We spend many days a year developing and updating preparedness plans. Public Health has more than its share of plans. In addition to being part of the overall planning for the county or the city, the health department must plan for those events that are uniquely related to public health. This includes plans for response to bioterrorism, pandemic influenza, and general disasters.
Bioterrorism and pandemic influenza are strongly associated with public health response. However, all manmade or natural disasters have some public health response element included. Whether it is ensuring temporary shelter sanitation, checking on restaurants after a power outage, or assisting in the placement of special needs citizens, public health will be called upon.
So, public health has a lot of plans, but will they work? That question is answered, at least as well as it can be short of a disaster, by exercising the plan. Exercises generally are of two types.
First, tabletop exercises provide an opportunity for those representing different disciplines (public health, emergency management, hospitals, ambulance providers, and others) to come together and see how they would collectively react to a specific disaster. A realistic scenario is developed by an exercise planning team. That scenario is then played out in a realistic fashion, usually in one room filled with tables, and participants in the exercise are able to react as they would in a real situation except in a non-threatening atmosphere. Rather than actually responding to the designed scenario, the participants are involved in a discussion-based response. Tabletop exercises are highly effective as a means to test current readiness while identifying gaps in preparedness. They also can be conducted at a moderate cost and can be conducted on a more regular basis.
Second, full-scale exercises involve actually doing some of what would be done in a real-world disaster. Again, a realistic scenario is developed by an exercise planning team. Volunteers may be made-up to look like they have certain injuries. They may be initially diagnosed by medical responders and then be treated on-scene or transported to a hospital that is participating in the exercise. Real phone calls are made and real radio communications are used. These calls or transmissions always start with the announcement, “This is an exercise.” The full-scale exercise is more hectic and requires the use of actual resources, both time and material. It does, however, truly test the plans and responses of various agencies under stress. They are more expensive and as a result are not conducted as frequently as tabletop exercises.
Later this month, public health departments in the bi-state metro area will conduct a tabletop exercise to test our ability to work together effectively as a region. This will be followed by a full-scale exercise in June, also testing a regional response model. A lot will be learned in the course of these exercises. One absolute certain expectation is that there will be more exercises on a regular basis in the future. We never can stop learning and adapting. THAT would be disastrous!