Orientation to Public Health Emergency Preparedness Staff Orientation

Orientation to Public Health Orientation to Public Health Emergency PreparednessEmergency Preparedness

Staff OrientationStaff Orientation

In order to meet the annual requirements for In order to meet the annual requirements for education and training under the Emergency education and training under the Emergency Preparedness Program Standard, you have Preparedness Program Standard, you have been asked to read through the following been asked to read through the following emergency and response education and emergency and response education and training information as it relates to the Perth training information as it relates to the Perth District Health Unit.District Health Unit.

Educational Training OutlineEducational Training Outline

Key elements to be discussed:Key elements to be discussed:

Hazard Identification and Risk Assessment (HIRA)Hazard Identification and Risk Assessment (HIRA) Key elements of the PDHU Emergency Response PlanKey elements of the PDHU Emergency Response Plan Roles of key people within the Incident Management Roles of key people within the Incident Management

System System Key elements of the PDHU Continuity of Operations Plan Key elements of the PDHU Continuity of Operations Plan The 24/7 Notification ProtocolThe 24/7 Notification Protocol

Hazard Identification and Risk Hazard Identification and Risk Assessment (HIRA)Assessment (HIRA)

HIRA is a process by which the hazards facing a particular HIRA is a process by which the hazards facing a particular public health unit are identified and assessed in terms of public health unit are identified and assessed in terms of their probability and consequence(s) that they pose. their probability and consequence(s) that they pose.

Based on this risk assessment, we can effectively plan and Based on this risk assessment, we can effectively plan and prepare for potential public health emergencies or prepare for potential public health emergencies or emergencies with public health significance.emergencies with public health significance.

The HIRA process is a key component of a comprehensive The HIRA process is a key component of a comprehensive emergency preparedness program and assists in emergency preparedness program and assists in establishing priorities for preparedness activitiesestablishing priorities for preparedness activities

Identifying Risks to Public Health in Identifying Risks to Public Health in Perth CountyPerth County

The HIRA process is comprised of the The HIRA process is comprised of the following steps: following steps:

Step 1Establish the Context

Step 2 Identify potential hazards

Step 3Determine probability and consequence rating for each hazard

Step 4Plot each hazard on risk assessment grid


Establish the ContextEstablish the Context

Things that are considered specific to Perth County:Things that are considered specific to Perth County:

Geographic locationGeographic location Geographic dispersion of population Geographic dispersion of population Classification of area (i.e. rural, urban, mixed) Classification of area (i.e. rural, urban, mixed) Vulnerable populations Vulnerable populations Main transportation avenues Main transportation avenues Main industries Main industries Critical service suppliers (i.e. electricity, telecommunications, gas) Critical service suppliers (i.e. electricity, telecommunications, gas)

Additional Tools Additional Tools

Maps of main communities illustrating key facilities, institutions and transportation Maps of main communities illustrating key facilities, institutions and transportation avenues etc.avenues etc.

Relevant historical data in relation to past public health emergencies or Relevant historical data in relation to past public health emergencies or emergencies with public health significance emergencies with public health significance


Identify Potential HazardsIdentify Potential Hazards

1)1) Natural HazardsNatural Hazards Natural hazards are unexpected or uncontrollable natural events which Natural hazards are unexpected or uncontrollable natural events which affect a group of people by disrupting their activities and potentially causing affect a group of people by disrupting their activities and potentially causing loss of life; (e.g. Floods, Severe Weather, Human Health Emergencies) loss of life; (e.g. Floods, Severe Weather, Human Health Emergencies)

2) 2) Technological HazardsTechnological HazardsTechnological hazards refer to a wide range of conditions emanating from Technological hazards refer to a wide range of conditions emanating from the manufacture, transportation, and the use of modern technology and the manufacture, transportation, and the use of modern technology and substances such as chemicals, explosives, flammables, and radioactive substances such as chemicals, explosives, flammables, and radioactive materials (e.g. Critical Infrastructure Failures, Oil, Natural Gas materials (e.g. Critical Infrastructure Failures, Oil, Natural Gas Emergencies, Transportation Emergencies)Emergencies, Transportation Emergencies)

3) 3) Human-caused HazardsHuman-caused HazardsHuman-caused hazards are threats having an element of human intent, Human-caused hazards are threats having an element of human intent, negligence, or error or involving a failure of a system (e.g. Special Events, negligence, or error or involving a failure of a system (e.g. Special Events, Civil Disorders)Civil Disorders)


Once a hazard is identified the risk is assessed by figuring out theOnce a hazard is identified the risk is assessed by figuring out theprobability of the hazard occurring and the consequence it causes.probability of the hazard occurring and the consequence it causes.

