CSTE Disaster Epi Resource Tool

Draft Outline

  • Introduction
    • ATSDR developed RRR after identified as need following 9/11 long-term surveillance 
    • when appropriate to create a registry (reference ATSDR article)
    • ACE included RRR as one of the tools, hope to develop generic OMB package to start registry after a disaster
    • RRR has never been implemented by federal or state; developed for LPH/state to download and use
    • following case studies in planning for post-disaster surveillance, developing state-specific RRR, and practicing its implementation 

Case study: Short-term Surveillance Planning
Overall: How state and local health department collaborated to develop active surveillance plans for chemical exposures.
  • Brief background on Umatilla chemical weapons depot and CSEPP – frames need for roster plan
  • PSET developed roster form to identify exposed individuals and quickly classify the nature of their exposure; also developed accompanying database including web entry for self-reporting from evacuees    
  • Local health dept. developed local implementation plan including ICS organizational chart, resource list, communications plan   
  •  Local health dept. conducted field exercise
  • Lessons learned and adaptations made: PSET developed some just-in-time training resources for field staff and process diagrams to help partners understand how rosters and registries work  
  • CSEPP program completed successfully; roster plans integrated into state active surveillance plan and can be modified for other public health emergencies 
  •   Future direction: consider additional field exercises, consider adding expectation of rostering into specific hazard surveillance plans

Case study: Long-term Surveillance Planning
Overall: How a state health department collaborated with their emergency preparedness division to develop long-term surveillance planning and education for response staff.
  •  Lack of emergency preparedness LTS planning, how to integrate into state response plan 
  •  Developed LTS annex to identify and collect information on three populations likely exposed following disaster (workers, hospitalized cases, general public/bystanders)
  •  Developed MN Rapid Response Roster online survey tool to identify general public exposed 
    • criteria for implementation
  •  Exploring use of condition codes to identify disaster-related cases in hospital discharge data
  •  How to engage Partnerships:
    • MDH Emergency Preparedness & Response
    • MDH  Behavioral Health 
    • MDH Environmental Health
    • Local health departments, district epidemiologists
    • External partners: MN Poison Control Center, MN Pollution Control Center, Local Red Cross, University of Minnesota
  •  Practicing response, challenges, and lessons learned:
    • Radiation release tabletop exercise
    • Train derailment scenario DOC functional exercise with LTS annex, another with external partner
    • Chronic disease staff not traditionally involved in emergency planning. 
      Differentiating roles of environmental health division and other agencies.
    • Not many other models or examples of how to integrate LTS into normal preparedness planning.
    • Large-scale data collection and balancing quick collection with having enough data.
    • Partners were very willing and eager to be involved.
    • Make connections with other groups who have similar resource needs. 
    • Tabletops and exercises not only identify gaps, but further collaborations and resource sharing.
    • It’s important to practice large-scale exposure scenarios, since unusual and different response groups involved.
  • Future directions: 
    • Address gaps identified by last year’s tabletops
    • Refining RRR tool and legal sanctions
    • Annual staff training and exercises   
    • Establish mutual aid agreements with external partners
    • Identify and establish occupational health contacts for next year’s further development of occupational health population data collection