Recognition

Jaryll
Good morning ladies and gentlemen,
I apologize for interrupting your busy schedules but Im sure most of you have heard
that we have a crisis on our hands. Just to make sure everybody is on the same
page, let me brief you all on the current situation. As of last week, there has been an
increase on the number of hospital admission due to severe diarrhoea and
abdominal pain and unusual reports of skin lesions along with the mentioned
symptoms. The increase has pushed many hospitals in the Klang Valley to the
breaking point. We have to find out and identify the culprit before its too late.
I invite my deputy directors to further elaborate the current situation on the ground.
Nera
Thank you, sir. The hospitals currently affected by the increase of patients with
severe diarrhoea and abdominal pain are Kuala Lumpur Hospital, National University
Hospital, Serdang Hospital, Selayang Hospital, Sungai Buloh Hospital and Ampang
Hospital. All hospitals capacities are at their maximum and some of them are even
beyond their capacity to handle the situation and are requesting additional support of
facilities and staffing. We currently do not know what is the cause but have sent
samples to the laboratory and are awaiting confirmation to treat accordingly.
Unfortunately, some patients have already succumbed to their infection and the
mortality rate is very high and acute. We have also sent the bodies for autopsy and
are also awaiting for results.
Char Sin
There are also many patients visiting the local pharmacies requesting for anti-
diarrhoeal and pain killers but without a doctors prescription, the pharmacies cannot
do much as it is controlled medicine. Many have tried to medicate themselves due to
the long lines at medical facilities which currently have not enough capacity to deal
with the volume of patients.
Ash
We are currently monitoring the situation and trying to figure out the outbreak
through case reports and the signs and symptoms that could be related to a
particular disease to see if we have dealt with such a case before but we have not
reached a conclusion.
Joanne
The city council has also received many reports from businesses that reported a lot
of workers calling in sick and absenteeism in school and university is at an all-time
high. The economy in the Kuala Lumpur has dropped tremendously as more people
are getting sick to go to work or school.
Lilian
The communications and multimedia department has also observed an increased
traffic over social media regarding this bizarre sickness and many people have
expressed their concern and distrust in the relevant authorities capability to deal with
the situation. The general media is also not helping because they are condemning
the governments inept ability to respond to the situation. We cannot come up with a
press conference to pacify and calm the public without knowing what are we dealing
with.
Anis
There has also been increased reports of criminal activity in the Klang Valley which
can also be attributed to this bizarre outbreak whereby pharmacies are being looted
for their drugs, increased violence at medical facilities due to overcrowding and
grocery stores being looted because people fear it might be the apocalypse.
Jaryll
Hold on a second, who is that person sitting beside you officer?
Anis
We believe this is something related to the incident that occurred with SYABAS
recently. You see
Harvin
Wait! Now look here, I was told everything was settled and that a potential crisis was
averted because you told me that the suspect was arrested!
Jaryll
Let me repeat myself, who are you again?
Harvin
I am the Director for SYABAS Sdn. Bhd.
Anis
As I was saying, the police have recently apprehended a suspect related to a
terrorist plot to harm the SYABAS company based on our intelligence. We managed
to arrest the suspect in time before he was able to commit the act or so we thought.
We believe it was bioterrorism but we have only submitted the samples of the vial
the terrorist had in his hands to the lab today.
Everyone shocked
Jaryll
What?!? You had the suspect for days and only now you tell us that we have a
potential terrorist attack in the Klang Valley and this bizarre outbreak could be
related to your case?!? I pray to God that no one else dies while awaiting for the
laboratory and autopsy results to identify and confirm this outbreak! Now I have to
report to the Minister of Health that this catastrophe could be the polices doing with
their lack of information sharing.
Lets adjourn the meeting until we receive the results. In the meantime, I ask that all
parties handle the situation as best you can before we can respond appropriately to
the current situation. As you know, its best we do not hastily make rash decision
without evidence. As they say, fools rush in. Meeting adjourned.
Response
Jaryll
Good morning everyone,
I have spoken to the Minister of Health and briefed him on the situation. Might I say
that he wasnt pleased is an understatement. I hope you guys have good news to
tell me so that next time I report to the Minister of Health, I wont have my head
chewed off.