Risk Assessment =Hazard + Probability + ConsequenceRisk Assessment =Hazard + Probability + Consequence

Assessing Probability

Has it happened before?Has it happened before? What is the frequency with which it has occurred?; and What is the frequency with which it has occurred?; and How long since the last occurrence? How long since the last occurrence?


Assessing Consequence Assessing Consequence The purpose of this step is to determine the overall risk presented The purpose of this step is to determine the overall risk presented by each hazard. The consequence of a hazard is determined by by each hazard. The consequence of a hazard is determined by the impact the hazard has on life, physical infrastructure and thethe impact the hazard has on life, physical infrastructure and theeconomy.economy.

Things to consider:Things to consider:

Concentration of peopleConcentration of people Critical transportation corridorsCritical transportation corridors Special populations Special populations Key facilities for emergency services, response and evacuationKey facilities for emergency services, response and evacuation Injury, death, environmental damageInjury, death, environmental damage Negative economic impactNegative economic impact Disruption of basic and essential servicesDisruption of basic and essential services

Perth County Hazards/RiskPerth County Hazards/RiskAfter applying the methodology of the HIRA process the following are the After applying the methodology of the HIRA process the following are the hazards/risk for Perth County, from highest to lowest.hazards/risk for Perth County, from highest to lowest.

Severe Weather EventsSevere Weather Events Power Outages Power Outages Extreme TemperatureExtreme Temperature Food RecallsFood Recalls Oil/Natural Gas/Propane EventsOil/Natural Gas/Propane Events Critical Infrastructure FailuresCritical Infrastructure Failures Pandemic InfluenzaPandemic Influenza Adverse Water EventsAdverse Water Events Explosion/FireExplosion/Fire Hazardous Materials (Transportation)Hazardous Materials (Transportation) Animal DiseaseAnimal Disease FloodingFlooding Disease Outbreaks Disease Outbreaks Hazardous Materials (Fixed Site)Hazardous Materials (Fixed Site) Foodborne illnessFoodborne illness

Extreme-High/Substantial

High-High/Substantial/Limited

Moderate-Substantial/Limited

Key Elements of the PDHU Key Elements of the PDHU Emergency Response PlanEmergency Response Plan

The current emergency response plan is a “living” The current emergency response plan is a “living” document and is reviewed and tested annually. It can be document and is reviewed and tested annually. It can be accessed through the intranet under Emergency Response.accessed through the intranet under Emergency Response.

Key Elements of the plan include:Key Elements of the plan include: Health Units Role in an EmergencyHealth Units Role in an Emergency The the Incident Management System (IMS)The the Incident Management System (IMS) Roles of the Incident Management Team (IMT)Roles of the Incident Management Team (IMT) Activation of the PlanActivation of the Plan Continuity of Operations Plan Continuity of Operations Plan Notification ProcessNotification Process

Health Unit’s Role in an EmergencyHealth Unit’s Role in an Emergency

In an emergency, the Health Unit’s role is to:In an emergency, the Health Unit’s role is to: Assess the impact of the emergency situation on the Assess the impact of the emergency situation on the

health of the publichealth of the public

Advise the public on matters concerning public health, Advise the public on matters concerning public health, through communication channels established by the through communication channels established by the Municipal Emergency Control Group (MECG)Municipal Emergency Control Group (MECG)

Control communicable diseaseControl communicable disease

Provide advice on the health and safety aspects of Provide advice on the health and safety aspects of emergency water supplies, sanitation, shelters, food emergency water supplies, sanitation, shelters, food supplies, mass feeding, garbage and sewage disposalsupplies, mass feeding, garbage and sewage disposal

Health Unit’s Role in an EmergencyHealth Unit’s Role in an Emergency

Enforce applicable regulationsEnforce applicable regulations

The Health Unit is aware of certain vulnerable populations The Health Unit is aware of certain vulnerable populations through the delivery of Health Unit programs and services.through the delivery of Health Unit programs and services.

