BIOTERRORISM: SOUTH BIOTERRORISM: SOUTH CAROLINA RESPONDSCAROLINA RESPONDS

OBJECTIVESOBJECTIVES

To understand the response to a bioterrorist act through use of the unified incident command system

To describe the role and responsibility of each responding agency

To raise other issues that must be dealt with in planning a response to a bioterrorist act

To best respond to the bioterrorist threat, our state is divided into local regions for an initial response. South Carolina eight regions

Federal and state resources are available when local resources are overwhelmed

Each region coordinates its response through a Unified Incident Command System using the nationwide template or guidelines of the National Incident Management System (NIMS)

The NIMS guidelines provided a flexible framework to allow coordination and cooperation between involved agencies to develop policies and procedures prior to an incident. These are exercised and followed to ensure a safe and effective emergency response

All response agencies need to develop close working relationships and work together to save lives, preserve health, minimize panic and minimize disease impact

To best manage an incident each jurisdiction must use a unified incident command system.

Each involved agency can have its own incident command system which is integrated with others. Hospitals use the Hospital Emergency Incident Command System (HEICS)

Each agency has its defined role and responsibilities

In a bioterrorist attack, health agency personnel may need to interact with individuals from other response agencies

These may include: Emergency Management Authority Emergency Medical Services (EMS) Mental Health agencies Community Health Centers/Medical Offices Law enforcement authority Fire/Rescue Volunteer community agencies Medical examiner or coroner Neighboring health jurisdictions(possibly in another state)

In this section, the role and responsibility of each response agency will be presented

Each agency must coordinate with others in the planning for, response to, recovery from, and mitigation of a bioterrorist incident

It is important to note that functions assigned to each response agency may vary by jurisdiction

THE ROLE OF THE PUBLIC THE ROLE OF THE PUBLIC HEALTH DEPARTMENTHEALTH DEPARTMENT

In a bioterrorist incident, public health is the lead agency

Provide support services and public health/medical services to include: Activation of the Emergency Health Powers Act to deal

with quarantine and isolation Distribution of the Strategic National Stockpile (SNS)

and dispensing vaccines and antibiotic prophylaxis Environmental control (animal bites, wastewater, food

services inspections, general sanitation) Operate shelters for those with special needs

ROLE OF PUBLIC HEALTH ROLE OF PUBLIC HEALTH

Disease surveillance, detection, and epidemiologic investigation

Ensure operational coordination in a mass casualty disaster response through an Emergency Operations Center (EOC)

Keep the public informed of available mass casualty assistance programs

Collect,compile, maintain and share all essential information

Provide laboratory support

THE ROLE OF HOSPITALSTHE ROLE OF HOSPITALS

Hospitals and usually with a one hospital taking the lead provide: Emergency and definitive acute medical care Isolate contagious individuals Dispense medications and vaccines to staff and

inpatients Maintain safe and appropriate disposal of medical

waste Decontamination of victims and facilities as

necessary Train/Educate/Utilize volunteers

THE ROLE OF THE EMERGENCY THE ROLE OF THE EMERGENCY MANAGEMENT AUTHORITYMANAGEMENT AUTHORITY

Hosts the Emergency Operations Center (EOC) for the county

Has overall responsibility for coordination of the county response logistics including food, water, electricity, shelter and transportation

Mobilize and deploy assets during the crisis and in the recovery phase

Develops and maintains communication links and issues appropriate warnings to the public

Prepare for state and federal on-site assistance

THE ROLE OF EMERGENCY THE ROLE OF EMERGENCY MEDICAL SERVICESMEDICAL SERVICES

Is first on the scene and delivers initial triage of incident victims

Transports casualties Augments hospital services

THE ROLE OF MENTAL THE ROLE OF MENTAL HEALTH PROVIDERSHEALTH PROVIDERS

Coordinate and provide mental health crisis counseling to victims, staff, and the worried well

Make referrals as needed Provide post-crisis mental health

counseling

THE ROLE OF COMMUNITY HEALTH THE ROLE OF COMMUNITY HEALTH CENTERS AND MEDICAL OFFICESCENTERS AND MEDICAL OFFICES

Remain alert for initial cases of illness in their practice

Deliver outpatient ambulatory care to victims of a mass casualty disaster

Dispense medications and vaccines as needed Provide triage to victims of a mass casualty

event

THE ROLE OF THE LAW THE ROLE OF THE LAW ENFORCEMENT AUTHORITYENFORCEMENT AUTHORITY

Ensure the public safety Facilitate response and recovery Provide threat assessment, criminal

investigation, forensics, and evidence processing. The site on an incident is a crime scene

Provide security and access control in and around the disaster site and at affected hospitals

THE ROLE OF THE ROLE OF FIRE/RESCUEFIRE/RESCUE

+Evaluate the danger in a situation

Responsible for hazardous materials management

Establish decontamination control in response to actual conditions

Perform search and rescue as needed

THE ROLE OF VOLUNTARY THE ROLE OF VOLUNTARY AGENCIESAGENCIES

Names of agencies may differ from county to county, but they are generally responsible for:Support county relief efforts and provide

shelters, feeding, blood supplies, emergency welfare or family support (Red Cross)

Support county relief efforts and provide warehouse support, feeding and/or emergency welfare support (Salvation Army)

MEDICAL EXAMINER OR MEDICAL EXAMINER OR CORONERCORONER

Involved in activities related to managing and processing incident related fatalities including:Body recovery Identification, pathology, autopsy, storage

and forensics involving casualtiesDecedent’s family assistance services

SOME IMPORTANT PLANNING SOME IMPORTANT PLANNING CONSIDERATIONSCONSIDERATIONS

Each region must develop sufficient “surge

capacity” including facilities, assets and staff to handle a very large number of casualties

Each region must develop a plan to recruit, credential, train and equip staff, as well as volunteers and retirees

PLANNING PLANNING CONSIDERATIONSCONSIDERATIONS

Each region must develop a communication system for its response agencies to use when telephonic communication is not available

Each region must develop communication channels with the state and Federal governments

Each region must ensure the safety of its first responders and their families

If a region adjoins a neighboring state cross border issues need to be dealt with

PLANNING PLANNING CONSIDERATIONSCONSIDERATIONS

Animal care issues need to be dealt with

Laboratory capabilities must be adequate

Special needs populations, e.g. non-English speakers, hearing and visually impaired and other disabled individuals must be planned for

CONCLUSIONCONCLUSION

As we have heard from our governing officials

It is not if we will be attacked, but

when----Will we be ready? Only time and

our preparation will tell