Lessons Learned from Local Radiation Shelter Exercises and Resources to Help Advance Radiation Preparedness Within Local Jurisdictions

Transcription

1 Lessons Learned from Local Radiation Shelter Exercises and Resources to Help Advance Radiation Preparedness Within Local Jurisdictions National Radiological Emergency Preparedness Conference 2016 Annual Meeting and Training Charleston, South Carolina Patrick P. Rose, PhD Wednesday, May 4 th, 205

2 A Leader In Public Health About NACCHO: The National Association of County and City Health Officials (NACCHO) represents the nation s 2,800 local health departments (LHDs) and 162,000 employees. NACCHO s mission: To be a leader, partner, catalyst, and voice for LHDs in order to ensure the conditions that promote health and equity, combat disease, and improve the quality and length of all lives. 2

3 NACCHO Radiation Project 3

4 The Threat Remains Clear And Present We cannot afford to wait for an act of nuclear terrorism or a radiological accident before working together to collectively improve our radiation preparedness, share our best practices, and raise our standards response and recovery. 4

5 Radiological Emergency Planning A Low Priority Reasons for Low or No Priority (n=150) n (%) Low risk on Hazard Vulnerability Assessment 86 (57.3) Grants are not allocated for nuclear preparedness 37 (24.7) Limited resources 93 (62.0) Little guidance for 50 mile EPZ planning 49 (32.7) Other 30 (20.0) 5

6 NACCHO s Mission: Understand The Threat 6

7 NACCHO s Mission: Mitigate, Respond, Recover 7

8 Implementing Guidance 8

9 Taking The Lead In Public Health Security 9

10 Emphasize the communication, coordination, and actions necessary to activate and execute radiation sheltering for displaced populations. A Guide To Operating Public Shelters In A Radiation Emergency 10

11 Guidance Shelter History Reviewed existing regulations and standards concerning radiation exposure and radioactive contamination to determine which ones were applicable to mass care operations. Developed to assist with planning and response efforts related to shelter operations in a radiation emergency. 11

12 Radiation Sheltering Exercises Discuss and validate local jurisdiction response plans and A Guide to Operating Public Sheltering in a Radiation Emergency GOAL: Develop a Radiation Shelter Tabletop Exercise toolkit for national release 12

13 Public Shelters In A Radiation Emergency Intended for shelter operators, planning, staff, emergency managers, and public health professionals: Establishing a Shelter Screening & Decontamination Radiation Monitoring Registration & Public Health Follow-up Health Surveillance Communicating Radiation Risk 13

14 NACCHO Radiation Sheltering Exercises Understand the effects and implications of a radiation emergency on a community outside the impacted area. Outline key considerations for establishing a radiation shelter including: location and floor plan, utility availability, background (baseline) radiation levels, workforce requirements, and health and safety of staff/residents Examine the jurisdiction s capacity to provide long-term sheltering and associated services to evacuees and displaced 14

15 NACCHO Radiation Sheltering Exercises Examine strategies and resources needed for screening, decontamination, and ongoing monitoring at a radiation emergency shelter. Evaluate strategies for decontamination resource prioritization. Understand key health surveillance considerations including: physical health, ongoing radiation monitoring in shelter, and psychological distress and impact. Identify strategies for communicating radiation risk to shelter staff/residents, general public, and media. 15

16 Two pilot sites: Callaway County, Missouri Monroe County, New York 2016 Radiation Sheltering Exercises Radiation Basics and CDC shelter guidance overview 3 Modules: Establishing a Shelter: Assessment & Activation Communicating Radiation Risks to Shelter Staff and Residents: Communication & Coordination Screening, Decontamination, Surveillance, and Tracking: Shelter Operations and Resources 16

17 Callaway County, MO Scenario A radiological dispersal device set off in St. Louis, Missouri at the Mardi Gras parade. Evacuation of potentially exposed to Callaway County 17

18 Callaway County, MO Participants State health and emergency management, county health department, first responders, humane society, city government, humanitarian organizations 23% 6% 6% 6% City Government County Humane Society State Department of Transportation 6% State Emergency Management 6% State Health Department Humanitarian Organizations 18% 12% First Responders Local/County Emergency Management 17% County Health Departments 18

19 Monroe County, NY Scenario A radiological dispersal device is set off at a Buffalo Bills game in Buffalo, New York. Evacuees are instructed to evacuate to Rochester, NY 19

20 Monroe County, NY Participants County health department, state department of health and emergency management, local and county emergency management agencies, first responders, humane society, universities 9% 9% Local/County Public Health Agency 5% 5% State Department of Health 9% 5% 5% 14% Local/County Emergency Management State Emergency Manegement Management Local/County First Responders Other Local Agencies Education Facilities 39% Hospital/Health Care Provider Humanitarian Organization 20

21 Challenges And Participants not always aware of local health department role or their agencies role Not all participating agencies were familiar with radiation and/or sheltering Some jurisdictions have radiation response plans focused on evacuation rather than sheltering displaced persons Radiation shelters need additional resources and different layouts than traditional shelters Effective risk messaging for radiation is needed for shelter staff, residents, and surrounding community 21

22 Unresolved Issues Service animals, pets, livestock, vehicles, and personal possessions need to be considered Storage and disposal of contaminated waste and water needs consideration Behavioral health resources should be incorporated but are likely limited Specific message templates and protocols for responding agencies not always developed in advance Management of ambulatory contaminated persons by EMS and healthcare providers needs clarification 22

23 Areas For Improvement There will be expanded data collection needs and coordination between state and local health departments for long-term health surveillance 23

24 What We Learned Additional radiation training are needed for responding agencies and volunteers All agencies with a potential role must participate to be aware of roles, responsibilities, and resources Collaboration and coordination between agencies pools resources and builds awareness Health surveillance data and management systems and processes need expansion All jurisdictions should have some level of radiation preparedness, regardless of proximity to power plant 24

25 National Implementation Plan Utilize tabletop pilot site evaluation feedback to improve and edit exercise materials to create nationally available templates: Situation Manual Tabletop Slide Desk Exercise Evaluation Guides Facilitation Guide 25

26 NACCHO s Radiation Preparedness Contribution NACCHO Radiation Workgroup Formed in 2014, this workgroup is composed of local, state, federal public health, emergency management, healthcare, and radiation stakeholders Developing policy statement and key considerations document for local health departments NACCHO Local Radiation Preparedness Policy Statement Provide recommendations for actions needed to address the needs for local health departments to develop effective and comprehensive radiation preparedness strategies and programs NACCHO Clearinghouse on Radiation Resources and Standards 26

27 Acknowledgements Pilot Site Participants: Dupage County, IL Cobb and Douglas Counties, GA Callaway County, MO Monroe County, NY Centers for Disease Control and Prevention: Radiation Studies Branch Radiation Injury Treatment Network 27

28 Thank You Patrick Rose, PhD Raymond Puerini, MPH 28