Coronavirus (COVID-19) Medical Contingency Plan Version 2.0

Medical treatment and evaluation should only be conducted by trained medical professionals. This plan is designed to provide information on identifying and minimizing potential risk, not to treat or evaluate potential patients. If at any point you feel uncomfortable with the situation immediately notify the appropriate authorities.

Remember, your personal safety is the number one priority.

Additionally, this plan is proprietary information created by Emergency Concierge International, LLC (ECI) specifically for use by the purchasing party. Any reproduction, adaptation, replication or plagiarism without the express written consent of ECI is strictly forbidden.

Coronavirus (COVID-19) Preparation & Response Action List

1. Communicate Organizational Preparation to Attendees
2. Educate Self & Staff on Factual COVID-19 Information
3. Gather Local Resource Information
4. Discuss Response Strategy with Venue & Staff
5. Gather Necessary Supplies
6. Implement Mitigation & Preparedness Techniques
7. Monitor Crowd Health and Dynamics
8. Respond to Suspected Incidents
9. Manage Communications
10. Complete After-Action Review

4 PHASES OF EMERGENCY MANAGEMENT…………………………………………………………………… 4
MITIGATION & PREPAREDNESS …………………………………………………………………………………. 5
STEP 1: Provide Communication to Attendees………………………………………………………………. 5
STEP 2: Attain Factual Background Information……………………………………………………………. 6
STEP 3: Local Resource Information ……………………………………………………………………………. 8
STEP 4: Discuss Preparedness & Response Strategy with Venue & Staff ……………………….. 8
STEP 5: Gather Supplies………………………………………………………………………………………….. 10
STEP 6: Implement Mitigation & Preparedness Techniques………………………………………. 10
RESPONSE ……………………………………………………………………………………………………………. 11
STEP 7: Monitor Crowd Health and Dynamics…………………………………………………………….. 11
STEP 8: Respond to Suspected Incidents…………………………………………………………………….. 12
STEP 9: Manage Communications…………………………………………………………………………….. 14
RECOVERY ……………………………………………………………………………………………………………. 15
STEP 10: Complete After-Action Review…………………………………………………………………….. 15
Real-time Scenario Based Consultation……………………………………………………………………… 15
Frequently Asked Questions…………………………………………………………………………………….. 16
Local Requirements ……………………………………………………………………………………………… 16
Individuals with COVID-like symptoms…………………………………………………………………… 16
Best Practices………………………………………………………………………………………………………… 16
Attendee Testing Positive ……………………………………………………………………………………….. 17
APPENDIX A………………………………………………………………………………………………………… 20
EMERGENCY CONTACT INFORMATION………………………………………………………………. 20
CRISIS COMMUNICATION TEAM – CONTACT NUMBERS…………………………………….. 20
References & Resources………………………………………………………………………………………… 21

4 PHASES OF EMERGENCY MANAGEMENT

MITIGATION & PREPAREDNESS

MITIGATION refers to the process of identifying elements of risk and removing those possibilities from the event. At this phase of emergency planning you are looking to remove or minimize areas of risk that you feel can be avoided.

While mitigation deals with eliminating or minimizing potential risks, PREPAREDNESS, refers to steps put into place to minimize the level severity of risk for elements that cannot be removed. Simply put, preparedness is figuring out how to deal with the risks you cannot avoid. The following steps provide actionable guidance to help you mitigate and prepare for risks associated with your next event.

STEP 1: Provide Communication to Attendees

It is important to put your attendees’ minds at ease by informing them of the steps being taken to prepare for and respond to any suspected issues. A significant mistake you can make, from a crisis communication standpoint, is to be dismissive of attendee concerns. The goal here is to acknowledge and inform without further instigating any panic or concern. Additionally, this is an opportunity to define expectations you have of attendees.

Sample Communication…

Hello (GROUP),

We have begun to receive questions asking what steps we have made to prepare to handle issues related to the current COVID-19 situation as it relates to our upcoming event. We expected these questions to come and have been focused on making sure that we have the appropriate steps in place to make the event go off without issue or concern.

We are taking countless proactive steps to make sure that the spread of germs, in general, is significantly minimized. COVID-19 aside, we always want to focus on our attendees being happy and healthy. With that in mind, we ask, for the benefit of your fellow attendees, that you stay home if you are currently experiencing COVID-like symptoms (fever, cough, shortness of breath). Your contributions will certainly be missed but we feel it is better safe than sorry at this point.

