Emergency Preparedness UpdateEmergency Preparedness UpdateOctober 3, 2005October 3, 2005

C. Richard Packer, MSC. Richard Packer, MS

Public Health Preparedness CoordinatorPublic Health Preparedness Coordinator

Pennsylvania Department of HealthPennsylvania Department of Health

PurposePurpose

Review the preparedness role of the Review the preparedness role of the Department of HealthDepartment of Health

Discuss opportunities for school nurses to Discuss opportunities for school nurses to provide leadership in school preparedness provide leadership in school preparedness planningplanning

Explain POD’s (Points of Dispensing) and Explain POD’s (Points of Dispensing) and how they may impact your schoolhow they may impact your school

Review individual preparedness activities to Review individual preparedness activities to keep your family safekeep your family safe

Erie

C ra wfo rd

M e rc e rVe na ng o

Wa rre n M c Ke a n

Elk

C le a rfie ldJ e ffe rso nC la rio n

Fo re st

La wre nc e

Butle r

Arm stro ng

Ind ia na

C a m b ria

We stm o re la nd

Fa ye tte

So m e rse tG re e ne

Wa shing to n

Alle g he ny

Bla ir

Be d fo rd

Fu lto n

Hunting d o n

M ifflinJ unia ta

Pe rry

Fra nklin

Ad a m sYo rk

Da up hin

Le b a no n

La nc a ste r

D e l a w a r e

Be rks

Sc huylkill

M o ntg o m e ry

C he ste r

Le hig h

N o rtha m p to nC a rb o n

M o nro e

Wa yne

La c ka wa nna

Susq ue ha nna

Wyo m ing

Luze rne

Po tte r

Tio g a Bra d fo rd

C lin to nLyc o m ing

Su lliva n

C e ntre

Snyd e r

Unio nM o nto ur

N o rthum b e rla nd

C o lum b ia

C o unty He a lth De p a rtm e nts

M unic ip a l He a lth De p a rtm e nts Sta te He a lth C e nte rs

Be thle he m

Alle n to wn

Yo rk

Distric t O ffic e s

C a m e ro n

C um b e rla nd

No rthwe st No rthc e ntra l No rthe a st

So uthe a stSo uthc e ntra lSo uthwe st

Willia m sp o rt Wilke s-Ba rre

We st Re a d ingHa rrisb urg

Pittsb urg h

Pe nnsylva nia De p a rtm e nt o f He a lthC o m m unity He a lth Distric ts

Be a ve r

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Department of Health Role:Department of Health Role: Provide strategic directionProvide strategic direction Support preparedness & response Support preparedness & response Access resources to support activities = $Access resources to support activities = $ Monitor performance & accountabilityMonitor performance & accountability

Public Health Preparedness in PAPublic Health Preparedness in PA

Pyramid of Public Health Pyramid of Public Health PreparednessPreparedness

PublicHealth

Response

• Bioterrorism Emerging Infections Other Public Health Programs

SurveillanceLaboratory

PracticeEpidemic

Investigations

WorkforceInformation

SystemsOrganizational

Capacity

Essential Scientific

Capabilities

Basic Infrastructure

Strengthening Public Health Strengthening Public Health PreparednessPreparedness

Enhancing laboratory capacity Enhancing laboratory capacity Enhancing local public health capacityEnhancing local public health capacity Statewide disease surveillance: Statewide disease surveillance:

o PA NEDSS PA NEDSS o Syndromic SurveillanceSyndromic Surveillance

Public Health Preparedness in PAPublic Health Preparedness in PA

Preparedness PlanningPreparedness Planning

And Readiness AssessmentAnd Readiness Assessment

Statewide Advisory Committee Statewide Advisory Committee CHEMPACKCHEMPACK Strategic National Stockpile (SNS)Strategic National Stockpile (SNS) Cities Readiness Initiative (CRI)Cities Readiness Initiative (CRI)

PA DOH Involvement in Disaster PA DOH Involvement in Disaster Planning Planning

SNS – State and regional plans and SNS – State and regional plans and exercisesexercises

