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April 07
New Evidence-Based Planning Guidance for Patient Decontamination

Author: Susan M. Cibulsky, PhD, Medical Countermeasure Strategy and Requirements Division, ASPR Office of Policy and Planning

Large quantities of hazardous chemicals are made, transported, stored, and used in homes, offices or industrial settings every day in the United States. Even taking every safety precaution, there still is a risk that the chemicals could be released into the environment either by accident or intentionally to cause harm.

Many toxic chemicals are readily absorbed into the body and cause injury and illness quickly. Decontaminating patients can prevent or limit absorption of the chemical and minimize adverse health effects. Decontamination also can prevent the spread of contamination to other people (including responders and receivers) and to health care equipment and facilities. In fact, since it can protect health, patient decontamination is considered a medical countermeasure.

To respond effectively to an event that involves the release of hazardous chemicals, our communities’ first responders, medical providers, and public health officials need guidance based on scientific evidence on decontaminating patients in ways that improve health outcomes. Now the nation’s first draft guidance is available for comment.

ASPR and the U.S. Department of Homeland Security’s Office of Health Affairs led the effort to develop this evidence-based guidance. Joining us were experts in emergency response, emergency medicine, toxicology, risk communication, behavioral health, and other relevant fields from academic and non-government organizations and federal, state, and local agencies.

To shape and substantiate the recommendations, this working group of experts sought out and used all of the evidence available. The draft guidance covers mass casualties, chemical release, external contamination, and decontamination of people (not animals, not inanimate objects, not facilities).

In drafting the guidance, the working group recognized that the primary goal of patient decontamination should be improved health outcomes. The group also recognized that as a medical countermeasure, patient decontamination needs to be coordinated with other medical aspects of the emergency response and that patient decontamination is a whole community issue.

The draft guidance also recognizes that a risk and crisis communication strategy should be in place pre-incident to reach all community members, and that system-wide coordination is essential, especially between on-scene responders and hospital-based receivers. The working group recommended a tiered, risk-based approach which matches the nature and extent of decontamination to the characteristics of the incident.

For ease-of-use, the guidance organizes recommendations by functional components of a response. In this extensive process to develop this guidance, the working group found that more research is needed to answer many of the essential questions. So the guidance will be updated periodically as new evidence becomes available.

We’d like your comments on that draft, called “Patient Decontamination in a Mass Chemical Exposure Incident: National Planning Guidance for Communities.” The guidance can be found in the Federal Register and is open for comment through May 19. Responders and public health officials: let us know what you think.

March 31
What emergency managers can learn from emergency medicine

When a tsunami hit Japan in 2011 and crippled the Fukushima Daiichi nuclear power plant, Americans visiting or living in Japan turned to the American Embassy for information. A team of radiation, health and communications experts joined the American ambassador and nuclear power plant experts in Tokyo, Japan, to provide that information. The team used a real-time, medical decision model and now recommends that model to emergency managers as they make key decisions during an incident​​​.

Used daily in emergency medicine, medical decision-making provides timely decisions and relies on on-site subject matter experts. Decisions are made based on the best information available at the time, and these decisions are modified the course as new information emerges.

Consider the process for treating cancer. When recommending a treatment plan, doctors look at the likelihood of the treatment’s effectiveness and risk of toxicity on the patient’s overall medical condition. They consider the properties of the tumor (not all of which will be immediately known), and current scientific data. They may consult with other experts as they identify a course of action to avoid tumor growth and dissemination. Then working closely with patients and their families, doctors develop a treatment plan, initiate it in a timely manner, monitor its effectiveness, and modify its course as appropriate.

This approach contrasts to the deliberative, multistep, and more time-consuming decision-making process that waits for a great degree of certainty when more of the outcome is known before making a decision. This deliberative approach can go on in the background and provide advice and guidance. Like traditional approaches to disaster response, the medical decision model uses experts and committees for consultation and advice, but the medical decision model differs in that those experts are on-site, not “back at headquarters,” and decision makers are empowered to make time-critical decisions based on information, experience, and data from the on-site experts. Those decisions are made refined as new data becomes available.

