1. COMMUNITY DISASTER RESPONSE- Your Role Ronald R. Blanck, D.O. LTG, USA (Retired)

2. Disaster? What Disaster? In My Community? Why should I get Involved? How do I participate?

3. Four Horsemen of the Apocalypse Conquest War Famine Death (Pestilence)

4. THREATS THREATS Hurricanes Tornados Floods Explosions Chemical Release …and more

5. WMD : Significant casualties from terrorist use of:  Chemical Device ● Tabun (GA) ● Tabun (GA) ● Sarin (GB) ● Sarin (GB) ● Soman (GD) ● Soman (GD)  Biological Device ● Botulism Toxin ● Botulism Toxin ● Anthrax ● Anthrax ● Plague ● Plague ● Ricin ● Ricin  Large Conventional Explosive Device  Nuclear Device

7. And, of course…… Naturally occurring infections Influenza- immediate threat ….. And more

9. AVIAN INFLUENZA- H5N1 Situation Report 438 human cases, 262 deaths in 15 countries* 36 countries documented H5N1 in birds for the first time in 2006, bringing the total to 55 countries Spread via migratory birds and movement of birds through trade or smuggling No evidence of sustained, efficient human-to- human spread *As of August 9, 2009

11. Swine Influenza- H1N1 Situation Report Over 182,166 cases, 1799 deaths* H1N1 includes gene segments from swine, bird and human flu strains Highly contagious- person to person transmission Young people especially susceptible *As of August 13, 2009

12. Threats Are Real…… Disasters are possible in your community Your involvement is important You have needed expertise There is social responsibility/moral imperative

13. Your Role Awareness- special community circumstances (e.g. flood zone, chemical factory) Education Participation Planning Preparation Execution Reconstitution

14. Education Disaster Life Support courses Literature (e.g. Subbarao et al “A Consensus-based Educational Framework and Competency Set for the Discipline of Disaster Medicine and Public Health Preparedness”) Web sites for CDC, DHS, DHHS, etc.

15. Planning Template

16. National Disaster Life Support Foundation Course Information Basic Disaster Life Support™ (BDLS®) Advance Disaster Life Support™ (ADLS™) Core Disaster Life Support™ (CDLS™) eBDLS - e-Basic Disaster Life Support

17. Disaster Life Support Courses BDLS- targeted to multiple disciplines, from first responder on- multidisciplinary ADLS- advanced practicum focusing on community planning with exercises CDLS- 4 hour awareness course NDLS-D- training in dealing with casualties from chemical or radiologic event ADLS- Instructor- additional education to teach ADLS eBDLS and eCDLS- on-line versions

18. Participation Local Regional National International But like politics, all disaster response and thus preparation is ultimately local and community-based.

19. Health Departments Boards of Health Health Care Systems/Hospitals/Clinics Medical Retiree Groups Emergency Management Local Emergency Planning Committees (LEPCs) Police and Fire Departments Community-Based Disaster Groups Healthcare Outreach Coalitions Retired and Senior Volunteer Programs Schools and Universities Emergency Medical Services Military Organizations/National Guard Neighborhood Associations City Attorney Offices Local Businesses/Corporations Others… Local Partners and Resources

20. Major groups to approach… Medical Societies Public Health Departments City/Town Government Hospitals

21. U.S. Department of Health and Human Services Office of the Surgeon General Medical Reserve Corps 101

22. MRC Concept Establish groups of volunteers with interest in strengthening local public health system and providing help in emergencies Organize/utilize locally Integrate with existing programs and resources Identify, credential, train and prepare in advance Include medical and public health professionals, and others

23. MRC Concept Foster Community Resiliency! –Get all response partners to the table with a common goal –Strengthening the “everyday” public health system will improve community preparedness Prepared Communities → Prepared States → Prepared Nation

24. Status - Current Local Units Visit the MRC website http://www.medicalreservecorps.gov/FindMRC.asp to find up-to-date information on the MRC unit in your community.