Nera
The number of fatalities has almost doubled since we last spoke and now, even
healthcare workers have called in sick. This only further strains my departments
capabilities to handle the situation. We could be looking at a contagious disease.
Ash
We have yet to receive forensic results from the vial the police sent us previously
and Im not sure if this is good news or bad news but our laboratories have
confirmed that the culprit from patient and autopsy samples is Bacillus anthracis
through blood culture and PCR. We believe it to be gastrointestinal infection of
bacillus anthracis based on our results and this is most probably due to
contaminated meat.
Everyone shocked
Jaryll
Well that explains it, we thought too hard that it could be a novel bioweapon but all
along it was the same old clich bioweapon. Like they say, its so overt, its covert. It
could be modified with a higher fatality rate compared to the conventional anthrax.
Nera
Excuse me, director. If it is gastrointestinal anthrax infection caused by contaminated
meat which I highly doubt in this day and age since all cows are vaccinated, why is
there also cutaneous skin lesions presented in patients along with diarrhoea and
abdominal pain. Plus, the scale is too large to be just contaminated meat and the
patients comprises equally of all races, Chinese, Indian and Malays. If it is only
contaminated meat, we would only see an unequal distribution of Malays, Indian and
Chinese patients due to their religious practices of abstaining from meat.
Everyone agrees with Nera
Anis
Erm, excuse me, what is anthrax?
Everyone is in disbelief!
Ash
Anthrax is caused by an microorganism called Bacillus Anthracis which is Gram
positive rod bla bla
Anis
Huh?
Nera
Its a vicious infection, just bad
Char Sin
Well since this is highly associated with the recent terrorist linked attack in SYABAS,
the terrorist could have poured several vials into the water works without the police
knowing. This would explain the gastrointestinal and cutaneous infection of anthrax
because patients could have ingested contaminated water hence gastrointestinal
anthrax and patients could have showered in contaminated water hence cutaneous
anthrax.
Jaryll
Thats true!
Lilian
Now that we know it is anthrax, how should we go about it? Should we inform the
general public?
Everyone gets into a frenzy
Harvin
No! We cannot inform the general public because my corporations image will drop
and public trust will be an all time low for my company.
Lilian
We cant just hide the truth to save your business, the people ought to know!
Nera
That would be devastating to my resources, we will have an unprecedented increase
in medical facility visitation from paranoid civilians who think they have anthrax
infections!
Ash
It doesnt matter we still have to screen everyone in the affected areas to ascertain
their infection status and no one will get sick from visiting the hospital since anthrax
has no person-to-person infection
Jaryll
Everyone quiet!!!
Keep calm everyone, let us be professional. Now, Im sure this is not everyones first
time dealing with an outbreak. Yes, it maybe the first bioterrorist attack in Malaysia
but we are trained for this. Lets initiate the National Emergency Response Plan and
inform the public on our findings. The public will find out the truth one way or the
other and its best that we have the public trust to handle the situation better.
Lilian, inform the public on what has transpired and that the authorities are equipped
to handle the situation. Provide as much information to the public about anthrax and
assure them that it is under control.
Lilian
Very well sir, I will also inform all travel agencies to warn tourists that there is a
current outbreak in Kuala Lumpur.
Nera
I will instruct all hospitals to accept as much patients as we can by utilizing the
hallways and hospital car parks if needed but looking at the scale of this outbreak,
we require additional support.
Ash
Yes sir, my department will spearhead the emergency response. I suggest we locate
large venues such as stadiums and public halls we can use to set up field hospitals
to screen and isolate to treat the sick.
Joanne
I will instruct that all city hall large venues be placed at your disposal. I would also
advise the Chief Minister to declare a state of emergency and to close down all
businesses and schools until the police can confirm it is safe to resume daily
activities.
Ash
I would also need additional manpower to man these field hospitals and also security
personnel to maintain law and order.
Jaryll
I will request the national health ministry for additional support and relevant NGOs
such as the Red Crescent to support our field hospitals
Anis
I will place police personnel at these field hospitals and all medical facilities to ensure
law and order are maintained. I will also have riot police on standby and deploy them
if needed in case of rioting.
