VZCZCXRO1674
PP RUEHRG
DE RUEHBU #3110/01 3542118
ZNR UUUUU ZZH
P 202118Z DEC 05
FM AMEMBASSY BUENOS AIRES
TO RUEHC/SECSTATE WASHDC PRIORITY 2828
INFO RUCNBEH/BRASILIA ENVIRONMENTAL HUB COLLECTIVE

UNCLAS SECTION 01 OF 04 BUENOS AIRES 003110 
 
SIPDIS 
 
SENSITIVE, SIPDIS 
 
STATE FOR S/ES - O/CMS - Office of Crisis Management Support 
 
E.O. 12958: N/A 
TAGS: AMGT ASEC CASC AMED KFLO AEMR AR
SUBJECT:  Embassy Buenos Aires Avian Influenza Tripwires and 
Contingency Planning 
 
Reference: (A) State 219189 
           (B) State 220047 
           (C) Buenos Aires 2914 
 
¶1.  Sensitive But Unclassified - Not For Internet 
Distribution. 
 
¶2.  (SBU) Summary:  Embassy Buenos Aires has created an 
Avian Influenza (AI) Mission Task Force (MTF), chaired by 
the DCM and composed of a program coordinator and 
representatives from MED, CON, RSO, MGMT, FAS and ESTH.  The 
MTF recently met to explore Post's current posture, the 
Argentine health care environment and the advance planning 
necessary to confront a possible AI epidemic.  The GOA has 
created an extensive AI Contingency plan based on Pan 
American Health Organization (PAHO) and U.S. practices and 
may be capable of implementing it, depending on the severity 
of an AI outbreak.  However, a lack of resources makes it 
probable that a sustained AI epidemic would overwhelm the 
Argentine healthcare system within a short period. 
 
¶3. (SBU) The MTF identified steps that should be taken 
immediately, created an implementation action plan and 
developed a series of tripwires and corresponding responses. 
Of particular concern to the MTF is the lack of a stockpile 
of antivirals at Post and the unavailability of the drugs on 
the local market. 
 
¶4.  (SBU) In determining appropriate tripwires, the MTF 
factored a fast transmission rate, especially if the virus 
develops the ability to spread directly from human-to-human, 
into all assumptions concerning AI due to the historically 
rapid geographical dispersion of pandemics, the pace of 
modern air travel and Argentina's location as a major 
migratory bird flyway.  The tripwires also consider likely 
civil unrest and the probability that basic services and 
business organizations would either cease functioning or 
dramatically cut back services in the event of a pandemic. 
End Summary. 
 
¶5.  (U) Embassy Buenos Aires has created an ongoing Avian 
Influenza (AI) Mission Task Force (MTF), chaired by the DCM 
and composed of a program coordinator and representatives 
from MED, CON, RSO, MGMT and ESTH.  The purpose of the MTF 
is to explore Post's current posture, the Argentine health 
care environment in the event of a pandemic and coordinate 
the advance planning necessary to confront a possible AI 
epidemic, and develop emergency response procedures. 
 
¶6. (SBU) The MTF observed that Post currently does not have 
a supply of antiviral drugs and recommends obtaining enough 
of the drugs to ensure 100% coverage of all Embassy staff 
(including contract personnel) and EFMs in order to ensure 
continued Embassy operations. 
 
¶7. (SBU) There are a number of high-quality hospitals and 
clinics in the greater Buenos Aires area.  The quality and 
number of facilities outside of the capital varies greatly 
depending on the region, with healthcare in the northern 
provinces of a particularly low quality. 
 
¶8. (SBU) The GOA has created an extensive plan based on Pan 
American Health Organization (PAHO) and U.S. practices to 
deal with a possible outbreak of AI and coordinated the plan 
with the Ministries of Health in Chile, Uruguay and Brazil. 
The Ministry of Health (MOH) is active and involved and the 
GOA may be capable of implementing the plan depending on the 
severity of the outbreak and the availability of antivirals 
and vaccines from outside sources. 
 
¶9. (SBU) A lack of resources makes it probable that a 
sustained AI epidemic would overwhelm the Argentine 
healthcare system within a short period.  The GOA would need 
assistance with personnel, detection laboratories and 
medical equipment such as respirators and isolation wards if 
a pandemic outbreak occurred in Argentina.  The GOA does not 
currently have a supply of antiviral drugs, such as Tamiflu, 
although the GOA claims it is currently negotiating for a 
stockpile of the drugs. 
 
