NFA’s roles in response to COVID-19

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NFA’s roles in response to COVID-19

 Korean NFA is in charge of dealing with fire, disaster, rescue, and EMS, based on

the 「 Framework Act on Fire Services 」

 NFA may mobilize fire-fighting forces nation- wide

in case of national disasters.

 Therefore, NFA mobilized the EMS Forces na- tionwide in response to the COVID-19 disaster, which called for a national-level response, and has been transporting confirmed and sus-

pected cases to medical institutions.

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General Re- sponse

Unit

Situation Manage- ment Unit

Resource Support

Unit

Information Unit

Public Relations

Unit

Organization of COVID-19 Emergency Response Centers

Cent ral (NFA

)

Chief : NFA Commissioner Deputy Chief:

NFA Deputy Commissioner

General Director

(Director of Rescue & EMS Division)

(18 cities & provinces)

Command: Regional Fire HQ

General Director

(director of EMS division)

Regi onal

Fire HQs

General Re- sponse

Unit

Situation Manage- ment Unit

Resource Support

Unit

Information Unit

Public Relations

Unit

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NFA Responses by Crisis Alert Phases

Phase Conc ern

Jan. 3 ~ Jan. 19

Instruction of emergency measures to all regional Fire HQs nationwide,

in anticipation of domestic influx

Measures taken by each Phase, according to IDRM

Crisis Alert Phase: Concern(Blue) → Caution(Yellow) → Warning(Orange) → Serious(Red)

 Mandatory donning of all Personal Protective Equip-

ment(PPE), checking of a patient’s final diagnosis after transporting a suspected case(cough, fever, throat

swelling, etc.)

 Intensified monitoring of suspected symptoms from unknown causes

 Prompt situation debrief and activation of reporting

chain in case of EMS crew’s coming in contact with the virus

 Sharing information on situations of screening stations and quarantine(negative pressure) beds, etc.

 Inspection of PPE and all other equipment for the pro- tection of EMS crew.

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CAUT ION

Jan. 20 ~ Jan. 26

Re-emphasis thorough response for the possibil- ity of COVID-19 spread

to local communities and increased EMS transport demands ^ Urgent inspection of PPE and disinfectant stockpiles

 Distribution of manuals on report, consultation, and transport procedures for suspected cases

Operation of Infectious Disease Crisis Response Operations Unit(IDCROU)

365 days and 24 hours a day

 Providing around-the-clock medical consultations for Korean citizens abroad

 Swift gathering of COVID-19 related information

 Consisting of 2 units with 7 staff members on duty daily

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Phase Warn ing

Jan. 27 ~ Feb. 22

Around-the-clock operation of IDCRC

 The position of IDCRC chief upgraded to NFA Deputy Commissioner

 Expanded IDCRC to 4 units with 21 staff members on duty daily

 Coordination of nationwide EMS resources to cope with a large number of cases

 Joint government video conferences held

 Maintaining a system of cooperation with related agencies

First Mobilization issued in response to the sud- den increase of confirmed cases

in Daegu area(Feb. 21.)

^ Region: 6 cities and provinces(Busan, Daejeon, Ulsan, Gangwon, Chungbuk, Gyeongnam)

 Size: 36 EMS crew, 18 ambulances

 Mission: Transport of Confirmed Patients

′Residence↔Keimyung University Daegu Dongsan Hospi- tal(Feb. 22 ~ Feb. 24)

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Transport support for returning citizens from abroad

(Airport ↔ Hospital ↔ Temporary Living Quar- ters)

^ On arrival, suspected cases transported to hospitals,

asymptomatic cases transported to

Warn ing

Gathering Moving to Stand-by LocationStand-by

Screening suspected cases boarding ambulance

Transport to Hospital

※ Total of 32 people transported, with 57 vehicles and 126 crew

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『 COVID-19 』 emergency video conferences held by NFA commissioner and Central Disas- ter Countermeasures HQ(CDCHQ)

Phase Warn ing

(Notification of Transport Guidelines)

Various guidelines established for efficient

EMS dispatch systems*

^ Disinfection Guidelines, EMS Transport Guidelines, Mass Gathering Event Management Guidelines distributed to Fire organizations nationwide (18 HQs, 224 Fire Depart- ments)

