Public Health Emergency Response Guide

1. Public Health Emergency Response Guide

2. สถานการณ์ ท่านเป็นผู้รับผิดชอบด้านการควบคุมโรคในจังหวัด ได้รับรายงานว่ามีผู้ป่วยเสียชีวิตจากอาการปอดอักเสบและติดเชื้อทางเดินหายใจ ที่โรงพยาบาลศูนย์ ๓-๔ รายพร้อมๆกัน ผู้ป่วยมีอาการไข้สูง หายใจหอบเหนื่อย การหายใจล้มเหลว จนเสียชีวิตอย่างรวดเร็ว ภายใน ๒-๓ วันหลังจากเริ่มมีอาการ และขณะนี้พบว่ามีผู้ป่วยที่เริ่มมีอาการติดเชื้อทางเดินหายใจมารับการรักษามากขึ้นกว่าปกติ จากการประเมินสถานการณ์แล้ว ท่านคาดว่าอาจเป็นโรคติดต่อทางเดินหายใจที่รุนแรง จนเป็นภาวะฉุกเฉินทางสาธารณสุขได้ จึงเสนอให้เปิดศูนย์ตอบโต้สถานการฉุกเฉินทางสาธารณสุข ในการตอบโต้เหตุการณ์นี้ท่านมีแนวทางปฏิบัติอย่างไร?

3. วัตถุประสงค์ • บุคคลากรสาธารณสุขที่เกี่ยวข้องกับการตอบโต้ภาวะฉุกเฉินทางสาธารณสุข สามารถริเริ่มกิจกรรมการตอบโต้สถานการณ์ฉุกเฉินภายใน ๒๔ ชั่วโมงแรกได้อย่างถูกต้อง • สามารถปรับใช้แผนปฏิบัติการฉุกเฉิน, แนวทางปฏิบัติ, ทรัพยากรที่เกี่ยวข้อง, และระบบการตอบโต้เหตุการณ์ ให้เข้ากับสถานการณ์ • สามารถประสานการปฏิบัติตามแผนกับหน่วยงานที่เกี่ยวข้องและชุมชนได้อย่างถูกต้อง

4. http://emergency.cdc.gov/planning/responseguide.asp.

5. Scope • Public Health Emergency Preparedness Assumption • Public Health Emergency Response Functions and Tasks during the Acute Phase • Ongoing Public Health Emergency Response Functions and Tasks

6. Focus on First 24 Hours • Three response timeframe • Immediate (Hours 0-2) • Intermediate (Hours 2-6 and 6-12) • Extended (Hours 12-24)

7. Public Health Emergency Preparedness Assumption • Public Health Department must engage in preparedness activities • Completion of the following activities prior to an incident is essential to a successful response effort

8. Establish close working relationship and mutual-aid agreement with: • Emergency management agency (EMA) • Emergency Medical Service (EMS) • Medical/Health/Behavioral care providers • Fire, Law enforcement, and Other organizations • Local Emergency Planning Committee • NGOs, Volunteers, Neighboring, etc.

9. Participate in hazard vulnerability and risk assessment for your area(s). • Conduct capacity assessment • Acquire resources and surge capacity • Develop plans, procedure, guideline that are consistent with those used by other response agencies and organizations • Develop operational objectives for PHER • Develop basic system for surveillances and registry with appropriate archiving systems

10. Develop plans, procedures, guidelines for public affairs and risk communication • Engage in resource typing and credentialing for personnel, resources, and assets for emergency response • Ensure that public health personnel are trained and certified in safety and health practice (PPE, on-scene)

11. Provide orientation and training to public health response personnel • Participate in planning, design, and conduct exercises to evaluate PHEP&R • Participate in after action reviews of exercise and actual incidents

12. Immediate Response: Hours 0-2 • Assess situation • Contact key health personnel • Develop initial health response objectives and Establish an action plan • Public health participation in Emergency Operations Center (EOC) • Ensure that the site health and safety plan (HASP) is established, reviewed, and followed

