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HomeMy WebLinkAboutOES 49-02 REPORT TO THE Finance & Operations Meeting 21 Report Number: OES 49-02 Date: November 7, 2002 From: Everett Buntsma Director, Operations & Emergency Services Subject: Fire Services Protocol for Hazardous Material and Bio-Hazard Response - Team I Environmental Services File: FS 1000 Recommendation: 1. That Council receive Report OES 49-02 to confirm its procedure for addressing Hazardous and Bio-Hazard responses; and 2. That Council approve reimbursement to owners up to $1,000 per incident; and 3. That appropriate officials be authorized to give effect thereto. Executive Summary: Not applicable Financial Implications: Unknown but should be less that $4,000 per year Background: In November 2001 Council approved a recommendation to enter into a contract with Team I Environmental Services for responses to Hazardous and Bio-Hazard Incidents. At that time it was also recommended and approved that all such calls should be invoiced to the owner or person responsible for the incident. Since that time the City has used Team I Environmental Services on 2 occasions. The total costs invoiced to others was approximately $2,500. At this time one such owner is requesting that the City pay their invoice in the amount of $995.10. Upon review by staff and after careful consideration staff recommend that the City not pay invoices of Team I Environmental Services but that the City re-imburse the responsible owners or persons for Team I response to a maximum of $1,000 per incident upon receipt of a copy of the invoice. Such payment shall be in the form of a cheque jointly payable to the person / owner and Team I Environmental Services. 22 Report DES 49-02 Date: November 7, 2002 Subject: Fire Services Protocol for Hazardous Material and Bio-Hazard Response Page 2 Any costs in excess of $1,000 will be the sole responsibility of the owner or person responsible for the incident. It should be noted that this is not consistent with current provincial legislation, which clearly states that the shipper, courier and / or receiver are responsible for such costs. Regardless, as the City is responsible for Emergency Response it would be appropriate to assume this controlled level of the cost for such responses. Further it is recommended that such reimbursement be retroactive to November 1, 2001. This would then address all past responses. Attachments: 1. 2. Memorandum from Fire Chief Douglas Original Report to Council OES 31-01 Eve t Bunt a, NPD., CMM Director, Operations & Emergency Services EB:mld Attachments Copy: Chief Administrative Officer Director, Corporate Services & Treasurer Fire Chief Recommended for the consideration of Pickering City Co ncil ,\ n ATTACHMENT tI. I. REPORT#Q£~ 49-0::< .... .';;' Iw~ I ~{) 3> OPERATIONS & EMERGENCY SERVICES DEPARTMENT FIRE SERVICES DIVISION MEMORANDUM 23 November 7, 2002 To: Everett Buntsma Director, Operations & Emergency Services From: W. Douglas Fire Chief Subject: Advisement of TEAM-1 Environmental Services - Report requested at Finance and Operations Committee Meeting October 28,2002 - Attending emergency calls within the City - Policy of Surrounding Area Municipalities City Council has approved a Fire Services Protocol for Hazardous Material and Bio-Hazard Response. This protocol included the use of an independent company, TEAM-1 Environmental Services Inc., to attend emergency alarms dealing with clean up, removal and disposal of hazardous wastes. TEAM-1 Services would invoice the owner of the property to which the response had been requested or to the party responsible for the material spill. The City would not have to pay these invoices. After the events of September 11, 2001 response to chemical/biological terrorist (Bio-terrorist) incidents became an issue for emergency responders. Durham issued a draft protocol identifying a level of response by municipal Fire Services for these types of alarms. Within this protocol Fire Services would assume a lead role in these types of alarms. Pickering Fire Services is at an Awareness. Level. At this level firefighters are expected to recognize the presence of hazardous materials, protect themselves, secure the area, and call for trained personnel to handle the incident. They take no action to mitigate or control the hazardous material. They just assess, protect and notify. Hence, it was recommended that our City enter into a contract with TEAM-1 Environmental Services Inc. At the Finance and Operations Committee meeting of October 28, 2002 a request was received by Janet Ecker MPP for assistance in paying an invoice received by the owners of Legend Music Enterprises for a TEAM-1 response due to a possible Bio-Terrorist incident. Council requested advising on our policy and the policy of other area municipalities. 