Vocabulary List

• Emergency Preparedness and Response: How to prepare for and be ready for emergencies, including how strategies will be developed for a potential response. 

• Emergency Operations Plan (EOP): EOPs describe who will do what, as well as when, with what resources, and by what authority before, during, and immediately after an emergency. EOPs help to define the scope of preparedness and emergency management activities necessary for that jurisdiction. 

• Crisis and Emergency Risk Communication: The right message at the right time from the right person can save lives. 

• Business Impact Analysis: Predicts the consequences of disruption of a business function and process and gathers information needed to develop recovery strategies. 

(Preparedness & Planning | CDC Emergency Preparedness & Response, 2023)

Objectives

This Week's Objectives:

• Identify the four sectors of emergency preparedness and response.

• Describe the five steps for individual and family emergency preparedness.

• Describe a business impact analysis.

Sector 1: Emergency Preparedness for Individuals, Families, and Communities

To effectively plan for and manage disasters, the entire community must take on a role at some level (Preparedness & Planning | CDC Emergency Preparedness & Response, 2023). This approach aligns with what we are learning in the field of public health, in terms of developing strategies that focus on populations or groups of people. Public health emergency preparedness is a powerful contributor to any public health jurisdiction, and emergency managers are at the forefront of such efforts. 

And being prepared for an emergency starts with individuals and families. As we help ourselves in a self-reliance way, we can pattern our preparedness efforts after Jesus Christ. In the New Testament, Luke chapter 22 verse 32, we read how Jesus instructed Peter, “But I have prayed for thee, that thy faith fail not: and when thou art converted, strengthen thy brethren” (“Luke, Chapter 22, Verse 22,” n.d.). We as individuals and families must first be prepared for disasters and emergencies in order to support and help strengthen the communities where we live.

(U.S. Department of Homeland Security, 2023)

Personal and family preparedness includes preparing yourself and your family long before disaster strikes. Follow these steps to be ready for any hazard, disaster, or emergency:

1. Write a plan that answers the following questions:
   a. How will I receive emergency alerts and warnings?
   b. What is my shelter plan?
   c. What is my evacuation route?
   d. What is my family or household communication plan?
   e. Is my emergency preparedness kit updated and ready?

2. Review and document the needs of your family. Discuss needs and responsibilities such as the following: 
   a. Medical needs including prescriptions and equipment.
   b. Dietary needs of family members.
   c. Schools where your children attend school.
   d. Daycare or place where you children may be cared for.
   e. Business and work needs.
   f. Dietary, shelter, and medical needs of your pets.
   g. Disabilities or functional needs including devices and equipment.
   h. Cultural and religious considerations.
   i. Locations frequented.

3. Create a family emergency plan. Visit Ready: Make a Plan Form for a template to follow and use for you and your family. Keep in mind that during an emergency, certain communication channels may be unavailable, including cellular phones, the internet, and so on. For this reason, it is important to identify specific meeting locations or other ways to communicate with each other.

4. Practice your plan with your family or household. As often as you need to, but at least once per year, practice your family emergency plan. Even a family meeting or family council can be a great time to review, discuss, and improve your family’s emergency plan. 

5. Build a kit. After an emergency, you may need to survive on your own for a few days. Being prepared means having your own food, water, and other supplies that will last for several days. An emergency preparedness kit is a collection of basic items your household may need in the event of an emergency and can include the following:

   • Water (one gallon per person per day for several days, for drinking and sanitation)

   • Food (at least a several-day supply of non-perishable food)

   • Battery-powered or hand-cranked radio

   • Flashlight with extra batteries

   • First aid kit (with a whistle)

   • Dust mask (to filter dirty air. KN95, N95, or simple surgical mask)

   • Plastic sheeting and duct tape (to shelter in place)

   • Moist towlettes, garbage bags and plastic ties (for sanitation purposes)

   • Simple tools, such as a wrench and pliers

   • Manual can opener (for non-perishable food products)

   • Local maps

   • Cell phone with chargers and back up batteries or power sources

   •  Prescriptions and medical supplies

   • Food and water for pets

Community preparedness for disasters and emergencies focuses on how you can help your community before, during, and after a disaster, hazard or emergency. Components of community preparedness can include the following:

• Volunteer and Donate: During disaster response, impacted communities depend on volunteer organizations to provide trained volunteers and donated supplies. Communities build networks of volunteers, training, resources, supplies, and equipment in order to be ready for a disaster. One example of a community-led volunteer effort in disaster response is the Community Emergency Response Team. In some communities, this team may go by a different name, but an organization, such as a city, is usually the one who leads the team’s effort.  