Using the medical decision model, emergency response officials can act without undue delay using readily available and high-level scientific, medical, communication, and policy expertise. The decisions they make are appropriately modified as the information changes. Ongoing assessment, consultation, and adaption to the changing conditions and additional information play prominently in this model.

In Japan, the decisions about the health-related consequences of the disaster encompassed more than just the potential risk from the radiation, which dominated the media and public conversation. The team also had to consider risks associated with evacuation and public relocation, the impact on physical and mental health from disruptions to normal life, economic losses, and the ongoing anxiety of living through a widespread physical and economic disaster.

Using the medical decision model requires decision makers to be open and transparent with the public about what is known and unknown and that recommended courses of action may change as they learn more data becomes available. The American ambassador embraced this concept and fostered public trust and credibility as a result.

In emergency response, the medical decision model would use the same lines of command and local control abdicated in the National Response Framework. Given the central role of health and medical issues in all disasters, the model should be considered in effective management of complex, large-scale, and large-consequence incidents.

Learn more about applying the medical decision model to emergency response.

March 24
Four Ways Volunteers Can Contribute to Community Level Disaster Risk Reduction Efforts.

Author: LCDR Skip Payne, Program Officer, Division of the Civilian Volunteer Medical Reserve Corps

Do you wonder how to utilize eager volunteers when there is not an emergency? We all do from time to time. During the early stages of a disaster response, we are often inundated with resources but lack the human assets we need to accomplish the desired goals. Fortunately for us, many volunteers eagerly step up to fill the needs during the crisis.

The real struggle is not keeping volunteers busy during the immediate emergency phase of an event, but keeping enough activities flowing year-round to engage volunteers in the “off season.” Keeping volunteers busy during slow periods increases the probability that they will be with you during the “big one.” Volunteer coordinators and emergency managers should consider Disaster Risk Reduction activities to maintain the involvement of their volunteers during the off season.

Disaster Risk Reduction is defined by the United Nations as the “concept and practice of reducing disaster risks through systematic efforts to analyse and reduce the causal factors of disasters.” The stated aim is to reduce exposure to hazards and to lessen vulnerability by reducing or minimizing the exposure impact. Although reducing direct exposure to hazards arguably involves more political and social capital than any small group of volunteers may hold, reducing vulnerabilities via exposure, susceptibility, and increased resiliency is well within the reach of direct volunteer action. The following are four ways to engage volunteers in disaster risk reduction:

1. Participating in Community Assessments

Volunteers can help your community determine which vulnerability interventions and related reduction activities are reasonable. Utilizing volunteers trained to assist with established community level assessments, such as the Community Assessment for Public Health Emergency Response toolkit, can also inform Public Health’s understanding of the community’s needs.

2. Crafting the Intervention and Activities

Volunteers often have a better understanding of the subtleties of the groups with which they belong and interact. This awareness allows them to provide types of input in the planning and customization of interventions and activities that government planners may not fully appreciate. Therefore, volunteer involvement can assist with preventing negative impacts on an otherwise successful outcome through the sharing of volunteers’ insights on the community and its key players, culture, and potential risks. In addition, volunteers can bring subject matter expertise, such as veterinary, pharmacy, and program evaluation, which might not be readily available on staff at the local health department.

3. Delivering the Intervention

One difficulty encountered while delivering interventions and activities is determining how to meet people where they are within the community. Governmental agencies vary, depending upon the level and type, in the amount of public trust they garner from members of their communities. Oftentimes, governmental agencies cannot rely on positive intentions alone to carry their desired interventions forward.

Although social media and various newer technologies are bridging the gap of governmental hierarchy, it is still generally accepted that individuals place the most trust in the levels of government closest to them. Volunteers, as part of the community and acting of their own free will for something they personally support, are more likely to overcome these (actual or perceived) governmental trust barriers and to reach the communities with a targeted message. Engaging those experienced and trained volunteers will not only enhance intervention targeting and access, but may also improve the fidelity of the interventions. Fidelity, generally defined, is the best practice or the intended manner of how the intervention should be rolled out, and it supports comparability across like interventions.

