General Population Assessment
During an actual event the high-risk category would also include
persons exposed to the initial release. Face to face contacts of cases,
household, or close contacts may be considered high-risk depending on the scope
of response as determined by technical staff investigating the outbreak. All
residents may be at risk depending on the biological or chemical agent used. For
this scenario, general population estimates should be used to determine
vaccine/prophylactic medication requirements by proposed clinic site. These
estimates should be recorded in advance for each clinic site (see figures 2 and 3). These estimates
may differ throughout the year if an area has large transient populations (e.g.
university students, seasonal workers). Since some of these fluctuations are
predictable, they should be considered in the plan's estimates.
Agencies should plan for a high percentage of persons to attend
clinic due to "fear factor". (Those from outlying or bordering areas will
possibly replace the number of people in a community that choose not to attend
clinic). Plans should also consider distribution procedures in the presence of
severe vaccine/prophylactic medication shortages, moderate shortages, and in the
presence of no shortage.
III. Clinic Site Selection and
Determine non-hospital locations where vaccine and/or prophylactic
medications could be administered for case contacts and large numbers of the
general public. Visit proposed sites before making final selections. For each
site selected prepare the following:
- Written plan for physical layout
- Clinic information sheet (see figure 2)
- Clinic site selection criteria sheet (see figure
Schools are the preferred location for any clinic larger than can
be held in the local health department. Schools have parking lots, long
corridors, large classrooms, cafeterias, private offices, and other immediately
available resources such as tables, chairs, restrooms, and offer an ideal
physical structure that can meet most clinics needs. Enclosed sports arenas and
other facilities at universities should be considered. Also, local employers may
offer sites to vaccinate staff and family members.
Figure 4. Clinic Site Selection
|Clinic Site Selection Criteria Sheet
||Protected from weather; adequate climate control (heating and
||Adequate space for large crowds, intake, briefing, screening,
vaccine or prophylaxis administration, and medical emergencies. There should be
space enough to contain long lines inside. The site should be large enough to
handle the target population with "room to spare".
||Adequate power sources for equipment and hygiene for workers
and public; access to water and electricity
||Familiar and accessible to the public
||Adequate parking and/or public transportation
||Storage for large amounts of supplies and biohazardous
||Refrigeration as indicated for storage of vaccine/prophylactic
||Adequate restrooms/space for portable restrooms if
||Accommodation available for special needs (e.g.
||Communication including telephone and FAX
||Secure or can be made secure with adequate law enforcement
Highly trained volunteers or clinical staff observe clients as
they arrive at the client to screen for obvious signs of illness. Standard
precautions (protective gear, etc.) should be followed in accordance with EMS
and HAZMAT guidelines. Those with illness and symptoms are directed IMMEDIATELY
to the Sick Station.
Establish eligibility to receive vaccine/prophylactic medication.
Review address, identification, referrals, or any information needed to
First point of entry for clients who need administration of
vaccine/prophylactic medication. Separate and direct clients to the appropriate
station according to the following:
- Those who are pregnant females (Pregnant Station)
- Those who are "well" males and females (Interpretation Station)
- Those with documentation of previous prophylaxis/vaccination (Refer out of
receiving line to Problem Station)
- Distribute Information Statements to those receiving vaccine/prophylactic
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