State Wide Credentialing SystemState Wide Credentialing System Beaver Nuclear Power plant exercisesBeaver Nuclear Power plant exercises PNC Park TTXPNC Park TTX Pandemic Influenza Response PlanPandemic Influenza Response Plan WMD, ICS, Bioterrorism training for PH WMD, ICS, Bioterrorism training for PH

PA DOH Response ActivitiesPA DOH Response Activities

KI DistributionKI DistributionHepatitis A OutbreakHepatitis A OutbreakSalmonella Outbreak Salmonella Outbreak Mass Flu Immunization ClinicsMass Flu Immunization ClinicsKatrina response and supportKatrina response and support

CollaborationsCollaborations

• County, Regional and State Emergency County, Regional and State Emergency ManagementManagement

• AgrAgriculture iculture • Public WelfarePublic Welfare• DEPDEP• HospitalsHospitals• Community Health Centers Community Health Centers • RCTTF’sRCTTF’s

Wa shing to n

So m e rse t

Be a ve r

Butle rArm stro ng

Ind ia na

We stm o re la nd

Fa ye tteG re e ne

Alle g he ny

La nc a ste r

D e la w a re

Be rks

Sc huylkill

Buc ks

M o ntg o m e ry

Phila d e lp hia

C he ste r

Le hig h

No rtha m p to n

C a rb o n

M o nro e

Pike

Wa yne

La c ka wa nna

Susq ue ha nna

Wyo m ing

Luze rne

Po tte r Tio g a Bra d fo rd

C lin to n

Lyc o m ingSu lliva n

C e ntre

Snyd e r

Unio n

M o nto ur

No rthum b e rla nd

C o lum b ia

Erie

C ra wfo rd

M e rc e rVe na ng o

Wa rre n

Elk

C le a rfie ld

J e ffe rso nC la rio n

Fo re st

La wre nc e

C a m e ro n

Bla ir

Be d fo rd Fu lto n

Hunting d o n

M ifflin J unia ta

Pe rry

Fra nklinAd a m s

Yo rk

Da up hin

Le b a no n

C um b e rla nd

Re g io na l C o unte r-Te rro rism Ta sk Fo rc e s

N o r th w e s te rn PA E m e rg en c y R e s p o n s e

G ro u p

S o u th w e s te rn PAE m e rg en c y R e s p o n s e

G ro u p

S o u th C e n tr a lM o u n ta in T T F

N o r th w e s t C e n tra lPA E m e rg e n c y

R e s p o n s e G ro u p

S o u th C e n tr a l PAR e g io n a l C o u n te r-

Te r ro ris m Ta s k F o rc e

N o r th C e n tra lC o u n te r-Te rro ri sm

Tas k F o rc e N o r th e a s tPA E R G

E a st C e n tr a lPA C T E

S o u th e a s tPA R T F

C a m b ria

B-NICEB-NICE

There are five categories of possible There are five categories of possible terrorist weapons:terrorist weapons:

Biological

Nuclear

Incendiary

Chemical

Explosive

What is the Risk?What is the Risk?Im

pac

t

Probability/Likelihood

NuclearWeapons

ImprovisedNuclearDevice Chemical

Biological

ExplosiveIncendiary

BIOTERRORISMBIOTERRORISM

Many experts say that it is no longer a question of whether a major bioterrorist attack will occur, but when, where, and with what weapon.

People must recognize that the threat of bioterrorism is not a curiosity, but a grim reality. “Bioterrorism Special Report”: by Robert Taylor

HoursHours

DaysDays

DELAYDELAYin Detectionin Detection

Lives LostMore

Fewer

Time is CriticalTime is Critical

Shorter Shorter (1-2 Days)(1-2 Days)

Longer Longer (4+ Days)(4+ Days)

DURATIONDURATION of Campaign of Campaign

Strategic National Strategic National

Stockpile ConceptStockpile Concept

Biological or chemical agent releasedBiological or chemical agent released Civilians may require large quantities of Civilians may require large quantities of

pharmaceuticals or medical suppliespharmaceuticals or medical supplies State/local governments have limited State/local governments have limited

funding to create maintain stockpiles funding to create maintain stockpiles HHS Bioterrorism Initiative in 1999HHS Bioterrorism Initiative in 1999

