Challenges for Local Healthcare

Systems

Preparing and Responding to

Disasters

Objectives

1. Understand the scope of healthcare systems preparedness

2. Know the hazards and consequences we all face

3. Identify the capabilities and tools your healthcare system should have in place

4. Identify lessons learned from past events and how communities can better prepare

When Disaster Strikes King County Again…

1. Will we be able to protect our staff, families, selves and continue to carry out our mission?

2. Will we use our resources most efficiently?

3. Will we have the information we need to respond effectively?

4. Will we make the right decisions regarding how our healthcare system will function under extreme stress?

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

What We Face…

• Pandemics are inevitable

• Can be disruptive catastrophic

• On a global scale, high levels of:

sickness and death disruption of critical services economic loss

Influenza Pandemic - Planning Assumptions

CharacteristicModerate

(1958/68–like)Severe

(1918 – like)

US King County US King County

Illness 90 Million 540,000 90 Million 540,000

Outpatient Care 45 million 270,000 45 million 270,000

Hospitalizations 865,000 5,190 9,900,000 59,400

ICU Care 128,750 773 1,485,000 8,910

Mechanical Ventilation

64,875 389 742,500 4,455

Deaths 209,000 1,254 1,903,000 11,418

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

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)

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

Anticipated H1N1 Pandemic Consequences

Fall 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???

Anticipated H1N1 Pandemic Consequences

Fall 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

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

Capabilities - Expectations

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

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

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…)

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

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”

Lessons Learned

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?

www.kingcounty.gov/health

Pandemicflu.gov

Public Health Reserve Corps

Information available:

Questions?

Michael Loehr, MRP, CBCPPreparedness DirectorPublic Health – Seattle & King CountyMichael.loehr@kingcounty.gov206-263-8687