Public Health Emergency Response Guide

สถานการณ์ ท่านเป็นผู้รับผิดชอบด้านการควบคุมโรคใน จังหวัด ได้รับรายงานว่ามีผู้ป่วยเสียชีวิตจาก อาการปอดอักเสบและติดเชื้อทางเดินหายใจ ที่ โรงพยาบาลศูนย์ ๓ - ๔ รายพร้อมๆกัน ผู้ป่วยมี อาการไข้สูง หายใจหอบเหนื่อย การหายใจ ล้มเหลว จนเสียชีวิตอย่างรวดเร็ว ภายใน ๒ - ๓ วันหลังจากเริ่มมีอาการ และขณะนี้พบว่ามีผู้ป่วย ที่เริ่มมีอาการติดเชื้อทางเดินหายใจมารับการ รักษามากขึ้นกว่าปกติ จากการประเมิน สถานการณ์แล้ว ท่านคาดว่าอาจเป็นโรคติดต่อ ทางเดินหายใจที่รุนแรง จนเป็นภาวะฉุกเฉินทาง สาธารณสุขได้ จึงเสนอให้เปิดศูนย์ตอบโต้ สถานการฉุกเฉินทางสาธารณสุข ในการตอบโต้เหตุการณ์นี้ท่านมีแนวทาง ปฏิบัติอย่างไร ?

วัตถุประสงค์ บุคคลากรสาธารณสุขที่เกี่ยวข้องกับการ ตอบโต้ภาวะฉุกเฉินทางสาธารณสุข สามารถริเริ่มกิจกรรมการตอบโต้ สถานการณ์ฉุกเฉินภายใน ๒๔ ชั่วโมงแรก ได้อย่างถูกต้อง สามารถปรับใช้แผนปฏิบัติการฉุกเฉิน, แนวทางปฏิบัติ, ทรัพยากรที่เกี่ยวข้อง, และระบบการตอบโต้เหตุการณ์ ให้เข้ากับ สถานการณ์ สามารถประสานการปฏิบัติตามแผนกับ หน่วยงานที่เกี่ยวข้องและชุมชนได้อย่าง ถูกต้อง

Scope Public Health Emergency Preparedness Assumption Public Health Emergency Response Functions and Tasks during the Acute Phase Ongoing Public Health Emergency Response Functions and Tasks

Focus on First 24 Hours Three response timeframe Immediate (Hours 0-2) Intermediate (Hours 2-6 and 6-12) Extended (Hours 12-24)

Public Health Emergency Preparedness Assumption Public Health Department must engage in preparedness activities Completion of the following activities prior to an incident is essential to a successful response effort

Establish close working relationship and mutual-aid agreement with: Emergency management agency (EMA) Emergency Medical Service (EMS) Medical/Health/Behavioral care providers Fire, Law enforcement, and Other organizations Local Emergency Planning Committee NGOs, Volunteers, Neighboring, etc.

Participate in hazard vulnerability and risk assessment for your area(s). Conduct capacity assessment Acquire resources and surge capacity Develop plans, procedure, guideline that are consistent with those used by other response agencies and organizations Develop operational objectives for PHER Develop basic system for surveillances and registry with appropriate archiving systems

Develop plans, procedures, guidelines for public affairs and risk communication Engage in resource typing and credentialing for personnel, resources, and assets for emergency response Ensure that public health personnel are trained and certified in safety and health practice (PPE, on-scene)

Provide orientation and training to public health response personnel Participate in planning, design, and conduct exercises to evaluate PHEP&R Participate in after action reviews of exercise and actual incidents

Immediate Response: Hours 0-2 Assess situation Contact key health personnel Develop initial health response objectives and Establish an action plan Public health participation in Emergency Operations Center (EOC) Ensure that the site health and safety plan (HASP) is established, reviewed, and followed

Immediate Response: Hours 0-2 Establish communications with key health and medical organization Assign and deploy resources and assets to achieved established initial health response objectives Address requests for assistance and information Initiate risk communication activities

Public Messages in Crisis STARCC Principle S: Simple T: Timely A: Accurate R: Relevant C: Credible C: Consistent Source: Reynolds, B., Crisis and Emergency Risk Communication by Leaders for Leaders. Atlanta, GA: Centers for Disease Control and Prevention, 2004

When engaging in risk communication, build trust and credibility by expressing... –Empathy & Caring –Competence & Expertise –Honesty & Openness –Commitment & Dedication

Top Tips. Don’t over reassure Acknowledge uncertainty Express wishes (“I wish I had answers”) Explain the process in place to find answers Acknowledge people’s fear Give people things to do Ask more of people (share risk)

As a spokesperson Know your organization policies Stay within the scope of responsibility Tell the truth. Be transparent Embody your agency’s identity CONSISTENT MESSAGE ARE VITAL Source: Reynolds, B., Crisis and Emergency Risk Communication. Atlanta, GA: Centers for Disease Control and Prevention, 2002.

Immediate Response: Hours 0-2 Engage legal counsel as part of the emergency response effort Document all response activities

Intermediate Response: Hours 2 – 6 Verify that health surveillance systems are operational Ensure that laboratories likely to be used during the response are operational and verify their analytical capacity Ensure that the needs of special populations are being addressed

Intermediate Response: Hours 2 – 6 Health-related volunteers and donations Update risk communication messages

Intermediate Response: Hours 6 – 12 Collect and analyze data that are becoming available through health surveillance and laboratory systems Prepare and update information for shift change and executive briefings

Intermediate Response: Hours 6 – 12 Prepare for state and federal on- site assistance Assess health resource needs and acquire as necessary

Extended Response: Hours 12 – 24 Address mental and behavioral health support needs Prepare for transition to extended operations or response disengagement

ONGOING PUBLIC HEALTH EMERGENCY RESPONSE FUNCTIONS AND TASKS Environmental hazard identification Hazards consultation Epidemiological services Health and medical needs assessment Identification of affected individuals

ONGOING PUBLIC HEALTH EMERGENCY RESPONSE FUNCTIONS AND TASKS Contamination control Health surveillance Laboratory specimen collection and analysis Infectious disease identification, treatment, and control

ONGOING PUBLIC HEALTH EMERGENCY RESPONSE FUNCTIONS AND TASKS Quarantine/Isolation Public health information Risk communication Responder safety and health Health and medical personnel resources

ONGOING PUBLIC HEALTH EMERGENCY RESPONSE FUNCTIONS AND TASKS Health and medical equipment safety and availability Health-related volunteer and donation Coordination In-hospital care Evacuation

ONGOING PUBLIC HEALTH EMERGENCY RESPONSE FUNCTIONS AND TASKS Sheltering Special populations needs and assistance Mass trauma Mass fatality Mortuary service

ONGOING PUBLIC HEALTH EMERGENCY RESPONSE FUNCTIONS AND TASKS Mental/behavioral health care and social services Potable water Food safety Vector control and pest management disposal

ONGOING PUBLIC HEALTH EMERGENCY RESPONSE FUNCTIONS AND TASKS Wastewater and solid-waste management/ disposal Building/facility assessment Sanitation/hygiene service Continuity of public health programs, services, and infrastructure

ONGOING PUBLIC HEALTH EMERGENCY RESPONSE FUNCTIONS AND TASKS Veterinary services Animal rescue/control/shelters Long-term community recovery

Template 1: Documentation of contacts & actions

Template 2: Health department personnel emergency contact information

Template 3: State, local, tribal emergency contact information

Template 4: Leadership assignment

Template 5: Incident-specific public health preparedness