Evacuation and Sheltering of People with Medical Dependencies: Knowledge Gaps and Barriers to National Preparedness

This article appeared in Homeland Security Affairs (February 2013), v.9, article 2Emergency plans are mandated by a number of federal regulations, often with conflicting definitions, to incorporate people with medical dependencies. However targeted planning for this segment is presently hampered by substantial knowledge deficits defining this population and the potential resource requirements in a disaster. These gaps prevent the development of evidence-based best practices for locating, communicating with, transporting, sheltering, and ensuring the safe recovery of those with medical dependencies. The authors discuss the knowledge gaps in preparing for this population and propose solutions to fill these gaps in order to facilitate enhanced preparedness for people with medical dependencies

Anger Versus Fear: Perceptions of Terrorism Among the American Public

With recent terrorist attacks in Brussels, Belgium; Paris, France; San Bernardino, California and elsewhere, the rhetoric for addressing the issue of terrorism has grown more polarized. In particular we have seen increasingly aggressive statements demanding limits to immigration, increasing vigilance against Muslim communities, and calling for more direct military action against terrorist organizations.The tone of these statements has prompted an important question as to the underlying reason for the desire for more aggressive policing and military tactics. It has also raised critical questions regarding surveillance and data privacy rights via encryption backdoors on every day technologies. Is this desire for action driven more by a sense of fear and anxiety? Or is this driven by anger and humiliation?The answer to these questions may help understand which groups of individuals are likely to support or reject various approaches to combatting terrorism, as well as their perceptions of the kind of leadership needed

A Philanthropic Approach to Supporting Emergent Disaster Response and Recovery

In August 2017, Hurricane Harvey struck the US Gulf Coast and caused more than US $125 billion in damages in Texas. The loss of lives and the economic damages resulted in an outpouring of support for the recovery efforts in the form of federal assistance and private donations. The latter has supported more creative approaches to recovery. Organizations that normally would not receive funding were able to obtain resources to use in novel manners. Using the framework of Dynes typology to identify groups and their respective structures and tasks, this report from the field analyzes Hurricane Harvey and the financial support mechanisms used to support recovery efforts in Texas, what organizations were funded to do, and where they fit into Dynes typology. The authors close by noting the importance of these emerging organizations and the need to support diversity in funding disaster response and recovery efforts beyond large nonprofit organizations

Acts of terrorism and mass violence targeting schools : Analysis and implications for preparedness in the USA

To enhance the preparedness of US schools to acts of terrorism and mass violence, the landscape of threats against schools must first be understood. This includes exploring the global trends of acts of terrorism against schools, as well as looking specifically at the history of terrorism and acts of mass violence against schools domestically. This paper conducts a review of two databases in order to look at the trends in acts of terrorism and mass violence carried out against schools, and provides recommendations for domestic school preparedness based on this information

Initial Coronavirus Disease–2019 Closure Strategies Adopted by a Convenience Sample of US School Districts: Directions for Future Research

School closures are an important strategy to mitigate the impacts of a pandemic. But an optimal approach to transitioning from in-person to distance learning approaches is lacking. We analyzed a convenience sample of public K-12 schools in the early weeks of the COVID-19 pandemic in the United States. This initial snapshot provides some insights to inform future research into the variation of strategies across school districts, and would benefit from more rigorous methods to determine true correlations between demographic and geographic factors. Additionally, many of these strategies have evolved in response to ongoing and prolonged public health social distancing measures implemented after this analysis was conducted

Schools and Terrorism: Global Trends, Impacts, and Lessons for Resilience

This study characterizes trends in the frequency and characteristics of terrorist attacks in child-serving educational institutions around the world, examining the specific vulnerabilies of children and schools with regard to terrorist violence, as well as the various impacts that violence has on children, communities, and societies. Following the analysis of available data on terrorist attacks against educational institutions, vulnerabilities, and impacts, the study concludes with a discussion of what still needs to be understood in the intersection of child vulnerability and terrorism, and provides recommendations for improving resilience to terrorist attacks against child-serving educational institutions. One would like to think that certain truths or values would be universally understood as rules of engagement, formally declared or otherwise. The sanctity of children's well-being should be unquestioned, regardless of the issues at stake in the larger conflict. Sadly, history shows that this understanding is neither universally shared nor uniformly valued. —Irwin Redlener, Americans at Risk, 2007 Since the violent attack on School Number One in Beslan, Russia in 2004, the perceived threat of massive terror attacks targeting schoolchildren has loomed in the public consciousness. In recent years, attacks against educational institutions worldwide have increasingly been reported and documented. The kidnapping of 276 schoolgirls by Boko Haram in Nigeria and the massacre of at least 150 students and staff in a Peshawar school by the Pakistani Taliban in 2014 are still fresh in the minds of the public. These attacks serve as reminders of the vulnerability that children in schools face, being “soft targets” whose symbolic value has the capacity of invoking mayhem at the largest possible scale. They also demonstrate the urgency with which this emerging trend in violence must be systemically recorded, analyzed, and mitigated. The following article will discuss the vulnerability of children with regard to terrorist violence, exploring the literature on what makes children and educational institutions particularly desirable targets. Trends in the frequency and characteristics of terrorist attacks against child-serving educational institutions around the world will be examined, paying particular attention to potential school level and gendered disparities. Finally, a critical analysis on what can be learned from the available data and what still needs to be researched in the nexus of child vulnerability and terrorism will be provided

