Biological Agents Overview Quiz

Disaster Planning Essentials

• Disaster planning utilizes traditional planning principles to prepare for and respond to the impact and post-impact phases.
• Public health and healthcare personnel participate as integral parts of community disaster preparedness plans.
• Collaboration with all community health partners and with state and federal planners is essential.

Federal Planning

• Federal planning is organized into four key areas: Federal Emergency Support Function 8 (ESF-8), playbooks for national planning scenarios, regional emergency coordination, and collaboration with government officials at all levels in disaster preparedness.
• State and local planners develop disaster plans, integrated with federal plans, and evaluate state/local preparedness programs receiving federal funds, including those for Chemical, Biological, Radiological/Nuclear (CBRN) events.
• Expertise in CBRN is provided through playbooks and development of tools for CBRN event response.

Planning for Various Disasters

• Two key strategies exist: agent-specific planning (focusing on threats most prevalent in a region) and an all-hazards approach (planning for common problems across various disasters).
• Assistant Secretary for Preparedness and Response Playbooks (covering specific disasters, such as hurricanes and aerosolized anthrax) provide guidance on integrating planning efforts with federal response.

Playbooks Content

• Playbooks contain five key sections: Scenario, Concept of Operations, Action Steps/Issues, Pre-Scripted Mission Assignment Subtasks, and Essential Elements of Information.

Common Disaster Response Tasks

• Interorganizational coordination (sharing information among various organizations) and resource management are critical.
• Evacuation from danger zones, search and rescue operations, and use of both mass and social media are essential.
• Triage procedures (casualty distribution, patient tracking, and care for patients) and management of volunteers and resources are integral.

Surge Capacity

• Inventory available inpatient/ambulatory facilities (medical and mental health care), public health agencies, and services within a given geographic area.
• Projects for increasing capacity in response to an incident involve estimating casualty type, volume and intensity of issues among projected patients, treatment and triage availability, alternative resources, response timeframes, work schedules, and types of additional services.

Environmental & Occupational Health Issues

• Technical assistance is critical for addressing environmental threats and hazards, and either containment or evacuation of affected individuals.
• Monitoring environmental conditions (sampling, waste management, replacement of contaminated barriers) and ensuring safe water, food, and shelter. These considerations should support disruptions to sanitary environments.
• Equipment must be available for cooking and food preparation and safe storage.
• Inspections of temporary housing, feeding centers, and water distribution areas are critical for proper waste disposal.
• Provision of commercial toilets, handwashing stations, and latrine constructions are key.
• Worker safety, illness, and injury monitoring is vital for optimizing working conditions.
• Regular advisories for the public and the medical community are recommended.

Environmental Surveillance

• Monitoring is essential to estimate the number of individuals whose environment has been affected by a disaster.
• The key indicators are access to excreta disposal facilities (number of people per latrine, and availability of latrines), water consumption (water availability and security concerns, and amounts collected), and percentage of people consuming safe water supply. Pipes and taps should be tested to ensure safe use in emergencies.

Water Supply Issues in Disasters

• Groundwater, surface water and rainwater are different water sources with different microbiological qualities.
• Groundwater, whilst high quality, is hard to access. Surface water is readily available, but is often unsafe and rainwater is often unpredictable and seldom used.

Vulnerable Populations

• Communities must proactively include vulnerable groups and the organizations that serve their unique needs into the disaster planning process.
• Comprehensive and accurate plans should be created to take into account needs of vulnerable populations, and ensure effective action in times of emergency.
• Coordination efforts to ensure vulnerable population needs are met in healthcare delivery, shelter and distribution centers.
• At-risk individuals may need support for maintaining independence in daily tasks, communication, transportation and supervision. Medical needs, such as care for those with unstable or terminal conditions, must also be considered.
• Other vulnerable population groups include people with disabilities, those with limited or no proficiency in English, transportation disadvantages, chronic medical disorders or pharmacological dependency.
• Disaster planning councils for vulnerable populations should identify necessary resources and strategies during a disaster, and which agency/group should take the lead in delivering aid.
• These councils may include governmental agencies, community providers, organizations, advocacy groups, congregate living centers, and local national advocacy groups.

Registries for Vulnerable Populations

• Public health and community-based organizations should work together to generate registries identifying at-risk individuals/groups.
• Registries ensure adequate planning for services needed during a disaster.
• Challenges include creating effective registries, keeping them current, having voluntary participation (which can lead to inaccurate data) and maintaining confidentiality.

Specific Disaster Strategies for Vulnerable Groups

• Vulnerable individuals should know their evacuation plan and should have access to shelter, transportation, and support services, and keep assistive devices nearby.
• Training for responders on interaction with service animals (like guide dogs).
• Preparedness tips for the blind (navigating to safety, and considerations for evacuating with strangers).
• Preparedness for those with hearing or communication disorders (equipment like hearing aid batteries, and communication tools for emergencies).
• Preparedness for people who are bedridden or require additional care (prepared transportation, and extra supplies for daily care).
• Preparation for those with specific medical needs (extra medical supplies, caregivers support, and potentially a generator).

Go Packs

• Individuals should prepare comprehensive kits, preferably in waterproof containers, including at least a week's supply of medication (rotated weekly).
• Other necessities may include assistive devices, emergency communication tools, evacuation supplies, food, and water. Animals may also need special care kits.

Emergency Communication

• Emergency communication systems must be accessible to people with disabilities (with options besides standard spoken language).
• Additional education is required for vulnerable populations, and individuals with cognitive disabilities must also be considered.