¶10. (SBU) Post has sufficient resources to shelter essential 
personnel in place at the Embassy for two weeks. 
 
¶11. (SBU) Post management has tasked two U.S. citizen 
employees, ESTH Officer Tim Hall and Post Medical Officer 
Dr. Michael Heald, with responsibility for inputting the 
tripwire data.  Both possess secret clearance or higher. 
 
¶12. (U) All DoD personnel are under COM authority. 
 
 
BUENOS AIR 00003110  002 OF 004 
 
 
 
¶13. (SBU) In determining appropriate tripwires, the MTF 
factored a fast transmission rate, especially if the virus 
develops the ability to spread directly from human to human, 
into all assumptions concerning AI due to the historically 
rapid geographical dispersion of pandemics, the pace of 
modern air travel and Argentina's location as a major 
migratory bird flyway.  Post's plan also addresses the civil 
unrest and breakdown of basic services that could result 
from a pandemic outbreak in Latin America.  It is highly 
possible that basic services and business organizations 
would either cease functioning or dramatically cut back 
services. 
 
¶14. (SBU) All tripwire responses have been made under the 
assumption that an effective human vaccine will not be 
available.  Any of the tripwires discussed below could occur 
independently of each other.  It is also possible that two 
or more tripwires could occur sequentially or 
simultaneously. 
 
¶15. (U) In the course of discussions, it was apparent that 
certain actions need to take place now, before any tripwires 
are met, in order to be fully prepared in advance.  This 
report lists A) actions that require immediate attention, 
and B) tripwires and responses. 
 
¶16. (SBU) A) Actions to be taken immediately: 
 
- As deemed necessary by Post management, provide Mission 
briefings for both American and LES employees and 
dependents.  Topics will include General AI info, MED 
guidance, Post's contingency plans and the address of the 
Embassy website containing information about avian 
influenza. (Action:  MGMT and MED) 
 
- After briefing Mission (see above), provide American 
Citizen Community with information presented during briefing 
via email. (Action:  MGMT and MED) 
 
- Identify Staff with medical background and skills. 
(Action:  MED) 
 
- Train non-medical personnel in caring for those suffering 
from AI and to supplement the health unit staff in the event 
of a pandemic. (Action:  MED) 
 
- Request sufficient Tamiflu to cover all staff (including 
contract employees) and EFMs.  Conduct inventory of personal 
protective equipment (gowns, gloves, protective eyewear, 
alcohol-based cleaners and N95 respirators).  In 
coordination with Consular Section, determine quantities 
needed in the section.  Procure needed supplies. (Action: 
MGMT and MED) 
 
- Provide proper security measures for Tamiflu supply in 
mission. (Action:  RSO) 
 
- Stockpile emergency supplies for a period of at least 
several weeks.  This should include a practice of 
maintaining full tanks of fuel in all vehicles. (Action: 
MGMT and GSO) 
 
- Plan for continuation of operations with reduced staff and 
prepare for conducting work from home or other locations 
under conditions of a pandemic limiting access to mission 
offices.  This includes the ability to disseminate warden 
messages from an alternate location. (Action:  DCM and CONS) 
 
- Identify essential staff to remain through possible 
authorized or ordered departure.  This list will likely 
mirror that in the Emergency Action Plan (EAP).  (Action: 
DCM) 
 
- Identify staff with medical issues or risk for severe 
disease to depart when authorized. (Action:  MGMT and MED) 
 
- Prepare pre-planned packets - including travel orders - 
for potential Mission evacuees under an authorized 
departure. (Action:  MGMT and GSO) 
 
- Engage host country officials, including NGOs, to keep 
abreast of host country's AI response strategy and health 
care capabilities. (Action:  ESTH) 
 
- Update list of alternative local physicians in case the 
Post doctor is unavailable.  Alternative doctors should be 
briefed by Post medical staff on AI procedures.  (Action: 
MED) 
 
- Inspect MRE and bottled water supplies.  Determine if 
 
BUENOS AIR 00003110  003 OF 004 
 
 
additional MREs and other supplies should be ordered to 
sustain Mission operations and for unforeseen contingencies. 
(Action:  MGMT and GSO) 
 
- Conduct periodic meetings of the MTF to review Post's AI 
preparedness posture.  (Action:  DCM and all sections) 
 
¶17.  (SBU) B) Tripwires and Responses: 
 
Tripwire One:  A substantial and sustained spike in the 
number and/or broadening geographic spread of animal to 
human cases or sustained human-to-human transmission 
anywhere in the world. 
 
