Transcript Emergency Response Planning How do we prepare?

Preparing for and Responding to
Bioterrorism:
Information for the Public Health
Workforce
Northwest Center for Public Health Practice
University of Washington School of Public Health and Community Medicine
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Acknowledgements
This presentation, and the accompanying instructor’s manual,
were prepared by Jennifer Brennan Braden, MD, MPH, at the
Northwest Center for Public Health Practice in Seattle, WA, for the
purpose of educating public health employees in the general aspects of
bioterrorism preparedness and response. Instructors are encouraged
to freely use all or portions of the material for its intended purpose.
The following people and organizations provided information and/or
support in the development of this curriculum. A complete list of
resources can be found in the accompanying instructor’s guide.
Patrick O’Carroll, MD, MPH
Project Coordinator
Centers for Disease Control and Prevention
Judith Yarrow
Design and Editing
Health Policy and Analysis; University of WA
Washington State Department of Health
UW Northwest Center for Public Health Practice
Jeff Duchin, MD
Jane Koehler, DVM, MPH
Communicable Disease Control,
Epidemiology and Immunization Section
Public Health - Seattle and King County
Ed Walker, MD; University of WA
Department of Psychiatry
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Emergency Response Planning
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Emergency Response Planning
Learning Objectives
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Identify the different agencies involved in
response to a bioterrorism event
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Describe the Incident Command System and
how this system may be integrated into an
agency’s bioterrorism response plan
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Identify factors to consider and include in the
development of a local emergency response
plan
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Emergency Response Planning
Learning Objectives
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Describe national and local efforts in the area of
BT preparedness and response
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Describe the roles of public health in
bioterrorism preparedness and response
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Bioterrorism Preparedness and Response
Crisis and Consequence Management
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Crisis management: law enforcement response
to terrorist acts
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Local, state, and federal law-enforcement agencies
Consequence management: response to the
disaster focusing on the alleviation of damage,
loss, hardship, or suffering
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Public health, medical, and emergency mgt
personnel
Falls under ESF-8 (Health & Medical Services) of
Federal and State Disaster Response Plan
PDD-39
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Community Preparedness
A Coordination of Efforts
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Partnerships between public health and:
Clinicians and health care facilities
Law enforcement
Public safety: fire, HAZMAT
Emergency management
Coordinate response across agencies at the
local, state, and federal levels
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Local Emergency Response Planning
Committees (LEPCs)
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Established under the Emergency Planning and
Community Right-to-Know Act
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Membership includes a wide variety of
stakeholders in the community
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Develop comprehensive plans to prepare for
and respond to hazardous substance
emergencies
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National Responders
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Health and Human
Services (HHS)
Centers for Disease
Control and Prevention
(CDC)
Federal Emergency
Management Agency
(FEMA)
FBI
Environmental
Protection Agency
(EPA)
Department of
Agriculture
Department of Defense
State and Local Responders
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Health care providers
and facilities
Local and state health
departments
Emergency
management agencies
Search and Rescue,
EMS, and HAZMAT
teams
Volunteers
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Law enforcement,
National Guard
State emergency
management agency
Political leaders
Community service
organizations
The Emergency Response System
Emergency occurs and is detected by…
Local citizen
Health surveillance system
Calls 911
Clinician/hospital
Local health jurisdiction
Local emergency management office
Local law enforcement
FBI
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Fire
State health dept
State Emergency Mgt Dept
HAZMAT
EMS
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Incident Command System
Definition
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A model for how to conduct and coordinate efforts in
response to an emergency
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Required to be used in HAZMAT incidents; also
used in other types of emergencies
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Five major components
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Command
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Planning
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Operations
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Logistics
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Finance/administration
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Incident Command System
Some Basic Principles
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Unity of command
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Each person in an organization reports to
only one designated person
Unified command structure
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Used when more than one agency responds
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All agencies involved in response establish a
common set of objectives and strategies
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Incident Command System
Some Basic Principles
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Modular organization (expands or contracts as
required)
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Common terminology
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Common names/titles used for all personnel
and equipment
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Differences in Public Health and Law
Enforcement Investigations
Public Health
Law Enforcement
Event
Surveillance or calls Announced by
Recognition from clinicians
attacker or otherwise
evident
Initial Data
Hypothesis
Questioning
Collection
generation
witnesses and
suspects, follow-up
on tips
Goal of
Effective disease
Prevention and
Investigation prevention and
deterrence of future
control measures
attacks, arrest of
perpetrators
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Adapted from: Butler et al. EID, 2002 15
Emergency Operations Plan
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A document that
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Assigns responsibility to organizations and
individuals for carrying out specific actions
at projected times and places in an
emergency that exceeds the capability or
routine responsibility of any one agency
BT and Emergency Response
Plan Clearinghouse
bt.naccho.org
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Emergency Operations Plan
Types of Plans
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Describes the response to any emergency
affecting the agency, county, or state
Health-related emergency response plan a
subset of overall EOP
Lead and supporting agencies in an emergency
depend on the type of emergency
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Roles designated by emergency support function
(ESF)
ESF 8 = health and medical services; public health
agency has lead role in response activities
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Emergency Operations Plan
State and Local Roles
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Public health terrorism plan integrated into or
annexed to overall state/county EOP
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Local government responds first
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State government
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Assists local when capabilities overwhelmed
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Responds first in certain emergencies
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Works with federal government when federal
assistance necessary
WA's Emergency Management Plan
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Developing a Local Public Health
Emergency Operations Plan
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Establish a planning team
Analyze capabilities and hazards
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Current resource base
Geographic factors affecting response
Special needs populations
Develop and implement the plan
“Work” the plan
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Regular drills to:
 Ensure understanding of procedures/roles
Emergency Mgt Guide for
 Test and update procedures
Business and Industry
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Legal Issues to Consider in
Planning for a Health Emergency
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What is the legal authority for:
 Undertaking actions to protect public health
and safety?