• Train and Educate: Learning all you can about emergency management is a great starting point. Then, consider being trained in different areas, regardless of your background or professional experience. Trainings that can make a significant impact during and after emergencies include Cardiopulmonary Resuscitation (CPR), first aid, stop the bleed, automated external defibrillator (AED). You do not need to be a healthcare professional to receive training in these areas. In emergency situations, there is a saying that tends to ring true: You are the help until help arrives. For example, at schools, teachers and administrators are the help until help arrives. The same can be said for your business or workplace, among other settings. The more confident you are in your emergency response skills, the more effective you will be.

• Know Your Communication Options: Communicating before, during, and after disasters and emergencies is essential so that important life-saving information can be conveyed. Unfortunately, not all communication channels may be available (for example, cellular phones, internet). For this reason, research how your community is prepared to communicate before, during, and after an emergency. Communication tools that communities may use include the following:

  • Emergency alert systems with phone, text, and email.

  • Sirens or horns.

  • Amateur radio (ham radio).

  • Traditional radio.

  • Television.

(Before, During, and After School Emergencies | CDC, 2023)

Sector 2: Emergency Preparedness for Schools

Schools that serve students from various age groups have a responsibility to protect their students and staff from a variety of threats and hazards. These threats can include emergencies that are short-term and long-term, natural or man-made, and incidents that require evacuation or sheltering in place. 

When schools plan for emergencies, they are better prepared to respond in an effective manner in order to protect and save lives. Furthermore, proper planning can help schools to reduce the short and long-term impact on operations. This can help schools to remain open or allow them to reopen in a more timely manner, which helps to continue the educational process for the students and continue offering programs and services that families may need.

The Centers for Disease Control and Prevention (CDC) reinforce that communication is key during an emergency. Having a communication plan in place can help schools more efficiently and quickly communicate to emergency personnel, media, staff members, students, and families during and after an emergency. This communication can help ensure that adequate, targeted support is provided by emergency personnel. It can also help reassure family members and prevent a surge of calls and visitors to the school during and after an emergency. During longer emergencies, such as epidemics or a severe flu season, communication is critical so staff members, students, and families know how the school is protecting students and what actions they need to take.

Planning, preparing for, and responding effectively to emergency situations can help prevent injury, disability, illness, and death. These emergency management principles help ensure that staff and other personnel are trained and ready to act promptly during an emergency to evacuate, shelter in place, or take other actions to keep themselves and students safe. This is the key to sound emergency management: protecting people, property, and resources. 

Remember that emergencies are usually short-term, unexpected events that can happen anytime and anywhere. They can occur at many different levels, including local, state, regional, national, or international. Emergencies can occur as a single event or a group of events. At times, emergencies last for a few minutes or hours, such as during a tornado or civil disturbance. Emergencies and disasters can last for a few days or weeks, such as a chemical release, a hurricane, or a flood. There are also times when an emergency can last months or years, such as during a pandemic like COVID-19.

As part of the overall emergency management process, schools should develop emergency operations plans, which can be planned and written in collaboration with local organizations, such as city government and non-governmental organizations. It is also important to test out these emergency operations plan by practicing their plan on a regular basis. Schools should also incorporate preparedness into their daily activities.

After an emergency occurs while students are in the care of school staff, schools will need to support reunification of students with their families. Emergency operations plans (EOPs) should include plans for reunification. This primarily applies to short-duration emergencies, such as weather emergencies or natural disasters that occur while students are at school. 

Schools should work with the appropriate staff and community organizations to consider the following:

• Communication about reunification plans to families in their preferred language before, during, and after emergencies occur.

• How privacy laws and regulations affect reunification.