We know that the information in the media can be scary, especially when you are about to embark on a trip. We can assure you that we are actively engaged in this process, putting the necessary steps into place to promote a safe event and remain vigilant in safeguarding your well-being.

Sincerely,
(GROUP REPRESENTATIVE)

For more information on ECI’s comprehensive Crisis Communication Plan development services CLICK HERE. We are available to consult and advise on your customized messaging.

STEP 2: Attain Factual Background Information

Coronaviruses are a large family of viruses, some causing respiratory illness in people. Signs and symptoms, similar to the common cold or the flu, include a runny nose, cough, sore throat, fever, and general feeling of being unwell. The current version of “coronavirus” is named “COVID-19” both names are often used interchangeably.

COVID-19 has officially been deemed at “community spread” level which simply means infection occurs from an unknown source. This is why you have seen a decrease in “contact tracing” from public health officials.

How it Spreads

The virus spreads mainly through person-to-person contact
The virus is also thought to spread through aerosolized droplets when an infected person coughs or sneezes.
Additionally, the virus is able to be spread through contact with contaminated surfaces although this is not thought to be the main form of spread. This form of transmission requires the person to then touch their own nose, mouth and potentially eyes.

Symptoms

Symptoms of COVID-19 range in severity from mild to severe and in some cases result in death. Often showing similar signs and symptoms to Influenza (Flu), coronavirus is primarily a respiratory illness. The CDC provides the following symptoms for both illnesses;

Prevention and Treatment

Currently no vaccine exists for prevention of coronavirus infection. The only known definitive prevention measure is avoidance of exposure. The CDC recommends the following general respiratory disease spread precautions:

No treatment for coronavirus currently exists. Treatment protocols for infected individuals focus
on symptom management; fever reduction, hydration, and vital organ health management.

Stigma & Overreaction

One of the biggest issues to be faced by meeting and event planners on-site is overreaction to individuals presenting with flu-like symptoms. The flu is very common, and although severe in many cases, is typically not life threatening to adults of average health.

Unfortunately, in the current environment attendees presenting with flu-like symptoms may be ostracized by fellow attendees. Staff should consider requesting that attendees not feeling well not attend and offering refunds to attendees on-site who present with flu-like symptoms as the spread of the flu is also not a desirable event outcome.

The most significant thing that anyone can do to prepare themselves for dealing with COVID-19 concerns, both for themselves and others, is to ensure you stay informed from CREDIBLE resources. Specifically, the Centers for Disease Control and local public health agencies.

STEP 3: Local Resource Information

We recommend having an All-Hazards Emergency Operations Plan (EOP) for each event. There should be a Medical Plan component in the EOP that provides the location and description of the available emergency medical services within a prescribed area of response to your event.

For information on customized All-Hazards Emergency Operations Plans or Emergency Plan Templates CLICK HERE.

Having this knowledge allows your team to make an informed decision with regards to appropriate facilities, treatment, and transportation. Information in the Medical Plan includes but is not limited to;

Location/distance of local hospital(s)
Level of care provided
- Emergency Room, Burn Treatment Capabilities, Trauma Level
911 system (or international equivalent)
First Responders
- Fire, EMT, Paramedic
Venue – On-site medical capabilities

STEP 4: Discuss Preparedness & Response Strategy with Venue & Staff

Either on-site, or prior to arrival, it is vital that preparedness, response and evaluation procedures are coordinated with venue staff to prevent the spread of the virus, calm concerned attendees, ensure that requirements are being adhered to, and prepare for appropriate response in the event of an attendee presenting with flu-like symptoms.

What requirements do I have to meet?

Although certainly the experts, and often referred to as the guiding agency, the CDC makes recommendations from a national standpoint that cover a wide variety of situations (i.e. businesses, healthcare settings, long-term care, group gatherings, etc.). While that information is incredibly helpful, requirements for your gathering will most likely be set by the local public health agency. When planning for your event, you, or your designee, should research the local requirements regarding large group gatherings. While often not significantly different from the CDC, local requirements are enforceable, provided they are established in ordinance. The best location to find that information is in state or county local health agencies.

Sample Requirement Questions

Are there group size limits?
- Maximum total?
- Per Room?
- With physical distancing?
- Etc.
What physical distancing requirements need met?
- Typically, 6 feet
Is health monitoring required?
- If so, what type? Temperature checks, symptom checks, etc.
What other mitigation requirements exist?
- Masks
- Gloves
- Etc.