4. Gauging the Effect of Interventions and Activities

Applying metrics is a necessary, but often overlooked, aspect of local public health preparedness activities that includes interventions. These metrics need to be collected and interpreted locally to gain an accurate understanding of the new circumstances; no two geographies are directly comparable, and information is lost in the comparison of the disparate populations. In order to gauge the success of an intervention, the baseline risk (determined in the community assessment) must be compared to the new, hopefully reduced, risk. Volunteers can assist in this by repeating the community assessment mentioned earlier or by participating in other intervention-related evaluation projects.

The Medical Reserve Corps (MRC) is an example of a group of volunteers already participating in a variety of ways to reduce risk and vulnerabilities in their communities. The MRC is a national network of community-based units consisting of medical, public health, and other volunteers working to improve the health, safety, and resilience of the area where they live and work. MRC volunteers have helped develop trainee evaluations of various trainings based on best practices (e.g., community mass care, medical triage, psychological first aid). MRC volunteers have also helped design a public health active surveillance system for childhood nutrition and fitness programs, dental screenings for children, and other health promotion activities.

While the preceding four points do not cover the full depth and breadth of the support that volunteers can give in community-level Disaster Risk Reduction Interventions and Activities, they will hopefully trigger some ideas for volunteer managers, emergency managers, and even potential volunteers. To learn more about Disaster Risk Reduction, you can to listen to the recorded Principles of Planning for Disaster Risk Reduction conference call hosted by the Centers for Disease Control and Prevention. To learn more about the Medical Reserve Corps and how MRC volunteers can help your community, talk to your local MRC leader. Visit http://www.medicalreservecorps.gov/FindMRC and search by your city or zip code.

March 17
Journey to First Place

Author: Ashley Small Public Affairs Specialist, Office of the Assistant Secretary for Preparedness and Response

Lt. Cmdr. Leo Angelo Gumpas and Mr. Xadean Ahmasi haven’t known each other very long. In fact, they just met last year when Leo moved into Xadean’s neighborhood. In the short span of their friendship, the two developed a potentially life-saving solution that can help communities support patients who depend on durable medical equipment (DME) during emergencies.

As neighbors, Leo and Xadean got to know one another and discovered they had a lot in common. Not only were they both single dads raising young children, but they also shared similar professional interest in technology. Leo, a proud parent of one, works for the U.S. Department of Health and Human Services (HHS) National Institutes of Health (NIH). Xadean, a proud parent of two, is the owner and principal consultant for an IT consulting firm called BizTech Fusion, LLC.

A commissioned officer in the U.S. Public Health Service, Leo also serves as a logistics and information technology officer on a team that deploys to support communities across the country during emergencies when hospitals and other parts of the local health system are unavailable or overwhelmed.

In September 2013, one of Leo’s colleagues informed him of an ASPR Idea Challenge seeking solutions on a system that, in emergencies, could determine the location and status of life-sustaining durable medical equipment (DME). Leo immediately felt the need to enter this challenge.

While deployed for Hurricane Sandy Leo had seen, firsthand, the need for this type of technology in impacted communities. He decided to reach out to Xadean to gage his interest in entering the challenge with him.

“The challenge required a merge of two heads,” said Leo. “With Xadean’s IT background and my disaster deployment experience, I felt like we could put together a good solution.”

Xadean agreed, and the two went to work. As single dads, the project required the two of them to carve out time between their busy day jobs and time with their children.

“We would work while our kids were playing with each other,” noted Xadean. “Sometimes, it would be late at night after we put them to bed.” Over a three-week period, the two worked together to develop and submit an innovative solution to Challenge.gov.

On Feb. 20, HHS announced winners of the Idea Challenge. Leo and Xadean’s submission, an internet-based solution that monitors and transmits essential information from DME devices to caregivers and responders during emergencies, had won first place!

“We were shocked but very honored and excited to win,” said Leo. “Xadean and I firmly believe a solution like this can help communities identify needs of DME patients and minimize potential risks to their health and safety during emergencies.”

Going forward, Leo and Xadean hope this idea can become reality.

“There is a lot that needs to be done before this solution is viable,” said Xadean. “But people who depend on DME really need better support in disasters, so we look forward to one day seeing our idea in practical use.”

