Many major disasters start without warning, continue for periods ranging from mere seconds to weeks or months, and leave behind a chaotic mass of useless rubble and ruined lives. The work of public health agencies necessarily starts well before the first tremor, continues through the entire response/recovery/resilience process, and ends - well, never.
True or not, the fact that "It never happened here" frequently morphs into a belief that "It can't happen here." That is an extremely dangerous assumption, as the "45-second" tornado that devastated Joplin, Missouri, proved once again. The resilient citizens of that gallant city are digging out, though, and recognize that the real key to survival is to "Plan for the worst, but hope for the best."
The twin goals - total security, and immediate accessibility - prescribed for the perfect medical antidote program are not only mutually exclusive but also theoretically impossible to achieve. Almost. But there are some effective compromise measures that can bridge the differences, lower the loss rate, and significantly improve on-scene operational needs at the same time.
It is reasonable to expect that, when the population of a community - or nation - grows, the need for a mass evacuation of some type will grow at the same pace. That need increases exponentially, though: (a) when catastrophic weather events occur with greater frequency; and/or (b) in the current "Age of Terrorism" when mass-casualty incidents have become the normal way of waging war. In either case, the protection of special-needs populations becomes immensely more difficult.
Thanks (sort of) to the ravages caused by Hurricane Katrina, and a number of other disasters - including terrorist attacks - there is a growing awareness that U.S. healthcare facilities must focus much greater attention on building, and/or improving, their individual and collective "surge" capabilities. Here is a brief report on what has been accomplished so far, and some helpful recommendations to both improve and accelerate the process.
Doctors, nurses, and other highly visible professionals get the greatest credit, deservedly, in most public-health incidents and events. Playing increasingly important roles, though - before, during, and after such incidents - are the nation's unsung and much less publicized sanitarians whose special expertise in numerous operational scenarios is finally being recognized.
As most people know, it is impossible to be totally prepared, at all times, to cope with any and all disasters of any type and of any magnitude imaginable. But there are many common-sense steps that can be taken to lessen the impact of most if not all of the most likely disasters. Here is a brief check list of some of the more effective ways, reasonable in cost, that major cities and small towns alike should consider to cope with potential mass-casualty incidents.
by Donald Brannen, Amy Schmitt, and Mark McDonnell -
The chill wind that started on 31 January immobilized a major area of the country and brought ice, snow, sleet, and misery to 100 million Americans. Among the hardest hit were numerous special-needs patients, already incapacitated, waiting for help that came far too late or, in some cases, not at all.
New Jersey calls on Hippocrates to help top officials cope with a major mass-casualty incident with significant international implications; the initial result was a burning success. In Tarrant County, Texas, NACCHO and school nurses put the emphasis on children in fighting the flu and both detecting and controlling the outbreak of other life-threatening diseases. The lessons learned in both situations are available to other states and hereby highly recommended.
Question: Does a sausage leave a fingerprint? Answer: Well, yes, sort of - but not one detectable by the naked eye. Read here to find out how CDC, the APHL, PulseNet, and epidemiologists from five mid-Atlantic states worked hand-in-glove (literally) to crack "The Dangerous Case of the Fermented Sausage" in record time.