Superstorm Sandy: Lessons for Optimizing Limited Training Resources for Local Impact

Professional training development, whether for a classroom, work environment, or other setting, typically follows a validated instructional design model that includes an assessment of learner needs before the development of a training. This foundational principle is integrated into federal guidance documents for emergency preparedness training. That said, local preparedness resources are sometimes in misalignment with this principle. Funding tends to favor nationally defined priorities as a proxy for the assessment of local needs. This letter explores this dynamic in the context of the response to Superstorm Sandy, and proposes a revised funding paradigm to support training development

Crisis Decision-Making During Hurricane Sandy: An Analysis of Established and Emergent Disaster Response Behaviors in the New York Metro Area

Objective This collective case study examined how and why specific organizational decision-making processes transpired at 2 large suburban county health departments in lower New York State during their response to Hurricane Sandy in 2012. The study also examined the relationships that the agencies developed with other emerging and established organizations within their respective health systems. Methods In investigating these themes, the authors conducted in-depth, one-on-one interviews with 30 senior-level public health staff and first responders; reviewed documentation; and moderated 2 focus group discussions with 17 participants. Results Although a natural hazard such as a hurricane was not an unexpected event for these health departments, they nevertheless confronted a number of unforeseen challenges during the response phase: prolonged loss of power and fuel, limited situational awareness of the depth and breadth of the storm’s impact among disaster-exposed populations, and coordination problems with a number of organizations that emerged in response to the disaster. Conclusions Public health staff had few plans or protocols to guide them and often found themselves improvising and problem-solving with new organizations in the context of an overburdened health care system

Operational Epidemiological Modeling: A Proposed National Process

This article appeared in Homeland Security Affairs (February 2013), v.9, article 1To support the successful integration of civilian and military domestic disaster medical response, the Yale New Haven Center for Emergency Preparedness and Disaster Response (YNH-CEPDR) and US Northern Command (USNORTHCOM) have established the National Center for Integrated Civilian-Military Domestic Disaster Medical Response (ICMDDMR). As part of the ICMDDMR, YNH-CEPDR has conducted research to determine the requirements of a national operational epidemiological modeling process to integrate modelers with operational decision makers during an infectious disease event of national significance. This article presents a proposed process that is based on research and consultation with a workgroup of interagency and organizational stakeholders

Emergency Preparedness Training for Hospital Nursing Staff, New York City, 2012–2016

Purpose Many nurses are trained inadequately in emergency preparedness (EP), preventing them from effectively executing response roles during disasters, such as chemical, biological, radiological, nuclear, and explosive (CBRNE) events. Nurses also indicate lacking confidence in their abilities to perform EP activities. The purpose of this article is to describe the phased development of, and delivery strategies for, a CBRNE curriculum to enhance EP among nursing professionals. The New York City (NYC) Department of Health and Mental Hygiene (DOHMH) and the National Center for Disaster Preparedness at Columbia University's Earth Institute led the initiative. Methods Curriculum development included four phases. In Phases I and II, nursing staff at 20 participating NYC hospitals conducted 7,177 surveys and participated in 20 focus groups to identify training gaps in EP. In Phase III, investigators developed and later refined the CBRNE curriculum based on gaps identified. In Phase IV, 22 nurse educators (representing 7 of the original 20 participating hospitals) completed train‐the‐trainer sessions. Of these nurse educators, three were evaluated on their ability to train other nurses using the curriculum, which investigators finalized. Findings The CBRNE curriculum included six modules, a just‐in‐time training, and an online annual refresher course that addressed EP gaps identified in surveys and focus groups. Among the 11 nurses who were trained by three nurse educators during a pilot training, participant knowledge of CBRNE events and response roles increased from an average of 54% (range 45%–75%) on the pre‐test to 89% (range 80%–90%) on the posttest. Conclusions By participating in nursing CBRNE training, nurses increased their knowledge of and preparedness to respond to disasters. The train‐the‐trainer curriculum is easily adaptable to meet the needs of other healthcare settings. Clinical Relevance The CBRNE curriculum can be used to train nurses to better prepare for and more effectively respond to disasters