Building Preparedness for People with Disabilities

• Organizations and buildings should establish evacuation plans that account for those with special needs.
• Hazard assessments need to consider ADA compliant standards for buildings.
• Communications and emergency alerts should have provisions for accessibility by multiple means, both tactile and audible.
• Disasters require specialized plans based on the unique needs of individuals with relevant disabilities in buildings.

Public Health Response to Emerging Infections

• Collaboration of multiple disciplines should occur for protocols to establish criteria for surveillance systems.
• Expanding lab capacity, and training microbiologists in reporting protocols can support quick response.
• Developing diagnostic protocols, quick access to treatments, improving rapid reporting systems and plans for responding to biological incidents are key components.

Response to Unknown Diseases

• Public Health departments are the primary responders for cases of identifying infectious diseases.
• Climate change, globalization and inadvertent vector transport increases the likelihood of health systems facing new or uncommon infectious diseases.
• CBRNE events require specialized preparedness strategies.
• Shortage of medical services, equipment, hospital beds and high demand for mortuary/funeral services can occur.

Stages of a Pandemic

• The WHO defines stages based on the appearance of new or uncommon diseases and the development of human-human transmission.

Chemical or Biological Warfare

• Covert releases of chemical/biological agents (without prior warning) pose greater threat than overt releases. This covert nature makes early identification and response exceptionally difficult.
• The incubation period in the community creates a likelihood of a wider spread before identification.
• Accurate assessments of the affected population and the most likely causes are needed to develop effective prevention measures.

Critical Biological Agents

• The Centers for Disease Control and Prevention categorizes biological agents according to the risk they pose to the public- with Category A-agents posing the highest risk to public health and national security.
• Category B-Agents are moderately easy to spread and cause mild/moderate illness.
• Category C-Agents are genetically engineered and pose a major threat due to its easily accessible materials for replication and wide spread transmission.

Biological Incident Response

• The Biological Incident Annex outlines federal response framework for bioterrorism or naturally occurring disease outbreaks.
• It includes threat detection/assessment, notifying at-risk populations, and response procedures, as well as epidemic control.
• Recovery activities are also part of this framework.

Federal Response to Biological Incidents

• The US Department of Health and Human Services (HHS) manages the response to biological incidents or disease outbreaks.
• This response involves notification, identification of affected populations and areas, implementation of protective measures, targeted disease investigation, dissemination of safety information, intensified surveillance and the deployment of federal public health/medical response assets.

Controlling the Epidemic

• HHS is responsible for the coordination of epidemic surveillance.
• The need for increased surveillance, isolation, quarantine, and social distancing must also be assessed.

Defining Biological Events

• A potential biological attack can be identified by a single, definitive case (if undiagnosed or difficult to explain), a cluster of similar cases with unusual characteristics, or an increase in a common illness rate that exceeds seasonal expectations.

Active Surveillance & Epidemiological Investigations

• Surveillance must support rapid and advanced tools for public health and healthcare systems. Tools will include data collection forms for assessment of exposure, risk and care, sampling techniques, centralized databases, investigation and response teams, active hospital-based surveillance, enhanced passive surveillance, and contact tracing, in collaboration with poison control centers.

Laboratory Response Network (LRN)

• The Laboratory Response Network (LRN) is a response system with three levels, each having a more specific function.
• Hospitals and other healthcare facilities may identify suspected outbreaks, reference labs confirm the cause of disease, and national labs perform research and develop procedures to address incidents and disseminate information on findings to other levels of the network.

Public Health in Recovery & Reconstruction

• Public health must restore public health/healthcare infrastructure, implement community-wide healthcare/public health programs, address community needs, and assess long-term health and behavior needs.
• Community involvement is vital. Accurate needs assessments are critical, alongside addressing short-term and long-term needs.
• Strategies will include restoring physical infrastructure and determining community preparedness and how best to support recovery and reconstruction efforts.
• The emergency/transition and reconstruction stages can need substantial support from community groups, volunteers, individuals and NGOs.

Post-disaster Assessments

• Assessment of the path to recovery, emergency needs, and long-term needs that may vary based on situation and time. Evaluation steps will include assessments community capabilities/vulnerabilities (physical environment, social conditions, community attitude, population motivation).
• Essential steps include determining baseline needs through community involvement, including visits to affected areas or communities, interviewing impacted communities, and conducting rapid assessments. Data on needs (quantified when possible), community needs, and vulnerabilities must be ongoing and continually assessed and reevaluated.

Shelters

• Temporary shelters must be located in facilities capable of withstanding disasters and meet basic needs (communication, accessible power and water, health care services, mental health services, childcare, sanitation, recreation) with appropriate spacing and safety measures for people with specific needs.

Evaluation Methods - Public Health and Medical Response

• The purpose of evaluation methods in public health and medical response to disasters is to assess the extent to which a response, organization, program or unit meets its defined objectives.
• Evaluation methods examine aspects of response as well as allocation of resources; examine sequence of events and impact on various stages; evaluate process effectiveness, any resulting limitations; and provide lessons learned for policy.
• The need for data and information to evaluate the response of public health and healthcare systems is essential. The tools used in this data collection/evaluation process may vary but should be appropriate for the needs of the communities being assessed.
• Planning considerations for collecting and reviewing data need to reflect the goals of the evaluation as well as appropriate approaches for gathering and analyzing quantitative and qualitative information. These plans and their methods and processes should also be documented and implemented.