On-Site Medical Professionals

If the venue is not providing on-site medical professionals, it is important to establish common notification practices to ensure everyone is on the same page. (DO NOT confuse first aid trained security officers with medical professionals). If your organization, or the venue, is providing on-site medical professionals, while it is appropriate to defer patient treatment to a higher level of medical authority, it is crucial that staff are engaged in the process to remain aware of situation status, ‘control the narrative’ and better prepare for any potential fallout from the incident.

For more information on contracting ECI’s on-site crisis management staffing services (including medical professionals) CLICK HERE.

Sample questions to ask…

How will we notify each other of a potential issue?
Who is going to take the lead on dealing with suspected infected attendees?
Who will make notification to local emergency services where appropriate?
How will we coordinate any crisis communication, both internally and externally in
the unlikely event of an incident?

STEP 5: Gather Supplies

The following is a list of commonly utilized bodily substance isolation (BSI) personal protective equipment (PPE) used to help protect staff that may come into contact with a potentially infected attendee;

Gloves (medical grade with body substance isolation)
Masks (N95)
Medical gowns
Eye protection

Additionally, the following supplies can be used to attempt to minimize the overall risk of
contamination and promote positive general hygiene and housekeeping procedures;

Disposable disinfectant wipes
Alcohol based hand sanitizer
Record keeping supplies (for after-action reports)

STEP 6: Implement Mitigation & Preparedness Techniques

Mitigation Steps

Utilize outdoor venues
Provide 6-foot minimum social distancing
Establish touchless registration
Stress to employees and attendees that they should stay home if they are not feeling
well.
Enforce good housekeeping with a focus on improving sanitation and cleanliness.

Review/adjust/modify agendas to decrease personal contact amongst attendees. Options
include;

Decrease or limit activities that entail personal contact.
- Promote a no handshake environment.
- Provide single-serve scenarios to decrease congregating
Focus on activities that get attendees outside and/or out of confined quarters.
- Mix up the agenda to provide movement out of ‘stagnant’ areas.
- Integrate these opportunities into agenda to accommodate increased
  cleaning intervals.
Consider providing immune support products as a pro-active and positive approach
to attendee health and wellness.
- Vitamin packs, nutritional shakes, focus on hydration, etc. Often the best
  remedy is a good immune system and the belief that you are protected.

Preparedness Steps

Frequently disinfect highly touched places (elevator buttons, door handles,
tabletops, etc.)
Remind staff of the importance of good general hygiene to include thorough and
frequent hand washing, as well as covering the nose and mouth when sneezing or
coughing.
Advise staff to reduce physical contact with guests.
Remind staff to avoid touching their nose, mouth, or eyes without washing their
hands.
Review Emergency Operations Plan and consider executing a tabletop exercise with
staff to discuss worst case potential scenarios.
Reduce attendee risk
- Notify attendees that the venue has taken available control measures.
- Educate attendees on how to report any issues through venue staff.
- Provide hand sanitizing stations in high traffic areas and restrooms.
- Provide mini-hand sanitizer and tissues at registration.

RESPONSE

RESPONSE, in this scenario, addresses the actual actions taken when on-site and/or dealing with a known or suspected COVID incident.

STEP 7: Monitor Crowd Health and Dynamics

Pay close attention to overall attendee health and wellness (without further inciting concern). Items to watch for;

‘Violation’ of physical distancing guidelines
- DECISION POINT – How strict do you want to be? You have provided the mechanisms, structure and protocols for attendees to be socially distanced. If THEY choose to violate those practices you and your team need to determine, before the event, to what degree you want to enforce those requirements.
What if an attendee is exhibiting signs/symptoms of illness consistent with
COVID/flu?
- Coughing, shortness of breath, etc.
- It is better that your team identify these individuals before other attendees do.
  - Consider offering a refund for attendee to leave event.
  - Try to get the attendee to self-isolate to decrease exposure. At a minimum try to get the attendee to wear a mask while in public.
General unsafe hygiene/housekeeping practices.
- Coordinate with venue to enhance hygiene and housekeeping practices.
- Request additional cleaning services/intervals from venue.
  - Assign staff specific to ensuring agreed upon expectations are met.

STEP 8: Respond to Suspected Incidents

If an attendee self-identifies with flu-like symptoms?