Leo Angelo Gumpas is a Greenhouse Gas (GHG) program manager at NIH. He develops NIH’s GHG inventory and devises strategies to reduce NIH’s carbon footprint. He recently won the HHS Ignite (beta) program, an internal competition to test new and unconventional ideas at HHS. His project involved using energy meters to develop energy reduction strategies in NIH labs and to fine tune design standards for equipment loads in NIH labs to maximize energy efficiency.

Xadean is the owner and principal consultant for BizTech Fusion, LLC and has over 18 years of experience working in all major areas of Information Technology (IT). His expertise specifically includes hands-on experience managing, developing, and securing enterprise data, video, and voice communications for government, IT consulting firms, telecommunications companies, health care organizations, and financial Institutions. Xadean has led the design, implementation and maintenance of data centers, enterprise infrastructures, and unified communication platforms across a broad range of industries.

March 04
Using expert planning and an intricately woven support system to increase disaster behavioral health

Author: Rachel E. Kaul, LCSW, CTS, Senior Public Health Advisor, Division for At-Risk, Behavioral Health & Community Resilience, Office of the Assistant Secretary for Preparedness and Response

Psychologically, people respond differently to disasters. Planning for those different reactions can help individuals and their communities become more resilient in the face of a disaster.

During and after an emergency, people affected by the event—including response workers—may feel distressed or anxious about their safety, health, and recovery. People may experience grief and a sense of loss.

Most survivors recover psychologically from a disaster without formal behavioral health intervention. They have pre-existing support systems that contribute to their resilience. Some people may have more severe behavioral health reactions that hinder their recovery; they may develop psychological conditions or begin substance use or abuse or these behaviors may get worse if their needs are not addressed.

Disaster behavioral health services can help people who need it after an event through communication, education, basic support, access to clinical behavioral health services, and other tools. Disaster behavioral health seeks to increase health resilience and improve the success of emergency response and recovery.

In preparing for disasters, behavioral health activities primarily focus on planning, training, and exercising public health capabilities that mitigate the behavioral health impacts of disaster. Plans that strengthen pre-existing systems, build on the daily delivery of health and behavioral health care, and address reimbursement requirements are essential to effective disaster response.

During a response, disaster behavioral health actions often focus on supportive, strengths-based interventions such as psychological first aid, crisis counseling, risk communication, and response worker support. These interventions may be provided by behavioral health professionals, but are often also provided by paraprofessionals, other health workers, volunteers, and laypeople who have received training in basic disaster behavioral health support.

Federal disaster behavioral health officials collaborate with these entities to promote preparedness and to respond in ways that integrate behavioral health into larger public health and medical response and recovery efforts. Federal experts supplement local responders based on behavioral health needs defined by state, territorial, tribal and local agencies, and they partner in longer-term recovery efforts to promote individual and community resilience.

The latest HHS Disaster Behavioral Health Concept of Operations (CONOPS) reflects this intricately woven whole community approach to resilience that includes voluntary organizations, government, academia, and behavioral health care and professional organizations. The CONOPS goes beyond a traditional CONOPS.

The CONOPS aims to improve coordination of federal preparedness, response, and recovery efforts concerning behavioral health in a manner consistent with—and supportive of— state, territorial, tribal and local efforts.

The CONOPS is meant to be easy for agencies and organizations outside HHS to use. For these partners and for response agencies less familiar with the overall field of behavioral health, the CONOPS includes conceptual language to frame disaster behavioral health, in addition to discussing federal disaster behavioral health operational response and recovery.

The newest CONOPS adds a checklist of key disaster behavioral health activities and indicates the definitive action to be taken. New sections describe disaster behavioral health considerations and roles through each phase of the emergency, from readiness to long-term recovery. This CONOPS builds on past versions and leverages experience with the most recent emergency response and recovery operations.

Have your agency or community found ways to incorporate behavioral health into emergency preparedness, response, and recovery? Share your experiences in a comment to this blog.