• How schools will determine whether and when reunification can occur (for example, whether it is safe to be outside or whether the roads or subway lines are safe for travel). This should include alternative locations in case the primary site is impacted by the emergency.

• Transportation.

• When schools will need to transport students to their homes.

• When students who normally walk or bike home will need transportation.

• When families should pick up their students from school (and considerations for families who do not have transportation, use public transportation, or whose work hours may conflict with their ability to pick up the student).   

• Tracking.

• How schools will track who is allowed to pick up students from school.

• How schools will track where students are located, and which students have been reunified with their families.

• How schools will track any students who have been sent to the hospital for emergency medical care, and how they will inform the students’ families.

• How schools will coordinate with health officials to identify and track any deceased students, and how they will inform the students’ families.

• If individual students are not at school during an emergency, how the school will track student status and well-being after the emergency (for example, if they have a caregiver or if they are safe).

• Relocation site if a school is not safe, how to transport students and staff safely (including people with disabilities), and how to communicate a student’s location to families.

• Protocols for if no family member can be contacted about reunification with a student.

• Organizations that can support reunification efforts (for example, transportation, tracking, social services, law enforcement).

Sector 3: Emergency Preparedness for Businesses

Preparedness Planning for Your Business

(Ready Business | Ready.Gov, n.d.)

As we have learned previously, businesses and their employees are at risk for a number of hazards, including the following:

• Natural hazards like floods, hurricanes, tornadoes, and earthquakes.

• Health hazards such as widespread and serious illnesses like influenza.

• Human-caused hazards including accidents and acts of violence.

• Technology-related hazards like power outages and equipment failure.

Businesses can do a lot to prepare their organizations for their communities' most likely hazards. Business leaders should make a preparedness plan to get ready for these hazards. The Ready Business Toolkit includes hazard-specific versions for earthquake, hurricane, inland flooding, power outage, and severe wind or tornadoes that can help create preparedness plans. Toolkits offer businesses a step-by-step guide to build preparedness plans within their business. Visit Ready: Ready Business to learn more about these important toolkits that are specific to businesses desiring to be prepared for emergencies. Each toolkit contains the following sections:

• Identify Your Risk.

• Develop A Plan.

• Take Action.

• Be Recognized and Inspire Others.

A business impact analysis (BIA) predicts the consequences of disruption of a business function and process, and it gathers information needed to develop recovery strategies (Business Impact Analysis | Ready.Gov, n.d.). Potential loss scenarios should be identified during a risk assessment. Delayed deliveries may interrupt operations. There are many possible scenarios which should be considered.

Consider the Impact

The BIA should identify the operational and financial impacts resulting from the disruption of business functions and processes. Impacts to consider include the following:

• Lost sales and income.

• Delayed sales or income.

• Increased expenses (for example, overtime labor, outsourcing, expediting costs, and so on).

• Regulatory fines.

• Contractual penalties or loss of contractual bonuses.

• Customer dissatisfaction or defection.

• Delay of new business plans.

Timing and Duration of Disruption

The point in time when a business function or process is disrupted can have a significant bearing on the loss sustained. A store damaged in the weeks prior to the holiday shopping season may lose a substantial amount of its yearly sales. A power outage lasting a few minutes would be a minor inconvenience for most businesses but one lasting for hours could result in significant business losses. A short duration of production disruption may be overcome by shipping finished goods from a warehouse, but disruption of a product in high demand could have a significant impact.

Conducting the BIA

Consider using a questionnaire to survey managers and others within the business. Survey those with detailed knowledge of how the business manufactures its products or provides its services. Ask them to identify the potential impacts if the business function or process that they are responsible for is interrupted by a disaster or emergency. The BIA should also identify the critical business processes and resources needed for the business to continue to function at different levels.

BIA Report

The BIA report should document the potential impacts resulting from disruption of business functions and processes. Scenarios resulting in significant business interruption should be assessed in terms of financial impact, if possible. These costs should be compared with the costs for possible recovery strategies.

The BIA report should prioritize the order of events for the restoration of the business. Business processes with the greatest operational and financial impacts should be restored first.

Business Disruption Scenarios

• Physical damage to a building buildings.