Depending on the nature of the emergency, and when resources Depending on the nature of the emergency, and when resources permit, the health unit will assist in identifying and responding to permit, the health unit will assist in identifying and responding to stress reactions, both immediate and long term, in such stress reactions, both immediate and long term, in such vulnerable health unit clients. Where this is not possible, clients vulnerable health unit clients. Where this is not possible, clients will be advised to access assistance using usual channels such will be advised to access assistance using usual channels such as their family doctor and the emergency departmentas their family doctor and the emergency department

Notify other agencies and senior levels of government of health Notify other agencies and senior levels of government of health matters relating to the emergencymatters relating to the emergency

Incident Management System Incident Management System (IMS)(IMS)

We respond to large public health emergencies using We respond to large public health emergencies using Incident Management System.Incident Management System.

What is IMS?What is IMS? It is a standardized systems approach to emergency It is a standardized systems approach to emergency

managementmanagement It includes personnel, facilities, equipment, procedures, It includes personnel, facilities, equipment, procedures,

communications all within a common organizational communications all within a common organizational structurestructure

It can be used for simple and/or complex incidentsIt can be used for simple and/or complex incidents It can expand or contract depending on the emergencyIt can expand or contract depending on the emergency

Incident Management System Incident Management System (IMS)(IMS)

This group is known as the Incident Management Team (IMT)

Decision Makers

Section Chiefs

Roles and Responsibilities for Each Roles and Responsibilities for Each Sector Under IMSSector Under IMS

The Medical Officer of Health is responsible for providing the The Medical Officer of Health is responsible for providing the Municipal Emergency Control Group (MECG) with information and Municipal Emergency Control Group (MECG) with information and advice on all areas of public and environmental health issues.advice on all areas of public and environmental health issues.

This person is in charge of the incident. The Incident Manager has This person is in charge of the incident. The Incident Manager has ultimate responsibility for development of an incident action plan, ultimate responsibility for development of an incident action plan, allocation of resources and assuring that the necessary sections allocation of resources and assuring that the necessary sections are activated (or deactivated). are activated (or deactivated).

The Incident Manager is provided with information and advice and The Incident Manager is provided with information and advice and counsel from the Incident Management Team for the sections that counsel from the Incident Management Team for the sections that have been activated. The Incident Manager oversees the have been activated. The Incident Manager oversees the development of the response objectives and from this comes the development of the response objectives and from this comes the development of an incident action plan. development of an incident action plan.

Medical Officer of Health

Incident Manager

Roles and Responsibilities for Roles and Responsibilities for Each Sector Under IMSEach Sector Under IMS

This individual is responsible for ensuring that appropriate information This individual is responsible for ensuring that appropriate information is provided to the public and media and that required information is is provided to the public and media and that required information is provided to Health Unit staff. This ensures consistent messaging. provided to Health Unit staff. This ensures consistent messaging. The Communications Officer frequently serves as the official The Communications Officer frequently serves as the official spokesperson for the Health Unit, or may brief or assist the Medical spokesperson for the Health Unit, or may brief or assist the Medical Officer of Health or Incident Manager when preparing for a press Officer of Health or Incident Manager when preparing for a press conference or other major information session. During an emergency, conference or other major information session. During an emergency, all information that is provided to the public is done through the all information that is provided to the public is done through the Communications Officer. Communications Officer.

““The Doers” The Doers”

The Operations Chief ensures the specific tasks and objectives The Operations Chief ensures the specific tasks and objectives related to the health unit’s incident response are carried out properly.related to the health unit’s incident response are carried out properly.

Examples of Operations activities include: risk assessment, Examples of Operations activities include: risk assessment, epidemiological investigation, data collection, inspection and epidemiological investigation, data collection, inspection and sampling, distribution of vaccines, and case investigation. sampling, distribution of vaccines, and case investigation.

Communications Officer

Operations Chief


““Day to Day”Day to Day”

The Health Unit does not usually close during an incident, so programs The Health Unit does not usually close during an incident, so programs and services may need to continue. The Health Unit will need to and services may need to continue. The Health Unit will need to determine which of its current services are essential and which can be determine which of its current services are essential and which can be either reduced or temporarily suspended according to the Continuity of either reduced or temporarily suspended according to the Continuity of Operation Plan. Operation Plan.

Examples of Continuity of Operation activities include: ensuring all Examples of Continuity of Operation activities include: ensuring all essential programs and services continue as directed in the COOP essential programs and services continue as directed in the COOP plan, Health Line capacity increased/decreased, and walk-ins are plan, Health Line capacity increased/decreased, and walk-ins are addressed. addressed.

““The Thinkers”The Thinkers”

The Planning Chief’s role is to organize data, make projections and The Planning Chief’s role is to organize data, make projections and forecasts about the event and report the information to the Incident forecasts about the event and report the information to the Incident Manager so planning can begin to deal with future issues. Manager so planning can begin to deal with future issues.

