Public Health s Response to the Oso Mudslide Gary Goldbaum, MD, MPH www.nwcphp.org/hot-topics Polling Question Does your agency have a mass fatality plan? 1
Polling Question Has your organization developed strong relationships with the emergency management agencies and other responders in your area? Polling Question Does your organization have a staffing plan to manage a prolonged event? 2
Objective Share what we learned about: Public health s unique roles during a disaster Significant challenges to effective disaster response Saturday, March 22, 2014 At 10:37AM on 3/22/14, a landslide occurred near Oso, WA. The mile-long slide completely stopped the flow on the North Fork of the Stillaguamish River, covered a section of SR 530, and limited access to Darrington, WA. 3
Snohomish County Map Aerial View of the Slide Photograph by Gordon Farquharson, APL-UW 4
Slide Area Map Slide Model 5
Initial Questions How big is the slide? How many people were in the slide area? How many are injured? Missing? Dead? To which hospitals were the injured taken? Does the medical community have sufficient capacity to manage injuries? What hospital surge and coordination is needed? Sunday, March 23 Casualty Status: 7 confirmed dead 8 reported injured 54 unaccounted for and possibly growing Damage Overview: Estimated 30-38 homes damaged Many responders in the field Many untrained volunteers 6
View of SR 530 Mudslide & Flood View of SR 530 Mudslide & Flood 7
Volunteers & Professional Responders Work Side by Side Washington National Guard photo by Air Force Maj. Tawny Dotson Initial Public Health Actions Activate Disaster Management Coordinating Center (DMCC) at Providence Call area hospitals to find out where injured individuals were taken Activate Medical Reserve Corp volunteers to support Emergency Operations Call Center Activate Emergency Support Function 8 (ESF8) 8
Snohomish Health District Emergency Operations Center Arlington Incident Command Post 9
Onsite Command Post Medical/Veterinary Issues Support Medical Examiner (ME) staffing Help ME get identifying information on missing persons Request additional ME personnel through Pierce County & State Federal Disaster Mortuary Operational Response Team (DMORT) Community access to medical care Veterinary Services For response animals (search dogs) if hurt or ill Recovery of animal remains 10
Hospital Tent for Body Handling Canine Response Teams Photograph source: FEMA 11
Mental Health Issues Different populations: Survivors & families of missing Responders Community Who can provide services? ME Office usually, not here Incident response teams brought support (Critical Incident Stress Management) Red Cross, Green Cross, local human services for community Environmental Health Issues Flooded houses Possible mold issues Proper cleaning Likely damaged septic systems Responder risk? Unsure of chemicals/hazards in the mud Responder risk? Assuring proper debris removal 12
View of SR 530 Mudslide & Flood Photograph source: FEMA 13
Environmental Health Issues (cont.) Sporadic cases of diarrhea On-site exposures? Foodborne illness? Need for long term water testing Testing for home wells & surface water Funding (initial estimate $100,000)? Technical assistance where personal property collected & cleaned for return to families 14
Worker Safety Personal protective equipment Heavy rubber boots, full waders, gloves, helmets Masks not required Personal hygiene Surveillance Active reports from field medical units Passive reports from community providers Decontamination Acute care Federal medical units on-site Staging Area 15
Hand Washing Station 16
Decontamination Station 17
Decontamination Station Decontamination Station 18
Public Messaging Multiple agency coordination issues Unclear as to the role of the Joint Information Center (JIC) and Emergency Support Function (ESF) 15 Create messages? Push out messages created by responding agencies? Coordinating local messages with State and Federal messages Public Health s Many Roles Worker Safety & Health Environmental Monitoring & Technical Assistance Assuring Medical Response Capacity Public Messaging 19
What We Learned (Again?) Confusion unfolds quickly Events rarely follow plans Expect new responsibilities Medical examiner & veterinary? Mental health & worker safety Volunteers can create challenges Environmental health core Relationships key Next Time Solidify relationships & agency roles early Place public health liaison on-site Manage internal communications directly (not via JIC) 20
Questions? Photograph by Kurt Hilt 21