Border Health Preparedness Exercise

Table of Contents:    Goals….

2 

Objectives…. 

2 

Community Profile….

3 

Timeline....

4 

Scenario….

4 

Potential Roles…

5 

            Important Considerations…   Health Impacts...   Maps…

6  7  8   

References….

10

1

Goals:  Facilitate dialogue between local, national and international agencies and  stakeholders who need to collaborate in order to:  1. Discover  2. Communicate  3. Find a solution  4. Distribute resources effectively  In the event of a public health emergency.   

Objectives:  During this exercise, participants will:  1. Describe the types of actions that may be considered in response to a  disease outbreak   2. Determine who takes these actions  3. Identify members of the Incident Command Structure   4. Identify the agency or agencies that will supply the resources necessary to  take these actions  5. Describe the procedural requirements, limitations, or conditions on taking  these actions  6. Assess the feasibility of successfully applying these measures during an  epidemic  7. Communicate and collaborate effectively across the border 

                         

2

Community Profile  Cameron County​1  ● Total Population: 422,135  people  ● Total area: 1,276 square miles  ● Approximately 89.4% of  Hispanic Descent  ○ 74.2% of the  households speak a  language other than  English  ○ 28.2% speak English  less than “very well”.  ● Education:   ○ 34.4% have less than a  high school diploma,  ● Income  ○ Average Income: $15,457   ○ 29.1% population estimated to be at or below the federal poverty level.  ● Only county in US that has 4 ports of entry  ○ Rails, Cars, Seaport, and Air    2  Matamoros​ ● Total population: 520,367 people  ● Total area: 1,789 square miles   

                      3

Scenario    March 24: Nurse at local school refers child to Harlingen Medical Center with  suspected case of X    March 31: Reports from Matamoros community of similar cases     March 31: Reports from Brownsville community of similar cases     March 31: Local teacher is admitted to Harlingen Medical Center with X    April 3: Valley Baptist Medical Center receives a case of an asylum seeker from the  Border Patrol Processing Center who is sick    April 4: Valley Baptist Medical Center receives a case of a local resident with X    April 10: Contract worker from processing center is admitted to HMC with X    April 10: CCHD is notified that someone is in isolation at the Gateway Bridge    April 3: Dozens of reports of illness from Border Patrol Processing Center    April 3: Staff shortages at CBP because of reported illnesses     April 6: Overcrowding at all health facilities in the area    April 8: Lab results come back for child case at HMC: Positive for Mumps  

                    4

Potential Roles    ● Cameron County Health Department   ○ Health Administrator  ○ Program Directors  ○ Health Educators  ○ Epidemiologists  ● Border Patrol  ● CBP Incident Coordinator  ● Hospital Preparedness Program Coordinator  ● Cameron County Emergency Planner  ● Cameron County Emergency Manager  ● Community Members of Brownsville  ● Community Members of Matamoros  ● Hospital IPC Director  ● Hospital ED Director  ● First Responders  ○ Fire  ○ Police  ○ Paramedics/EMR  ● Principal  ○ Teachers  ○ Social Workers  ● Matamoros Health Department  ● Hospital leaders in Matamoros     

     

5

Important Considerations  Labs  The closest Public Health lab is in Austin.    

Children  If children take advantage of services it would affect their parents path to  citizenship. Also, parents may feel wary about accessing services for their child  when they themselves are undocumented. Because of this, child’s health is at risk  and their vaccination status is lower. Disease can spread in schools quickly because  of the lack of vaccination in both Brownsville and Matamoros.   

Asylum Seekers  Asylum seekers picked up by border patrol are taken to a processing facility. Many  border patrol offices and processing facilities don’t have any health staff. People  detained by the border patrol are put in close quarters until they are processed.  The rule is that people are only allowed to be kept here for 24 hours, but because of  the high volume and staff shortages, it may be much longer. Border Patrol receives  no medical training and agents must use their own judgement to determine if  someone is sick and should be taken to a health facility. Disease can spread quickly  in these areas because of the lack of health staff and the longevity of close quarter  contact.    

Contract Workers  Contract workers are hired for transportation from the processing center. While  Border Patrol agents are very up to date on health standards, contracted employees  are not required to be.   

Asylum Seekers at the Border   Those seeking to cross the border legally in order to claim asylum are put on a waiting list.  When they are allowed to cross, they may have come into contact with people from all over  the world with various health conditions.    

Local residents travelling back from Mexico  Many residents travel to Mexico for healthcare. Those who walk across the border are in  close contact with each other and there are no health staff present. CBP officials use their  judgement to pull people out of line and even quarantine them if they are sick. A person  who is already immunocompromised can contract disease at the border easily.  

 

6

Health Impacts​4   

● Mumps is caused by a  virus  ● Best known for the  puffy cheeks and  swollen jaw that it  causes. This is a result  of swollen salivary  glands.  ● Common signs and  symptoms  ○ Fever  ○ Headache  ○ Muscle aches  ○ Tiredness  ○ Loss of appetite  ○ Swollen and tender salivary glands under the  ears on one or both sides (parotitis)  ● Symptoms tend to appear 16-18 days after  infections  ● The best way to prevent mumps is to receive the ​M​M​R  (Measles-​Mumps​-Rubella) Vaccine  ○ Some people may not be able to receive the MMR vaccine for a variety  of reasons  ■ Access to providers  ■ Insurance  ● Free vaccines available to children through some  programs   ● Some people may not want to obtain benefits because it  could affect their ability to obtain citizenship  ■ Not feeling comfortable vaccinating child  Texas Vaccination Rate​5​: ​90.3% for the MMR Vaccine       

7

Maps    Gateway International Bridge 

Veterans International Bridge 

   Brownsville & Matamoros Express International Bridge

8

  Valley Baptist Medical Center, Brownsville 

Harlingen Medical Center

  ​US Border Patrol Harlingen Station 

  9

References:   ​Title Page: https://www.cdc.gov/pcd/issues/2008/oct/bmscp_map.htm 

1. Cameron County Facts Sheet- Cameron County Health Department  2. https://factfinder.census.gov/faces/tableservices/jsf/pages/productview. xhtml?pid=ACS_17_5YR_DP05&src=pt  3. Texas State Border Health Report.  4. https://www.cdc.gov/mumps/about/index.html  5. https://www.dshs.texas.gov/immunize/coverage/NIS/ 

     

10