(Disinfection Support for the Police)

Police officers(dispatched to COVID-19 related

cases) permitted to use the 723 EMS Infection

Management Rooms(IMR) (Feb. 17 ~ end of dis-

aster)

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Group Blood Donations from Fire Organizations following shortage of blood

Warn ing

(Fire Prevention Consulting)

105 mask manufacturing factories supervised

by fire department chiefs

^ Emphasizing fire safety, caution for machine overheating by long hours of operation or negligence

Ttransport of 7 Korean citizens from the Cruise Ship in Japan

 Participated by 50,000 full-time and 950,000 volunteer fire-fighters

※ Feb. 12 ~ Feb. 14 / Out of 105 factories, 103 checked and 2 re-opened after taking supplementary measures

 All 7 confirmed negative and transported from Incheon Airport quarantine station

to Central Quarantine Medical Center by bus

Phase Serio us

Feb. 23 ~

DCRC further expanded

 Chief upgraded to NFA Commissioner(the highest level)

 5 Units and 30 staff members

⇒ 18 Regional Fire HQs with 5 units and daily maxi- mum of 500 staff

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Declared Daegu as an Infectious Disease Dis- aster Area,

Second Mobilization (129 vehicles, 258 crew) issued

Phase Serio us

 5 cities and provinces(Chungnam, Chang- won, Jeonbuk, Jeonnam, Gwangju)

with 18 vehicles and 36 crew

Feb. 28

Mobilization No.1 Expanded

 7 cities and provinces(Seoul, Gyeonggi, In- cheon, Chungbuk, Gyeongbuk,

Gyeongnam, Busan) with 81 vehicles and 162 crew

Mar. 3

Mobilization No.2

Mar. 4

Mobilization No.2 Expanded

⇒ Transports to patients′home after taking sample and between hospitals

⇒ Confirmed cases from Daegu transported to Residential Treatment Facilities(RTF) in Yeongdeok and Gyeongju

 8 cities and provinces(Daejeon, Gwangju, Ul- san, Gangwon, Gyeonggi, Chungnam, Jeonbuk, Jeonnam) with 30 vehicles and 60 crew

⇒ Confirmed cases from Daegu transported to RTF and hospitals

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Distribution of National PPE Stockpiles

to 18 all metropolitan cities and provinces nationwide

Serio us

* Supplied by NFA following the shortage of PPE due to transports of confirmed cases

PPE Protective

Suits N95 Masks face masks Goggles

14,744 21,776 104,000 104,000 5,000

COVID-19 related cases of EMS Forces:

67,834 cases total

《 Jan. 3, 2020~May. 20 》

NFA Transport for COVID-19 Medical Consultation

Confirmed

cases Suspected cases

Transports between Hospitals

Patient Sample

Transports Domestic Overseas Koreans

10,106 26,357 751 588 29,999 33

Transport : 37,802 cases Counseling :30,032 cases

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Mobilization of EMS Forces

Operations Outline

Total Seoul Bu

san Dae jeon Dae

gu

cheoIn n

Gwang ju

Ul

san Gang won

Gyeong gi

Chung buk

Chung nam

Jeon buk Jeon

nam

Gyeong buk

Gyeong nam

Chang won Ambulanc

es 170 ¹¹ ⁷ ³ ²³ ⁴ ⁵ ² ¹² ²⁷ ¹² ⁸ ¹⁰ ¹⁰ ²⁰ ¹⁴ ²

EMS Staff 340 ²² ¹⁴ ⁶ ⁴⁶ ⁸ ¹⁰ ⁴ ²⁴ ⁵⁴ ²⁴ ¹⁶ ²⁰ ²⁰ ⁴⁰ ²⁸ ⁴

Details

 Period : Feb. 21. 2020 ~ Apr. 2. (42 days)

 Resource Gathering Point(RGP) : Duryu Water Purification Plant in Daegu (135,000 ㎡ )

