Unless you’ve been living under a rock lately, you should be quite aware of the headlining threat in public health and public safety – Ebola hemorrhagic fever. Ebola has been in existence for quite a while, but the current outbreak of this deadly virus in western Africa has garnered much attention. Thus far, beyond western Africa, infected persons have been identified in Spain and the United States. The ease and frequency of air travel, combined with the virulence of Ebola have led to a frenzied reaction by politicians, the media, and our health care system. While we are at a stage in the US where only a handful of infected persons have been identified, this virus is quite dangerous and could easily and rapidly spread.
While I’m not a public health expert, preparedness is universal. Public health is at the tip of the spear for this fight and must be supported by other professions within public safety and beyond – that’s what emergency management is all about. That said, this is proving to be quite a test for our public health partners. The consequences of failure could be devastating.
Considering the five mission areas, we are most strongly functioning within Prevention, Protection, and Response for Ebola. Certainly the three common Core Capabilities of Planning, Operational Coordination, and Public Information and Warning are all fully engaged across the three mission areas. Additionally, we are seeing a great deal of work within in the Intelligence and Information Sharing; Screening, Search, and Detection; Public Health and Medical; and Situational Assessment Core Capabilities; along with some work in other capabilities to a lesser degree. Why is it important to recognize the mission areas and Core Capabilities? It helps to keep us focused and prompts us to examine the critical activities for each.
In which mission areas and Core Capabilities does your agency fit in?
What are you responsible for?
Are you doing it?
Do you have all the information you need to do it safely and effectively or are you waiting for public health to call and tell you what to do? I’m betting you haven’t gotten that phone call.
In a situation like this, we are seeing a lot of activity and emphasis at the Federal level through US Health and Human Services and the Centers for Disease Control. Their focus is on solving the problem in front of them. While they have people engaged in getting messages out and engaging partners, they have a lot to accomplish and likely haven’t gotten to all the stakeholders. We will hopefully see some more aggressive messaging given the circumstances that have been described at the Texas hospital where Ebola patients have been treated. So what should you do? Hopefully your agency is already in contact with your local health department to discuss both your role in the public safety system and the potential exposures and vulnerabilities you may have to Ebola. If your local health department doesn’t seem to have much information, reach up to your state health department. Don’t wait to get a call… by then it could be too late.
Very simply, we are looking at preparations for your agency’s role. These preparations, although slightly different based on the agency, apply to all agencies; from first responder agencies, to local government, K-12 and higher education schools, hospitals, private sector, and not for profits. Let’s break this down with the Preparedness Cycle:
The Preparedness Cycle – FEMA
Plans, policies, procedures – do you have them in place and up to date? Depending on the role and function of your agency you can have several of the following – emergency operations plan, emergency procedures, infection control plan and procedures, public health plan, communicable disease or pandemic influenza plan. You should engage with public health experts to ensure that your plans, policies, and procedures address everything known about Ebola. You may need to create some procedures specifically addressing issues pertaining to Ebola and your agency’s role. Do your plans, policies, and procedures link up to your agency’s critical activities for each Core Capability you are engaged in? What agencies do you need to coordinate with to be effective?
Organizing – depending on your agency’s role, you may need to make some internal changes or designations within your organization to better streamline your activities.
Training – train everyone who has anything to do with any component of the plan in what they need to do. This is a great opportunity to ensure that everyone is trained up in their role of the emergency operations plan. If your agency has physical contact with the public, training in personal protective equipment (PPE), identification of signs and symptoms, and patient care are extremely important. Given the detail of the activities and the just-in-time training, job aids will be a great help to your staff to ensure that they follow the procedures you provide for them. Don’t get caught short… communicate to your staff in what is going on, what your agency is or may be responsible for, and what they will be called upon to do.
Equipping – your staff need the right equipment for the job. Not only PPE, but the forms and databases used to record information, decontamination equipment, etc. It is extremely important that staff are trained not only in how to use equipment but to prevent contamination of equipment and prevention of cross contamination. Do you have all the equipment you need? If not, who does?
Exercising – Conduct table top exercises to talk through policies and higher levels plans to validate and become familiar with them. Identify shortfalls and correct them immediately. Conduct drills to test the skills of staff for specific activities and larger exercises – functional or full scale – to test multiple functions and plans.
Evaluating – Evaluation is a constant throughout all of the preparedness cycle. We need to evaluate every step within the preparedness cycle and make adjustments and improvements as needed. Embrace best practices and fix shortfalls. This leads directly to the next step…
Taking Corrective Action – Some corrective actions are quick and easy fixes while others can take a while or cost money above budget to address. A corrective action plan (aka improvement plan) will help you keep track of what needs to be fixed, the priority it holds, who is responsible for making it happen, and a strategy to make it happen – it’s a living document.
The preparedness cycle can be applied to any hazard, be it Ebola or a flood. With all this attention on Ebola, it’s a great opportunity to pull plans off the shelf and have discussions with internal and external stakeholders on these preparedness steps.
© 2014 – Timothy Riecker
The Contrarian Emergency Manager 