Health Aspects of Evacuation and Shelter Emergency Preparedness Department of Health

“a game of two halves” Evacuation – getting people out Shelter – receiving those who have been evacuated

Evacuation The decision to evacuate What are the indications? How much notice to evacuate? How long will the evacuation be for? Will we evacuate everyone? Will we evacuate hospitals?

Who are we evacuating? Three categories :- General population Those with special needs Those in hospital or residential care facilities

General population General advice :- Need to take any medications [repeat prescriptions] Baby foods and fluids Food and fluid for the journey Special food/dietary needs The basics - a first aid kit!

Those with special needs Individuals need to be identified before evacuation Detailed plans for their evacuation made Type and size of transport for special chairs/beds Transport may not be able to make “round trips” Carers needs Arrangements made for reception and on going care Do not plan for ambulances to be available

Hospital and residential care Need as much notice as possible This will need to be a local decision Cannot rely on ambulances being available to evacuate patients Most evacuation plans are for horizontal evacuation in the event of fire No recent experience in UK of whole hospital evacuation

Hospitals and residential care Bed occupancy rates Will staff move with patients? What other facilities than hospitals can be used? Probably unable to move much kit and equipment

Receiving those evacuated Assume most care can be managed at receiving facility Need good quality triage –Hospital –Ambulatory care centre –General population primary care needs Need to treat injuries sustained in the incident or evacuation

Medical History and medication People may have no medical history or medication record with them Many will have left with no medication Need a system for dispensing prescription medication Chronic conditions may have destabilised in the incident/evacuation eg diabetes, asthma Need to have arrangements for those needing regular treatment eg Renal dialysis

Public Health Issues Sports facilities are not designed for 24/7 occupation by large numbers of people! Toilet and hand washing facilities not sufficient Use of alcohol hand scrub Microbiological safety of :- –Water supplies –Food sources

Surveillance Epidemiological surveillance can identify outbreaks of communicable disease early Need for rapid intervention ?quarantine/isolation There may be need for mass vaccination/ prophylaxis

Risk communication Advice and behaviours need to be consistent [gloves vs full PPE] All staff should follow same risk assessment and behaviours

Mental health Risk of significant distress following event/ evacuation/uncertainty Post 7 th July Study is assessing if can identify those who will develop PTS later Need to provide as “safe” environment as possible and reduce uncertainty Ensure frontline workers can recognise symptoms [eg Family Liaison Officers}

Key Problems Morbid obesity Those requiring wheelchairs or other mobility aids People will not leave their pets!