Category Archives: Emergency Preparedness and Response
How do you prepare for the safety and health of 27,000 runners and 500,000 spectators? And how do you prepare for the unexpected—such as a terrorist attack—so that the public health response can be as swift and effective as possible?
That was the first topic of Monday's American Public Health Association (APHA) session, "Late Breaking Developments in Public Health." Mary E. Clark, Director of Emergency Preparedness Bureau at the Massachusetts Department of Public Health, presented on "Public Health and Medical Response to the Boston Marathon Bombing."
Discussing the particular difficulties of staffing an event such as the Boston Marathon, Clark noted that the route goes through 26.2 miles, crosses through eight different communities in Massachusetts and then goes straight into the city of Boston. Along the way, there are thousands of runners and hundreds of thousands of spectators.
"This presents us with medical and health challenges, as well as security challenges," Clark explained.
"This year was the 117th running of the Boston Marathon, and each year we plan this as a planned mass casualty event," Clark said. "We have to build on the work that has gone on in the 116 years before."
To do this, Clark said, the department takes at least four months of preparedness planning, with the assumption that at least 1,000 runners or spectators will need some sort of medical care.
But how did they deal effectively with the unexpected?
"We had a remarkably quick response to bombings," Clark said. She noted that less than a minute after the bombs went off, gurneys were heading to the victims. And in just 18 minutes, they were able to remove 30 critically injured spectators off the scene into ambulances. Massachusetts General Hospital received their first patient 14 minutes after the explosions.
Since the marathon bombings, though, Clark said, they have identified further needs—particularly in the areas of mental health.
"One of the key things that's happened since the Marathon is the recognition of the need for a robust mental health response,” she said. “We have created more mental health support systems for volunteers and staff.”
But her biggest takeaway from the tragedy and the response? "Lessons learned were the benefit of preparedness activities," Clark said.
"People did what they were trained to do and they did it very well."
>>NewPublicHealth will be on the ground throughout the APHA conference speaking to public health leaders and presenters, hearing from attendees on the ground and providing updates from sessions, with a focus on how we can build a culture of health. Follow the coverage here.
Severe weather is expected to impact at least four regions of the U.S. this weekend including a tropical storm in the Gulf Coast, a tornado threat in the Midwest, snow in the West and spreading fires in California fueled by dry weather. The Federal Emergency Management Agency (FEMA) has already recalled some furloughed staff to prepare for the storms expected on the Gulf Coast.
Because there is an exception during the shutdown for agencies that help protect against loss of life and property, the National Hurricane Center and the National Weather Service (NWS) are regularly updating their websites, and the NWS site has an option to search by state at the bottom of the map on the Service’s home page at weather.gov.
Other federal sites, including ready.gov, the federal disaster preparedness site, and the Centers for Disease Control and Prevention (CDC), currently say they are not adding new information, though government sites already have excellent general disaster preparedness information consumers and health departments can access. The U.S. government has a web page explaining what’s up and running and what is not, during the shutdown. If any of the weather threats become disaster situations, some of the sites may be permitted to update with specific information for individual disasters. The Weather Channel, a commercial site, is updating its information regularly.
Many agency social media feeds, including CDC’s, are not updating during the shutdown, however FEMA is updating its Twitter feed for the severe weather in the Gulf. Yesterday FEMA tweeted:
“I’ll pack the dead batteries.”
“I’ll only put what I don’t need into a duffle bag.”
“I’ll try to get the generator going without any gas.”
Not exactly smart moves in the event of a natural disaster or other emergency…but maybe not far from reality for many families. Six out of 10 Americans don't have a disaster plan and only 19 percent said they were very prepared for a disaster. A new PSA campaign from the U.S. Department of Homeland Security’s Federal Emergency Management Agency (FEMA) and the Ad Council hopes to change that.
The campaign is designed to educate and empower families with children in the household to take steps to get everyone prepared for emergencies. That means giving everyone a role and ensuring everyone knows the plan. Unfortunately, because the subject matter is difficult and weighty, some parents hesitate to even bring it up.