24 Subject: Date: ATTACHMENT # ~TO REPORT # ~ 4D -O~ I C,q¿ d OJ .3 Advisement of TEAM-1 Environméhtal Services - Report requested at Finance and Operations Committee Meeting October 28,2002 - Attending emergency calls within the City - Policy of Surrounding Area Municipalities November 7,2002 2 Advising on the Policy: I am advising the following in respect to the policy approved by our Council. (a) (b) (c) (d) We view any act of terrorism as police matter and a crime scene and therefore, police services should take the lead role at such incidents. We believe that paying any invoice for such incidents may subject the City to future large invoices if or when further terrorist activity occur in our Municipality. Current law (the Spills Bill) regarding hazardous material spills stipulates that the shipper, carrier and/or the receiver are responsible for hazardous materials spills and clean-up costs. Although responses to terrorism alarms should not be equated to normal hazardous materials calls, it seems that the same rules should apply as far as responsibility for any costs associated. There have been two alarms associated with TEAM-1 Involvement. One was for an incorporated company who paid the invoice and the other is a sole proprietorship. It would be very difficult for the City to differentiate between various victims of possible terrorist activities - homeowner, large company or small business. Therefore, it should be one rule for everyone. Policy of Area Municipalities ClarinQton Fire Services Clarington have an agreement with TEAM-1, but have not had them respond as of this date for this type of emergency. They felt they would probably absorb the costs, but if these types of emergencies were to escalate they would probably re- think the costing issues. Their thoughts were that possibly the public and Council would expect them to react and be able to handle these types of emergencies, and if not able, then to get the appropriate training, etc. It should be noted that Clarington Fire Services have hazardous materials suits and have gone into premises to handle potential bio-terrorist packages during the anthrax scare. Oshawa Fire Services Oshawa Fire has not run into this situation yet, and they also have an agreement with TEAM-1. They feel that if a homeowner or business owner calls TEAM-1 then the homeowner is responsible. If it was on City property or the Fire Subject: ATTACHMENT#-i-,TOKI:t"UK! tf~~ 4q-ðJ..- fJ~ 34?:> Advisement of TEAM-1 Environm~tal Services - Report requested at Finance and Operations Committee Meeting October 28, 2002 - Attending emergency calls within the City - Policy of Surrounding Area Municipalities November 7,2002 3 25 Date: Services could not determine who owned the problem Fire Services would be responsible. The owner would be counseled as to what services are available to them and the approximate costs. Oshawa is at the operations level of hazardous material response and so can respond in a defensive fashion to control the hazardous material from a safe distance and keep it from spreading. Ajax Fire & Emerqency Services Ajax has not entered into a contract with TEAM-1. They have purchased haz- mat suits and would enter and bag a substance and hand it over to either Police or the Health Department. Whitby Fire & Emerqency Services Whitby Fire does not have a written agreement with TEAM-1. They are at operational level as far as donning chemical suits and decontaminating. Summary Pickering Fire can certainly train our firefighters to the higher level of haz-mat response or we can look into various joint training opportunities within the Region. If we do train to this next level, it will enhance our ability to deal with some of this hazardous materials and rescue response issues. It has to be said that there will be monetary costs associated with going to another level of response training. Ongoing costs for hazardous materials suits, training and decontamination costs will have to be budgeted for. One of the concerns associated with biological terrorist alarms is that, even at opèrations level, firefighting personnel should be aware of the substance they are dealing with before touching the substance. At terrorist associated alarms the substance cannot be identified at the scene, which presents a major healthy and safety issue for our services. As well, I am sure that the PPFA will want to be involved in any response protocols for biological terrorist alarms just to ensure. the safety of their membership. WTD:nrm COPY: /7 ~~,;;7'/~~ - W. T. Douglas Deputy Chief j:\...\RepHazmat.doc ATTACHMENT#r;t ,TOREPOhT#,Q~~ L¡..9-o~ ?6 REPORT TO COUNCIL FROM: Everett Buntsma Director, Operations & Emergency Services DATE: November 1,2001 REPORT NUMBER: OES 31-01 SUBJECT: Fire Servi<;es Protocol for Hazardous Material (Hazmat) and Bio Hazard Response - File: FSlOOO RECŒvlMENDA TI ON: 1. That Council receive Report OES 31-01 and endorse the "Protocol for Accessing Team.