Public Warning and The Science Behind EM

Rescuers at the L’AQUILA, Italy earthquake.

I was completely shocked to read this article at NBC News about six scientists and a government official in Italy being convicted of manslaughter and causing criminally negligent injury for their failure to predict an earthquake in 2009.  The article doesn’t give a lot of background, including what their statements or warnings may or may not have been.  It does mention that there were several smaller quakes in the months preceding a devastating 6.3 magnitude earthquake that killed over 300 people.  It goes on to elude that the scientists (seismologists, presumably) perhaps didn’t give these smaller quakes much consideration as possible precursors to a larger earthquake.

I’m not a geologist, nor do I play one on TV, but we all know that we can’t predict earthquakes with any measure of reliability.  Here in the northeast there are plenty of small quakes, which are generally no cause for alarm.  Italy, however, is earthquake prone.  One would think that people would have in their minds that the possibility of a sizeable earthquake is always present, especially after a series of smaller earthquakes.  Unless these scientists really downplayed that possibility (which would be ludicrous in that region of the world), I just don’t see how they can be held responsible.  Some disasters we can predict, others – such as earthquakes, we just can’t.  This is a dangerous precedent that I truly hope doesn’t catch on.  There are scientists in a variety of fields that are strong partners with emergency management.  While we know that the sciences (or the human interpretation of them) are often times imperfect, we go with the best information available to drive the planning and decisions we make.  Admittedly, it’s a gamble to a degree – a darn dangerous gamble – but I challenge anyone to find a better way.  If we cry wolf every time the possibility of something occurs, the population will become complacent and ignore our warnings.  We must strive for better science, achieve better balance, and maintain common sense.

The Monster Mash – What’s with the Zombie Thing in Emergency Management?

In May of 2011 the Centers for Disease Control (CDC) unleashed its Zombie Preparedness campaign upon the world.  This campaign took off like a flesh-eating monster, encouraging preparedness throughout the nation and prompting similar campaigns in other countries.  My guess is that the CDC took a creative prompt from the current pop culture zombie craze (mostly fueled by AMC’s The Walking Dead series – yep, I’m a big fan – note: season 3 starts on October 14th) as well as from the common sense, yet tongue-in-cheek group known in Zombie Squad.  Zombie Squad, whose website says they have been around since 2003.  ZS (as they are known) “… is an elite zombie suppression task force ready to defend your neighborhood from the shambling hordes of the walking dead.” “When the zombie removal business is slow we focus our efforts towards educating ourselves and our community about the importance of disaster preparation.”

So how does this all make sense?  Actually, it fits very well.  Contrary to the other monster fad currently sweeping the globe – vampires – which seems to be intent on teenage-level love stories, this zombie business is serious, really.  The Walking Dead has spurred many conversations in on-line discussion boards and in my own home about people functioning and surviving when society has crumbled around them.  Zombieism is also a disease, so all the concepts that go with a major disease, such as transmission prevention, isolation and quarantine, treatment, vaccination, etc. all apply.

From a preparedness angle, the zombie concept works well. On the CDC website, their director, Dr. Ali Khan explains “If you are generally well equipped to deal with a zombie apocalypse you will be prepared for a hurricane, pandemic, earthquake, or terrorist attack.”  They then further encourage people to get a kit, make a plan, and be prepared.  It’s great that we’re all using the same message!  The Zombie Squad website also encourages the same.

Now how about from the prospective of emergency response and emergency management folks?  Surely, we can’t be swayed by this pop culture silliness as well?  We sure can – and I think it’s great!  For many of the same reasons explained earlier, we can draw many similarities between a zombie attack and an actual incident.  Sure, we take some liberties and we have a little fun with it, but why can’t we?  A successful exercise is one that tests our objectives, is it not?  Drawing the scenario similar to a pandemic or hazardous materials type of incident, agencies are testing objectives related to mass casualties, mass fatality management, isolation and quarantine, public messaging, incident command, crowd control, looting, disease prevention, points of distribution, etc.  So many times I had heard from those who taught me ‘the art of exercises’, that the scenario really doesn’t matter, it’s all about the objectives.  Sure, in the past we’ve always given consideration to the scenario being realistic so that the participants buy into it, but I think many can totally get into the zombie thing.  This local exercise is using the zombie theme later this month (they are even giving prizes for things such as ‘best zombie walk’ to encourage volunteers to come for this, and yes, they are holding a ‘Thriller’ dance!), and you’ve probably seen articles on National Guard and Department of Defense units using a zombie attack as their scenario.

Bottom line, it’s fun, it’s effective, and it’s a graveyard smash!

Using Layered Exercises to Add Value to an Exercise Initiative

Over the last several years, I have had the opportunity, and the pleasure, to lead and participate in some very significant exercises. For some of these larger exercises (mostly functional) we were more interested in testing objectives associated with activities which would occur 72 or 96 hours into the incident (i.e. well after the initial response phase). I’ve made the mistake of scripting (assuming) what would be accomplished in those first few operational periods in an effort to set up the players sufficiently for play starting a few days into the incident. Despite my experience, the input of others, and some dedicated writing it would be rather heavily criticized (i.e. “We would never do that!”). The end result was not only some disgruntled participants, but also skewed results. What we needed was the players to write that part of the exercise for us.