 Enforcing quarantine of infected individuals?
 Waiving legal liability to emergency workers?
 Provision of disaster services by coroners,
medical examiners, or mortuary workers?
 Access to, use of, and reimbursement for
private sector resources in an emergency?
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Legal Issues to Consider in
Planning for a Health Emergency
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What are the legal responsibilities of different
agencies/officials in emergency response?
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What is the scope of authority of different
agencies/officials in emergency response
efforts?
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How do local laws compare with state and
federal laws? What circumstances warrant early
state or federal involvement?
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Workplace Emergency Response Plans
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Workplace-specific emergency operations plan
Plan should include a bioterrorism component
Be familiar with your agency’s plan
 Who activates it and when it might be
activated
 Your responsibilities
 Evacuation plans
 Communication procedures (i.e., phone
tree/call-down roster)
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National Preparedness
1999 Initiative
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National Bioterrorism Preparedness and
Response Initiative
 1999 DHHS Initiative to prepare the nation to
respond to potential BT activity
 CDC designated lead in upgrading nation’s
public health capacity and in developing a BT
preparedness and response plan
More on 1999 Initiative...
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National Preparedness
CDC Activities
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CDC bioterrorism preparedness and
response activities
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Preparedness and prevention
Detection and surveillance
Diagnosis and characterization of biological
and chemical agents
Response
More on CDC program...
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National Preparedness
CDC Activities, cont.
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CDC bioterrorism preparedness and
response activities
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Education and training
Improved communication systems
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Health Alert Network
Laboratory Response Network
National Pharmaceutical Stockpile
More on CDC program...
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National Preparedness
Other DHHS activities
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Medical Consequence Management: HHS
Office of Emergency Preparedness (OEP),
expanding efforts to develop medical response
capabilities at local and national levels
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Community Preparedness
Role of Public Health
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Coordinate preparedness and response
activities
Requires collaboration with medical
professionals, first responders, and other
partners
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Provide information to health professionals,
government leaders, and the public
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Community Preparedness
Role of Public Health
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Detection and evaluation of biological disaster
 Requires robust surveillance, epidemiology, and
disease investigation infrastructure, plus new
detection methods
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Facilitate medical management of exposed
persons
 Provide information on diagnosis, treatment,
prophylaxis, and infection control issues
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Community Preparedness
Role of Public Health
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Coordinate and engage state and federal
resources
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Education, training, and information
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Surveillance, disease case and outbreak
investigation
Public Health Preparedness and
Response Capacity Inventory
http://www.phppo.cdc.gov/od/inventory 29
Community Preparedness
Role of Public Health
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Inventory and address deficiencies in regional
resources
 Hospital response capacity/preparedness
 EMS/first responder capacity/preparedness
 Mass treatment and prophylaxis
 Mortuary capacity/preparedness
 Law enforcement/security
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Summary of Key Points
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BT preparedness and response requires
coordination between public health, clinicians,
emergency management, first responders, and
law enforcement officials.
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The Incident Command System is a hierarchical
and unified system of managing an emergency
response involving single or multiple agencies.
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All agencies should include a bioterrorism
component in their overall emergency response
plan.
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Summary of Key Points
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Emergency response planning in public health
includes:
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Development and evaluation of detection
systems
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Development and evaluation of policies and
response procedures
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Awareness of relevant laws
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Evaluation and coordination of resources
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Education and training
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Resources
National
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Centers for Disease Control and Prevention
Bioterrorism Web site: http://www.bt.cdc.gov
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Emergency Preparedness and Response
branch 24-hour notification telephone number
[(770) 488-7100]
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CDC Public Inquiry Hotlines:
English(888) 246-2675
Español (888) 246-2857
National Domestic Preparedness Office:
1-202-324-9026 M-F 8am-5pm EST
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Resources
Washington State
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Washington State Department of Health
http://www.doh.wa.gov
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Communicable Disease Epidemiology
 1-877-539-4344 - 24-hour emergency number
 (206)-361-2914
Julie Wicklund, BT Surveillance Epidemiologist
(206) 361-2881
Washington State Emergency Management
Division http://www.wa.gov/wsem/
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Resources
Emergency Management
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State Emergency Management duty officer
1-800-258-5990
Regional Emergency Coordinator,Region X
206-615-2266
FBI
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Western WA and after hrs, Statewide:
(206) 622-0460
Eastern WA: (509) 747-5195
Federal Emergency Management Agency
(FEMA) http://www.fema.gov
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Incident Command System Self-study Course
http://training.fema.gov/EMIWeb/crslist.htm
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Resources
Emergency Response Planning
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Bioterrorism and Emergency Response Plan
Clearinghouse http://bt.naccho.org/
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Washington State Comprehensive Emergency
Management Plan
http://www.wa.gov/wsem/3-map/a-p/cemp/cemp-idx.htm
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Emergency Management Guide for Business
and Industry (FEMA)
http://www.fema.gov/library/bizindex.shtm
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