Examples of Planning activities include: situational Examples of Planning activities include: situational awareness/timelines, documentation, and forecasting.awareness/timelines, documentation, and forecasting.

Continuity of Operations

Chief

Planning Chief


““The Getters”The Getters”The Logistics Chief provides support to all the groups that have been activated in The Logistics Chief provides support to all the groups that have been activated in the Health Unit so that the work can be accomplished. the Health Unit so that the work can be accomplished.

Examples of Logistics activities include: arranging and scheduling staff to support Examples of Logistics activities include: arranging and scheduling staff to support the incident, organizing training for new and redeployed staff and providing the incident, organizing training for new and redeployed staff and providing nutrition, lodging and depending on the emergency family support for staff. nutrition, lodging and depending on the emergency family support for staff. Logistics also coordinates the use of Health Unit volunteers with the Volunteer Logistics also coordinates the use of Health Unit volunteers with the Volunteer Coordinator. Coordinator.

““The Payers”The Payers”The Administration Chief has several key responsibilities. These include ensuring The Administration Chief has several key responsibilities. These include ensuring that a contractual and financial process is in place for emergency procurement of that a contractual and financial process is in place for emergency procurement of supplies and tracking of resources that are expended during the response (so that supplies and tracking of resources that are expended during the response (so that costs can be recovered by the agency during the recovery phase of the event). costs can be recovered by the agency during the recovery phase of the event).

Examples of Administration responsibilities include: payroll and any claims, Examples of Administration responsibilities include: payroll and any claims, compensation or work refusals related to the emergency, monitors and maintains compensation or work refusals related to the emergency, monitors and maintains our building and staff facilities, maintains emergency operations centre and assists our building and staff facilities, maintains emergency operations centre and assists Logistics with the procurement and set up of internal and external facilities.Logistics with the procurement and set up of internal and external facilities.

Logistics Chief

Administration Chief

Expanding IMSExpanding IMSSupport Groups:Support Groups:

These groups are activated or de-activated under each of the 5 sectors when the These groups are activated or de-activated under each of the 5 sectors when the

health unit is operating under the IMS structure. All PDHU staff have been pre-health unit is operating under the IMS structure. All PDHU staff have been pre-

assigned to a sector and will be asked to work in any support group that is assigned to a sector and will be asked to work in any support group that is

activated under that sector. Talk to your manager if you are unsure where you willactivated under that sector. Talk to your manager if you are unsure where you will

be assigned.be assigned.

Operations Planning Logistics Administration

Mass Vaccination Post Prophylaxis

Case Management & Contact Tracing

Environmental Inspection &

Sampling

Epidemiological Investigations

Situational Assessment

Documents

Facilities

Staff Needs

Human Resources

Resource Deployment

Supplies Services and Materials

Claims & Compensation

Costing

Purchasing

Continuity of

Operations

Walk-ins

Health Line

Continuity of Operations

Activation of the PDHU Emergency Activation of the PDHU Emergency Response PlanResponse Plan

Once a public health emergency is reported the Incident Manager will Once a public health emergency is reported the Incident Manager will assemble the assemble the “Decision Makers”“Decision Makers” (which consists of the Incident (which consists of the Incident Manager, Operations Chief, Medical Officer of Health, and the Manager, Operations Chief, Medical Officer of Health, and the Communications Officer). Communications Officer).

They will discuss the immediate key public health issues and determine They will discuss the immediate key public health issues and determine the scope of the emergency. the scope of the emergency.

If the scope of the emergency is too large, for the Health Protection If the scope of the emergency is too large, for the Health Protection Department to respond alone, and time permits; the Executive Department to respond alone, and time permits; the Executive Committee will be called together to discuss the activation of the Committee will be called together to discuss the activation of the emergency response plan.emergency response plan.

Activation of the PDHU Emergency Activation of the PDHU Emergency Response PlanResponse Plan

The PDHU Emergency Response Plan will automaticallyThe PDHU Emergency Response Plan will automatically be activated when:be activated when: a county/municipal emergency is declareda county/municipal emergency is declared

Continuity of Operations Plan Continuity of Operations Plan (COOP)(COOP)

The purpose of the Perth District Health Unit Continuity of The purpose of the Perth District Health Unit Continuity of

OperationsOperations

Plan is to ensure:Plan is to ensure: employee life and safetyemployee life and safety maintenance of critical programs and servicesmaintenance of critical programs and services restoration of time critical services in the event of threat restoration of time critical services in the event of threat

to PDHU functions. to PDHU functions.

