1. Emergency Preparedness Update October 3, 2005 C. Richard Packer, MS Public Health Preparedness Coordinator Pennsylvania Department of Health

2. Purpose  Review the preparedness role of the Department of Health  Discuss opportunities for school nurses to provide leadership in school preparedness planning  Explain POD’s (Points of Dispensing) and how they may impact your school  Review individual preparedness activities to keep your family safe

4. Department of Health Role:  Provide strategic direction  Support preparedness & response  Access resources to support activities = $  Monitor performance & accountability Public Health Preparedness in PA

5. Pyramid of Public Health Preparedness Public Health Response Bioterrorism l Emerging Infections l Other Public Health Programs Surveillance Laboratory Practice Epidemic Investigations Workforce Information Systems Organizational Capacity Essential Scientific Capabilities Basic Infrastructure

6. Strengthening Public Health Preparedness  Enhancing laboratory capacity  Enhancing local public health capacity  Statewide disease surveillance: oPA NEDSS oSyndromic Surveillance

7. Public Health Preparedness in PA Preparedness Planning And Readiness Assessment  Statewide Advisory Committee  CHEMPACK  Strategic National Stockpile (SNS)  Cities Readiness Initiative (CRI)

8. PA DOH Involvement in Disaster Planning  SNS – State and regional plans and exercises  State Wide Credentialing System  Beaver Nuclear Power plant exercises  PNC Park TTX  Pandemic Influenza Response Plan  WMD, ICS, Bioterrorism training for PH

9. PA DOH Response Activities  KI Distribution  Hepatitis A Outbreak  Salmonella Outbreak  Mass Flu Immunization Clinics  Katrina response and support

10. Collaborations County, Regional and State Emergency ManagementCounty, Regional and State Emergency Management AgricultureAgriculture Public WelfarePublic Welfare DEPDEP HospitalsHospitals Community Health CentersCommunity Health Centers RCTTF’sRCTTF’s

12. B-NICE There are five categories of possible terrorist weapons: Biological Nuclear Incendiary Chemical Explosive

13. What is the Risk? Impact Probability/Likelihood Nuclear Weapons Improvised Nuclear Device Chemical Biological Explosive Incendiary

14. BIOTERRORISM Many experts say that it is no longer a question of whether a major bioterrorist attack will occur, but when, where, and with what weapon. People must recognize that the threat of bioterrorism is not a curiosity, but a grim reality. “Bioterrorism Special Report”: by Robert Taylor

15. HoursDays DELAY in Detection Lives Lost More Fewer Time is Critical Shorter (1-2 Days) Longer (4+ Days) DURATION of Campaign

16. Strategic National Stockpile Concept  Biological or chemical agent released  Civilians may require large quantities of pharmaceuticals or medical supplies  State/local governments have limited funding to create maintain stockpiles  HHS Bioterrorism Initiative in 1999

17. SNS Unit of Use Containers

18. Region-13 Dispensing Plan  County EMA Directors identified locations of POD’s in their counties  Population of Region-13 = 2.9 million  One POD per ~20,000 population  Total of 113 POD’s identified  Locations include: –Universities –Public facilities –Majority in high schools

19. Role of the School Nurse  Educate administrators and staff of the rationale and ramifications of conducting POD operations at your school  Lead/participate in the planning process  Emphasize the importance of developing partnerships and being involved with the emergency response system

20. People come to where the pills are

21. POD Staffing  Health Professionals –Nurses –Pharmacists –Allied Health (EMS, Mental Health)  Security, Technical, Clerical, Logistics  ~50/shift x 2 = 100  100 x 113 POD’s = 11,300 staff

22. Incident Command System Incident Commander OperationsPlanningLogistics Finance / Administration

23. Normal Hierarchy Structure vs. ICS

24. Department of Health Incident Command Structure Department of Health Incident Command Structure Public Health Incident Commander Planning & Intelligence Chief Resource Status Leader Situation Status Leader Documentation Unit Demobilization Unit Operations Chief Distribution Site Director Clinical Teams Director External Site Director Logistics Chief Support Director Service Director Facilities Manager Equipment Manager Finance Chief Procurement/ Costs Time Units Documentation/ Recorder