So that’s exactly what they did – or rather, they told us what to write. We accomplished this by conducting a table top exercise with the agencies who would be most heavily involved in the response for those first several operational periods. Through careful structure and injects we were able to walk away with the data we needed to create an Incident Action Plan and a detailed briefing which could be provided to the players for the functional component of the exercise. We had to allow ourselves a few weeks between the TTX and the FE to create a detailed and workable IAP (all based on the actions of the agencies at the TTX) along with the supporting information and materials they needed to help get up to speed – this document we called a ‘Ground Truth’. This methodology resulted in a far better functional exercise, allowed us to bring in first responder agencies for the table top exercise (who where actually happy getting to discuss a response beyond the first operational period), and got us a lot of bang for our buck.

The planning of these types of undertakings is a bit more complicated than just planning one exercise. First of all, you truly are planning two exercises at the same time. While obviously the functional exercise is the most complex, don’t leave planning for the TTX until the last minute as so much actually hinges on the outcome of the TTX. That said, there is still plenty of work that can be done to prepare for the fuctional exercise before the TTX occurs. Much of the MSEL can be developed, but it will need some tweaking based on the information that comes out of the TTX. Be sure to have plenty of evaluators and note takers (I know – this isn’t an official HSEEP function) on hand at the TTX to capture their discussion and actions.

I’ve led a few ‘layered’ exercises such as this and will be evaluating another at the end of this month. I’d encourage you to consider the potential value in this approach for your next exercise.

Preparedness Exercise a Best Practice

Over the last few months I’ve been working with a county health department through my role as chair of our local VOAD (Volunteer Organizations Active in Disaster).  This work has revolved around an exercise that is required of them for Points of Distribution, or PODs.  PODs, if you don’t know, are designated locations where a local health department can bring in citizens for inoculations or prophylaxis in the event of an epidemic or other severe health event.  PODs can also be used for distribution of commodities, such as food, water, or tarps, in the event of other disasters.  There exist standards of practice for PODs – from the management system (the incident command system, or ICS), to the stations the POD is organized in.  The exercises are required by way of the state and federal health preparedness grants that the local health departments receive to ensure that the plans are tested and the personnel are practiced.

Early in the planning stages for this exercise, the health department decided they would use this exercise as a way of contributing to the preparedness of the community.  They had the funding available to provide basic preparedness kits for 300 families and would use the POD stations to provide information and kit materials to those who went through it.  What a great idea!

The local health department could have done this on their own, but instead chose to invite several community partners to join them.  These included the local chapter of the American Red Cross, local Salvation Army Corps, the county Department of Emergency Services, the new Regional Volunteer Center, the County Animal Response Team (CART), and others, including the VOAD.  The partnership was hugely beneficial, leveraging the resources and talents of all participants for the exercise.  The local health department was able to obtain the kit materials and handle promotional activities such as a local commercial featuring the county executive, radio ads, local news paper mentions, and posters for print and e-mail distribution.  They also handled the on-line registration for the event.  The assisting agencies provided their expertise and knowledge of various preparedness areas, providing speakers and print materials for the event.  Our area is very culturally diverse and the assisting agencies were able to provide the print materials in a variety of languages, and some agencies provided much needed services of interpretation.

Two days before the event registration reached 300 – the cut off based on the kit materials we had available.  I’m confident that, had we the materials, we could have accepted registrations upward of 400 or even 450.  Clearly this was an indicator of an interested community and the need to do this again!

The event itself went very well, with even the host facility – who has a catering service – providing refreshments and snacks for both staff and attendees.  The schedule was tight… with only about 20 minutes being given per group to go through the POD.  Groups averaged between 15 and 20 people, and a new group was ushered in every 10 minutes (when people pre-registered for the event they chose a time slot).  There were some late comers, early arrivals, and a few walks in – all of which were accommodated with a bit of coordination.  We had parking attendants ensuring a good flow of traffic, sign in staff ensuring that people were getting in, and other staff to help folks all along the way through the POD.

Comments made by people as they went through, along with the brief surveys they took at the end, were all quite positive.  The event had local media exposure, with the county executive and health department director being interviewed, as well as some attendees.  The attendees received information on the importance of preparedness, local hazards and information, how to be alerted in the event of an emergency, information on special family needs, and, of course, the kit itself.

Many health departments conduct POD exercises by cycling volunteers through and handing out candy or breath mints – which is fine if you don’t have much funding – it still accomplishes the goal of the exercise.  Using a POD to conduct flu clinics is common practice and very functional.  This idea, though, was creative and provided an excellent opportunity to give something back to the community.  It increased awareness of members of the community and helped them to be better prepared.  Obviously we hope they will all tell their friends and family about what they learned.  We know that any future events like this would be very successful.  I absolutely encourage others to something like this – it’s a true best practice.

Tim Riecker