  - EAC meets to confirm tripwire has been crossed. 
  - Provide Mission briefings for American and LES 
  employees and dependents. 
  - Restrict official and unofficial travel. 
  - Ensure that any public announcements or travel warnings 
  issued are disseminated to American citizens in host 
  country. 
  - Recall all employees who are currently in remote areas. 
  - If the disease has already reached the U.S., consider 
  sheltering in place of all non-essential personnel in 
  lieu of authorized departure. 
  - Begin preparations for actions in Tripwire Two. 
 
Tripwire Two:  A spike in the number and/or broadening 
geographic spread of animal to human cases or sustained 
human-to-human transmission in Latin America or South 
Africa. 
 
- EAC meets to confirm tripwire has been crossed. 
- Provide Mission briefings for American and LES employees 
and dependents. 
- Restrict official and unofficial travel to suspected 
areas. 
- Request authorized departure of non-essential staff and 
family members.  If this is not possible due to shutdown of 
airports or if the disease has already reached the U.S., non- 
essential staff and families should shelter in place.  (It 
is probable that staff and family members will onQ have a 
limited time to depart Argentina.  This will depend on the 
rate of dispersion of the disease and the pandemic 
associated shutdown of national and regional airports.) 
- Non-essential personnel will be placed on administrative 
leave. 
- Cancel incoming official travel to host country except for 
personnel involved in investigative/containment efforts, or 
as otherwise deemed necessary by COM. 
- Ensure that staff purchases sufficient supplies of Qod 
and water for a shelter in place scenario. 
- Social restrictions (restrict movements of all personnel 
in the city; restrict dinner parties, participation in 
sporting events, etc.) 
- Begin preparations for actions in Tripwire Three. 
 
Tripwire Three:  A spike in the number and/or broadening 
geographic spread of animal to human cases or sustained 
human-to-human transmission in Argentina. 
 
 - EAC meets to confirm tripwire has been crossed. 
 - Provide mission briefings (perhaps by phone or email) for 
American and LES employees and dependents. 
 - Cancel incoming official travel to host country except 
for personnel involved in investigative/containment efforts, 
or as otherwise deemed necessary by COM. 
- Coordinate with CA/OCS on issuance of guidance (public 
announcement ortravel warning, as appropriate) urging 
American citizens to defer all non-emergency travel to host 
country and particularly the affected regions. 
- In coordination with the Department, prepare press 
guidance. 
- Implement home quarantine of any staff or dependents who 
have been in contact with a person confirmed to have an AI 
infection and implement at home monitoring procedure. 
- IF AD/OD is not permissible, instruct all non-emergency 
American and LES staff to remain home on administrative 
leave.  Children should remain home from school. 
- Implement social distancing (limit movement of all 
personnel and dependents in the city). 
- Plan for home visits to sick individuals who receive care 
under the Embassy health unit. 
- Consider delivery service of groceries and other essential 
items to residences. 
- Depending on level of public inquiries, Embassy staffs and 
equips a situation room.  Consular officers should establish 
a database tracking American citizens who have been 
quarantined, hospitalized or ill at home.  Also, prepare 
guidance for American citizen community on treatment 
 
BUENOS AIR 00003110  004 OF 004 
 
 
options. 
- Reduce consular operations to emergency consular services 
only. 
-  Consider dividing the Marine Security Guard detachment 
into two separate and independent entities to decrease the 
risk of the spread of the disease and ensure proper coverage 
of classified materials. 
- Severely restrict visitor access to Mission. 
- Consider prophylactic Tamiflu treatment only for staff 
that is required to be in direct contact with potentially 
infected persons and those at high risk if they develop the 
disease. 
- In the event of civil unrest, consider increasing the size 
of the local guard force and the frequency of patrols to 
personal residences.  If necessary, consider relocating 
personnel sheltering in place to a safer location. 
 
Alternate Tripwire:  Mission employee or eligible family 
member develops AI infection. 
 
Alternate Tripwire Response: 
 
- Employee or eligible family member begins Tamiflu 
treatment. 
 
- Medevac if possible; otherwise home quarantine patient and 
anyone who has had direct contact with patient. 
 
GUTIERREZ