By showing exactly how not to approach the discussion of preparedness—the above quotes are from family members sitting around a table—the new campaign encourages parents to have honest conversations with their kids about disaster preparedness, which can inspire a sense of confidence, control and calm when an actual emergency strikes.
“Humor is important because people get their guard down when they’re engaged in message,” said Priscilla Natkins, Ad Council’s executive vice president and director of client services. “They’re laughing, they’re smiling—yet they’re listening to the content. They’re listening to what these people are saying.”
>>Read More: Go to CNN.com to read the full story and watch a video on the new PSA campaign.
>>Bonus Link: Learn more about how families can prepare for disasters at Ready.gov/kids.
As part of an effort to help make sure their residents’ health information is available after a hurricane or other wide-spread disaster, four Gulf states have partnered with six states in the East and Midwest to help relocated patients and their temporary health care providers access critical health information.
State health information exchange (HIE) programs in Alabama, Georgia, Louisiana, Florida, South Carolina, North Carolina, Virginia, Michigan, Wisconsin, and West Virginia worked with the Department of Health and Human Services Office of the National Coordinator for Health IT to create the new system. All of the state HIE programs participating in the initiative have established at least one operational interstate connection and are working with other states including Arkansas and Mississippi. The initiative uses a tool called Direct, created through a collaboration that allows for the secure exchange of health information over the Internet.
The Agency for Healthcare Research and Quality recently published a guide to help primary care clinicians connect their patients’ electronic health records to a local HIE hub and regional health information organizations.
NewPublicHealth has been conducting a series of interviews with health directors impacted by weather disasters this year. Last month marked the official start of hurricane season in the Atlantic. We recently spoke with Mary O’Dowd, health commissioner of New Jersey, which is continuing its recovery and rebuilding after Hurricane Sandy last fall.
>>Read our interview with Oklahoma Health Commissioner Terry Cline on the tornadoes that struck Oklahoma this summer.
NewPublicHealth: How far along are you in the recovery process?
Mary O’Dowd: One of the things that we’ve learned is that recovery takes years not months when you’re dealing with a disaster of the proportion that Superstorm Sandy was for New Jersey. I would say that we’ve made significant progress. Some communities have very little signs of Sandy left, others are still working to rebuild a significant amount of their property and they’re still in the process of demolition of damaged buildings and properties. Great strides have been made, much progress has already occurred, but there still is a lot of work yet to be done.
NPH: What are some of the public health endeavors you’re still engaged in for the response?
In several recent and upcoming posts, NewPublicHealth is connecting with communities that have faced severe weather disasters in the last year. New York City, for example, is continuing to regroup and rebuild after Hurricane Sandy struck the region eight months ago. The city, and its health department, recently announced several initiatives aimed at “building back better” while supporting residents still facing housing as well as mental health problems since the storm last October. Some examples are detailed below.
- The New York City Building Resiliency Task Force, an expert panel convened after Hurricane Sandy to help strengthen buildings and building standards, recently issued a report with recommendations for buildings and homes of all sizes in the city. The report recommends establishing backup power in the event that primary networks fail; protecting water supplies and stabilizing interior temperatures if residents need to shelter in place. ”Making our city’s buildings more resilient to coastal flooding and other climate hazards is a challenge that requires collaboration among government, designers, engineers, and building owners, among others,” said City Planning Commissioner Amanda M. Burden. “The Task Force's work exemplifies the kind of innovation and cooperation necessary to prepare our city for a changing climate.” To create the report, the Task Force convened over 200 volunteer experts in architecture, engineering, construction, building codes and real estate.
Millions of cell phone customers might have heard their phones let out a high pitched alarm and spontaneously shake yesterday afternoon. The mobile siren is an indication that the severe weather is threatening the area—and roughly 62 million Americans were in the path of severe weather along the East Coast yesterday, as the region was wracked with severe thunder storms, tornados and flooding.
The mobile shake, rattle and siren is a free service from the Federal Emergency Management Agency and many nationwide cell phone carriers. You can find out if you’re covered by pressing 6-1-1 on your cell phone, which is your carrier’s customer service line. Earlier this week a NewPublichealth reporter, unaware of the service, suddenly felt his phone shake and was alerted to potential life-threatening flooding along his commuting route.