February 20
Collaborating to Improve Health Information Exchange

Authors: Kevin Horahan and Tara Holland, Emergency Care Coordination Center (ECCC), HHS Office of the Assistant Secretary for Preparedness and Response

Getting a complete and accurate picture of a patient’s medical history is a challenge under normal circumstances, but it is even more difficult – and even more important - in an emergency. Take, for example, a fairly common occurrence. A woman falls and breaks her arm. Someone calls 9-1-1 and an ambulance arrives. An emergency medical technician (EMT) or paramedic provides treatment and transports her to the emergency department (ED) where she gets an x-ray and a cast. After leaving the ED, she follows up with an orthopedic surgeon and receives treatment from a physical therapist.

Each of these providers creates a record, and there’s a pretty good chance those records are electronic. However, in many cases – and for emergency medical services (EMS) it’s virtually all cases - these systems aren’t integrated, making it difficult to get a complete picture of the patient’s medical history or health needs.

But what exactly does a connected and interoperable emergency care system look like?

This was a question posed to a group of members from the EMS, emergency care, and health information technology (HIT) communities at a meeting hosted earlier this month by ASPR’s Emergency Care Coordination Center in conjunction with the Office of the National Coordinator for Health Information Technology.

EMS is both the gateway to and an integral part of the healthcare system. Currently, few EMS systems are connected to a health information exchange or other electronic health/medical records system. There are many challenges to sharing of EMS data, including funding, proprietary systems, and a lack of collaboration.

It’s our hope that EMS will become a full participant in the electronic exchange of health information. This would entail the regular and secure two-way exchange between EMS and other health care facilities and payers.

Improving the current system will lead to more efficient transitions of care, more fully integrate EMS into the health care system, and provide better patient outcomes and experiences. It will also improve resilience in the face of disasters and other disruptions of our healthcare system.

During the meeting, members of the EMS and HIT communities openly discussed their experiences and successes, while identifying innovative ideas, potential business use cases and pilot projects for the future. Attendees also identified current challenges and issues and brainstormed solutions related to the incorporation of HIT in the pre-hospital environment.

As a result of this stakeholder engagement, we are excited to announce that the Office of the Assistant Secretary for Preparedness and Response is launching the ASPR Collaboration Community campaign on IdeaScale.

The community’s first campaign, Health Information Technology and EMS, is focused on the issue of health information technology in the pre-hospital environment. It provides interested stakeholders a place to connect and continue the discussion on issues and successes surrounding connectivity to the new health information exchanges.

You can access the collaboration community at www.phegov.ideascale.com to participate in our first campaign. Please check out our current campaign and subscribe to this campaign to receive updates as new ideas are posted.

Please note: The ASPR Collaboration Community IdeaScale website is not for the purpose of advising ASPR or the U.S. government. Rather, it is available for all as a means to share insights and experiences so that others might benefit from those experiences and the resulting knowledge.

February 13
Changing the Landscape for Global Pandemic Influenza Vaccine Manufacturing

Author: Julie Schafer, Project Officer, Biomedical Advanced Research and Development Authority, HHS Office of the Assistant Secretary for Preparedness and Response

In the event of a severe influenza pandemic, the global need for vaccine would far outstrip current production capacity. To address this gap between potential need and capacity to meet the need, the BARDA International Influenza Vaccine Manufacturing Capacity Building Program has used smart investments and strong partnerships to support thirteen influenza vaccine manufacturers in twelve low- to middle-income countries to enhance their capacity to produce influenza vaccine. In 2005, vaccine producers in these countries, collectively, could produce less than one million doses of pandemic influenza vaccine. Today, vaccine producers in these countries have a combined pandemic influenza vaccine production capacity of over 280 million doses, on track for the program goal of a production capacity for 500 million doses of vaccine by 2016.

Expanding and diversifying worldwide influenza vaccine manufacturing capacity may reduce the global threat of pandemic influenza, provide international stability and security, and reduce demand for the United States to produce and distribute limited supplies of vaccine outside the country during a public health emergency.

