This record is a partial extract of the original cable. The full text of the original cable is not available.

UNCLAS SECTION 01 OF 03 ALMATY 000925 
 
SIPDIS 
 
SENSITIVE BUT UNCLASSIFIED 
 
DEPT FOR NEA/SA/EX PMO FRANK LEDAHAWSKY; SCA/CEN; S/ES- 
O/CMS - OFFICE OF CRISIS MANAGEMENT SUPPORT 
 
E.O. 12958: N/A 
TAGS: APER AMGT AEMR AMED KPAO KFLU KZ ECONOMIC
SUBJECT: ALMATY AVIAN INFLUENZA PREPAREDNESS UPDATE 
 
REFS: A) ALMATY 0001; B) STATE 219189; C) DOS/MED DRAFT 
 
PANDEMIC INFLUENZA PLAN 
 
¶1.  (SBU) Summary: The Embassy Almaty Emergency Action 
Committee Pandemic Influenza (PI) Subcommittee has re- 
convened to discuss and execute the "Preparedness 
Checklist" (Ref C). Participants in the PI Subcommittee 
include the DCM and representatives from MED, CDC, ADM, 
PAS, RSO, Principal Officer Embassy Branch Office (EBO) 
Astana, USAID and Peace Corps.  For the purposes of PI 
planning, the current plan for EBO Astana is included in 
the overall preparedness plan for the Mission.  End 
Summary. 
 
¶2.  (SBU) Introduction: 
 
- Host Country AI/PI update: There have been no reported 
cases in Kazakhstan of Avian Influenza in bird populations 
since summer 2005.  Migratory birds are expected to 
reappear in the region during the spring northward 
migratory season, and may bring H5N1 influenza strains to 
domestic flocks.  The Government of Kazakhstan (GOK) 
Ministry of Health has a surveillance program in place to 
test for H5N1 strains when suspicious avian deaths are 
reported.  There have been no confirmed human cases of 
Avian Influenza in Kazakhstan. 
 
¶3. (SBU) Preparedness Checklist - 1. Structure for 
planning and decision making: The multidisciplinary 
planning committee has been created and consists of the 
Emergency Action Committee Pandemic Influenza (PI) 
Subcommittee.  The coordinator is RMO Monte Makous with 
alternate coordinator CDC Country Director Michael Favorov 
or his designee from CDC.  Members of the planning 
committee include representatives from Management, DCM, 
GSO, HR, RSO, IT, PAS, DAO, CA, POEC, USAID, PC, Foreign 
Commercial Service, MED Astana, PO Astana, GSO Astana, 
ECON Astana, and USAID Astana.  The committee liaison in 
the GOK Ministry of Health is Dr. Kenes Ospanov of the 
Republican Sanitary and Epidemiology Station.  Dr Ospanov 
also provides linkage with the host country emergency 
preparedness group. 
 
¶4.  (SBU) Preparedness Checklist - 2. Development of a 
post specific written pandemic influenza plan: Ref A 
delineates Post tripwires and actions and includes 
elements as listed in the Pandemic Influenza Plan.  The 
organizational structure to operationalize the plan and 
the responsibilities of key personnel will reflect what 
currently is in place for the post EAP.  Post plans on 
conducting a tabletop simulation exercise per further 
guidance on this from M/MED. 
 
¶5.  (SBU) Preparedness Checklist - 3. Elements of a 
Pandemic Influenza Plan:  Surveillance Plan: Per guidance 
of the DOS/MED Pandemic Influenza Plan, the Health Unit 
has established surveillance procedures for influenza-like 
illness, and has criteria in place to distinguish pandemic 
influenza.  A system for internal review of pandemic 
influenza activity is in place. 
 
¶6.  (SBU) Preparedness Checklist - Communication Plan: 
- External communication has been assigned as follows: 
Public health reporting to DOS/MED - RMO Monte Makous, CDC 
country Director Michael Favorov, or designee; Clinical 
spokesperson - RMO Monte Makous or designee; Media 
spokesperson - PAS Information Officer Jacqueline 
McKennan. 
 
- Key points of contact: Local health ministry - Dr. 
Ospanov of the Republican Sanitary and Epidemiology 
Station; Local CDC contact - Michael Favorov, CDC 
Director; Newspaper and radio contact - PAS Officer; 
Public official contact through the Embassy front office 
or PAS Officer. 
 
