Neil Muscatiello, M.S. New York State Department of Health March 23, 2011 Bridging the Gap: Public Health and Radiation Emergency Preparedness Conference Experiences and Lessons Learned from “Empire 09” Community Reception Center

“Empire 09” “Empire 09” DOE-sponsored national level exercise RDD scenario Three phases – Phase I – First 48 hrs., tabletop format – Phase II – hrs, simulated real-time field response, including establishment of Community Reception Center (CRC) – Phase III – 45+ days, tabletop/facilitated discussion 30+ agencies (local, state, federal)

Population Monitoring Goals Identify individuals who need medical treatment. Detect radioactive contamination on the body or clothing. Assess intake of radioactive materials into the body. Remove external or internal contamination (decontaminate). Assess the radiation dose received and the resulting health risk from the exposure. Track long-term health effects.

“Empire 09” CRC Objectives Establish CRC Test CRC flow Develop and test CRC forms Develop and test criteria for bioassays and laboratory prioritization

Establishing a CRC - Participants Public Health Local DOH – Jurisdictions of simulated attack – Other regional DOH NYSDOH CDC State Fire Law Enforcement Medical Reserve Corps

Establishing a CRC POD Model – Consistent with emergency preparedness activities – Familiar to LHD staff – Separate “contaminated” from “less likely to be contaminated” quickly “Just-in-time” training for CRC job duties Resources/Equipment

Tracking and Epi Form Assess contamination in the affected population – Who is visiting CRC? – Where was individual at time of event? Consideration of “Time/Distance/Shielding”? – What symptoms are individuals presenting with? Document external contamination ~ indicators of potential internal contamination Who needs referral for further treatment/lab testing?

Bioassay Criteria Detectable external contamination in face/neck area Detectable contamination after shower Location at the time of incident 1 mile or less from the incident site First Responders Clean “clothes” provided after shower

Laboratory Prioritization Criteria Detectable contamination in face/neck area after shower Presence of open wounds, penetrating injuries, or foreign bodies Pregnant women and children (<16) First Responders to the scene who did not wear PPE

Lessons Learned Use existing resources/infrastructure (e.g. POD model) “Just-in-time” training effective Operating more than 1 CRC would be challenging Forms were generally thought to be understandable and easy to follow Don’t forget mental health

Issues…What we didn’t test… Communicating with ICP Collecting/packaging/transporting bioassays from CRC to lab Protocols for reporting lab results to individuals Distribution of radiological countermeasures? Coordination with health care providers Information on individuals who were exposed but didn’t go to a CRC

Current/Next Steps Deliverables in next FY Emergency Preparedness Grant Continuing collaboration with internal and external partners Enhance/update plans Build-out and test CRC in other areas Rad Volunteers