- 1 Services" as the City's procedure for addressing Bio Hazard incidents. . . ORIGIN: Operations & Emergency Services Department AUTHORITY: Municipal Act Section 210 FINANCIAL IMPLICATIONS: All responses of Team. - 1 Services will be invoiced to the owner(s) of the property to which the response has been requested or to the party who is responsible for the material spill which has resulted in the need to call Team. - 1 Services. EXECUTIVE SUMMARY: BACKGROUND: On October 17, 2001 the Durham. Police Services issued a "Temporary Protocol to deal with Anthrax Incidents and Suspected Bio Terrorism" and a "Cheniical / Biological Terrorist (Bio Terrorist) Incident Procedure". These documents identify a level of response for local fire services within the Durham. Region response zone. These documents further suggest that a responding Fire Service will assume the lead role. The Pickering Fire Services (PFS) is at an Awareness Status but is not at a status, which would enable it to respond in the manner outlined in the Police procedure. ATTACHMENT # ;< TO REPORT # 06 q c¡ -0 ~ ReporttoCouncilOES31-01 Date: November 1,2001 ?7 Subject: Fire Services Protocol for Hazardous Material (Hazmat) and Bio Hazard Response File: FS 1000 Page 2 Asa proactive measure to ensure adequate safe response to such incidents and to protect the PFS staff resources the Operations & Emergency Services Department has initiated the development of an appropriate protocol to "comply" with the Durham Police Service procedure. It must be noted that to equip and train PFS staff is not a financially feasible option nor should it be necessary as Team - I Services is equipped and capable of "immediate" response.. Their services, if called upon, will obviously be evaluated on a per call basis. It should further be noted that our Fire Service administration officers endorse the use of Team - I Services in lieu of expending City Funds for staff training and very specialized equipment acquisition. . It is recommended that Council receive and endorse the "Protocol for Accessing Team - I Services" as the City's procedure for addressing Bio Hazard incidents. AITACHMENTS: 1. 2. 3. Protocol- Fire Services Division Temporary Protocol (Durham Police) Durham Region Emergency Response Procedure - ChemicallBiólogical Terrorist (Bioterrorist) Incident ~ EVe - ti BUnisma - . . Director, Operations & Emergency Services EB:mld Attachments Copy: Clùef Administrative Officer Fire Chief Recommended for the consideration of Pickering City Council Thomas J. Quinn, Chief Administrative Officer ?8 {'. j¡ 'L.-LÚ/ of 1616 Bayly Street Pickering, Ontario Canada LlW3NZ Direct Access (90s) 839-8095 cityofpickering.com , ' OPERATIONS&EMœRGENCYSER~CESbEPARTMENT Fire Services Division Division (905) 839-9968 Facsimile (905) 839-6327 fire@city.pickering.on.ca Pickerill!! Fire Services Protocol.fòr Accessin!! Team-:-l Services Effective immediately Team 1 will be providing us with all levels Ç>f ill¡.zardous. materials' response above the level of aw~ess. This will inc1u~e productremovaJ 3I!-d biohazard issues (ine1udIDg anthrax). - ' Team 1 will respond to the location within 40 minutes but it is dependent upon the number of calls and 1raffic conditions. They, are responding fì:om two sites in Toronto, the a,Í:rport area and Gardiner & DVP junction. This company can pto:vide seIVÍces for land and water boUle situations. ' " Where another 'agency provides en1ry and expects us to provide decontaminatiQn, Team 1 will provide this role. This is in re(erence to theDRPS protocol for "Anthrax" ex.posùres. . ' Team 1 will provide US with hazanlous materials pritigation in those ciJ:cumstances where the owner' of the' mate:J;i.al or p.rop~ does not have a competent team to call in to niitigate the problem. ' Platoon Chiefs shall always check with the owner of the property and ask if they have a company that will mitig¡J.te the hazardous materials. Some larger companies will have a company OI;J. call to deal with those types of situations. JIowever, if a company cannot-find someone to provide this service Picke]jng Fire Services (PES) can call Team., 1 to the scene. Teain.l will operate under the CoD1l"p.3n~ of PFS staff, however it will become necessary to Jollow their ~clance when it pòmes to hazardous materials. PFS persc:lllnel will suppo~ Te;mi 1. in this role but are not to function above awareness level. . Team 1 will not forward a bill to PFS; rather they will bill the owners of.the propertY or shipper. They will notbill ~ for municiþ~ properties Q1" roadside ~sistai1ce. " The emergency nwnber is 1~800':32-spill (l-ßO~-327- 7455). If you are unSure whether or 110t yo.u are to contact Team 1, the Chief and Deputy are available for validatiòn ofyour:decision. ' Deputy Chief Mark Diotte MEMO To: All Members From: Sgt. James Grimley, Emergency Measures Officer Effective: October 17, 2001 16:00 hrs Re: Temporarv Protocol to deal with Anthrax Incidents & Suspected Bio Terrorism As a result of a number of incidents involving suspicious mail, the following interim protocol bas been developed. Currently, no formal protocol exists within the Province of Ontario to deal with these types of calls. As a resul~ officers attending these calls may receive conflicting information from the other emergency service providers and