All Hazards Planning Edward P. Richards Director, Program in Law, Science, and Public Health Harvey A. Peltier Professor of Law LSU Law Center richards@lsu.edu

Problems with Emergency Powers Laws and Thinking Jurisprudential Overly specific Disrupts established legal precedent and legal chains of authority Creates the illusion that laws solve emergency problems Practical Real emergency problems almost never have legal solutions that only apply in emergencies

Preparing for Bird Flu Evacuation of New Orleans for Katrina All Hazards Planning Preparing for Bird Flu Evacuation of New Orleans for Katrina

Episode-based Plans "Plans to Plan" Bird flu plans Anthrax plans Bomb plans Plans to plan What you need to think about, not what you need to do No operational detail

What is an All Hazards Plan? A unified plan that, as much as possible, uses common strategies for emergency response Emergency response is built on day-to-day procedures and resources All Hazards plans are operational plans They tell you what to do, not just what to plan The public is fully informed and an integral part of the emergency response

Elements of an All Hazards Plan Analysis of common factors in the different types of emergencies Relation of these common factors to routine procedures Modification of existing procedures to incorporate elements that will be needed in emergencies Public information and education

Assumptions Behind All Hazards Planning Equipment and materiel that is not routinely exercised will not be maintained and will not function when needed Emergencies are the worst time to change procedures Public cooperation depends on pre-event education and buy-in

Transforming a Bird Flu Plan into an All Hazards Plan Example Transforming a Bird Flu Plan into an All Hazards Plan

Episode Planning: Bird Flu Plans for emergency quarantine Plans for ethical guidelines on vaccine allocation Plans for stockpiles of PPE Plans to work with public health, including an MOU that says we will play nicely Plans for how to plan to handle the SNS Maybe some training on how to put on a mask

All Hazard Planning: Bird Flu What are core problems? Protecting staff from infection Assuring adequate staff for operations What are related issues? Yearly flu pandemic Exposure to tuberculosis and other communicable diseases in the workplace

All Hazards Recommendations: Vaccinations Assure vaccination status of employees Mumps, measles, etc, which can disable a force Yearly flu Benefits Reduction in lost time from work Readiness if there is an outbreak Resolves individual and union opposition to vaccination before there is an emergency

All Hazards Recommendations: Working Sick US culture and especially law enforcement encourages people to work sick Limits on sick days Rules that you cannot be on special teams Increases the spread of diseases such as the flu in the workplace Set up criteria for exclusion of contagious workers Change work rules to eliminate punishment for being excluded so employees will not hide illness

All Hazards Recommendations: Personal Protection Key personal protection hand washing behavior limitations - handshaking, etc. goggles, masks Recommendations Train and equip all officers Use these for regular flu and other possible disease exposures Make behavioral modifications so these become routine

All Hazards Recommendations: Public Information There maybe a need to limit travel or impose home quarantine The public should be educated about all aspects of these possible limitations What is their role? Why is it important? How will essential services be provided? How will you assure families will not be separated? This will identify problematic areas and reduce confusion in an emergency

All Hazards Planning: Staffing Staffing in emergencies Any emergency that threatens the general public will threaten the employees families You have to provide for the families if you want staff to show up Develop a general plan for family issues

Evaluation: Episode Based Planning Episode based plans are invisible until there is an emergency These are very low probability events The only testing is by artificial exercises Quality control theory (Demings, etc.) You can only achieve quality through iterative improvement based on data analysis and feedback This is impossible with an episode based plan

Evaluation: All Hazards Planning All Hazards planning does fit the criteria for proper quality control Elements of the plan are in operation at all times This provides intermediate data, i.e., things to measure short of a disaster happening Improves routine operations There is almost no data on communicable diseases in most workplaces

Political Reality The public (legislature) has a short attention span and will not support emergency response once they move on to the next crisis de jure Reality Check: 23 states, including most of the most populous, have done away with mandatory childhood vaccinations Are you health department employees fully immunized? What if you had to investigate the recent mumps epidemic?

The Blind Men and the Elephant Why the Evacuation Failed Lessons from Katrina The Blind Men and the Elephant Why the Evacuation Failed

Transportation Issues Surface Causes Evacuation not triggered until too late No provision for moving folks without transportation When transport was available - school busses - there was no provision for drivers No provisions for jails and hospitals No provision for secondary evacuation form the Superdome and other facilities

Transportation Issues: Surface Solutions Better plans More modes of transportation Earlier evacuations "Manditory" evacuations All sound, but all miss the point

Transportation Issues: Root Causes New Orleans has flooded frequently Most of the land that flooded is reclaimed bay and swamp that is up to 20 feet below sea level, not historic New Orleans People lived next to levees with water 5 feet over street level every day Flood insurance was not required because it was assumed that the levees could not break

The Implications of a Real Evacuation The only reason to really evacuate is if the levees fail, which was ruled out The Superdome and shelters of last resort Delaying the call for evacuation Why? 40 years of false alarms Admitting the levees could fail would destroy the real estate values in New Orleans Routine serious evacuations destroy business

The Real Lessons from Katrina Plans based on politically unacceptable actions will not be carried out Long term prevention loses out to short term economic and political considerations Do not build in dangerous areas Require realistic risk analysis for insurance Do not downplay risks that cannot be managed

How Would All Hazards Planning Have Changed the Outcome? Focus would have been on the risks of living below sea level, not just on the evacuation Planning would have explicitly included levee failure Flood insurance Business interruption insurance Meeting appropriate life-safety codes for hospitals Personal evacuation planning Addressing these would have changed the political dynamic, allowing a proper evacuation