 Number of Mobilized Ambulances and EMS Crew

 Transport of confirmed cases to hospitals and RTC

 RGP → Patient’s Residence → Hospital & RTC

 RGP → Hospital & RTC → Hospital

 Management of ambulances and EMS crew

 Code-Numbering for mobilized ambulances(NFA 1 ~ NFA 147)

 Operating two rotating teams to prevent fatigue (dispatch team, stand-by team)

 Operating buses, tents, resting facilities, laundry vehicles, food vehicles for the crew’s convenience

 Vehicle-maintenance company stationed on site

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※ Return to RGP ➪ Disinfect vehicle with crew on board ➪ Disin- fect crew

Infection Management

 Infection prevention for EMS crew

 Frequent checking of body temperature and general physical condition

 Frequent hand sanitization(preparing hand sanitizer and en- couraging its use), supply of N95 masks

 Eating meals spread out, facing one direction

 Donning of PPE, minimum number of crew dispatched for patient transports

 Step-by-step infection prevention and disinfection man- agement

Before transport

During transport

After transport

 Read Infection prevention manuals

 Train for proper use of PPE

 Dispatch only minimum crew(1 person). Wear Level D PPE.

※ The patient must wear a facemask and gloves.

 Turn on the Plasma sterilizer during return

 Clean and disinfect the vehicle(inside&out) and body in IMR

 Discard PPE in sealed bags

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Photos of Incheon International Airport NFA following the expansion of SE

Suspected Cases

Confirmed cases Subtotal Hospitals in

Daegu

Hospitals outside

Daegu

Patient Gathering

Point

940 6,608 3,230 490 2,888

⇒ Number of Transports: Total 7,548

《 Feb. 21, 2020~ Apr. 2. 》

Infection Management

 Waste management of used PPE

- Store in waste containers → dispose at Public Health Centers

 EMS activities during mobilization period

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Incheon International Airport

The Korean government intensified the SEP (00:00 Mar. 19, 2020)SEP (Special Entry Procedure)

Procedure of quarantine which involves taking body temperature, filling out special quarantine report form, etc.

Everyone entering Korea is subject to the process, Koreans and foreigner alike. If refused, entry is limited.

Fire Forces in support : 106 staff, 22 vehicles

NFA began transporting confirmed and suspected cases entering Korea.

In case of a large number of suspected cases, they were transported to temporary facilities.

10 6 11 8 1 1 1

Staff Bus Ambulance Recovery Vehicle

Food Vehicl

e

Relay Vehicle

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Airport Terminal → CQMC: Sample Collection → Temporary Stand-by Facility(TSF)

* Night-time (22:00~06:00)→Arrival hall(sample collection)→ Airport terminal→ TSF

《 Mar. 19, 2020~May. 20 》

*Airport Gate→Quarantine Station at CQMC→TSF

Procedures for transporting confirmed and sus- pected cases entering the border

Number of transports from the airport

Entr

y Suspected Diagnostic test

Released (from TSF /self-quarantine)

Transport to hospital / RTC

Negative Positive

Suspect Releaseed d from

ConfirmTSF

ed

TSF, Central Quarantine Center(CQC) → Airport Terminal 1

TSF, Airport Terminal, CQC → Hospital / RTC

TSF Confirmed cases

transports Released Total

Case 1,000 281 797 2,078

Person 9,814 293 8,649 18,756

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 Vehicle disinfection

 Bus(11) : Disinfection for 1 hour(after transporting suspected/released cases)

 Ambulance(8) : Disinfection for 2 hours(after transporting confirmed cases)

Infection Prevention Activities

 Procedure

 Crew must be trained in infection prevention, and wear PPE

1. Disinfect in open areas with ventilation

2. Must wear complete PPE(goggles, shoes, mask, coverall, gloves).

3. Disinfect by wiping all surfaces that have patient’s bodily fluids(vomitus, blood, etc.).

- Wipe seats with fabric and alcohol.

- Disinfect everything including doors, handles, straps, belts, and wires.

4. All PPE must be taken off at the site of disposal, and disposed as medical waste.

5.Ventilate sufficiently after disinfection(recommend two hours after transporting confirmed /suspected cases)

6. Designate the front three rows of a bus as cargo space and disinfect.

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