                                                 

SNS Unit of Use ContainersSNS Unit of Use Containers

Region-13 Dispensing PlanRegion-13 Dispensing Plan

County EMA Directors identified locations of County EMA Directors identified locations of POD’s in their countiesPOD’s in their counties

Population of Region-13 = 2.9 millionPopulation of Region-13 = 2.9 million One POD per ~20,000 populationOne POD per ~20,000 population Total of 113 POD’s identifiedTotal of 113 POD’s identified Locations include:Locations include:

– UniversitiesUniversities– Public facilitiesPublic facilities– Majority in high schoolsMajority in high schools

Role of the School NurseRole of the School Nurse Educate administrators and staff of the Educate administrators and staff of the

rationale and ramifications of rationale and ramifications of conducting POD operations at your conducting POD operations at your school school

Lead/participate in the planning Lead/participate in the planning processprocess

Emphasize the importance of Emphasize the importance of developing partnerships and being developing partnerships and being involved with the emergency response involved with the emergency response systemsystem

People come to where the pills are

POD StaffingPOD Staffing

Health ProfessionalsHealth Professionals– NursesNurses– PharmacistsPharmacists– Allied Health (EMS, Mental Health)Allied Health (EMS, Mental Health)

Security, Technical, Clerical, LogisticsSecurity, Technical, Clerical, Logistics ~50/shift x 2 = 100 ~50/shift x 2 = 100 100 x 113 POD’s = 11,300 staff100 x 113 POD’s = 11,300 staff

Incident Command SystemIncident Command System

Incident Commander

OperationsOperations PlanningPlanning LogisticsLogistics Finance / Finance / AdministrationAdministration

Normal Hierarchy Structure vs. ICSNormal Hierarchy Structure vs. ICS

There is not one agency that can handle all of There is not one agency that can handle all of the aspects of a major terrorist attack.the aspects of a major terrorist attack.

In Pennsylvania we are taking a “Team of In Pennsylvania we are taking a “Team of Teams” approach to meet this challenge.Teams” approach to meet this challenge.

Jonathan Duecker, DirectorJonathan Duecker, Director

Pennsylvania Office of Homeland SecurityPennsylvania Office of Homeland Security(derived from an address to the PA Private Sector Security Seminar on March 3, 2005)(derived from an address to the PA Private Sector Security Seminar on March 3, 2005)

Participating Local Participating Local AgenciesAgencies

County Emergency Management Agency County Emergency Management Agency (EMA)(EMA)Local Emergency Planning Committees (LEPC)Local Emergency Planning Committees (LEPC)

Emergency Medical Services (EMS) Councils Emergency Medical Services (EMS) Councils HospitalsHospitalsFire Depts. & HazMat TeamsFire Depts. & HazMat TeamsPolice DepartmentsPolice DepartmentsField Representatives (from DOH, DEP, & Field Representatives (from DOH, DEP, & PEMA)PEMA)

THE FEDERALTHE FEDERAL

RESPONSERESPONSEPLANPLAN

THE FEDERALTHE FEDERAL

RESPONSERESPONSEPLANPLAN

DisasterOccurs

LocalFirst

Responders

LocalFirst

RespondersCounty

Executive

CountyExecutiveAlert

RequestsAid From

GovernorGovernor

FEMARegionalDirector

FEMARegionalDirector

Informs

FEMADirector

FEMADirector

Advises

PresidentPresident

Contacts

DeclaresDisaster

DeclaresDisaster

RequestsAssistance

EmergencyResponse

Team

EmergencyResponse

Team

12Emergency

SupportFunctions

(ESFs)

12Emergency

SupportFunctions

(ESFs)Provides

FederalCoordinating

Officer

FederalCoordinating

Officer

StateCoordinating

Officer

StateCoordinating

Officer

Appoints

Sets Up

Joins

Field Operations

Disaster

Field Office

Personal PreparednessPersonal Preparedness

Keep informedKeep informed Have a planHave a plan Make a kitMake a kit Practice your planPractice your plan

Keep InformedKeep Informed

Department of Homeland Security threat Department of Homeland Security threat level: level: – What response required at work, at home?What response required at work, at home?

