There was an outbreak of the plague in Hudson County last week. Hundreds of thousands of infected patients were going to need some sort of medication in the matter of 48 hours. A cause of action had to be implemented – and fast.
Thousands of victims were shuttled to their respective Point of Dispensing (POD) sites, including the John Jay Moore Fitness and Athletic Center at New Jersey City University. The patients had to be examined, diagnosed, treated, medicated and released as fast as possible, with the goal of 1,000 per hour receiving proper medication, in this case, either Cipro or Doxycycline.
Needless to say, it was a massive undertaking. Time was of the essence.
What transpired Wednesday morning at NJCU was simply an exercise – part of the U.S. Department of Homeland Security’s statewide terrorism drill called TOPOFF 3 (Top Officials 3), the most comprehensive terrorism response exercise ever conducted in the country.This is only a test
The full-scale exercises took place in New Jersey and Connecticut last week, April 4-8, involving participants from international, federal, state, local and private sector agencies. In both states, participants were being asked to respond to simulated crises.
In Hudson County, the crisis was the outbreak of pneumonic plague, and it was up to local officials to simulate what to do in the case of such an outbreak.
The Hudson Regional Health Commission supervised the exercise, which utilized close to 3,000 local high school and college students as “role players.”
Each person was given a script that they had strictly follow, according to HRHC health educator Monique Davis.
“They’ve each been assigned a script, like say a 47-year-old man who has some existing health problems,” Davis said. “Then they are asked to go through the flow of the POD. They have to do it quickly. We hoped to dispense and service at a rate of 1,000 people per hour.”
If it were a real event, the emergency workers assigned to process and dispense the medications would have been given the antibiotics the evening before.
The number of PODs is based on the general population of each municipality. Jersey City, with 240,000 residents, would need at least eight-to-10 POD sites. Smaller towns would need fewer. In all, some 660,000 Hudson County residents would have had to be medicated within 48 hours.
It’s not as simple as handing out pills to everyone in a frenzy. Each exposed victim has to be evaluated.
“Medical screening and medical consultation are two important aspects here,” Davis said.
Carol Ann Wilson, the Hudson County Director of Health and Human Services, took a tour of the POD site at NJCU with members of the media and other information officials.
“We have people in the county who are already trained to handle situations like this,” Wilson said. “Each municipality has a system in place.” Teachers, residents participate
“They really got into the role playing,” Wilson said of the volunteers who participated. “Some were told to have hysteria. Some were told to panic.”
Jose Gonzalez is a teacher at North Bergen’s High Tech High School. He was one of those who took the exercise very seriously and even went beyond the call of his assigned script.
“The way I look at it is that I’m a teacher and I’m supposed to teach,” Gonzalez said. “What good would it do if we stood on line and went through the motions? What good would they get out of it? They wanted us to role play, so that’s what I did.”
Gonzalez portrayed a man who was becoming delirious after being infected.
“I gave them something to work with,” Gonzalez said.
His delirious behavior eventually had him escorted away by police from the Hudson County Office of Rapid Deployment and Emergency Management, who were also on hand to participate. Police and fire officials from Jersey City, Kearny, Harrison and Guttenberg were there.
Although the North Hudson Regional Fire & Rescue did not have an active hand in the exercise, there were representatives on hand to observe, like co-director Jeff Welz.
“I think it was a great educational tool,” Welz said. “It was very impressive. It was a good way to move the people through. We have a plan, but this way, we got to see the plan implemented.” If this had been an actual emergency…
“It was a very valuable experience for emergency planners,” said Bernadette Ojelko, a registered nurse in the NJCU Bachelor of Science in Nursing program. “This exercise exposed many areas that can be streamlined to improve the overall process.”
All of the local hospitals were on call to treat possible plague victims if the script called for it. The hospitals were prepped on the procedures of TOPOFF 3 and were on standby throughout the course of the exercise.
Another important aspect of the exercise is communication. Wilson said that there were representatives of 48 different languages that could provide translation in order to speed up the dispensing process.
After the three-hour exercise was completed, there was a discussion involving county officials about whether the exercise was a success. County officials discuss
“We did not fail,” Wilson said. “Of course, there are always concerns when you handle this volume. Even if we missed five clients, it’s a problem. But I found that it went much better than expected. It turned out to be self-fulfilling. It’s an exercise that we hope we don’t ever have to put into reality, but it’s important to know that the mechanisms are all in place.”
“We needed to sit down and have a course of action,” said Hudson County Executive Thomas DeGise. “It was a good tool on a lot of levels. It’s not easy to accomplish and we realized that. We recognize the need to have a program like this. What we find later is that a program like this was not sufficiently funded.”
The exercise was part of a federal and state mandate, but yet the county received only $20,000 to put together the exercise. It is likely that they spent much more.
“We did not want to have a placid exercise,” Wilson said. “It was orderly, but we were very careful to put a whole variety of scenarios out there. I think we can basically conclude that we have a system in place and we’re better off now than we were when the 9/11 crisis took place.”