health . care professionals involved. Although the following interim protocol should not be regarded as a perfect procedure, it does reflect the best information currently available and will provide the basis for a consistent and safe approach to these increasingly prevalent calls for service. When in any doubt, officers are UfŠ;ed to confer with their . supervisors who in turn will facilitate access to other required police service contacts and resources. Dr. Fearon, a member of the Provincial Laboratory òfthe Ministry of Health, and Emergency Measures Ontario were contacted, and advise as follows: There have been a number of incidents to date, throughout the Province. Their lab is . currently working full time on analysis, and there are NO confirmed Anthrax cases to report. All of these incidents have been determined to be hoaxes. Anthrax is a micro.organism and is generally contracted through inhalation (primary cause), ingestion or cuts and/or abrasions. It is not transferred person to person. It bas an incubation period of between one (1) and six (6) days. Further information was obtained on how to deal with suspicious letters or packages, whether delivered by hand (Courier) or mail, as follows: Staff responsible for incoming letters and packages should maintain an awareness of the possibility of the risb posed by explosive and/or bio-hazardous contents. Common . features ofletters or packages that should be regarded as suspicious are as follows: };> No return address provided, };> Excessivepostage };> Hand written, poorly typed or incorrect recipient information, 29 30 ~ Misspelling of common words, ~ Restrictive markings such as "Confidential" or "Personal", etc ~ Excessive weight ~ Oily stains, discolourations or odour ~ Any indications that a powder or grainy substance is enclosed, or appears on the outside surfaces. If our Communications Unit is notified that someone has received a suspicious package or letter, the caller should be instructed to adhere to the following procedure: 1. If the letter or package isnot opened, do NOT ODen it. In most cases, the. risk of exposure is low, provided that notbIDg is leaking from the package or envelope. The calÌer should be advised to seal the letter or package in a plastic bag, or wrap, and turn it over to the custody of an attending police member who will ensure its safe disposal. 2. If the letter or package has been opened, and an accompanying note claims that the recipient has been infected or contaminated, but there is no substance seen or felt in the envelope or letter, in most cases the risk of infection or contamination is low. The letter or package should be handled in the manner described above and the attending police member shall seize it for further investigation. The caller should be advised to see their family doctor, as a precaution. 3. If opening a letter or package causes a substance,to contaminate the recipient, .. they should: . a) Cover the spilled material with. anything available .that will prevent the material from becoming airborne, . b) Seal off and leave the immediate vicinity, c) Ifpossible, shutdown the heating and ventilation systems in the area d) Immediately wash their hands with soap and water (do not use bleach or other disinfectants on your skin) e) Avoid contact with others, and f) Await the arrival of, and abide by the instructions provided by responding emergenCY personnel. . NOTE ----- 31 a) In most cases, people who were not in the room at the time the envelope or package was opened are not at risk, b) In most cases, people who were in the room at "the time, but did not come in direct contact with the substance, are at minimal risk. c) Even in the event of the substance actually being Anthrax, infection is unlikely and treatment is extremely effective. Decontamination of surfaces can be immediately accomplished by washing the contaminated area with a 10% bleach solution. (Do not use this method on skin) A. Officers attending calls regarding suspicious letters or packages that appear to involve the threat of explosive devices shall strictly abide by the provisions of D~ective ER-O7-001 "Bomb Threats and Explosives". B. Officers attending calls regarding suspicious letters or packages that DO NOT appear to involve the threat of explosive devices shall proceed as follows: L Ensure you are wearing protective gloves, 2. If the letter or package is unopened, ensure that envelope or package is . sealed in a plastic bag, or ' 3. If the envelope or package was opened, and an unidentified substance released, the attending officers shall: a) Notify the Patrol Supervisor and Duty Inspector, b) Evacuate the recipient of the letter or package, and any others who may have had contact with the substance, from the. immediate vicinity,' ensuring that they are prevented from contacting others, c) Take appropriate steps to isolate the recipient, or others who may have had contact with the substance, until they can be assessed by members of the Durham Health Department, , d) 'Establish