Mass fatality exercise puts region’s disaster preparedness plans to the test

THIS IS AN EXERCISE…

Less than six weeks after the first confirmed cases of a novel influenza virus in Hamilton county, the virus has now become widespread, with most parts of the globe affected to some degree or other. As a result of the current situation, The World Health Organization (WHO) has officially declared a pandemic.

The numbers of people showing serious symptoms due to infection has alarmed medical experts. Although not official, it appears that the virus has an infection rate of about 20-25%. The Case-fatality rate appears to be approximately 3% (3% of cases die). In an attempt to limit the spread of the virus, many Governments have taken measures such as closure of schools and bans on large public gatherings.

“IT’S CRITICAL FOR ALL AGENCIES TO KNOW EXACTLY WHAT THEIR ROLES ARE AND TO COORDINATE THEIR RESPONSES IN CONCERT WITH ONE ANOTHER.”

Tonda Francis, VP Regional Coordination and Clinical Initiatives

Fortunately, the above scenario is fiction.

On Thursday, March 30th, 2017, The Health Collaborative’s regional disaster and emergency preparedness staff led public health, hospitals, and emergency management agencies in what is referred to as a “functional exercise” to test the region’s ability to respond to a mass fatality event.

Whenever a widespread health epidemic occurs, disaster and emergency preparedness professionals region-wide respond with a set of agreed-upon plans, pre-tested equipment, and best practice recommendations to address the situation. These responses are tested periodically to ensure disaster response activities are conducted as safely and efficiently as possible, and to identify gaps in meeting community needs.

As a functional exercise, the mass fatality event tested response activities across sectors for effectiveness, and identified gaps to enable better planning and more efficient procedures. Each agency participated from their own location to test procedures and equipment, and connect with other response partners virtually.

Other approaches besides functional exercises can include tabletop exercises, which are in-person workshop-style meetings for agencies to walk through scenarios together, and full-scale exercises mimicking a true mass casualty event, in which volunteers are recruited to play the part of victims, and they are moved for treatment or treated in place in real-time, based on the scenario selected for the exercise. The type of exercise conducted is specific to the scenario and individual grant requirements.

“This type of functional exercise is crucial for our hospitals, public health agencies, and emergency management agencies to test their readiness in the event that a disaster strikes our community,” says Tonda Francis, VP Regional Coordination and Clinical Initiatives at The Health Collaborative. “While nobody would ever want such an emergency to occur, it’s critical for all agencies to know exactly what their roles are and to coordinate their responses in concert with one another.”

For the March 30 exercise, the fictional pandemic influenza outbreak resulted in numerous deaths across the region. The handling of a mass fatality event is one of the capabilities the Center for Disease Control (CDC) and the office of the Assistance Secretary of Preparedness and Response (ASPR), under the Department of Health and Human Services (HHS), require of hospitals and public health agencies.

Specific elements of the exercise tested the capabilities of area hospital systems to handle a higher-than-usual number of fatalities, and addressed other logistical issues surrounding a large scale health event. Public health and emergency management personnel tested their procedures for handling requests from other agencies, to ensure they have the tools to help agencies best respond to the incident.

Among the facilities and agencies participating in the exercise were: all acute care facilities in Southwest Ohio, St. Elizabeth, and Dearborn, as well as all public health agencies and emergency management agencies across the eight counties in Southwest Ohio.

Once procedures have been verified and equipment tested, the evaluators at each site receive a survey known as an Exercise Evaluation Guide (EEG). The EEG determines whether the agency met the objectives. The EEGs are then analyzed by The Health Collaborative staff to identify regional issues, then update the plans or fill needs accordingly. Finally, an “after-action report” is drafted from the summary aggregate information from the EEG’s and submitted to the State of Ohio. These findings then go on to inform future preparedness activities and planning.

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