2014 Preparedness Summit: Q&A with Paul Biddinger
Paul Biddinger, MD, FACEP, director of the Emergency Preparedness and Response Exercise Program at the Harvard School of Public Health, was a member of this morning’s opening panel on disaster preparedness at the 2014 Preparedness Summit. NewPublicHealth spoke with Biddinger ahead of the conference on what students and communities need to know and do to be best prepared for a disaster.
NewPublicHealth: Is it a requirement for students in graduate school for public health degrees to take at least one class in disaster preparedness?
Paul Biddinger: It is not. They have the option, but it is not a required element of what they have to take.
NPH: How do you think recent disasters have informed what students and public health staff members need to know about response?
Paul Biddinger: I think some of what students need to know has always been the case—but maybe has been underscored by recent events—which is that no matter what you do in public health you may be needed as part of the response, and whether you're working in maternal and child health or smoking cessation or HIV/AIDS, when a disaster happens it’s all hands on deck. And I think the hurricanes, the pandemic and other events have showed that often we need to reach well outside the traditional emergency response or preparedness work staff in public health, and so everyone has to be flexible, has to be able to participate in the response. I think in order to participate in the response you have to know that there is an emergency operations plan, what your role in it would be, how you would get information, to whom you would be responsible or to whom you would report. And those are things that you should know ahead of time.
I think the other thing we see when we see these wide-area disasters like we saw in Sandy, like we saw in Katrina, is the central role that public health can play in coordinating the health response—that multiple hospitals, long-term care facilities, out-patient facilities such as dialysis centers all need to be coordinated in their response to achieve the best possible health outcomes for the community. And public health is in a particularly strong place in the community to be able to help make sure that each of those individual participants is pointed in the same direction and is leveraging the community resources as best they can.
I think those things are independent of technology or social media and are really, really important. Now, we certainly are learning that messaging is no longer along the traditional media lines and is now so much broader. So certainly some person or some group of people within a health department needs to not just know the basic characteristics of good public health messaging in an emergency, but they need to be somewhat technologically facile to be able to work with social media both to gather information to know what’s happening in their communities and to push out information.
And we are also learning that communication really isn’t just a single track event, that you can’t just push information out even if you use ten different venues. That there really are different audiences within a community and whether it’s language or cultural differences you often have to release a message in several different versions and venues to really make sure you're hitting all of the community, that you're protecting all of the community.
NPH: What disaster response research are you working on currently?
Paul Biddinger: I’m working on trying to see how simulations of disaster events can be measured in order to best improve the system. Thankfully, even though there have certainly been disasters recently, most places in the country and most people have not been through a disaster and that actually makes it hard to know how well-prepared they are because they're not testing their systems if they don’t use proxy events like exercises.
So my research is trying to figure out how we measure what we see in a proxy exercise—to identify things that need improving, things that are going well, how we can aggregate the results of different exercises across regions so that we can know how well-prepared a state is, a part of the country is and what things they need to work on better. Right now that’s very subjective. We're trying to figure out ways that are reliable and valid that will improve our evaluation of the systems so we can continue to improve in the most cost-effective and health-effective way as possible.
NPH: What are the key things people in public heath need to already know once a disaster strikes?
Paul Biddinger: I’ll repeat one again, and that is to know the basic elements of your emergency operations plan wherever you work. Most people don’t know that there is a plan, most people don't know what the elements are. And before an event is exactly the right time to find out what those are.
The second recommendation is to know what your expected role is within that plan when there’s a disaster. Oftentimes people don’t really know the first two, three, four things that are expected of them when they hear there’s been an activation of the emergency operations plan, and if every worker knows that then it makes the communication and activation of the plan that much faster and easier.
The third thing I'd say is actually be prepared at home. Everyone of course has a life outside of work and a family or loved ones or pets or other things that they really care about and they will worry about or that will worry about them if they're not adequately planned for and protected during an emergency. Visit a website like Ready.gov which has great resources to help people plan, to be prepared at home so that they can be an effective part of the response and not worried about what’s happening at home.
The last thing I would say is for those that are interested, join the response. There are lots of ways to join the response outside of your day job, even when you're within medicine or within public health. You can join a local medical reserve corps, you can join a community emergency response team, a CERT team. These teams offer additional training, basic things such as CPR or first aid skills, but also communications techniques, how to operate an emergency dispensing site that may be an integral part of their health community or their community health plan.