Emergency Planning: The Galveston National Laboratory Joan E. Nichols PhD University of Texas Medical Branch Associate Director GNL Galveston, Texas
GNL Emergency Preparedness There is always the possibility of a public health emergency such as a natural disaster, act of terrorism, or disease outbreak Do Risk Analysis Develop a plan Personal, University (local), Healthcare facility, Research, Community, etc. Determine communication plan Provide training and education Drill Scenarios
Welcome!
Biosafety Levels 2-4 BSL-4 (Ebola, Crimean Congo Hemorrhagic fever) BSL-3 (SARS, West Nile viruses) BSL-2 (Hepatitis C and Influenza viruses)
BSL4-Highly infectious agents no vaccines or antiviral therapies. These agents cause life-threatening disease in humans and/or animals Personnel wear a space suit. Nothing leaves the laboratory without complete disinfection. GNL BSL4 Examples: Ebola virus, Lassa virus, Nipah virus, Marburg
The UTMB/GNL Emergency Plan: Has a well organized approach to disaster preparedness training, communication and command structure. Has a staged approach with reduction of research, patient care, elective surgeries, etc. Covers evacuation of patients and nonessentials. Contains plans for securing facilities. Designates a team to remain with the facility number of employees, ER open, tremendous spirit of dedicated employees committed to serving the community and protecting human life. Covers plans for communication with local, state and federal officials.
The UTMB Emergency Plan: Is not a hurricane plan It is about Emergency Preparedness. In Galveston our major worry is storms. We could be discussing earthquakes, flashfloods, tornadoes, etc.
UTMB s Complete Risk Analysis: EVENT PROBABILITY RISK PREPAREDNESS TOTAL HIGH MED LOW NONE LIFE THREAT HEALTH/ SAFETY HIGH DISRUP- TION MOD DISRUP- TION LOW DISRUP- TION POOR FAIR GOOD SCORE 3 2 1 0 5 4 3 2 1 3 2 1 NATURAL EVENTS Hurricane X X X 30 Flood, Storm Surge X X X 30 Drought X X X 24 Extreme Heat X X X 24 Disease Outbreak / BT X X X 20 Severe Thunderstorm X X X 9 Tornado X X X 8 Earthquake X X X 8 Urban Fire X X X 8 Ice/Snow X X X 6
Other Risk Items HUMAN CAUSED EVENTS MCI Hazmat/Chemical Release (External) with Mass Casualty Mass Casualty Incident (eg Active Shooter Infant Abduction Hostage Situation / Armed Suspect / Active Shooter VIP Situation Civil Disturbance Bomb Threat Labor Action Forensic Admission TECHNOLOGICAL EVENTS Electric Power Failure HVAC Failure Water Supply Failure Fire Alarm Failure Structural Damage Steam Failure Generator Failure Information Systems Failure Sewer Failure Fire, Internal Elevator Failure Medical Gas Failure Unavailability of Supplies Medical Vacuum Failure Telephone Failure Hazmat Exposure, Internal Flood, Internal Fuel Shortage
Critical Communications Outside UTMB- GNL Local Galveston community (CAB and CLC) Greater Houston community National International Emergency services Local, state and federal government Regulatory agencies Education/information: Meet the public and give talks Give tours and let people see the facilities
Biocontainment Risk and Assessment Committee A partnership of all those in the UTMB community involved in biocontainment. Plays important role in Emergency Preparedness for biocontainment operation Composed of : Research Faculty Environmental Health and Safety Staff Administration Representatives Facilities Staff ARC Staff Biosecurity/Legal Representative Physical Security Representatives Biocontainment Lab Directors
Emergency Weather Planning During Storm Season Monitor storms as they form. Coordinate travel plans with Biocontainment team. Plan for long term experiments or critical experiments. Communicate any problems or issues with equipment or facilities immediately. Review and update SOPs for weather emergency.
Emergency Weather Plan Phased Shut Down Occurs when Galveston is a potential target. Terminate experiments in process. Decontaminate all work areas. Store all infectious materials. Move non-infected animals to safe areas. Pack freezers not on generator power with dry ice. Move critical pathogen stocks to storage areas.
Hurricane Rita September 2005
Lessons learned from Rita Improve ties that hold air units on roofs of buildings. Shut off steam lines to autoclaves. Switch off incubators. Raise temperatures of freezers to -60 o C. Improve communications satellite phones? Incident command includes BRAC on weather updates.
Hurricane-Ike September 2008
September 12: Coastal Flooding/Storm Surge Before Ike s Landfall
Hurricane Ike September 13, 2008
Post Hurricane Ike
Immediately after the Storm Basic services to campus restored power, water, sewer and natural gas. Cleaning and Restoration began immediately 400 contract workers on campus one week after Hurricane Ike landfall. E-1 s command structure rotating buddy system to maintain site. Top priority of taking care of employees, students, patients field mess, EAP, web site, relocation of students and opening clinics off-island to care for patients.
Select agent regulations, Post Ike UTMB Responsible Official telephoned CDC on to confirm that UTMB select agent inventories were safe. Health and Safety contacted CDC by telephone to confirm that UTMB select agent inventories were safe. ONCE AGAIN ADDRESSED FOUR QUESTIONS Did we have any facility damage? Some Did we have any loss of biocontainment? No Do we have any release of agent? No How long will it take us to become operational?
Storm Track Time Line TS Gustav forms H Gustav reforms TS Gustav landfall TS Ike forms H Ike track targets TX H Ike landfall GNL to normal power Clean up Evaluate EQ losses Salvage equip Return services Students return to classes Gustav Slow down in BSL 3/4 No new Expts 8/25 8/29 9/1 9/3 9/10 9/12 9/13 9/20 9/27 10/3 10/10 10/17 10/24 IKE Slow down in BSL 3/4 No new Expts Move to closing all BSL 3/4 Labs Finalize animal and pathogen moves Final clean up all BSL Labs Shift insectary Stabilize Research Areas Emergency power Animal care Emergency supplies Staged Re-opening of Research Labs started 10/20/08
Check Lists Emergency supplies Freezer forms Note if dry ice use is acceptable. Freezer keys Unlock freezers or leave a key with Joan Nichols. H & S Forms for doors Essential Equipment on Emergency Power for Freezers-Refrigerators Unplug all other equipment. Update your lab contact information with your department. Make sure new staff/students provide their information.
Change or Modify Components Opportunity to make significant changes to facilities and organizational capability by remediating areas that were problematic and providing solutions to prevent future occurrences. Raise essential services above 2nd floor in all buildings. Institute a floodgate system to protect the core areas of campus. Build new facilities for essential services like ER, blood bank, and pharmacy. Construct a central facility for the animal research center to eliminate need for transporting animals during emergencies.
Ebola Waste: One Ebola patient generates eight 55-gallon drums of waste each day.
Ebola Waste:
Summary Prepare Identify Potential Risks Assess Risk Respond Recover Have recovery plans Modify after event Mitigate