25. There is not one agency that can handle all of the aspects of a major terrorist attack. In Pennsylvania we are taking a “Team of Teams” approach to meet this challenge. Jonathan Duecker, Director Pennsylvania Office of Homeland Security (derived from an address to the PA Private Sector Security Seminar on March 3, 2005)

26. Participating Local Agencies County Emergency Management Agency (EMA) Local Emergency Planning Committees (LEPC) Local Emergency Planning Committees (LEPC) Emergency Medical Services (EMS) Councils Hospitals Fire Depts. & HazMat Teams Police Departments Field Representatives (from DOH, DEP, & PEMA)

27. THE FEDERAL RESPONSEPLAN RESPONSEPLAN Disaster Occurs Local First Responders Local First Responders County Executive County Executive Alert Requests Aid From Governor FEMA Regional Director FEMA Regional Director Informs FEMA Director FEMA Director Advises President Contacts DeclaresDisaster Declares Disaster Requests Assistance Emergency Response Team Emergency Response Team 12 Emergency Support Functions (ESFs) 12 Emergency Support Functions (ESFs) Provides Federal Coordinating Officer Federal Coordinating Officer State Coordinating Officer State Coordinating Officer Appoints Sets Up Joins Field Operations Disaster Field Office

28. Personal Preparedness  Keep informed  Have a plan  Make a kit  Practice your plan

29. Keep Informed  Department of Homeland Security threat level: –What response required at work, at home?  NOAA Emergency Alert System (EAS) –Weather alerts: watch vs. warning –Newer models: restrict to geographical location by zip code  Local risks: Industrial, nuclear, chemical, terrorism

30. Have a Plan  Family/Employee meeting to discuss why you need to prepare, establish buy in and ownership as a team  Common disasters –Fire – requires evacuation; rally point?  Outside home & outside neighborhood (relative’s home) –Severe weather – shelter in place (basement) –Chemical release – shelter in place (upstairs bath)?

31. Have a Plan (more)  Designate out of state contact – report location, status, action plan –Cell phones may not function –Long distance calls may be possible –Pay phones restored first –Record your out of state contact number on emergency card

32. Make a Plan – a bit more  Utilities: how to shut off; restore –Gas, water, electric  Family records: mortgage, vehicle titles, passports, birth certificates, insurance policies –Store in fireproof, waterproof safe that is portable! –Copies in your emergency kit

33. Evacuation or Shelter-in-Place Evacuation or Shelter-in-Place  Airborne hazardous materials spread quickly.  Evacuation is not always the best way to stay safe.  Staying inside your home, workplace, or other building can be a viable alternative.  If not in immediate danger, listen to the Emergency Alert System for directions.

34. Home Emergency Kit (shelter in place)  Water  Food  First aid kit  Clothing/Bedding  Special items/medications  Tools  Spare keys

35. Employer Planning  Practice emergency plans and procedures –Shelter in place – lockdown, secure HVAC –Evacuation  Assist staff in developing family plans and emergency home kits

36. Shelter in place: Living at work  Overnight accommodations  Water – extra bottled water  Food – energy bars, granola bars –store food in airtight containers  Emergency blankets

37. How you can help  Personal preparedness  Encourage preparedness planning at your school  Support community preparedness planning  Get to know your county EMA Coordinator

38. Public Health Preparedness in PA www.health.state.pa.us

39. Additional Information  www.ready.gov www.ready.gov  www.health.state.pa.us www.health.state.pa.us  www.cdc.gov www.cdc.gov  www.pema.state.pa.us www.pema.state.pa.us –County Emergency Management Coordinators C. Richard Packer Pennsylvania Department of Health 412.565.5107 x5106 cpacke@state.pa.us

40. QUESTIONS / COMMENTS