25. How Can an MRC Benefit Your Community? Resiliency – not as reliant on state and national resources Meet identified health needs/gaps Bolster public health and emergency response infrastructures Give community members an opportunity to help make their communities healthier and safer Provide mechanisms for information sharing and coordination between partner organizations Allow for national recognition of local public health and emergency response efforts

26. Health Departments Boards of Health Medical Centers/Hospitals Medical Societies Emergency Management Citizen Corps Councils Police/Fire Departments Volunteer Centers Faith Based Organizations Regional Planning Groups Medical Societies Non-Profit Community Organizations Others … Sponsor Organizations

27. Roles MRC members can have a profound impact on the health and safety of their community Examples:  Serve as MRC leaders  Provide medical care, administer vaccines and dispense medications  Provide health education as part of a local public health initiative  Provide counseling for victims, families and responders  Promote preparedness  Provide administrative, logistical and communications support

28. Recent MRC Activities: Support Existing Public Health Resources Natrona Co (WY) MRC – Firefighter Rehabilitation Trailer Ongoing. When the fire department is called out to a fire, the NCMRC follows the fire units out with their trailer. The NCMRC provides rehabilitation services to the fire fighters and medical support staff. Over the last year the NCMRC has responded with their trailer at least 5 times – once for an 8-day response to the Jackson Canyon Fire (expending over 339 volunteer man hours). Nebraska/ Western Iowa (NE) MRC - College World Series 2005 and 2006. Provided medical care during the both World Series events. Virginia Beach (VA) MRC – Flu Vaccination Clinic for Homeless 1/25 & 1/26. Virginia Beach Department of Human Services does a homeless Count each year in Virginia Beach. The VB Health Department asked the MRC to assist with the provision of flu shots to the homeless. Five MRC nurses were activated from 3pm- midnight on 1/25 and 8am- 11am on 1/26 to give flu shots and take blood pressure. Volunteers sometimes worked without heat in the three tents set-up for the event.

29. How To Volunteer with a Local MRC Get in touch with local unit If there is no unit in your area, talk to local leaders (i.e. health department, board of health or emergency management agency) about starting an MRC unit in your community

30. Finding A Local MRC - 1 1.Visit Find MRC UnitsFind MRC Units 2.Select a state and click Go…

31. How to Partner with a Local MRC Contact the unit coordinator to learn what roles have already been identified for volunteers Work with the local unit to determine how you can partner with the local unit –Additional types of volunteers would be needed, what training would be needed/could be provided –Other types of resources MRC may need –Incidents you may need MRC to respond to

32. How to Establish an MRC Unit Determine/assess community needs Partner with local key stakeholders to organize and establish an MRC unit that is right for your community Consult the MRC Technical Assistance Series – a guide to get you startedMRC Technical Assistance Series Talk with other MRC units in your region – they have valuable information on what is takes to start an MRC Contact Regional and State MRC CoordinatorsRegionalState

33. For More Information: MRC Program Office: Tel. (301) 443-4951 MRCcontact@hhs.gov www.medicalreservecorps.gov MRC Regional Coordinators: http://www.medicalreservecorps.gov/Coordinators/Regional MRC State Coordinators: http://www.medicalreservecorps.gov/Coordinators/State

34. Example…Community Preparations for an Influenza Epidemic Most immediate threat Need an integrated plan Healthcare expertise a must Risk communication critical

35. The Influenza Situation Today Our best countermeasure – vaccine – will probably be initially unavailable during the first wave of a pandemic, then available in limited amounts Antiviral treatment may improve outcomes but will have only modest effects on transmission Antiviral prophylaxis will have more substantial effects on reducing transmission Infection control and social distancing should reduce transmission, but strategy requires clarification

36. Lessons learned

37. LESSONS LEARNED 1

38. Available Evidence Suggests Community Actions Effective Early and Uniform Implementation of: Closing schools Keeping kids and teens at home Social distancing at work and in the community Encouraging voluntary home isolation by ill individuals and voluntary home quarantine by the household contacts Treating the ill and providing targeted antiviral prophylaxis to household contacts Implementing measures early and in a coordinated way

39. LESSONS LEARNED 4 LESSONS LEARNED 4

40. Disaster Response Your role is to get involved You can make a difference- perhaps the difference Threats are real, but we can deal with them if we plan and prepare