• Damage to or breakdown of machinery, systems, or equipment.

• Restricted access to a site or building.

• Interruption of the supply chain including failure of a supplier or disruption of transportation of goods from the supplier.

• Utility outage (for example, electrical power outage).

• Damage to, loss or corruption of information technology including voice and data communications, servers, computers, operating systems, applications, and data.

• Absenteeism of essential employees.

Sector 4: Emergency Preparedness for Healthcare

During times of disaster, hospitals play an integral role within the health-care system by providing essential medical care to their communities. Any incident that causes loss of infrastructure or patient surge (such as a natural disaster, terrorist act, or chemical, biological, radiological, nuclear, or explosive hazard), often requires a multijurisdictional and multifunctional response and recovery effort, which must include the provision of health care (Hospital Emergency Response Checklist, n.d.). 

In many countries, hospitals are required to have an Emergency Operations Plan (EOP). An EOP describes how a facility will respond to and recover from all hazards. It usually includes six components:

• Communications

• Resources and assets

• Safety and security

• Staff and leader responsibilities

• Utilities

• Clinical support activities

Without appropriate emergency planning, local health systems can easily become overwhelmed in attempting to provide care during a critical event. Limited resources, a surge in demand for medical services, and the disruption of communication and supply lines create a significant barrier to the provision of health care. Hospitals need an emergency operations plan to prepare their health facilities for the challenges of a disaster.

A national stockpile of medicines and supplies can be part of a federal medical response infrastructure. This stockpile can supplement medical countermeasures needed by communities during public health emergencies. A stockpile of supplies, medicines, and devices for lifesaving care can be used as a short-term solution when the immediate supply of these materials may not be available or adequate. Agencies tasked to manage emergencies work every day to prepare and respond to emergencies, support local preparedness activities, and ensure availability of critical medical assets to protect the health of a population (Strategic National Stockpile | SNS | HHS/ASPR, n.d.).

A medical reserve corps, or a group of medical professionals, can be a national network of volunteers, organized locally to improve the health and safety of their communities. These volunteer medical and health professionals could include doctors, nurses, dentists, veterinarians, behavioral health specialists, medical assistants, respiratory therapists, surgical technicians, and so on. These medical volunteers are committed to keep their family, friends, and neighbors safe and healthy.

(Medical Surge Capacity and Capability, n.d.)

As we learned in Chapter 1, a disaster typically involves a large number of injuries, the displacement of many people, a potentially large number of casualties, and considerable property damage or loss. To this end, communities and healthcare facilities must plan for and develop a medical surge capacity and capability. This management approach exists to develop a system that promotes public health and medical system resiliency. Moreover, such a strategy maximizes the ability to provide adequate public health and medical services during events that exceed the normal medical capacity and capability of an affected community.

Local communities ought to be mindful of an emergency prescription assistance program as well. This type of program helps people in a disaster area who do not have health insurance get the prescription drugs, vaccinations, medical supplies, and equipment that they need. This program helps people and communities better cope with a disaster and reduces stress on the healthcare system. People who are eligible for this type of program can file a claim at a network of pharmacies for prescription items that were lost, stolen, or destroyed because of a disaster.

Behavioral health describes the continuum of one’s emotional, cognitive, and relational wellbeing and is a key factor in the ways that people act. Following a disaster or emergency event, it is common for individuals and families, as well as disaster responders, to experience distress and anxiety related to safety, health, well-being, and recovery. Behavioral health is an integral part of the public health and medical emergency management system and should be fully integrated into preparedness, response, and recovery activities.

Disaster behavioral health is the provision of mental health, substance abuse, and stress management services to disaster survivors and responders. Federal disaster behavioral health also addresses the behavioral health care infrastructure, individual and community resilience, and risk communication and messaging (Disaster Behavioral Health, n.d.).

(Strengthening National Emergency Preparedness, n.d.)

Due to many countries lacking the minimum capacities necessary to rapidly detect and respond to known hazards and potential public health emergencies, the World Health Organization (WHO) works with countries to improve their operational readiness and handle the initial impact of emergencies and subsequent recovery. WHO’s work supports countries in meeting their commitments under the International Health Regulations to build capacity for all kinds of public health events.

