Back to Top Skip to main content

Thirteen years ago Ft. Knox prepared for outbreak scenarios

Front page of newspaper Cover of Fort Knox’s base newspaper announcing a medical exercise in June 2007. (Courtesy Photo by Fort Knox Public Affairs)

Recommended Content:

Coronavirus | Public Health

More than 13 years before the COVID-19 pandemic swept across the globe, a group of about 100 area organizations gathered at Fort Knox, Kentucky to work on plans to combat it, or something similar.

Nobody knew about the coronavirus back then. In fact, they weren’t even focused on the next big pandemic coming from a family of viruses that includes the common cold. Their one-day tabletop exercise pondered how they would respond if the next big influenza outbreak hit the area.

“Back then, we were planning for an avian flu pandemic, which turned out to be not so big of a deal,” said Joel Tiotuico, plans officer for the Plans and Operations Division at Fort Knox Directorate of Plans, Training, Mobilization and Security. “The planning for that pandemic was basically because we thought it was going to turn out like COVID-19 has.”

Tiotuico was charged with leading base’s efforts back in mid-May 2007. He and Sara Jo Best, director of Lincoln Trail District Health Department, gathered together about 100 people from local, county, state and federal organizations for the exercise, including several from each of 10 counties that surround Fort Knox.

“We had a really good turnout that year,” said Best, who mentioned that she had been promoted to oversee the preparedness department at the organization about three years prior. “We were tasked with developing emergency response plans, getting people trained to be able to respond; developing a community coalition to plan for emergency disasters. All that included Fort Knox.”

Tiotuico said the 2007 exercise was likely the first event at Fort Knox that emphasized coordination and cooperation among so many different organizations to discuss how best to deal with a potential pandemic from a medical capacity.

“Emergencies like fires, tornados, and ice storms — those are immediate action events. Whereas a pandemic similar to COVID-19 kind of starts slowly, and you’re reacting to something you don’t see, or don’t know it’s happening at first; you’re trying to prevent it from happening,” said Tiotuico. “In that tabletop exercise, we found out the best way to fight it was to try and prevent it.”

Some of the preventive measures that surfaced from the 2007 exercise included the wearing of facial coverings, regular sanitizing of surfaces and social distancing by such means as teleworking.

“Most of our guidance on this plan, up to now, was from the [Centers for Disease Control and Prevention],” said Tiotuico. “We had decision points, when to get people on telework, when to close stores and schools — it was all in the plan.”

Tiotuico and Best said they remember the threats posed by the H5N1 bird flu scare of 2006, though other strains of that particular influenza had been around since at least 1997. According to news reports, the 2006 strain was predicted by health experts to reach unprecedented numbers of deaths if not mitigated. By May of 2007, Department of Defense officials released a guidebook from which to start planning for a possible flu pandemic.

The 2007 Fort Knox exercise formed as a result of these concerns, said Tiotuico. The results were then placed into a document that could be revised over the years to fit whatever scenarios installation officials may face.

He also elicited the help of a preventive medicine doctor, who produced an 800-page clinical paper, from which Tiotuico modified it to about 150 pages.

“It’s pretty lengthy because everybody plays a part in it, from logistics to family welfare departments, to the schools and emergency management; even the commander himself,” said Tiotuico.

Fast-forward to March 2020, Tiotuico said leaders had voiced concerns about what measures needed to be taken when COVID-19 hit the United States. They approached him.

Tiotuico said the key to effective planning comes from having a flexible document that allows leaders to quickly adjust and make informed decisions when disasters hit.

You also may be interested in...

MSMR Vol. 27 No. 12 - December 2020

Report
12/1/2020

A monthly publication of the Armed Forces Health Surveillance Branch. This issue of the peer-reviewed journal contains the following articles: Cases of coronavirus disease 2019 and comorbidities among Military Health System beneficiaries, 1 January 2020 through 30 September 2020; Characteristics of U.S. Army beneficiary cases of COVID-19 in Europe, 12 March 2020–17 April 2020; Air evacuation of service members for COVID-19 in U.S. Central Command and U.S. European Command from 11 March 2020 through 30 September 2020; SARS-CoV-2 and influenza coinfection in a deployed military setting— Two case reports.

Recommended Content:

Health Readiness | Public Health

MSMR Vol. 27 No. 11 - November 2020

Report
11/1/2020

A monthly publication of the Armed Forces Health Surveillance Branch. This issue of the peer-reviewed journal contains the following articles: Acute respiratory infections among active component service members who use combustible tobacco products and/or e-cigarettes/vaping products, U.S. Armed Forces, 2018–2019; Fibromyalgia: Prevalence and burden of disease among active component service members, U.S. Armed Forces, 2018; Update: Cold weather injuries, active and reserve components, U.S. Armed Forces, July 2015–June 2020.