and maintain a suitable perimeter around the scene, e) Turn the contaminated scene over to emergency personnel equipped to deal with hazardous materials, , f) Take custody of the suspicious letter or package after it has been tripled-sealed (puncture-proof container)by the attending hazardous material handlers, . ' 32 g) Ensure that the seized property is tagged and a Property Report [DRPlD] is submitted, h) If there has been an exposure to a substance, or it is deemed appropriate to b.ave the letter or package tested, ensure that the Durham Health Department (Health Inspection Unit) attends the scene. (905) 576-9991. Note- the Durham Health Department is responsible for the decisipn as to whether the substance will be submitted for biological testing, but the responsibility for the actual transportation of the letter or package is borne by our police service. i) Transport the triple sealed package to the Oshawa Community Police Office and turn. it over to the Platoon or Pa1rol Supervisor on duty, j) The details Dfthe letter or package shall be entered in the property log and the items placed in Bio-hazard Locker #31, k) Obtain and document on a General Incident Report [DRPl} all pertinent information including who had contact with the suspicious . letter or package, and the degree of their of exposure. Note- a copy of - the report must accompany the letter or package if it is suþmitted for biological testing. . 1) The Oshawa: Community Police Office Platoon or Platoon Leader (or designate) shall make daily arrangements to have susPicious letters and packages, submitted in the manner described above, 1ransported to the Ministry of Héalth Laboratory, 81 Resources Road, Toronto. Note-please contact the laboratory personnel before attending. Tel: (416) 235-5725. We are determined to protect the health and welfare of the public and our -members, and this interim protocol has been developed to roinimize any risk. Results of the analysis of suspicious substances should be known within förty- eight (48) hours of the lab receiving the exhibit. Sergeant J. Grimley of the Emergency Measures Unit will notify members involved in dealing with these - incidents Dfthe analysis-results. This interim protocol shall remain in effect until such time as a formalized Directive, now under development, becomes available. Please- direct any questions or concerns regarding this procedure to Sergeant J. Grimley; Emergency Measures Unit, at extension 4350. (A:fterhours, contact the Communications Unit Supervisor at extension 6600.) , .. 33 -DURHAM REGION EMERGENCY RESPONSE PROCEDURE CHEMICAUBIOLOGICAL TERRORIST (BIOTERRORlsT) INCIDENT June 2001 . 34 DURHAM REGION EMERGENCY RESPONSE PROCEDURE CHEMICAL/BIOLOGICAL TERRORIST (BIOTERRORIST) INCIDENT Background/General "Bioterrorism" can be used to refer to the actual or threatened use of biological or chemical agents to create terror or to achieve a particular goal. The threat from an actual chemicallbiological terrorist incident in Durham Region is assessed to be low. However, an event cannot be ruled out and in the U.S. hundreds of threats or exposure incidents are reported each year(all of which have been hoaxes). Because of the panic and inappropriate measures that may result from even a hoax bioterrorist incident - and the potentially devastating health. consequences of a real release of an agent - there is a need to have a coordinated response to such an ~ci~~ .. Aim The aim of this procedure is to outline the actions for responding to a chemicallbiological terrorist (bioterrorist) incident in Durham Region. Scope This procedure will apply to the Durham Regional police Service, the Regional Emergency Medical Services (EMS), local municipal fire services, the Health Department and the Durham Emergency Measures Office (DEMO). Using this procedure as a guide, each ~gency is required to produce its own detailed internal procedure/checklist. Chemical Agents Toxic chemicals are described as any chemical that may cause death, temporary loss of performance or permanent injury to people. Chemical agents fall into five classes: nerve agents, blister agents; blood agents, choking agents and irritating agents. ' Threat assessments suggest that the possibility of a chemical attack or terrorist incident WoUld appear far more likely than biological materials largely due to the easy availability of many of the substances needed to construct a chemical weapon. Typical examples of chemical agents include: Sarin, Tabun, Soman, Cyanide, M ustard/b listerin g agents. Biological Agents l' Biological agents are living organisms and there are three common types: bacteria, viruses and toxins. Several biological agents can be adapted and used as terrorist weapons. These include: anthrax, tularemia, cholera, encephalitis and the plague. The primary routes for exposure for biological agents are inhalation and ingestion. Skin absorption and injections are also potential routes for entry but are less likely. 