Emergency Planning and Response

International Planning

Exercise Atlantic Blue was an international exercise involving the UK as part of a joint UK/US/Canadian counter-terrorist exercise. It was designed to examine and test individual and collective responses to a complex but credible international scenario across three countries and two time zones. The exercise was a week-long full-scale exercise which focused internationally on three specific areas;

 

• Public information

• Intelligence and investigation

• Consequence management

 

Nationally, Exercise Atlantic Blue focused on England 's ability to respond to a developing biological threat and on London 's management of the crisis and consequence issues surrounding a chemicals attack impacting on the City's business district.

The Agency prepared the health scenarios and provided the UK Health Exercise Control for this exercise. The main objectives for the Agency were to:

 

• Test international/national liaison and communications

• Test the Agency's national contingency plans

• Practise the Strategic Emergency Response Arrangements

• Test the appropriateness of these plans during the immediate action phase, the response phase and early recovery phase of a major chemical, biological, radiological or nuclear (CBRN) incident

 

Although, as expected, a number of areas for improvement were identified, the overall consensus was that the exercise was useful and successful. It demonstrated that the Agency could react in a timely and professional manner in such an event and worked well as a team. It was the first time many had played in an exercise of this size and provided valuable experience and underlined the need for the Agency to be involved in an exercise on this scale more frequently.

 

London Bombings

The lessons identified from exercise Atlantic Blue also helped to consolidate the Agency's response to such a threat, and indeed the London bombings, which occurred some three months later, provided unwelcome circumstances in which to test exactly this capability. On the day itself the Agency supported those providing clinical care to survivors by issuing immediate advice for clinicians and health professionals on the effect of smoke inhalation. This advice, along with other information and advice that was developed by the Agency over the following days, was published on our website, to which GPs were referred in an alert issued by the Chief Medical Officer.

 

Although the assessment of the risk of long-term adverse health effects as a result of exposure during the bombings is low, we believe that it is important that any health consequences that do occur are accurately documented. This will not only ensure that those involved can be provided with further health advice as necessary, but provides vital information that can help to protect the well-being of those involved in any future incidents. The Agency therefore initiated a long term follow-up of individuals exposed to the bombings and the immediate aftermath, working in close collaboration with the NHS, the Emergency Services and Transport for London . Everyone directly exposed to fumes, smoke, blood or blast effects from the explosions in the capital on 7 July 2005 was asked to join the follow-up, and also anyone helping in the immediate emergency response.

 

Pan European Exercises

The Agency Centre for Emergency Preparedness and Response was commissioned by Directorate General Health and Consumer Protection (DG-SANCO) of the European Commission to design and deliver two Command Post Exercises. These exercises, which took place during the autumn of 2005, were designed to evaluate the abilities, capabilities and functions of the response to a health related crisis within the European Union.

Exercise New Watchman took place on 19-20 October 2005 and in addition to 25 Member States, the EC, other countries and organisations were invited to take part. Additionally, observers from the newly formed EU Centre for Disease Prevention and Control (ECDC) were invited to participate along with European Economic Area States (EEA; Norway, Iceland and Liechtenstein), Switzerland, and the World Health Organisation (WHO).The exercise, which depicted a major outbreak of smallpox following a deliberate release, evaluated how Member States and other organisations implemented their infectious disease plans and the effectiveness of communications between them and the EC. It was designed for the health departments of the Member States' governments with an option to include other elements of government response.

Exercise Common Ground, an influenza pandemic exercise, took place on 23-24 November 2005 and involved hundreds of players across the EC, EU agencies such as the ECDC, 25 Member States and the pharmaceutical industry, reacting to a series of fictitious emergency events with a new human influenza strain starting a major pandemic in Europe . It was designed to represent a period of 26 weeks and tested the execution and interaction of national plans and measures, as well as examining the role of the EC. The exercise involved crisis rooms in national health ministries and agencies, linked up through early warning and monitoring systems.

Of Exercise Common Ground, EU Health and Consumer Protection Commissioner Markos Kyprianou said:

 

" To my knowledge, an exercise on this scale on human influenza pandemic preparedness is unprecedented. The main reason to carry out such an exercise is to learn from experience what works and what doesn't when plans on paper are applied in practice. The exercise report sets out important recommendations for the future and identifies areas of weakness in our pandemic preparedness plans where we need improvements. Work has already begun on addressing these weaknesses, and we will continue to refine, improve and upgrade our preparedness with Member States, the ECDC and our other partners ."

 

Regional and National Exercises

CEPR also runs a series of regional exercises to test emergency preparedness in the health service community, as part of a training programme delivered for the Department of Health. These exercises test and improve the current emergency health plans and help to ensure that the health services can respond in a rapid and co-ordinated way to any deliberate release of chemical, biological or nuclear agents (CBRN). Each exercise involves coordinating a wide cross-section of organisations on a national, regional and local level. This includes the Department of Health, other government agencies, NHS organisations, local authorities and other emergency services.

Exercise Hercules was a health-led field training exercise held in Worcester in June 2005. It tested the health service's capability to deliver prophylactic (preventative) treatment to large numbers of the general public who may have been exposed to a biological agent as a result of a deliberate release at a public event. The exercise tested the whole cycle of setting up a mass prophylaxis/treatment centre of sufficient size to treat in excess of 1000 patients in a normal working day, together with requesting and receiving medical countermeasures from national stocks.

Exercise Ultraviolet was held in March 2006 in the North West region and was the first heat wave exercise to be run by the Agency. The exercise brought together the health community, local authorities and other planning partners involved in dealing with a severe prolonged hot weather event. The aim of the exercise was to improve preparedness and resilience in such an event.

Exercise Argonaut envisaged another severe weather event, this time heavy rain and storms which brought about widespread flooding, both fluvial and tidal, in the whole of the South West region. Held in March 2006, this exercise explored issues around evacuation, re-housing, recovery, the health response, and business continuity within the health service, emergency services and the wider community. Additionally the roles of the local resilience forums and the regional civil contingencies committee were explored.

 

Influenza Pandemic Exercises

A number of regional exercises studied aspects of preparedness for an influenza pandemic. Exercise Arctic Sea , held in the East Midlands in June, was a health-led multi-agency exercise. It provided an opportunity for health professionals and others to practise and develop, in a multi-agency context, the regional responses during a global influenza pandemic. This exercise enabled players to explore issues around the health response itself and business continuity issues within the health service and the wider community during a protracted rising tide incident.

Exercise Aurora was a day long multi-agency exercise designed to explore regional responses to a global influenza pandemic lasting a number of months. It took place in Yorkshire in September 2005 and it provided a valuable opportunity to explore the formation of the Regional Civil Contingencies Committee and the Regional Public Health Advisory Team. Exercise New Day was held in Worcester in October 2005, and concentrated on the strategic management issues of an influenza pandemic, focusing on the health sector and the business continuity implications for partner agencies. The exercise enabled the trial of a new 'off the shelf' pandemic influenza exercise.