Recommended Content:

Health Readiness | Public Health

MSMR Vol. 27 No. 10 - October 2020

Report
10/1/2020

A monthly publication of the Armed Forces Health Surveillance Branch. This issue of the peer-reviewed journal contains the following articles: Characterizing the contribution of chronic pain diagnoses to the neurologic burden of disease, active component, U.S. Armed Forces, 2009–2018; Surveillance snapshot: Influenza immunization among U.S. Armed Forces healthcare workers, August 2015–April 2020; Acute and chronic pancreatitis, active component, U.S. Armed Forces, 2004–2018.

Recommended Content:

Health Readiness | Public Health

MSMR Vol. 27 No. 9 - September 2020

Report
9/1/2020

A monthly publication of the Armed Forces Health Surveillance Branch. This issue of the peer-reviewed journal contains the following articles: Update: Routine screening for antibodies to human immunodeficiency virus, civilian applicants for U.S. military service and U.S. Armed Forces, active and reserve components, January 2015–June 2020; Incidence of inguinal hernia and repair procedures and rate of subsequent pain diagnoses, active component service members, U.S. Armed Forces, 2010–2019; Surveillance of spotted fever rickettsioses at Army installations in the U.S. Central and Atlantic regions, 2012–2018.

Recommended Content:

Health Readiness | Public Health

MSMR Vol. 27 No. 8 - August 2020

Report
8/1/2020

A monthly publication of the Armed Forces Health Surveillance Branch. This issue of the peer-reviewed journal contains the following articles: Commentary: The limited role of vaccines in the prevention of acute gastroenteritis; Diarrhea and associated illness characteristics and risk factors among British active duty service members at Askari Storm training exercise, Nanyuki, Kenya, January–June 2014; Surveillance snapshot: Norovirus outbreaks in military forces, 2015–2019; Update: Incidence of acute gastrointestinal infections and diarrhea, active component, U.S. Armed Forces, 2010–2019.

Recommended Content:

Health Readiness | Public Health

MSMR Vol. 27 No. 7 - July 2020

Report
7/1/2020

A monthly publication of the Armed Forces Health Surveillance Branch. This issue of the peer-reviewed journal contains the following articles: Hearing conservation measures of effectiveness across the Department of Defense; Alcohol-related emergency department visits, hospitalizations, and co-occurring injuries, active component, U.S. Armed Forces, 2009–2018; Surveillance snapshot: Cervical cancer screening among U.S. military service women in the Millennium Cohort Study, 2003–2015; Epidemiology of functional neurological disorder, active component, U.S. Armed Forces, 2000–2018.

Recommended Content:

Health Readiness | Public Health

MSMR Vol. 27 No. 6 - June 2020

Report
6/1/2020

A monthly publication of the Armed Forces Health Surveillance Branch. This issue of the peer-reviewed journal contains the following articles: Absolute and relative morbidity burdens attributable to various illnesses and injuries, active component, U.S. Armed Forces, 2019; Hospitalizations, active component, U.S. Armed Forces, 2019; Ambulatory visits, active component, U.S. Armed Forces, 2019; Surveillance snapshot: Illness and injury burdens, reserve component, U.S. Armed Forces, 2019; A monthly publication of the Armed Forces Health Surveillance Branch. This issue of the peer-reviewed journal contains the following articles: Letter to the editor: G6PD deficiency in the Tafenoquine era; Summary of the 2018–2019 influenza season among Department of Defense service members and other beneficiaries; Brief report: Direct care cost of heat illness to the Army, 2016–2018; Animal-related injuries in veterinary services personnel, U.S. Army, 2001–2018.

Recommended Content:

Health Readiness | Public Health

MSMR Vol. 27 No. 5 - May 2020

Report
5/1/2020

A monthly publication of the Armed Forces Health Surveillance Branch. This issue of the peer-reviewed journal contains the following articles: Absolute and relative morbidity burdens attributable to various illnesses and injuries, active component, U.S. Armed Forces, 2019; Hospitalizations, active component, U.S. Armed Forces, 2019; Ambulatory visits, active component, U.S. Armed Forces, 2019; Surveillance snapshot: Illness and injury burdens, reserve component, U.S. Armed Forces, 2019; Surveillance snapshot: Illness and injury burdens, recruit trainees, active component, U.S. Armed Forces, 2019; Medical evacuations out of the U.S. Central Command, active and reserve components, U.S. Armed Forces, 2019; Morbidity burdens attributable to various illnesses and injuries, deployed active and reserve component service members, U.S. Armed Forces, 2019; Absolute and relative morbidity burdens attributable to various illnesses and injuries, non-service member beneficiaries of the Military Health System, 2019; Prevalence of selected underlying health conditions among active component Army service members with coronavirus disease 2019, 11 February–6 April 2020; Early use of ICD-10-CM code “U07.1, COVID-19” to identify 2019 novel coronavirus cases in Military Health System administrative data.