15' ". , Notification The Durham Region Non-Nuclear Notification Procedures (Dee 2000) currently in place will be used for any incident, threat or suspected threat of a bioterrorist incident. . When a notification of abioterrorist incident is received at the 911 Centre, the DRPS Communications Supervisor will immediately telephone the Durham Emergency Measures (DEMO) Duty Contact and initiate internal DRPS notification procedures. The DEMO Dutv Contact wit.1 alert the Medical Officer of Health/Health Department. the Regional Chair, CAO. and the Corporate Communications Manager. The DEMO Duty contact will establish direct liaison with the emergency coordinator of the affected municipality to either obtain or pass on information about the event. The DEMO Duty Contact will also alert Emergency Measures Ontario (EMO). Response .- On receiving a call conceming a suspected bioterrorist incident, the 911 Centre will ISp police, Fire and EMS to the scene. The respo ding Fire Service has protective þreathing apparatus and will assume the lead role, ntil the threat has been identified and assessed. Fire, Police and EMS will establish common command centre (such as three vehicles parked together) and appoint n emergency site manager to coordinate the response operation. It is "" jm ant that senior officers present remain at the command centre so that decisions, information and orders can be passed quickly to each organization (who are on separate communication systems). . { An outline response guide is attached at Annex A and is to be used by emergency response agencies when responding to a bioterrorist incident. Responsibilities The responsibilities of responding agencies are outlined below: 2 :~6 911 Communications Centre . dispatch police, fire and EMS to the scene and provide all available information. ' . for any call dealing with a suspicious substance or specific chemical/biological situation, Communications Supervisor to notify DEMO Duty Contact and initiate internal DRPS notifications. . write and disseminate bioterrorism procedure/checklist to supervisors and 911 staff. Durham Ememencv Measures Office (DEMOl . DEMO Duty Contact make notifications to the Medical Officer of Health or Health Department staff, Regional Chair, CAO. and the Corporate Communications Manager. . establish contact with the emergency coordinator of the affected municipality. . notify Emergency Measures Ontario and forward any support requirements. . provide any assistance required such as liaison with the Province. . write DEMO bioterrorism procedure/checklist. Fire Service designate the incident commander, until the el'l1ergency site manager is appointed. . . establish a command centre with police and EMS. . provide a trained entry team, with appropriate personal protection equipment. (PPE). . isolate people who may have been affected, isolate the room(s). . initiate evacuation of remainder of building. . identify the threat, if possible, and obtain all known information. . establish communications with the Health Department. pass on all information . and seek advice (m how to proceed. '., . ~ implement procedures for monitoring and decontaminating crews/equipment. . arrange for final clean up/decontamination of location by a professional company if recommended by Health Department. . . write and disseminate detailed bioterrorism procedure/checklist. ~ . /' ,~\ . r"~(ìOi . > . '\ Durham Reaional police Service (DRPSl . establish a secure perimeter around the site. .' order people, other than those at the site, inside the perimeter to stay indoors until advised otherwise. . . establish a joint èommand centre with the Fire Service and EMS at the site perimeter. . .' . . provide entry control, an emergency vehicle staging area and emergency vehicle ingress/egress route(s) as required. . . assist in evacuation of the site to a collection area, if deemed safe to do so by the Health Department. . control and register all people evacuated from the site. . be prepared to conduct an evacuation of nearby residents. 3 a provide on-scene media spokesperson who will assist the emergency site manager. a take control of the site as a possible crime scene. . write and disseminate detailed bioterrorism procedure/checklist to staff. ~~7 Emeroencv Medical Services'(EM~ a provide a representative to attend the joint command centre. . monitor any victims that may require decontamination. . take precautions to eliminate or reduce the risk of further exposure as recommended by the Health Department. a advise the hospital of the incident and provide an estimate of the number of affected people. . transport victims or persons who may have been exposed to hospital. . decontaminate ambulance as recommended by the Health Department. a conduct medical surveillance of staff involved. a write and disseminate detailed bioterrorism procedure/checklist to staff. Heàlth Department . provide advice as requested by the Fire Service on personal protective equipment, clothing and procedures for fire service initial entry teams as well as for other emergency responders. . . provide