Regardless of suspected coronavirus infection, all attendees presenting with flu-like symptoms should be treated the same. If at any point an attendee requests a higher-level of medical evaluation accommodate accordingly, (typically by notifying local emergency medical services). And remember, your personal safety is always the NUMBER 1 PRIORITY!

Mask, Ask, Isolate & Inform
- Provide the attendee a “surgical/exam mask” to put on themselves.
- Ensure any staff interacting with the attendee are wearing appropriate personal protective equipment (N95 mask, medical exam gloves, eye protection and medical gown (if available)).
- Relocate the attendee to an isolated location preferably one that can easily be decontaminated.
  - Minimize the number of staff/attendees that come into contact with the attendee.
If the attendee wants to be transported to the hospital;
- Immediately notify emergency medical services and advise them of potential exposure risk.
- Continue to isolate attendee and minimize the number of staff/attendees that come into contact with the attendee.
- Follow local emergency medical service direction regarding further isolation, decontamination and any other necessary steps.
- Remain in full personal protective equipment until done decontaminating
  area.
- Decontaminate the area where the attendee was evaluated.
- Remove and dispose of all personal protective equipment.
If attendee does not want to be transported to the hospital;
- Recognize that coronavirus cannot be definitively ruled out.
- Determine if attendee requests additional medical evaluation and contact resources accordingly.
- DECISION POINT – You CANNOT force someone to go to the hospital if they do not want to. You may however have the ability to exclude the attendee from your event thus decreasing exposure to other attendees. (Consult legal counsel).
  - Regardless of outcome there is value in having the attendee avoid other attendees for the duration of the event.
- Remain in full personal protective equipment until done decontaminating
  area.
- Decontaminate the area where the attendee was evaluated.
- Remove and dispose of all personal protective equipment.

See Flow Chart…

STEP 9: Manage Communications

Based on the heightened level of attention and sensitivity surrounding COVID-19 it is essential that planners and staff have a detailed reporting structure in the case of suspected issues. Additionally, it is crucial that communication strategies be pre-established prior to an incident occurring. In the unlikely event of a confirmed case of COVID-19 on-site of your event, ‘controlling the narrative’ e.g. social media, attendees, corporate, local news, is critical.

Consider the following:

Have a pre-established Crisis Communication Team identified (see APPENDIX A).
Control the Narrative.
- Advise staff not to post on social media or make any comments to the media.
Determine what information (if any) is to be shared with who and on what platforms.
- Never share Personally Identifiable Attendee Information.
- Collaborate with local emergency medical services on next steps.

Crisis Communication Plan Life Cycle

PLAN: Carefully determine the elements of the message to be delivered
PREPARE: Prepare the message, consider potential negative takeaways and revise, as needed, with the Plan.
IMPLEMENT: Deliver message.
REVISE: Revise further messaging strategy based on feedback and perception.

For more information on ECI’s comprehensive Crisis Communication Plan development services CLICK HERE.

STEP 10: Complete After-Action Review

Any incident, whether suspected or not, has great learning benefit to the staff and overall process. Any incident that is identified should be reviewed for best practices and areas for improvement. Staff should ask themselves, in a formal collaborative fashion;

Real-time Scenario Based Consultation

If you would like more information, please feel free to contact us for event specific consultations, and scenario specific, real-time consultation to assist with concerning situations or suspected infected attendees. We are here to help!

Additionally, if you would like to discuss our full-scale All-hazards Emergency Planning services CLICK HERE.

The most important thing to remember throughout this process is to remain calm and strategically work the issue. Panic and overreaction will do nothing but complicate and worsen the situation.

Frequently Asked Questions

Local Requirements

Whose RECOMMENDATIONS should I follow?
- YOUR OWN. CDC recommendations are just that, recommendations. You need to make calculated decisions based on your event, your attendees, location, agenda, options, resources available, and how willing you are to address issues.

Whose REQUIREMENTS should I follow?
- Local requirements. They are typically the only requirements, in this case, that are enforceable, other than venue requirements which are not typically legally required but may be contractually required. These are typically found in state or county health departments and are easily accessible via the internet. They are not always easily decipherable but with assistance you can work through them.

Individuals with COVID-like symptoms.

Can I, as the event promoter, force or require an attendee to go to the hospital if they have COVID symptoms
- No. You can strongly recommend but you cannot force an attendee to go to the hospital.