Char Sin
Our current state level strategic stock piles of anthrax vaccines and antibiotics to
treat anthrax is very limited. I will require further assistance from National Ministry of
Health for existing strategic national stockpiles from other states.
Jaryll
I will also look into requesting aid from the Ministry of Defense as I am sure the
Royal Medical Corps has medicine stockpiles for bioweapons such as anthrax.
Ash
We need to vaccinate the healthy population as quickly as we can to stop the
number of infected people from increasing.
Anis
The police will continue our investigation to bring the masterminds behind this attack
to justice. We will also ensure that this a lone-wolf attack and not a series of terrorist
attack.
Harvin
I will instruct all of my companys facilities to cease production and request
neighbouring state waterworks to supply water to our affected areas. In the
meantime, I will instruct my engineers to start decontaminating our water facilities
with sodium hypochlorite and liquefied chlorine.
Ash
My department will also inform the WHO and update them periodically. Being the
first to know about the identity of this infection and also responsible for public
education regarding the outbreak, my department has come up with this info graphic
to be disseminated to the public
Jaryll
Good job Ash.
Lilian, I want this infographic to be on every social networking sites, emails, and sms.
I dont care how you do it, make sure it is made known to the public. Have your men
call every citizen if you have to as long as word gets out.
Lilian
Yes sir
Jaryll
The last thing we want is to throw everyone into a panic mode and encourage
anarchy in the streets. Id rather be blamed for overreacting to the outbreak than be
blamed for our inadequate response. Lets do what we are supposed to do and stop
this terrorist plot to achieve its goal. I place my trust in all of you. Meeting adjourned.
Recovery
Jaryll
Good morning everyone
I have great news, the statistics of infected patients has dropped tremendously and
we have also managed to reduce the number of fatalities due to our quick screening
and treatment of patients. Thanks to our strategic national stockpiles, we have
managed to vaccinate all the healthy population.
Everyone applauds!
However, let us continue our efforts in monitoring and preventing further infections
and do not let our guards down.
Nera
My department is still on the lookout for anymore symptoms that can be attributed to
anthrax. We will immediately diagnose and treat patients who come in with
suspected anthrax infection.
Char Sin
We have successfully acquired antibiotics for treatment and will continue to replenish
our stockpiles for future use.
Ash
My department is currently monitoring the physical and mental health of survivors,
healthcare workers and their families through counselling with the help of the
Welfare department and Health Department.
Anis
The police investigation has concluded that this attack is a lone-wolf attack and any
subsequent attack is low. We will still be on alert for any rumours of future terrorist
attack.
Harvin
The decontamination process of my companys facilities have concluded but we are
also testing for ground contamination around our natural water catchment areas
such as ponds and lakes to ensure no further spores are detected in the ground. We
will upgrade security in all current facilities to ensure public safety and prevent future
attacks. We will also screen our personnel for mental health and psychiatric
evaluation periodically.
Lilian
My department will set up a task force dedicated to preventing terrorist acts by
monitoring online activities. We will alert the police on suspicious behaviour online
such as visiting radical extremists websites and flagging certain keywords in
chatrooms.
Joanne
The Chief Minister will be observing a memorial day for all those affected from this
terrorist attack. We will mourn for the dead and assure the public that the criminals
have been brought to justice and that we continue to strive for our city in memory of
those who have perished.
Jaryll
I thank you all for your efforts in handling this situation. I am sure without the
cooperation of the respective parties, the death toll will be much higher. However,
there are also many lessons to be learnt from this incident. Most importantly is the
communication between agencies because communication is power. The failure of
the police to share intelligence that a bioterrorist was captured and slow processing
of evidence led to the failure of the health authorities to prepare and respond to the
outbreak more efficiently. The failure of the police to direct the water works
department to shut down all operations pending investigation of the possible attack
which have occurred could have prevented this catastrophe. Coordination is also key
to outbreak response so that there is no overlap of responsibilities or completely
overlooking or neglecting certain aspects of outbreak response. I hope we will review
our standard operating procedures to ensure cohesion between agencies. I finally
declare this incident is no longer a public health emergency. Meeting adjourned.