BARDA has partnered with the World Health Organization (WHO), PATH, US- based and international universities, and other HHS agencies to develop and implement this program. In recognition of the considerable challenge of developing sustainable influenza vaccine manufacturing capacity, BARDA uses a three-pronged approach: 1) expanding vaccine manufacturing capacity through the WHO Global Action Plan to increase vaccine supply, which has supported thirteen manufacturers in twelve under-resourced countries; 2) ensuring a skilled workforce through biomanufacturing training programs at two US-based universities and through on-site training; 3) providing in-country technical implementation assistance to complement and reinforce training and to provide targeted clinical trial and manufacturing technical assistance to manufacturers with influenza vaccines nearing eligibility for licensure. BARDA also supports efforts to make new vaccine technologies available to these manufacturers.

BARDA’s International Influenza Vaccine Manufacturing Capacity Building Program has, in a short time, contributed to a significant change in the global influenza vaccine landscape. Since the program’s inception in 2006, four pandemic and three seasonal vaccines have been registered for used by National Regulatory Authorities including the recent approval of a Serum Institute of India seasonal Live Attenuated Influenza Vaccine (LAIV) in India. Two pandemic and one seasonal vaccine have been prequalified by WHO, which enables potential use in other countries, thus creating the potential for regional pandemic response capabilities.

BARDA’s efforts to increase international influenza vaccine manufacturing capacity are a complement to its ongoing domestic pandemic influenza vaccine capacity building. These initiatives have contributed to a dramatic increase in the global influenza vaccine production capacity critical to pandemic response. For more information, see BARDA’s Pandemic Influenza Program.

February 13
To Protect Health, Strengthen Cybersecurity

New framework helps companies and government better manage and communicate cyber risk
Author: By Steve Curren, ASPR Critical Infrastructure Protection Program Manager

In the health industry, the rapidly evolving world of IT offers new ways for doctors and patients to interact. We’re finding better ways to maintain business records, creating more accurate patient records, and using smart medical devices. Public health departments throughout the nation leverage IT technology to identify food safety concerns, track disease outbreaks, and transmit critical information for laboratory tests. Yet, this increased use of the Internet and reliance upon computer networks carries some unique risks for the health care and public health community. v

In some businesses, a hacker can disrupt the business, inconvenience the community, and steal business ideas and people’s identities. These data breaches can cost of millions of dollars. One study found that these incidents cost health care providers more than $1.6 billion a year; 61 percent of global health care organizations surveyed in that study had experienced a security-related incident in the form of a security breach, data loss, or unplanned downtime at least once in the previous 12 months.

In the healthcare and public health sector there’s an additional cost: health itself. A hacker can tamper with medical devices; change test results; prevent a health department from receiving or transmitting crucial data about disease outbreaks, or interrupt the software for analyzing images. Data breaches in the health industry also run the risk of damaging the community’s trust which, in turn, can impact people’s personal health care decisions.

So, what should government do about this? We can work together with private industry to prevent it. That’s what a new voluntary cybersecurity framework is all about. The framework was released yesterday and was called for in presidential executive order 13636. The executive order on improving cybersecurity for our nation’s critical infrastructure was released last year, along with presidential policy directive 21 on critical infrastructure security and resilience, to create more coordinated approach to infrastructure security and resilience before, during and after a cyber crisis.

The new framework provides non-regulatory standards to guide the way private industry approaches cybersecurity. In the health sector, these voluntary standards can help healthcare providers, medical manufacturers and distributors, laboratories and the vast array of partners help keep our nation’s healthcare system up and running. State and local agencies can use the framework to protect public health department IT systems, too.

Government agencies and representatives from private industry, including the healthcare sector, worked together to create the framework. The framework uses a common language to discuss cyber risks and offers ways to address and manage cyber risk in a cost-effective way. The approach is based on business needs and doesn’t require any new regulations.

The framework recognizes business drivers – like being able to provide services to patients throughout an emergency situation, potential profit loss and loss of patients’ trust from security breaches – and used these business drivers to guide the steps the health sector and other industries take for cybersecurity. The framework also shows how to manage cyber risks as part of all the other “business” risks managed by healthcare providers and public health agencies.

