Building Community Resiliency: Ensuring Emergency Preparedness Medical Library Association Marriott Inner Harbor October 10, 2007 Baltimore, MD

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1 Building Cmmunity Resiliency: Ensuring Emergency Preparedness Medical Library Assciatin Marritt Inner Harbr Octber 10, 2007 Baltimre, MD Gerges C. Benjamin, MD, FACP, FACEP (Emeritus) Executive Directr American Public Health Assciatin

2 Disaster Defined A disaster is the result f a vast eclgical breakdwn between humans and their envirnment, a serius and sudden event (r slw, as in a drught) n such a scale that the stricken cmmunity needs extrardinary effrts t cpe with it, ften with utside help r internatinal aid. (frm Nji, Gunn and Lechat) Disasters require a partnership between lcal, state and federal gvernment.. - and the cmmunity -

3 Disasters Cme In Many Frms: What Nature Des T Us Trnads Midwest Tsunami In Asia / Africa Influenza 1918 Texas Plant Fire, May 01, 2002, CNN

4 Disasters Cme In Many Frms: What We D T Each Other Gencide in Darfur, Sudan September 11, 2001 Baltimre Sun Phts 09/12/01 War in Iraq

5 Disasters Cme In Many Frms: What We Dn t D Hurricane Katrina/Rita September 2005

6 Defining Preparedness A prcess nt a pint in time! Always ask - Prepared fr what? Can use real life events t measure preparedness Drills are an essential activity Baltimre Sun Pht 04/29/02 Gal: T g frm chas t cntrlled disrder

7 APHA Natinal Pll Results Mst peple are unprepared fr a public health crisis & they knw it. 32% have taken n special steps 87% nt enugh steps 40% less prepared than in the past Many peple believe that they are mre prepared than they actually are. Only half have a three day supply f fd, water & medicatin The term public health crisis des nt resnate with peple. Yet they are cncerned abut events that culd lead t ne. Vulnerable ppulatins remain f special cncern Peter D. Hart Research Assciates, Inc., fr APHA, Feb 2007

8 APHA Natinal Pll Vulnerable Ppulatins Mthers with kids in husehld Lcal fd banks Hurly wage wrkers & emplyers Schls servicing kids kindergarten 12 th grade Individuals with chrnic health cnditins Mirrrs general ppulatin but has special needs 58% f mthers n 3 day supply f water 61% f peple with chrnic cnditins have at least a tw day supply f medicatins Only 18% f emplyers culd cntinue t pay all emplyees if peratins were interrupted Only 15% f hurly wrkers have enugh mney saved t prvide fr their family in such an event. Peter D. Hart Research Assciates, Inc., fr APHA, Feb 2007

9 Building Cmmunity Resilience Gal f A Resilient Cmmunity In a Disaster, a resilient cmmunity shuld be able t mitigate the risks t individuals, families, and the cmmunity as a whle frm preventable, serius health threats

10 Preparedness Capacities: Building A Resilient Cmmunity Planning Educatin Individual / Family preparedness Public health respnse General Infectius utbreaks Envirnmental Hurricanes / Trnads Flds Snwstrms Earthquakes Terrrism Bilgical Chemical Explsins Nuclear / Radilgical Recvery

11 Preparedness Capacity: Planning Activities Cmmunity engagement in lcal emergency planning Planning activities Individual & family plans Business cntinuity plans Schl emergency plans Health system plans

12 Cmmunity Awareness & Educatin Plan awareness Engage in drills Media advcacy Mre than a gvernmental respnsibility

13 Individual / Family Preparedness Family plan Learn first aid Get health insurance Get medical hme Becme health literate Learn hw t get care Medical recrds & histry Immunizatins up t date Family emergency cmmunicatin plan

14 Cmmunity Preparedness First respnders Healthcare system Cre public health respnse Infectius threats Envirnmental Terrrism Cmmunity engagement

