Old Lyme — Participants in an emergency preparedness drill filed into Town Hall on Tuesday morning carrying vouchers for antibiotics, as a team of volunteers sat ready to quickly dispense bottles of the medication or direct people to medical evaluation.

Evaluators in red vests timed the participants to see how quickly they received their antibiotics and jotted down notes on any areas needing improvement during the exercise that imagined the town was responding to exposure to anthrax.

Other volunteers guided the participants to spots around the room, or were available to help them fill out new medical questionnaires in case they lost their vouchers. 

Billed as the first of its kind in the state, Tuesday's exercise focused on the town of Old Lyme's "critical infrastructure," including town employees, emergency medical services personnel, firefighters and police officers, during a potential public health outbreak, said Kris Magnussen, Public Health Emergency Preparedness coordinator for Ledge Light Health District.

Tuesday's exercise would be applicable to bioterrorism, the flu, a foodborne illness outbreak or any public health problem, Magnussen said.

In the event of an emergency, these personnel need to quickly receive antibiotics for themselves and their families so they can continue to provide essential services for the town and then help dispense medication to the public, she said.

Tuesday was the first time during a full-scale exercise that Ledge Light tested an online medication screening form, Magnussen said.

The town, Ledge Light and the Old Lyme Visiting Nurse Association were participating in the mass-dispensing exercise to test the town's emergency plan in the event of a mass exposure. The goal was to test the plan and gather data to be used in case there ever is a real emergency, according to First Selectwoman Bonnie Reemsnyder.

The exercise imagined the activation of a closed "point of dispensing," or location for handing out medication only to a specific group of people in the community, in this case first responders and town employees.

Magnussen said that in the event of a public health outbreak, about 12,000 people would be needed to work around the clock for 36 hours to dispense medication to Ledge Light's mass dispensing area, which encompasses Lyme, Old Lyme, East Lyme, Waterford, New London, Groton, Ledyard, North Stonington and Stonington. If town personnel first receive their medication, then they could be free to help dispense to the public.

Organizers also wanted to see how quickly antibiotics could be distributed to people, with the hope that if the numbers are good enough, then the town's elderly and vulnerable populations also could be served at the same location as the town employees, rather than having to stand in line at a public clinic set up at a high school. 

Stephen Mansfield, director of health for Ledge Light, said that in the event of a pandemic of H1N1, also called swine flu, having more closed points of dispensing — considered a "best practice" by the Centers for Disease Control and Prevention — lessens the burden on public clinics throughout the area. Large institutions, businesses, and municipalities all could potentially set up their own closed points of dispensing.

"It just lessens the overall burden on our infrastructure and personnel," he said.

Exercises like Tuesday's serve to improve emergency preparedness plans, as participants discuss after the exercise what worked and what didn't work, according to Magnussen.

"We would much rather find the faults now than during a real event," she told volunteers.

During the training for Tuesday's exercise, Magnussen explained to participants that in the event of bioterrorism, such as anthrax, the governor would request countermeasures, in this case antibiotics, from the CDC's Strategic National Stockpile. The CDC would have 12 hours to get the antibiotics to the region. During that time period, those involved in the region's emergency response would get ready both closed dispensing points and public clinics.

Under the scenario played out on Tuesday, an epidemiologist would sign over the antibiotics to the Old Lyme Visiting Nurse Association for distribution.

Volunteers from the senior center and senior housing facilities and Town Hall employees participated in the exercise, while the Old Lyme Visiting Nurse Association, assisted by Ledge Light, worked at the dispensing point.

Based on feedback from using paper forms during a closed dispensing point exercise with the Visiting Nurse Association of Southeastern Connecticut, Ledge Light got permission from the state Department of Public Health to use an online form so they could screen in a more timely fashion, Magnussen said.

Participants in the exercise filled out an online medication screening form prior to arriving at the event that asked them information, including about allergies and their weight. The screening form featured a built-in algorithm with the capability to inform what medications should or should not be dispensed to each individual. Based on that, the participants received a voucher that indicated whether they should receive Doxycycline or Cipro, or either. People who could take neither antibiotic were referred to a medical evaluation station.

Old Lyme Emergency Management Director David Roberge said the town participated in the exercise, as the administration is very supportive of the special needs and elderly population. He also said it's critical for municipalities to support their continuity of government and operations in the event of a health emergency.

Cindi Taylor, the executive director of the Old Lyme Visiting Nurse Association, which consists of volunteers and one town nurse, said the exercise was a great opportunity. 

Reemsnyder said she jumped at the opportunity for Old Lyme to participate.

"I think that any time we can be well prepared for emergencies, it just keeps our residents that much safer," she said.

k.drelich@theday.com