Challenges for Local Healthcare Systems

1. Preparing and Responding to Disasters Challenges for Local Healthcare Systems

2. Objectives • Understand the scope of healthcare systems preparedness • Know the hazards and consequences we all face • Identify the capabilities and tools your healthcare system should have in place • Identify lessons learned from past events and how communities can better prepare

3. When Disaster Strikes King County Again… • Will we be able to protect our staff, families, selves and continue to carry out our mission? • Will we use our resources most efficiently? • Will we have the information we need to respond effectively? • Will we make the right decisions regarding how our healthcare system will function under extreme stress?

4. When Disaster Strikes King County Again… How will we respond, make decisions, stay informed when: • Medical resources are limited and require prioritization • “Normal” medical care protocols can not be sustained during the disaster • Healthcare facilities / staff have been affected causing impacts throughout the system • Impacts to supporting infrastructure (power, roads, communications) significantly effect healthcare operations

5. What We Face…

6. Influenza Pandemic - Planning Assumptions • Pandemics are inevitable • Can be disruptivecatastrophic • On a global scale, high levels of: • sickness and death • disruption of critical services • economic loss

7. Estimated Illness, Hospitalizations, and Deaths Moderate & Severe Pandemic: USA, King County

8. Severe Influenza Pandemic Consequences • Closing all schools and day cares for up to 8 weeks • Closing all theaters, stadiums; restricting services at churches, libraries, universities (no large gatherings) • Suspending non-critical government functions • Restructuring the healthcare response (prioritizing EMS, hospital care, medicines – some get treated, others do not)

9. Severe Influenza Pandemic Consequences • Storing bodies for months until conditions allow for standard burial practices • Economic ruin well beyond what we are currently experiencing (global depression) • Extreme unemployment, many small business failures • Long-term mental health impacts with little capacity to address

11. Anticipated H1N1 Pandemic ConsequencesFall 2009 • High rates of absenteeism – mild illness for most • High risk of severe illness for people with underlying health conditions, AND children • Availability of pandemic vaccine – shortage of supply • High potential for confusion over two different flu strains, two different vaccines, three doses???

12. Anticipated H1N1 Pandemic ConsequencesFall 2009 • Possible self closures by schools due to high absenteeism • Extreme demand for information by the public • High impact on critical healthcare components such as Emergency Departments, pediatric nurse lines • Long term event – 4 months or more for a pandemic wave

13. Consequences of Disasters Impact communities People – health, safety, mental well-being (Ourselves, Families, Workers, Clients, customers, suppliers) Infrastructure (roads, power lines, water/sewer, communications) Critical systems and industries (healthcare, food, civil order, trade, tourism) Employment (closed businesses, downsizing) Political challenges (command and control between multiple jurisdictions) Earthquakes, windstorms, snowstorms, flooding

14. Capabilities - Expectations

15. Capabilities:What we need to be good at • Make command decisions for the local healthcare system during disasters • Identify and control disease outbreaks EARLY • Maintain the most critical Public Health functions during disasters (business continuity) • Assist community organizations and healthcare partners with becoming prepared (build resiliency) • Communicate with the public – in every language, with every culture, under all circumstances

16. Capabilities:What we need to be good at • Deploy and manage field hospitals, volunteer medical staff to add patient beds when demand surges • Mass medication – provide medicines to large numbers of people in a short time period • Manage large numbers of fatalities during disasters and support the information needs of families • Prevent health emergencies caused by food or water contamination

17. Lessons Learned

18. Lessons Learned Emergency Information and Outreach • Communicating a negative message is not sufficient – must help provide a safe option • Community based organizations are essential response partners • We must learn how different cultures receive info • Creativity is key – use all types of organizations to inform your community (hospitals, restaurants, gas stations, hardware stores, door to door…)

19. Lessons Learned Diverse Healthcare Industry Requires Coordination and Command • Know who to call (share contact information) • Invest in preparing multiple sectors for all hazards • One person in charge of the Health and Medical Response across all of King County

20. Lessons Learned Business Continuity and Partnerships • Invest in sustainability of critical functions • Support critical partners in building continuity plans • Recognize the importance of “continuity of community”

21. Encourage staff and the public to prepare at home Develop Business Continuity plans to protect our most critical functions Develop response plans jointly with government, healthcare, business, and community organizations Innovate How should our communities prepare?

22. www.kingcounty.gov/health Pandemicflu.gov Public Health Reserve Corps Information available:

23. Questions? Michael Loehr, MRP, CBCP Preparedness Director Public Health – Seattle & King County Michael.loehr@kingcounty.gov 206-263-8687