15 Emergency First Respnders On scene individuals Plice Fire EMS Emergency managers Health prviders Public health Other gvernment agencies Lcal Federal Vluntary rganizatins Red Crss Citizens crps Initial respnse is lcal Then scales up

16 Cre Public Health Respnse Emergency care Evacuatin Nursing care at shelters Secure perishable fds Ensure ptable water Prvide medical care Basic sanitatin Disease & vectr cntrl Vaccinatin (e.g. tetanus) Mental health supprts Safety net primary care One cmpnent f verall emergency respnse

17 Public Health Respnse: Disease surveillance Labratry capacity Disease cntrl Mass vaccinatin Antiviral distributin Expsure reductin, scial distancing Health system surge capacity Patients, wrkfrce, supplies & equipment, space Risk cmmunicatin Mrtality management Rutine health management Crdinatin: Lcal, reginal, natinal Fr Infectius Threats

18 Cmmunity Respnse: Implement Scial Distancing Strategies Vluntary hme curfew Suspend grup activity Cancel public events Clse public places Suspend public travel Restrict travel Snw days Nn-essential wrkers ff Wrk quarantine Crdn sanitaire Islatin Separatin f infected persns Usually in a hspital setting (Other settings may be difficult) Quarantine Restrictin f persns presumed expsed Cmmunity r individual level Primary hygiene: Hand washing & cverage f nse & muth Barriers: Surgical Masks vs. N - 95 Masks

19 Cmmunity Respnse: Manage Scietal Disruptin Cntinuity f gvernment Business cntinuity Access t fd, water Transprtatin Public safety Trash, sanitatin Gds & supplies Services Critical infrastructure

20 Cmmunity Respnse Capacity: Prvide Human Services Fd & Water Husing Hygiene & sanitatin Scial supprt systems Treatment & prphylaxis fr disease Disease mnitring Dependent care Cmpensatin & liability issues

21 Cmmunity Capacity T Recver: Related T Scial Determinants Pverty Jb availability Husing Envirnmental cnditins Health infrastructure Chrnic health needs Mental health big prblem Educatin Helplessness and Hpelessness Discriminatin View yur pre-crisis wrk as a determinant f recvery speed

22 Directly Engaging The Public T Create Cmmunity Resilience APHA is creating a natinal mvement fr all Americans t be able t prtect themselves, their families, and their cmmunities frm preventable, serius health threats Prtect, Prevent, Live Well

23 First Campaign: Get Ready (Pandemic Influenza Preparedness & Emerging Infectius Diseases) It is cre public health A wave f activity exists Invlves many partners Engages the public Few fcused n the public & we add value Web site: Flu blg:

24 Value f A Library APHA & The Great Pandemic Flu The Cmmittee f the American Public Health Assciatin (A.P.H.A.), believing the disease extremely cmmunicable, strngly advcated legislatin that wuld prevent the use f cmmn cups and utensils and wuld ban public cughing and sneezing. The A.P.H.A. implred the public t develp the habit f washing their hands befre every meal and paying special attentin t general hygiene. They cautined that nervus and physical exhaustin shuld be avided and encuraged expsure t fresh air. A mre cntrversial methd f flu preventin, disputed by the A.P.H.A., invlved gargling with a variety f dubius elixirs. Varius physicians advised rinsing with everything frm chlrinated sda t a mixture f sdium bicarbnate and bric acid. APHA cmmittee n pandemic influenza Frm JAMA - December

25 Natinal Public Health Week 2007 Preparedness & Public Health Threats l l l l l Mnday-Addressing the unique needs f mthers with children in the husehld Tuesday-Addressing the unique needs f lcal fd banks Wednesday-Addressing the unique needs f hurly-wage wrkers and emplyers Thursday-Addressing the unique needs f schls serving children in kindergarten thrugh 12 th grade Friday-Addressing the unique needs f individuals with chrnic health cnditins, with a fcus n diabetes, asthma, cancer and high bld pressure

26 Gerges C. Benjamin, MD, FACP, FACEP (Emeritus) Executive Directr American Public Health Assciatin Prtect, Prevent, Live Well