Taking action to secure IT networks is a concern for organizations and businesses of any size, not just for large corporations, so the framework is flexible and can be adapted to different types of businesses from a physician’s office to a nursing home to a large pharmaceutical company. The interconnectedness of our computer systems may mean that a person or company you aren’t even aware of poses a threat to your computer networks. So by adopting the framework, partners large and small, urban and rural, public and private, help further secure our nation’s critical infrastructure.

If you are a physician’s office, an independent assisted living facility, or small pharmacy, the framework can provide you with a roadmap for how to get started in securing your computers and networks. If you are a large pharmaceutical company, nationwide pharmacy company, or a hospital/healthcare system, the framework can help you be sure you have done all that you need to do, and it can help you communicate cyber risks to your leaders and suppliers.

We used the framework’s approach to working together and sharing information to manage a real-life cyber security risk for medical devices in hospitals last summer. Check out our blog on it. And read through the new framework to see how it can help make your networks and systems more secure and resilient. You can learn more about cybersecurity for the healthcare and public health sector at http://www.phe.gov/preparedness/planning/cip/Pages/default.aspx.

January 18
Prepared to Serve: Medical Reserve Corps

Author: CAPT Robert J. Tosatto, Director, Division of the Civilian Volunteer Medical Reserve Corps

On the third Monday of January, we honor the legacy, heroism, and patriotism of Dr. Martin Luther King, Jr. with the MLK Day of Service. On this day, we pause to honor what he gave to his country through his words and actions. Now, we also pause and come together to give of ourselves and to improve our communities. As part of a community that is interested in emergency preparedness and response, you may wonder how your talents could serve your town, city, or county. The Medical Reserve Corps (MRC) is a national network of locally based volunteers, organized and committed to strengthening public health, improving emergency response capabilities, and building the resiliency of their communities. The MRC offers one important way to serve. This means that you can volunteer in your area to make strides to improving its’ capabilities and capacities – while using your talents in the medical, public health, emergency management, or other fields.

The MRC network is supported by the Division of the Civilian Volunteer Medical Reserve Corps in the Office of the Surgeon General, and currently includes more than 206,000 volunteers in almost 1,000 units nationwide. These volunteers come from all walks of life, and have a variety of skills, experiences, and backgrounds to contribute, but they share a common goal and desire to strengthen the community through their selfless service. The volunteers are identified, credentialed, screened, trained and begin their service before a disaster strikes so that they are ready and able to serve when needed. Whether involved in diabetes detection clinics; educational classes on family preparedness; drive-thru influenza vaccinations; first aid and CPR training; table top exercises; or response to an emergency incident, the MRC is integrated into the local health, preparedness and response structure.

MRC units and volunteers have shown their value time and again. Since its inception in 2002 following the terrorist attacks of 9/11 and the anthrax attacks that followed, MRC volunteers have been giving selflessly to protect, prepare, and respond to many types of hazards. For example, when over 250 MRC volunteers supported the Boston Marathon, most of them assumed that they would just need to provide routine care to runners and spectators. Some MRC volunteers were there as a part of the BAA Injured Runner Tracking Team at the finish line, while others worked in first aid stations and assisted with HAM radio operations along the course. The nature of their mission changed in an instant when two improvised explosive devices detonated near the Boston Marathon finish line. Following the explosions, some of them saw blast injuries, severe burns and traumatically amputated limbs. While they certainly did not expect the explosions, they were prepared and capable of delivering life-saving first aid and helping to transport the injured. After the initial response, MRC volunteers also assisted in staffing shelters for stranded runners and providing mental health services to those affected. What at first seemed to be another day at the race, turned into a rush to save lives and support those in need. The MRC unit leaders’, the MRC volunteers’, and the other responders’ actions that day clearly indicate a high level of training and personal resiliency, in the face of obvious uncertainty and upheaval.

MRC volunteers serve a vital role in the response to natural disasters as well. During Hurricane Sandy, more than 150 MRC units reported preparedness and response activities related to this storm. Some units supported general, functional, or special needs shelters, often alongside partners from the American Red Cross. Units also provided health education, emergency communications support, and surge staffing to local hospitals, emergency management agencies, and public health departments. These volunteers donated more than 35,000 hours of service, and many other units within the affected regions reported that they had more volunteers who were ready and willing to assist if needed. Additionally, some units not affected by Hurricane Sandy used it as an opportunity to perform call-down and notification drills as part of their preparedness planning.