advice to police for boundaries of the perimeter and for possible evacuation of the public. a provide advice on decontamination procedures for exposed persons and for emergency responders. . . . provide advice on infectious control protocols for the safe transport of exposed persons to hospital. . a prövide advice on, and monitor, the administration of prophylaxis and/or treatment for exposed persons or contacts of exposed persons. . .. . provide advice on handling and packaging suspect letters, boxes etc. . coordinate with DRPS the sending of suspect articles to a laboratory. . identify, register and implement medical surveillance of those persons potentially exposed. . pròvide informatiön for those potentially exposed. . arrange for counselling of those potentially exposed, as required. . provide advice to the Fire Service on final site decontamination. . . provide health information for media releases on the incident to the appropriate information/communications authority. . . . contact any "experts" on advice (e.g. Ministry of Health, Health Canada, Ministry of Environment, CDG). . . . write and distribute detailed procedure/checklist to appropriate Health Department staff. . 4 Annex A 38 BIOTERRORISM RESPONSE GUIDE Notification 1. 911 Centre receives call and routes call to appropriate emergency response agency (normally Fire). Emergency response agency communications obtains as much information on the incident as possible: . I . . location of incident. . caller's phone number. . . type of incident (threatening note, suspicious substance, exposure to substance). . . number of people possibly exposed. 2. 4. Emergency response agency communications to advise exposed persons: . to leave the room and shut the door. . . remain isolated from other people. . wait for emergency responders. Emergency response agency dispatch three tiered response, initiate bioterrorism checklist, conduct other notifications (DEMO and intemal) as required. 3. Initial Response 1. Responding Fire Service: . appoint an incident commander. . . set up a joint command centre with police and EMS at the established perimeter, up wind from the site. . . move appropriate personal protective equipment (PPE) to site and outfit an entry team.. . . 2. Responding DRPS: . if first on scene, do not enter, wait for Fire Service entry team. . establish a secure perimeter with entry control. (Isolate tne building. Order people within a minimum 90 meter radius of the location to shelter indoors until further notice).' . . determine ingress/egress route for emergency vehicles and staging area if required. . . .. . . . contact the Fire incident commander and set up a joint command centre at the perimeter. . . arrange for a media spokesperson to come to the command centre. 5 ~, ,), Responding EMS: ;i9 . if first at scene, await fire and police arrival. . . locate fire/police command centre and report to the emergency site manager. ' . establish contact with the Health Department for advice. Identification and Evacuation 1. 2. Fire entry team in PPE enter building: . quickly locate actual site. ' . remove and isolate any persons potentially affected from actual site. . report all details - suspicious package/letter, threatenìng note/letterltelephone call, any liquid/powder/aerosol present. . evacuate building using exits farthest from actual site. . if possible. have HVAC systems shut down. Emergency site manager to pass information to Health Department and obtain advice on how to proceed - management of exposed persons, immediate decontamination requirements, protective actions for responders, an assessment of whether the incident is "rea'" or possibly a hoax. 3. Health Department to send a representative to report to the command centre as soon as possible. 4. Police to arrange for the establishment of a temporary holding area to register names, addresses and phone numbers of all persons evacuated. 5. Fire entry team escort persons potentially affected to a decontamination/triage area. EMS personnel to take appropriate precautions based on advice from the Health Department and transport victims to hospital. Follow-up Action 1. Based on advice of Health Department, Fire entrY team to isolate the. suspicious packagelletter/substance and perform any local environmental decontamination to their level of training. . ' 2. . Police to maintain perimeter or keep site closed on direction of the Health Department. . ' Fire entry team conduct personal decontamination, on advice of the Health Department, 3. 4. Fire to arrange for professional decontamination of the site as requested by , the Health Department. ' 6 4:J 5. Suspicious package/letter/substance to be transported to a laboratory as arranged by the Health Department and DRPS. 6. Health Department to compile a complete list of victims and potentially contaminated persons from DRPS and EMS for follow up medical surveillance. 7. Each agency to initiate follow-uP medical surveillance of their staff. 8. Cost recovery action to be initiated by each agency. 7