The service is actually two years old, but to get consumers to pay attention to the alerts, and the threats they’re warning about, FEMA recently partnered with the Ad Council on a new public service announcement.
The specific warnings come through as text messages with no more than 90 characters. Categories of alerts include extreme weather, AMBER alerts indicating a child has been abducted, and Presidential alerts during a national emergency.
One of the best features of the service is that it automatically tunes to weather where you are, not where you’re from. Go on vacation to the Outer Banks of North Carolina from Missouri, for example, and you will get alerts, if needed, about whether out on the barrier island. That’s important. Gary Cox, health director of Oklahoma City, which recently saw devastating tornadoes that killed and injured scores of people, said among those killed and injured were travelers to the area who hadn’t tuned into weather forecasts and didn’t know to take cover.
>>Bonus Link: Read an FAQ from FEMA on the wireless alerts.
A new study from Columbia University finds that deaths linked to a warming climate may rise by as much as 20 percent by the 2020s. The study was published in Nature Climate Change, by an interdisciplinary team at Columbia University’s Earth Institute and the Mailman School of Public Health.
“This serves as a reminder that heat events are one of the greatest hazards faced by urban populations around the globe,” said coauthor Radley Horton, PhD, a climate scientist at the Center for Climate Systems Research. In fact, although tornadoes are currently trending as the most common “weather word” right now, according to the Centers for Disease Control and Prevention, extreme heat kills more Americans each year than tornadoes, hurricanes, flooding and earthquakes combined.
Cities could be hit harder than other areas, according to the new research that found that daily records from Central Park in Manhattan show that average monthly temperatures already increased by 3.6 degrees Fahrenheit from 1901 to 2000—substantially higher than the global and U.S. trends, according to the researchers, who say that cities tend to concentrate heat. Buildings and pavement soak it up during the day and give it off at night. Last year was the warmest year on record for New York City.
Resilience is about how quickly a community bounces back to where they were before a public health emergency—and only a healthy community can do that effectively.
RWJF President and CEO Risa Lavizzo-Mourey, MD, weighed in on what it takes to create healthy, resilient communities—and shared examples of some communities that have done just that—through a post on the professional social networking site, LinkedIn. Dr. Lavizzo-Mourey is one of about 300 LinkedIn Influencers. Read an excerpt of the LinkedIn post below.
It is a testament to the American spirit that less than a day after a tornado brought a 20-mile-wide swath of death and destruction to Moore, OK, public officials and residents unequivocally pledged to rebuild the community. “We will rebuild and we will regain our strength,” Gov. Mary Fallin told a news conference after viewing the devastation.
Similar assertions were made after Hurricane Sandy wiped out entire neighborhoods on the New York and New Jersey coasts eight months ago, and I am sure they will be made again after future natural disasters. I applaud the can-do determination. But I also suggest that we take a minute and think, not just about rebuilding, but creating something better. Why not rebuild communities where health and wellness is a top priority?
Imagine rebuilding neighborhoods that make healthy living an easy and fun choice, that offer more places to safely walk or bike, more open spaces where families can exercise and play, and more restaurants that offer healthy choices and provide nutritional information on their menus.
This is not just some do-gooder’s pipe dream. New Orleans has shown us that it can be done.
Aiding in the response and recovery effort in Oklahoma following last week’s tornadoes are several state disaster medical assistance teams (DMATs), requested by Oklahoma governor Mary Fallin. The New Mexico DMAT includes a member, Cliff Rees, who is experienced in law as it pertains to public health emergencies. Rees is the practice director of the Network for Public Health Law’s Western Region.
NewPublicHealth spoke with James G. Hodge, Jr., JD, LLM, Principal Investigator/Director of the Network for Public Health Law’s Western Region, about how knowledge of law during an emergency can help speed assistance to victims.
NewPublicHealth: What is Cliff Rees’ role on the ground?
James Hodge: As a member of the DMAT team, he is well trained in many areas of response and is working with his team to provide needed assistance on multiple fronts. However, Cliff is also capable of assessing legal concerns on the ground if they come up.
NPH: What are some of those concerns?