MRC units have also played an important role in preventing the spread of pandemic influenza. MRC units work with their local public health officials and plan on ways that they can best serve should a pandemic strike their local communities. These plans were put in action in the spring of 2009. As cases of H1N1 Influenza began spreading across the United States, MRC units rapidly mobilized to meet their communities’ needs. Almost 50,000 volunteers in 600 MRC units (approximately 70% of all MRC units) assisted in over 2,500 H1N1-related activities in 2009-2010. Hundreds of thousands of Americans received their H1N1 immunizations, and many more learned about flu prevention and care, from MRC volunteers.

I urge you to consider this important thought from Dr. King, “Life's most persistent and urgent question is, 'What are you doing for others?'” No matter where or in what capacity you volunteer, it will provide a powerful experience for you and a tremendous benefit for those you serve. I encourage you to gather your friends, family, colleagues and neighbors in a shared mission to improve the lives of those around you. Each person has something to give, and every community has a person, group, or issue in need of help.

To find contact information for your local Medical Reserve Corps – to volunteer, partner, or promote – visit www.medicalreservecorps.gov and search by your city or zip code. You can also connect with us on Facebook and Twitter.

January 15
Researchers: You Can Help Communities Recover Faster, Smarter

Author: By Marcienne Wright, Science Policy Advisor, Office of the Assistant Secretary for Preparedness and Response

After a disaster, people look for the best ways to recover and move on with their lives. In hard-hit areas recovery can take years, and community members must decide how to rebuild their healthcare systems and their entire communities in ways that respond better, recover more quickly, and withstand future disasters.

Often, these kinds of decisions are based on past experience or lessons learned from other communities. There is a pressing need for solid scientifically based research to help communities make decisions with confidence.

That’s why, in the wake of Hurricane Sandy, three HHS agencies – ASPR, CDC, and NIEHS – awarded a series of research grants to give hard hit communities data to drawn on as they make tough decisions about how to recover effectively from Hurricane Sandy and how to strengthen their resilience for future disaster preparedness in the process.

This week these three agencies did something pretty unusual — we convened a meeting with this group of grantees who will be researching public health, environmental health and healthcare in Sandy-impacted communities along with their public health and community partners. The meeting’s goal was to encourage grantees to explore opportunities for collaboration at the beginning, rather than at the end, of their projects.

Our grantees and their research partners were wildly enthusiastic. Distinct groups of researchers now want to work together to better support community needs in Sandy-impacted areas, do better science without duplication, and advance scientific knowledge on building resilience in these communities.

Researchers working in and collaborating with health departments in New York City, New Jersey, and Long Island discovered that, for some questions about the causes of increased mortality, they are using similar methods to create their datasets. Because of this meeting, they learned that there is an opportunity for them to now collaborate on this aspect of their research.

Steelworkers and other unions working with NIEHS on worker safety and clean up offered to collaborate with healthcare system response researchers on ways to strengthen healthcare worker resilience. Bringing groups like these together holds exciting possibilities.

We appreciate the willingness of everyone at the meeting to share information on their research projects and to explore taking a new and collaborative approach to advancing science, recovery, and resilience.

The research being conducted in Sandy-impacted communities is an example of what’s needed to support the decisions that communities across the country must make after disasters and every day – decisions about infrastructure, policies, procedures, partnerships, coalitions, and funding that drive your community’s resilience.

A better understanding of the science supporting response and recovery is absolutely needed for communities across the country – including yours – to become as ready and resilient as possible so that health stands up to disaster.

Sharing the information gained from this research with the impacted community and the nation is vital to building a country that is resilient to whatever comes our way. These projects as well as future studies initiated by the scientific community hold tremendous potential to bring people together to talk about tough decisions and difficult topics. A bonus to bringing people together for research purposes is that the action can lead to new coalitions, new partnerships and in turn stronger communities.

Potential researchers: think about it; by pursuing this line of inquiry you could help strengthen the health security of our entire nation. To learn about the projects underway now, visit www.hhs.gov/sandy.

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