WHO works in close collaboration with regional and country offices to accomplish the following:

• Help countries strengthen their public health surveillance system.

• Provide risk assessment support in the form of technical guidance and operational support on the ground.

• Provide guidance on risk communications.

• Advise countries on establishing or accessing laboratory services.

• Support national rapid response team trainings and training of trainers.

• Conduct simulation exercises to test national, regional, and global capacities to respond to emergencies.

• Initiate after action reviews (AAR) after the event to identifying best practices, gaps, and lessons learned.

(Strategic National Stockpile | SNS | HHS/ASPR, n.d.)

As part of WHO, the Strategic Framework for Emergency Preparedness is a unifying framework which identifies the principles and elements of effective national health emergency preparedness. It adopts the major lessons of previous initiatives and lays out the planning and implementation process by which countries can determine their priorities and develop or strengthen their operational capacities. The framework capitalizes on the strengths of current initiatives and pushes for more integrated action at a time when there is both increased political will and increased funding available to support preparedness efforts.

The health emergency preparedness framework advocates for prioritizing financial and other resources for community and country emergency preparedness and for mobilizing and sustaining increased domestic and international investment for these. Visit World Health Organization: A strategic framework for emergency. preparedness to download a copy of the WHO Strategic Framework.

Crisis and Emergency Risk Communication

(CERC: Introduction, n.d.)

What emergencies, disasters, and crises have in common is that something bad has happened or is happening. Crisis and emergency risk communication is the strategy used to provide information that allows an individual, stakeholders, or an entire community to make the best possible decisions during a crisis emergency event. 

When a crisis occurs, even if it is anticipated, initiating a full response can take time. The situation must be assessed and monitored for emerging or secondary threats, resources must be allocated, and personnel and materials must overcome any logistical or safety barriers to getting into the affected area. But the affected people and those at immediate risk are ready to act right away and need information on the situation and how to stay safe immediately. The Crisis and Emergency Risk Communication (CERC) framework and its principles can help you provide the public with information to make the best decisions and to accept the imperfect nature of choice, under incredibly challenging time constraints. You can help your organization and your community prepare for, respond to, and recover from an emergency by using CERC’s six main principles: be first, be right, be credible, express empathy, promote action, and show respect. We can have a real and measurable effect on the wellbeing of our communities by what we say, when we say it, and how we say it. 

The first few hours of any event are usually chaotic. This is a time of high uncertainty where a quick response can be critical. A crisis communication plan is designed to make some initial communication decisions before a crisis happens so your organization can respond promptly and adapt rapidly. While every event is unique, some crisis communication steps are universal and can help your organization effectively manage most emergencies. That said, many emergency management organizations use a variety of approaches to develop their own crisis and emergency risk communication plan. Each CERC plan may look a little different, but consider the seven step model described below (CERC Corner - Nine Steps in Crisis Communication Implementation, 2018). 

Step 1: Verify the Situation

Situational awareness is the first step in an informed response. Although information will be scarce, get the facts and try to verify them with more than one credible source.

Step 2: Conduct Notifications

Notify all necessary response points of contact, and keep a record of who was notified, when, how, and if they were reached or require follow-up.

Step 3: Conduct Crisis Assessment (Activate Crisis Plan)

Continually assess new information, the severity of the situation, the target audience, and what information should be communicated.

Step 4: Organize Assignments Quickly

Quickly assign responders specific responsibilities, dividing these assignments based on immediate and ongoing issues. Coordinate with appropriate response partners to address all communication needs.

Step 5: Prepare Information and Obtain Approvals

Coordinate development of activities and messages, rapidly sharing and clearing information within your organization for timely release.

Step 6: Release Information through Prearranged Channels

Identify audiences and communication channels prior to a crisis, so information can be disseminated rapidly during an emergency.

Step 7: Obtain Feedback and Conduct Crisis Evaluation

As soon as possible after a crisis starts, conduct an evaluation of your organization’s response. Feedback from key audiences and coverage from media can inform messages and allow problems to be addressed. Moreover, monitor communication activities on an ongoing basis (including media, social media, and responder interactions) to determine how to improve messages and the general communication strategy.

