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Public Health Risk Assessment

Public health CBRN course. Public Health Risk Assessment. Bonnie Henry, MD, FRCPC Doug Sider, MD, FRCPC. Case 1. A tornado has just hit your community; dozens of walking wounded are appearing at the local hospital, as well as individuals looking for loved ones

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Public Health Risk Assessment

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  1. Public health CBRN course Public Health Risk Assessment Bonnie Henry, MD, FRCPC Doug Sider, MD, FRCPC

  2. Case 1 • Atornado has just hit your community; dozens of walking wounded are appearing at the local hospital, as well as individuals looking for loved ones • Ambulance communications notifies the local hospital to expect at least 30 patients of varying severity in the next hour • Municipal officials have called you to the EOC and asked you to prepare some public safety messages (re food, water, shelter)

  3. Case 2 • An explosion has occurred at the Bloor station in the Toronto subway system • CBRN team is responding due to a phone call to a local TV station from a terrorist group chanting “Death to Canada” and claiming that a radioactive substance has been released

  4. Case 3 • A mysterious influenza-like illness beginning in Southeast Asia has been found to “jump” from birds to people • Over 400 people of all ages have been affected; mortality is 50% • Recent reports indicate some human to human transmission

  5. Case 3 • The disease is making its way west; cases are turning up in Europe • The WHO announced that the world may be entering Phase IV of the Pandemic phases (human cases found with subtype; established human spread)

  6. Questions to ask: • Is my organization/community prepared to respond to these events? • Does my organization/community need to be prepared anyway? • What are our priorities?

  7. Have you done your risk assessment?

  8. Goals of Session • Describe the need for and context of risk assessment in emergency health planning • Describe and prioritize the risks faced by of your organization/community to better prepare for public health emergencies

  9. Phases of an Emergency (F/P/T National Framework) • Risk assessment • Mitigation • Preparedness • Response • Recovery

  10. Public Health Emergency Preparedness and Response • GOAL: To enable and ensure a consistent response to public health emergencies and emergencies with public health impacts. Hazard Identification and Assessment Immediate Outcomes • Awareness of the hazards which are relevant to the catchment area of the board of health. • Risk-based emergency planning and programming to guide ongoing board of health preparedness efforts. Requirement • The board of health shall, in accordance with the Provincial Protocol on Public Health Emergency Preparedness, 2007, identify and assess the relevant hazards and risks to public health within the health unit area.

  11. What’s your risk? • Naturally occurring events • Technological/infra-structure events • Human related events

  12. Natural events - examples • Hurricane • Tornado • Extreme heat/cold • Ice storm • Snow storm • Flood • Epidemic/pandemic

  13. Epidemic/pandemic • Influenza • SARS • E Coli • Smallpox

  14. Technological/ Infrastructure events • Electricity system failure • Transportation emergency • Water system emergency • Structural collapse • HAZMAT events • Fire • Nuclear power station events

  15. Human Related Events • Terrorism – biological, chemical, nuclear, radiological • Civil disturbance • Labour actions • Armed conflict • Large public gatherings

  16. What is your risk for each? Risk = Probability x Impact www.ceep.ca

  17. Risk = Probability x Impact

  18. Probability? Highly likely? Likely? Possible? Unlikely? Impact? 4. Catastrophic 3. Critical 2. Serious 1. Marginal Components of Risk

  19. Probability

  20. Components of Impact Impact • Human • Physical infrastucture • Business Impact 4. Catastrophic 3. Critical 2. Serious 1. Marginal

  21. Impact - Human 4. high probability of death 3. high probability of injury or illness; low probability of death 2. low probability of injury, illness or death 1. unlikely to cause injury, illness or death in community members/providers

  22. Impact – Physical Infrastructure 4. extensive physical infrastructure damage with substantial service disruptions, high costs and extended recovery time 3. moderate physical infrastructure damage 2. minor physical infrastructure damage 1. unlikely to cause physical infrastructure damage causing service disruption with resultant costs/recovery challenges

  23. Impact - Business • numerous public/private sector entities unable to provide services 3. significant/widespread or long term service interruptions 2. minor or limited or short term service interruptions 1. unlikely to cause public/private sector service interruptions

  24. Overall Impact Rating

  25. Risk Assessment - examples

  26. Risk Rating

  27. Priorities • Pandemic ‘flu’ • Tornado • Dirty bomb

  28. Priorities Perform this exercise for all: • Naturally occurring events • Technological/infrastructure events • Human related events

  29. Summary • Assessment of risks is first step in planning • Helps focus efforts and ensures no possibilities are missed • Helps prioritize efforts in preparedness

  30. “The only thing more difficult than preparing for an emergency is having to explain why you didn’t”

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