Can I, as the event promoter, exclude or require an attendee to leave my event if they have COVID symptoms
- That will depend on your current attendee agreement status. If you ‘reserve the right to refuse service’ to attendees for myriad reasons, that should be included. CAUTION: it is best to offer a refund to smooth things over. YOU cannot definitively diagnose whether or not an attendee has COVID.

Best Practices

Should I do temperature checks on all attendees?
- Short answer: No.
- Long answer: Unless locally required, temperature checks tend to create more issues than solutions. Unless your intent is to make your attendees ‘feel better’ as a whole. There are myriad reasons why these checks are not diagnostic or helpful. They are logistically complicated and net minimum benefit. Therefore, unless desired or locally required, they are not typically an effective use of time and/or resources.

Should I require attendees to wear masks?
- Short answer: Most likely: Yes.
- Long answer: CDC recommends those in public wear cloth masks. Additionally, local requirements, may require attendees to wear masks. Best practice is to encourage attendees to wear masks. Recognize that requiring masks may cross into an enforcement and supply issue depending on event structure. New research suggests that wearing a mask can decrease the spread of the virus. Often masks are not worn appropriately, not handled appropriately and create a false sense of self-security thus decreasing their
  efficacy and the efficacy of other preventative measures (i.e. physical distancing, hand washing and cleaning frequently touched surfaces). Appropriate use of masks should be emphasized and other mitigation practices should not be disregard based on mask use.

Should I require attendees to wear gloves?
- Short answer: No.
- Long answer: No. Unless locally required. Most un-trained individuals cannot prevent cross-contamination thus COMPLETELY eliminating the value of gloves in this scenario. You are better off focusing on cleaning frequently touched surfaces, hand-sanitizing and hand washing.

Should I require attendees to physically (socially) distance?
- Short answer: Yes.
- Long answer: Yes, absolutely. This, in addition to cleaning frequently touched surfaces, has been the long-standing and most proven effective counter measure and should be the focus of your mitigation/preparedness.

Should I require cleaning of frequently touched surfaces?
- Short answer: Yes.
- Long answer: Yes, absolutely. This, in addition to physical/social distancing, has been the long-standing and most proven effective counter measure and should be the focus of your mitigation/preparedness.

Should I provide COVID-19 testing for attendees?
- Short answer: No.
- Long answer: No, there is currently not enough research to determine actionability of serology (antibody) tests. Additionally, someone could test negative through a PCR test (the familiar positive/negative COVID test) today and become infected tomorrow. Furthermore, these tests require trained medical professionals and laboratory collaboration.

Attendee Testing Positive

What if an attendee advises they tested positive for COVID-19 while at your event?

The most significant, COVID-19 specific, problem you potentially face is an attendee testing positive during your event. For example, during your event an attendee went to the hospital on their own and tested positive for COVID-19 and is now making you aware.

You have a few options as to how you want to handle this. Unfortunately, if you don’t address the issue up front and prepare yourself and your attendees, you may be left with no option but to cancel the rest of the event. Remember, sometimes the best defense is a good offense.

Best practice for consideration: Address the question up front through your registration process. For example, a statement, requiring acceptance, stating:

Essentially you have to make the decision up front whether or not you will tell the other attendees. Based on numerous issues to consider, we recommend discussing this with your legal counsel.

If you have not addressed this up front with your attendees…

First question to ask is…Is the event still going on?

If Yes: DECISION POINT – It will be virtually impossible to accurately track an attendee’s entire movement during an event unless you are still in the very preliminary phases i.e. registration. If you are far into an event you may need to cancel the remainder of the event to decrease further exposure to other attendees. If you can accurately track movement, i.e. they checked in, went to their room then went to the hospital, the venue can adequately decontaminate the guest room and the event can most likely continue. If not, it becomes extremely difficult to accurately decontaminate significant areas while attendees are present in those locations. Not only from a perception standpoint but from a logistical execution standpoint as well.

Steps you must take:

Notify the venue so they can determine decontamination strategy
Isolate other attendees from known contaminated areas
Determine continuation strategy

If the event is not still going on: Consult legal counsel and communications team to discuss next steps. There is nothing you can do to control exposure to other attendees at this point. There are benefits from a public health vantage point to let other attendees know they may have been exposed and recommend they get tested and limit exposure to other individuals until they receive results. This obviously creates some liability concerns that would need to be determined individually by the organization.

These strategies should be predetermined prior to the beginning of the event.

Additionally, if you would like to discuss our full-scale All-hazards Emergency Planning services CLICK HERE.

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