Recommended Content:

Health Readiness | Public Health

MSMR Vol. 27 No. 4 - April 2020

Report
4/22/2020

A monthly publication of the Armed Forces Health Surveillance Branch. This issue of the peer-reviewed journal contains the following articles: Commentary: The Warrior Heat- and Exertion-Related Event Collaborative and the Fort Benning Heat Center; Update: Heat illness, active component, U.S. Armed Forces, 2019; Update: Exertional rhabdomyolysis, active component, U.S. Armed Forces, 2015–2019; Update: Exertional hyponatremia, active component, U.S. Armed Forces, 2004–2019

Recommended Content:

Health Readiness | Public Health

MSMR Vol. 27 No. 4 - APR 2020

Report
4/2/2020

As of 1 APR, 186,101 total confirmed COVID-19 cases (3,603 deaths) have been reported in all U.S. states, the District of Columbia, Puerto Rico, Guam, the Northern Mariana Islands, and the U.S. Virgin Islands. Current hot spots include NY, NJ, LA, CA, GA, FL, SC, and Guam. Confirmed COVID-19 cases are rapidly accelerating in the U.S., an increase expected due to amplified testing capacity and ongoing community spread. As of 1 APR, CDC is reporting widespread transmission of COVID-19 in 25 (+12) U.S. states and Guam.

Recommended Content:

Health Readiness | Public Health

MSMR Vol. 27 No. 3 - March 2020

Report
3/30/2020

A monthly publication of the Armed Forces Health Surveillance Branch. This issue of the peer-reviewed journal contains the following articles: Update: Sexually transmitted infections, active component, U.S. Armed Forces, 2011–2019; Incidence of sexually transmitted infections before and after insertion of an intrauterine device or contraceptive implant, active component service women, U.S. Armed Forces, 2014–2019; Blood lead level surveillance among pediatric beneficiaries in the Military Health System, 2010–2017

Recommended Content:

Health Readiness | Public Health

MSMR Vol. 27 No. 2 - February 2020

Report
2/1/2020

A monthly publication of the Armed Forces Health Surveillance Branch. This issue of the peer-reviewed journal contains the following articles: Update: Malaria, U.S. Armed Forces, 2019; Diabetes mellitus and gestational diabetes, active and reserve component service members and dependents, 2008–2018; Increased risk for stress fractures and delayed healing with NSAID receipt, U.S. Armed Forces, 2014–2018; Brief report: Diagnoses of scarlet fever in Military Health System (MHS) beneficiaries under 17 years of age across the MHS and in England, 2013–2018; Images in health surveillance: Skin rashes in children due to infectious causes

Recommended Content:

Health Readiness | Public Health

MSMR Vol. 27 No. 1 - January 2020

Report
1/1/2020

A monthly publication of the Armed Forces Health Surveillance Branch. This issue of the peer-reviewed journal contains the following articles: Carbon Monoxide Poisoning, Active and Reserve Component Service Members and Non-Service Member Beneficiaries of the Military Health System, U.S. Armed Forces, July 2009–June 2019; Respiratory Pathogen Surveillance Trends and Influenza Vaccine Effectiveness Estimates for the 2018–2019 Season Among Department of Defense Beneficiaries; Brief Report: The Early Impact of the MHS GENESIS Electronic Health Record System on the Capture of Healthcare Data for the Defense Medical Surveillance System; and Brief Report: Incidence and Prevalence of Idiopathic Corneal Ectasias, Active Component, 2001–2018.

Recommended Content:

Health Readiness | Public Health

MSMR Vol. 26 No. 12 - December 2019

Report
12/1/2019

A monthly publication of the Armed Forces Health Surveillance Branch. This issue of the peer-reviewed journal contains the following articles: Editorial: Mitigating the risk of disease from tick-borne encephalitis in U.S. military populations; Tick-borne encephalitis surveillance in U.S. military service members and beneficiaries, 2006–2018; Case report: Tick-borne encephalitis virus infection in beneficiaries of the U.S. military healthcare system in southern Germany; Update: Cold weather injuries, active and reserve components, U.S. Armed Forces, July 2014–June 2019

Recommended Content:

Health Readiness | Public Health

MSMR Vol. 26 No. 11 - November 2019

Report
11/1/2019

A monthly publication of the Armed Forces Health Surveillance Branch. This issue of the peer-reviewed journal contains the following articles: Editorial: Mitigating the risk of disease from tick-borne encephalitis in U.S. military populations; Tick-borne encephalitis surveillance in U.S. military service members and beneficiaries, 2006–2018; Case report: Tick-borne encephalitis virus infection in beneficiaries of the U.S. military healthcare system in southern Germany; Update: Cold weather injuries, active and reserve components, U.S. Armed Forces, July 2014–June 2019

Recommended Content:

Health Readiness | Public Health
<< < 1 2 3 4 5  ... > >> 
Showing results 1 - 15 Page 1 of 18

DHA Address: 7700 Arlington Boulevard | Suite 5101 | Falls Church, VA | 22042-5101

Some documents are presented in Portable Document Format (PDF). A PDF reader is required for viewing. Download a PDF Reader or learn more about PDFs.