Health Alert
DELAWARE HOSPITAL ALERT - CODE ORANGE

The Department of Homeland Security issued a Code Orange - High Threat Alert on March 18, 2003. The High Threat Alert informed all states that intelligence reports indicate potential for terrorist attacks in the United States. State and local governments are advised to increase security at state and federal buildings, monuments, hospitals and high traffic locations.

NO SPECIFIC THREAT HAS BEEN RECEIVED AND NO SPECIFIC LOCATIONS OR WEAPONS HAVE BEEN INDICATED. Agents ranging from biological, chemical and radiological remain on the threat list and require advance response preparation.

Delaware's Division of Public Health (DPH) issues the following recommendations and protective actions to all Delaware hospitals to assure adequate advance preparation and response capabilities.

Each hospital should assure that this HAN alert, and those issued in the future, be provided to its emergency department, infection control program, laboratory, public information officer, director of nursing and head nurse. Subsequent HAN alerts will be sent to address signs and symptoms, as well as treatment protocols for potential terrorist agents as needed.

RECOMMENDATIONS

Assure Hospital Safety and Security

• Protect air handling system intakes
• Protect liquid oxygen supply
• Require all vendors to schedule deliveries
• Hold unscheduled deliveries at least 1500 feet from the facility
• Heighten security around loading docks
• Increase visibility of security
• Review facility lock-down procedures
• Removal of facility/site plans from web sites

Begin DAILY Syndromic Surveillance Reporting

Use usual system (DPH epidemiologists have contacted each hospital's infection control staff)

Provide a Specific Contact Person for Each Facility

Identify a hospital decision-maker responsible for coordinating future information and preparedness and response activities. Please indicate a method of contact and the number. (i.e. pager - 302-###-####) for this person on nights and weekends.

DPH also requests that hospitals make the following assessments and fax the information to DPH at 302-739-2352. If this information has been previously provided as part of an American Hospital Association report, please update the report at this time.

• Antidote supplies, i.e., atropine, 2-PAM Chloride, cyanide kits, ciprofloxacin, doxycycline, amoxicillin, gentamicin
• Current staffing levels and staffing required to implement your mass casualty plans
• Total and current available ICU, med/surg, and cardiac care bed status - available vs. vacant
• Equipment status and any specific shortages, i.e., ventilators, hazmat decontamination protective equipment
• Supply status, i.e., oxygen and oxygen delivery devices, IV fluids
• Lab preparedness for rule out and referral of bioterrorism agents