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The Role of Law Enforcement in Public Health Emergencies. Edward P. Richards, Katharine C. Rathbun, Corina Solé Brito, and Andrea Luna Available at: www.ojp.usdoj.gov/BJA www.dr-kate.com Email me - richards@lsu.edu. The Report. Driven by bird flu fears

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the role of law enforcement in public health emergencies
The Role of Law Enforcement in Public Health Emergencies
  • Edward P. Richards, Katharine C. Rathbun, Corina Solé Brito, and Andrea Luna
  • Available at:
    • www.ojp.usdoj.gov/BJA
    • www.dr-kate.com
    • Email me - richards@lsu.edu
the report
The Report
  • Driven by bird flu fears
  • Started as a study of quarantine and isolation
    • Darlings of the DHS and CDC and others who have never done public health
  • Became an all hazards approach
why not quarantine and isolation
Why not Quarantine and Isolation?
  • Logistics of a wide spread quarantine
  • Limited response options
  • SARS Experience
why all hazards
Why All Hazards?
  • Difficult to maintain readiness for a low probability event
    • Plan must provide short term benefits to be supported in the long term
  • Impossible to change behavior patterns on short notice
    • Plan must incorporate new behaviors and attitudes into everyday situations
overview of all hazards
Overview of All Hazards
  • Institute vaccination programs for all recommended adult immunizations
  • Address policies that encourage employees to work sick
  • Develop and implement workplace surveillance for infectious disease risks
  • Include families in these plans because officers cannot work effectively if their families are at risk
management oversight advantages
Management Oversight Advantages
  • Provides measurable outcomes, which disaster only planning does not
  • Provides an economic and workplace benefits which will make the program easier to continue
  • Requires policies to be worked out with unions and other stakeholders
    • Assures buy in
    • Identifies problems
the next step resilient communities

The Next Step: Resilient Communities

Bring All Hazards Planning for Public Health Emergencies to the Community

defining characteristics of public health emergencies
Defining Characteristics of Public Health Emergencies
  • Long term
    • Days to longer
    • Depletes manpower and resources
    • The affected population requires support
  • Widespread
    • Affects a region or significant urban area
    • Affects everyone, including the police
  • Significant Risk
examples
Examples
  • Epidemic
    • Bird flu
  • Hazmat incident with long term risks
    • Anthrax
    • Dirty bomb
  • Natural disaster
    • Hurricanes, Winter storms
    • Earthquakes
traditional emergency response scenarios
Traditional Emergency Response Scenarios
  • Geographically limited
    • Crime scenes
    • Parade routes
    • Look at the problems with riot control when whole neighborhoods become involved
  • Temporarily limited
    • No one is staffed to do a 100% mobilization for weeks
limited response options in public health emergencies
Limited Response Options in Public Health Emergencies
  • You cannot shoot people who are just trying to take care of their families
  • You cannot arrest large numbers of persons to restore order
  • You cannot occupy significant territory
your people are also victims
Your People are also Victims
  • Widespread public health and environmental crises affect law enforcement personnel
  • Most personnel will look to their families first
    • Law enforcement families cannot be protected outside of the context of their communities
day to day life goes on
Day to Day Life Goes On
  • No federal plan acknowledges that there are criminals and the homeless
    • Biggest joke - Pandemic flu plan says they will close the borders
  • Too many plans can only be staffed by assuming that no other law enforcement or first response activities will take place
    • Only works for short periods
why 9 11 is the wrong model
Why 9/11 is the Wrong Model
  • Deaths, but not injuries - limited impact on health care
  • Relatively small percentage of the population displaced for a long period of time
  • Relatively little infrastructure destroyed
why katrina is a better model
Why Katrina is a Better Model
  • Widespread
  • Long-term
  • Foreseeable
  • The risks could have been mitigated
  • The response needs outstripped all available resources
what do communities need in public health emergencies
What Do Communities Need in Public Health Emergencies
  • Food, water
  • Environmental management such as heat
  • Transportation and shelter if an evacuation
  • Health care
  • Family support - where are the kids?
complicating factors
Complicating Factors
  • Physical and Personnel Infrastructure Mismatch
    • Failure to do maintenance
    • Allowing development to outstrip infrastructure
  • Efficiency v. Reliability
    • Will your $100 microwave work in 5 years?
    • Will your low cost electric power company give you power 24/7/365 at 99.99%?
who will provide for the public
Who Will Provide for the Public?
  • Federal model
    • Local first responders
    • Supported by the military and federal support
  • State Models
    • Public health, supported by law enforcement
  • Reality
    • In most areas the police are the organizations with the most staff and resources
who will fund this
Who Will Fund This?
  • The existing money is coming from other essential services that cannot be postponed forever
    • Priorities will shift as fears of disaster abate
    • Many health departments are losing net money
  • Bottom-line: No one is funding real public support
objectives of resilient communities
Objectives of Resilient Communities
  • Reduce the need for support from public services
  • Reduce suffering and death
  • Reduce the risk of public disorder
  • Most important:
    • Build trust and credibility so the community will cooperate with needed mitigation measures
building blocks for resilient communities
Building Blocks for Resilient Communities
  • Honest risk communication
  • Realistic preventive strategies
  • Start with your own people
  • Working with other organizations
  • Reinforcing the message when disasters are no longer fashionable
honest risk communications
Honest Risk Communications
  • Be realistic about the risk
    • Bird flu v. yearly flu
    • Hurricane v. terrorist attack
  • Just say No to Potemkin planning
    • Big issue in public health
    • Hurricane Pam
    • Being a team player puts the public at risk
  • Do not suppress market risk signals
realistic preventive strategies
Realistic Preventive Strategies
  • Must fit in with real household management
    • Being Prepared
  • Examples
    • Gasoline
    • What to take in evacuations
    • How to keep food and water on hand
    • How to treat water and what is safe to eat when the refrigerator goes off
    • When to go back and what to do when you get there
start with your own people
Start with Your Own People
  • Get the families of your own people involved
    • Builds support - they become part of the solution
    • Direct benefits to the department
  • Encourage them to involve their neighbors
    • Stabilizes the neighborhood, making their own situation more secure
    • Do not be the only person on your block with water
working with other organizations
Working with Other Organizations
  • Find out if your local public health plans are really staffed and supported
  • Find out the plans of the local hospitals and other health care providers
  • Coordinate with retailers
  • Work with churches and other private organizations
    • Walmart and Home Depot can move goods more effectively than Northcom
reinforcing the message when disasters are out of fashion
Reinforcing the Message when Disasters are out of Fashion
  • Priorities are going to shift
    • FEMA has already punted on realistic building standards in New Orleans and the Gulf Coast
  • No politician will keep supporting prevent measures once the public gets interested in other things
    • We have a lot of social problems we have been ignoring
  • The problems will still be there
political benefits
Political Benefits
  • Most communities do not trust public health (some do not trust the police)
    • Anti-vaccination forces
    • Equating trans-fat with the plague
    • Incompetent political appointees in critical positions
  • Law enforcement will bear the risk of failed public health response