Due to today's changing threat environment, an all-hazardsDue to today's changing threat environment, an all-hazards

approach was used to develop the COOP.approach was used to develop the COOP.

COOP ActivationCOOP Activation

Two main scenarios:Two main scenarios: response to a public health response to a public health

emergency which impacts emergency which impacts the ability of PDHU to the ability of PDHU to provide its usual programs provide its usual programs and services, requiring a and services, requiring a plan for service reductions plan for service reductions

the main facility of PDHU the main facility of PDHU become inaccessible become inaccessible and/or inoperable requiring and/or inoperable requiring a plan for relocation a plan for relocation

COOP Table of ContentsCOOP Table of Contents

Introduction/OverviewIntroduction/Overview FrameworkFramework Impacts of Disruption OverviewImpacts of Disruption Overview Program and Service DependenciesProgram and Service Dependencies PDHU Plan for Service ReductionPDHU Plan for Service Reduction PDHU Plan for Relocation of West Gore OfficePDHU Plan for Relocation of West Gore Office Recovery StrategyRecovery Strategy Plan MaintenancePlan Maintenance GlossaryGlossary Appendices (Details for each program)Appendices (Details for each program)

PDHU Notification ProcessPDHU Notification Process

To protect the community and mitigate the health impacts To protect the community and mitigate the health impacts of an emergency, health hazard or reportable disease, it is of an emergency, health hazard or reportable disease, it is vital to activate and organize appropriate Public Health Unit vital to activate and organize appropriate Public Health Unit resources quickly and efficiently. resources quickly and efficiently.

Depending on the severity and/or urgency the Incident Depending on the severity and/or urgency the Incident Management System may be initiated to mount a response Management System may be initiated to mount a response to the issue. The Incident Management Team (IMT) to the issue. The Incident Management Team (IMT) members will be notified either in person, if they are at the members will be notified either in person, if they are at the office, or on their blackberry if they are out of the office and office, or on their blackberry if they are out of the office and instructed where to report. instructed where to report.

PDHU Notification ProcessPDHU Notification ProcessMass Notification

If the Incident Management System is initiated, health unit staff If the Incident Management System is initiated, health unit staff may to be pulled off regular duties during business hours to help may to be pulled off regular duties during business hours to help with the response or may be called after hours to report to a with the response or may be called after hours to report to a specific site. specific site.

Mass Notification-During Business Hours

All staff leaving the building are required to follow a process that All staff leaving the building are required to follow a process that informs their administrative assistants as to their whereabouts. informs their administrative assistants as to their whereabouts. Administrative assistants will be able to contact employees in the Administrative assistants will be able to contact employees in the field by phone if necessary. To inform staff who are in the office, field by phone if necessary. To inform staff who are in the office, an email notification, paging system, team/department meeting or an email notification, paging system, team/department meeting or physically informing the person to report to a specific location will physically informing the person to report to a specific location will be used. be used.

PDHU Notification ProcessPDHU Notification Process

Mass Notification – After Hours

If a large response to an incident or emergency, potential If a large response to an incident or emergency, potential health hazard or reportable disease including an health hazard or reportable disease including an institutional outbreak is needed, the necessary Health Unit institutional outbreak is needed, the necessary Health Unit staff will be called using the PDHU Telephone Fan-Out list. staff will be called using the PDHU Telephone Fan-Out list.

Staff will be informed to either physically report to the Staff will be informed to either physically report to the Health Unit or other site. They may also be placed on Health Unit or other site. They may also be placed on stand-by and may be called to report to work at a later time. stand-by and may be called to report to work at a later time.

Things to RememberThings to Remember During emergencies priorities change constantly-be flexibleDuring emergencies priorities change constantly-be flexible You may report to a different manager during an You may report to a different manager during an

emergencyemergency Be prepared to be assigned to something you may not Be prepared to be assigned to something you may not

have done beforehave done before Be prepared to be re-assigned as the emergency Be prepared to be re-assigned as the emergency

progresses progresses You have a team you can rely on, however it may not be You have a team you can rely on, however it may not be

your usual one and may have different staff from different your usual one and may have different staff from different departments. departments.

If you are unsure what sector you belong to or need more If you are unsure what sector you belong to or need more information/training on what you will be doing during an information/training on what you will be doing during an emergency talk to you manager.emergency talk to you manager.