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