Planning is the most important step to ensure an effective response using Crisis and Emergency Risk Communication. It takes considerable time and effort to develop and maintain a crisis communication plan. Plans should not try to answer all the questions or determine all the decisions, but they should reveal a process. Understanding the features of a plan, as well as the types of information to include and the kinds of questions to ask, are vital to a response’s success. 

(Templates and Tools|Crisis & Emergency Risk Communication (CERC), 2018)

A sound CERC plan should also include the following elements:  

• A signed endorsement from your director (in other words, top official).  

• Staff responsibilities for the public information teams. 

• Internal information verification and clearance or approval procedures.  

• Agreements on information release authorities (in other words, who releases what, when, and how).  

• Regional and local media contact list. 

• Procedures to coordinate with the public health organization response teams.

• Designated spokespersons for public health issues and third-party validators in an emergency.  

• Your organization’s emergency response team after-hours contact numbers. 

• Contact numbers for emergency response information partners (for example, government public affairs officer, local or regional department of agriculture or veterinarian public information officers, disaster response agencies, and other nongovernmental organizations).  

• Agreements and procedures to join the joint information center of the emergency operations center (if activated).  

• Procedures to secure needed resources (space, equipment, people) to operate the public information and media operation during a public health emergency 24 hours a day/7 days a week, if needed.  

• Identified ways to disseminate information to the public, stakeholders, partners (for example, email lists, broadcast fax, door-to-door handouts, press releases) during a crisis.

Remember that the right message from the right person at the right time can save lives. CERC aims to provide people with the information they need to make lifesaving decisions in critical situations. CERC is designed around the psychological processes of people affected by, responding to, or observing a crisis. CERC principles are vital to helping people cope and begin to rebuild. The right communication helps to bring a sense of order and understanding to otherwise chaotic situations. Good communication enables organizations to fulfill their mission, maintain public trust, manage limited resources, and most of all, prevent and reduce illnesses and injuries. 

Throughout every step of an effective response, there are six principles to follow and practice: be first, be right, be credible, express empathy, promote action, and show respect.

References

Before, During, and After School Emergencies | CDC. (2023, July 25). https://www.cdc.gov/healthyyouth/school-preparedness/emergency_preparedness.html

Business Impact Analysis | Ready.gov. (n.d.). Retrieved September 22, 2023, from https://www.ready.gov/business/planning/impact-analysis

CERC Corner—Nine Steps in Crisis Communication Implementation. (2018, November 30). https://emergency.cdc.gov/cerc/cerccorner/article_071516.asp

CERC: Introduction. (n.d.).

Disaster Behavioral Health. (n.d.). Retrieved September 22, 2023, from https://aspr.hhs.gov:443/behavioral-health/Pages/default.aspx

Hospital emergency response checklist. (n.d.). Retrieved September 22, 2023, from https://www.who.int/publications-detail-redirect/hospital-emergency-response-checklist

Luke, Chapter 22, Verse 22. (n.d.). In The Holy Bible, KJV.

Medical Surge Capacity and Capability. (n.d.). Retrieved September 22, 2023, from https://www.phe.gov/Preparedness/planning/mscc/Pages/default.aspx

Preparedness & Planning | CDC Emergency Preparedness & Response. (2023, March 7). https://emergency.cdc.gov/planning/index.asp

Ready Business | Ready.gov. (n.d.). Retrieved September 22, 2023, from https://www.ready.gov/business

Strategic National Stockpile | SNS | HHS/ASPR. (n.d.). Retrieved September 22, 2023, from https://aspr.hhs.gov:443/SNS/Pages/default.aspx

Strengthening national emergency preparedness. (n.d.). Retrieved September 22, 2023, from https://www.who.int/activities/strengthening-national-emergency-preparedness

Templates and Tools|Crisis & Emergency Risk Communication (CERC). (2018, November 30). https://emergency.cdc.gov/cerc/resources/templates-tools.asp

U.S. Department of Homeland Security. (2023, February 22). Make a Plan. Ready. https://www.ready.gov/plan