NOAA Emergency Alert System (EAS)NOAA Emergency Alert System (EAS)– Weather alerts: watch vs. warningWeather alerts: watch vs. warning– Newer models: restrict to geographical location Newer models: restrict to geographical location

by zip codeby zip code Local risks: Industrial, nuclear, chemical, Local risks: Industrial, nuclear, chemical,

terrorismterrorism

Have a PlanHave a Plan

Family/Employee meeting to discuss why you Family/Employee meeting to discuss why you need to prepare, establish buy in and need to prepare, establish buy in and ownership as a teamownership as a team

Common disastersCommon disasters– Fire – requires evacuation; rally point?Fire – requires evacuation; rally point?

Outside home & outside neighborhood (relative’s home)Outside home & outside neighborhood (relative’s home)

– Severe weather – shelter in place (basement)Severe weather – shelter in place (basement)– Chemical release – shelter in place (upstairs bath)?Chemical release – shelter in place (upstairs bath)?

Have a Plan (more)Have a Plan (more)

Designate out of state contact – report Designate out of state contact – report location, status, action planlocation, status, action plan– Cell phones may not function Cell phones may not function – Long distance calls may be possibleLong distance calls may be possible– Pay phones restored firstPay phones restored first– Record your out of state contact number on Record your out of state contact number on

emergency card emergency card

Make a Plan – a bit moreMake a Plan – a bit more

Utilities: how to shut off; restoreUtilities: how to shut off; restore– Gas, water, electricGas, water, electric

Family records: mortgage, vehicle titles, Family records: mortgage, vehicle titles, passports, birth certificates, insurance passports, birth certificates, insurance policiespolicies– Store in fireproof, waterproof safe that is Store in fireproof, waterproof safe that is

portable!portable!– Copies in your emergency kitCopies in your emergency kit

Evacuation or Evacuation or Shelter-in-PlaceShelter-in-Place

Airborne hazardous materials spread Airborne hazardous materials spread quickly.quickly.

Evacuation is not always the best way to Evacuation is not always the best way to stay safe.stay safe.

Staying inside your home, workplace, or Staying inside your home, workplace, or other building can be a viable alternative.other building can be a viable alternative.

If not in immediate danger, listen to the If not in immediate danger, listen to the Emergency Alert System for directions.Emergency Alert System for directions.

Home Emergency KitHome Emergency Kit(shelter in place)(shelter in place)

WaterWater FoodFood First aid kitFirst aid kit Clothing/BeddingClothing/Bedding Special items/medicationsSpecial items/medications ToolsTools Spare keysSpare keys

Employer PlanningEmployer Planning

Practice emergency plans and proceduresPractice emergency plans and procedures– Shelter in place – lockdown, secure HVACShelter in place – lockdown, secure HVAC– EvacuationEvacuation

Assist staff in developing family plans and Assist staff in developing family plans and emergency home kitsemergency home kits

Shelter in place:Shelter in place:Living at workLiving at work

Overnight accommodationsOvernight accommodations Water – extra bottled waterWater – extra bottled water Food – energy bars, granola barsFood – energy bars, granola bars

– store food in airtight containersstore food in airtight containers

Emergency blanketsEmergency blankets

How you can helpHow you can help

Personal preparednessPersonal preparedness Encourage preparedness planning at your Encourage preparedness planning at your

schoolschool Support community preparedness planningSupport community preparedness planning Get to know your county EMA CoordinatorGet to know your county EMA Coordinator

Public Health Preparedness in PAPublic Health Preparedness in PA

www.health.state.pa.uswww.health.state.pa.us

Additional InformationAdditional Information www.ready.govwww.ready.gov www.health.state.pa.uswww.health.state.pa.us www.cdc.govwww.cdc.gov www.pema.state.pa.uswww.pema.state.pa.us

– County Emergency Management CoordinatorsCounty Emergency Management Coordinators

C. Richard PackerC. Richard PackerPennsylvania Department of HealthPennsylvania Department of Health412.565.5107 x5106412.565.5107 x5106cpacke@state.pa.uscpacke@state.pa.us

QUESTIONS / COMMENTS