13. Immediate Response: Hours 0-2 • Establish communications with key health and medical organization • Assign and deploy resources and assets to achieved established initial health response objectives • Address requests for assistance and information • Initiate risk communication activities

14. Public Messages in Crisis • STARCC Principle • S: Simple • T: Timely • A: Accurate • R: Relevant • C: Credible • C: Consistent Source: Reynolds, B., Crisis and Emergency Risk Communication by Leaders for Leaders. Atlanta, GA: Centers for Disease Control and Prevention, 2004

15. When engaging in risk communication, build trust and credibility by expressing . . . • Empathy & Caring • Competence & Expertise • Honesty & Openness • Commitment & Dedication

16. Top Tips. • Don’t over reassure • Acknowledge uncertainty • Express wishes (“I wish I had answers”) • Explain the process in place to find answers • Acknowledge people’s fear • Give people things to do • Ask more of people (share risk)

17. As a spokesperson • Know your organization policies • Stay within the scope of responsibility • Tell the truth. Be transparent • Embody your agency’s identity CONSISTENT MESSAGE ARE VITAL Source: Reynolds, B., Crisis and Emergency Risk Communication. Atlanta, GA: Centers for Disease Control and Prevention, 2002.

18. Immediate Response: Hours 0-2 • Engage legal counsel as part of the emergency response effort • Document all response activities

19. Intermediate Response: Hours 2 – 6 • Verify that health surveillance systems are operational • Ensure that laboratories likely to be used during the response are operational and verify their analytical capacity • Ensure that the needs of special populations are being addressed

20. Intermediate Response: Hours 2 – 6 • Health-related volunteers and donations • Update risk communication messages

21. Intermediate Response:Hours 6 – 12 • Collect and analyze data that are becoming available through health surveillance and laboratory systems • Prepare and update information for shift change and executive briefings

22. Intermediate Response:Hours 6 – 12 • Prepare for state and federal on-site assistance • Assess health resource needs and acquire as necessary

23. Extended Response: Hours 12 – 24 • Address mental and behavioral health support needs • Prepare for transition to extended operations or response disengagement

24. ONGOING PUBLIC HEALTH EMERGENCY RESPONSE FUNCTIONS AND TASKS • Environmental hazard identification • Hazards consultation • Epidemiological services • Health and medical needs assessment • Identification of affected individuals

25. ONGOING PUBLIC HEALTH EMERGENCY RESPONSE FUNCTIONS AND TASKS • Contamination control • Health surveillance • Laboratory specimen collection and analysis • Infectious disease identification, treatment, and control

26. ONGOING PUBLIC HEALTH EMERGENCY RESPONSE FUNCTIONS AND TASKS • Quarantine/Isolation • Public health information • Risk communication • Responder safety and health • Health and medical personnel resources

27. ONGOING PUBLIC HEALTH EMERGENCY RESPONSE FUNCTIONS AND TASKS • Health and medical equipment safety and availability • Health-related volunteer and donation • Coordination • In-hospital care • Evacuation

28. ONGOING PUBLIC HEALTH EMERGENCY RESPONSE FUNCTIONS AND TASKS • Sheltering • Special populations needs and assistance • Mass trauma • Mass fatality • Mortuary service

29. ONGOING PUBLIC HEALTH EMERGENCY RESPONSE FUNCTIONS AND TASKS • Mental/behavioral health care and social services • Potable water • Food safety • Vector control and pest management disposal

30. ONGOING PUBLIC HEALTH EMERGENCY RESPONSE FUNCTIONS AND TASKS • Wastewater and solid-waste management/ disposal • Building/facility assessment • Sanitation/hygiene service • Continuity of public health programs, services, and infrastructure

31. ONGOING PUBLIC HEALTH EMERGENCY RESPONSE FUNCTIONS AND TASKS • Veterinary services • Animal rescue/control/shelters • Long-term community recovery

32. Template 1: Documentation of contacts & actions

33. Template 2: Health department personnel emergency contact information

34. Template 3: State, local, tribal emergency contact information

35. Template 4: Leadership assignment

42. Template 5: Incident-specific public health preparedness