- The list of other healthcare facilities with whom it is 
necessary to maintain communication: The International SOS 
Clinic, International Medical Clinic, and Peace Corps 
Medical Officers. 
 
- Due to the substandard medical facilities in Kazakhstan, 
a meeting with local healthcare facilities is not 
applicable.  (Ref A, para 2) 
 
- A plan for updating key facility personnel daily has 
been established.  It will entail the RMO or designee 
briefing the COM or DCM by telephone or in person. 
 
- A strategy for regularly updating the Health Unit staff 
on the status of pandemic influenza has been established 
and will consist of daily briefings in person or by 
telephone. 
 
- A plan for informing patients and the Mission community 
about the level of pandemic influenza activity has been 
established and will entail announcement at Country Team 
Meetings, the issuance of Administrative Notices, emails 
to the appropriate staff, use of unofficial email 
distributions, use of radios, and use of the Mission 
telephone tree. 
 
¶7.  (SBU) Preparedness Checklist - Education and Training 
Plan: 
- Language and reading level-appropriate materials have 
been identified by utilizing the PowerPoint program 
available on the DOS/MED intranet website with translation 
into the Russian language. 
 
- Means for accessing DOS/MED and federal web-based PI 
training programs have been identified.  This includes 
links to the Pandemic Influenza materials on the Office of 
Medical Services website and the HHS Pandemic Influenza 
website. 
 
- A system for tracking personnel who have completed 
pandemic influenza training has been set up. 
 
- Post plans on issuing an administrative notice to 
recruit and train non-health unit personnel when the 
health unit reaches surge capacity. 
 
¶8.  (SBU) Preparedness Checklist - Health Unit Personnel 
Training: LES nursing staff, laboratory technician and 
receptionist have received training on Post's Pandemic 
Influenza Plan.  Those providers with CERT training will 
be informed of the Post PI Plan. 
 
¶9.  (SBU) Preparedness Checklist - Triage Plan: Patient 
triage will be primarily by telephone contact followed by 
home visit by a medical provider if deemed appropriate. 
Those entering the facility seeking care will be directed 
to the HU and examined immediately in a separately 
designated room. Signage to instruct those with possible 
PI is under development. Criteria for determining which 
patients need evaluation are based on Ref C. 
 
¶10.  (SBU) Preparedness Checklist - Facility Access: 
Criteria and protocols to limit public gatherings, closing 
the mission to outside visitors and limiting visitors to 
the HU have been established.  RSO has been a key partner 
in designing procedures for enforcing facility access 
controls. 
 
¶11.  (SBU) Preparedness Checklist - Occupational Health 
Plan: 
- A system for delivering vaccine or prophylaxis to 
healthcare personnel has been developed, and has been 
tested during the non-pandemic influenza season. 
Prioritization based on risk has been established. 
 
- Thermometers have been procured for all Mission 
employees to be used for self-screening at home.  Those 
with fever or respiratory symptoms will be required to 
stay at home.  This has been tested as a table-top 
exercise. 
 
- A policy for managing healthcare personnel with symptoms 
of PI or documented PI has been established. 
 
- Developing alternative worksites for those with high- 
risk medical conditions will be done as needed on a case- 
by-case basis. 
 
- Mental health resources at Post are minimal, and will be 
identified on an ad hoc basis. 
 
- Post will accommodate personnel with child care 
responsibilities on a case-by-case basis. 
 
¶12.  (SBU) Preparedness Checklist - Vaccine and Antiviral 
Use: 
- A prophylaxis priority list of patients and healthcare 
personnel has been developed.  Exact forecasts cannot be 
determined due to the inherent fluctuations of counting 
these individuals.  There are approximately 20 first 
priority personnel, 150 second priority personnel, and 550 
remaining personnel. 
 
- A system for distributing the prophylaxis has been 
developed. 
 
¶13.  (SBU) Preparedness Checklist - Issues Relating to 
Surge Capacity: Persons responsible for assessing day-to- 
day clinical staffing needs during an influenza pandemic 
are RMO Makous, LES Nurse Almaty, and LES Nurse Astana. 
When necessary, an announcement will be made to the 
Mission community to recruit those with medical 
background.  Post awaits further guidance from DOS/MED and 
DOS legal counsel regarding liability issues and 
credentialing. 
¶14.  (SBU) Preparedness Checklist - Needs for Anticipated 
Durable and Consumable Resources: Post is developing a 
plan to address supply shortages to "shelter in place" 
that is subsumed into the current emergency disaster plan. 
 
ORDWAY