Disaster preparedness in the midst of COVID-19

Time feels like it is moving to a different beat now that the nation, and the world, has seen a radical shift in the business-as-usual aspects of our lives. Unfortunately, natural disasters and climate change continue to march on, irrespective of the global pandemic at hand. In just the past few weeks, we’ve already experienced spring tornadoes and severe storms in the South, as well as flooding in the Midwest and along the East Coast. June 1st marks the official start of the Atlantic hurricane season, and meteorologists are predicting a higher frequency of storms, hurricanes, and major hurricanes. Wildfire season in California and the West generally begins in the fall, but it is starting earlier and ending later each year as a result of increasing spring and summer temperatures among other variables. Moreover, sea level rise continues to threaten many coastlines, and earthquakes are as unpredictable as ever.

At the same time, the full range of COVID-19 impacts—from social distancing to supply chain interruptions—are likely to be in place for months to come. For many, this is the first-time experiencing disruption at this scale. The event has already placed considerable stress on community resources and public health, particularly in our most vulnerable communities. Should a community be impacted by a simultaneous natural disaster, conventional approaches to emergency management and disaster response like mass gatherings in emergency shelters, rapid evacuation of geographical regions, operational coordination, and mobilization of supplies will not be feasible under the unprecedented conditions of today. It is critical that communities review their emergency plans and procedures now to prepare for an overlapping disaster response in the midst of COVID-19.

To get started, below are strategies to consider for strengthening community resilience against the compounding threats we are faced with: identification of new or retrofitting shelter sites, preparing for virtual operations, reviewing existing disaster response protocols, mutual aid agreements, supplier contracts, and preparing for a quick and successful return of people to their homes. Emergency personnel may not know the timeframe of when this current crisis will be over or when the next disaster will strike, but by combining the fundamentals of disaster response with new information emerging about pandemic response, communities can become more resilient to whatever the future holds. Here are five key considerations to address today:

1. Review your existing procedures in light of COVID-19

The Coronavirus has impacted nearly every aspect of our lives. This is likely to trickle down to your emergency procedures. Take the time to review and revise your key emergency documents such as your Emergency Response Plans, Emergency Operation Plans, Standard Operating Procedures, Continuity of Operations Plans, and Sheltering Plans among others. For example, consider the following:

• Have you identified deputy and backup staff in case primary staff are ill, require self-isolation, or are needed to continue management assignment under COVID-19? Is there training that can be undertaken now to increase your community’s overall capacity and capability?
• Is your Emergency Operation Center (EOC) able to respond to more than one crisis at a time? Do you have trained emergency personnel available? Do shifts and roles need to be adjusted, or does the EOC site need to expand to accommodate multiple crises?
• Do your plans require adjustment for meal/food procedures based on current supply chain and personnel disruptions?
• Many first responders are currently isolated from their families, accommodated in vacant hotels or on-site in medical facilities. Can staff sleeping quarters accommodate responders / volunteers in alignment with social distancing criteria?
• In the event of a short- or no-notice natural disaster, like a hurricane or wildfire when timing is critical and we are still under social distancing restrictions, evacuation orders may need to be issued sooner to facilitate phased exodus of residents. In addition to mass text-alerts, consider leveraging real-time data tracking technologies, such as GIS mapping, to optimize this procedure.
• In the event new shelter locations have been activated, does the local community know where the shelters are located? How will they be informed when these sites are available for occupancy?
• In the event of mass casualties, coordinate now with healthcare facilities to identify which hospitals or portions of hospitals can or have already been dedicated to non-COVID-19 patients or could accept such patients to minimize the risk of in-hospital contamination. If one does not yet exist, create a database of public, private, and government hospital bed capacity, real-time occupancy, and predicted surge to expedite planning and coordination.

2. Prepare for virtual operations

Emergency Operations Centers are typically the heart of disaster response. While its function works to unite different agencies and departments to leverage and quickly deploy resources, they may be subject to overcrowding, putting disaster responders at risk.  While safeguards can be put in place, COVID-19 has provided our communities, many for the first time, with the opportunity to develop and deploy virtual strategies for operational coordination. Things to consider include:

• Do you have adequate hardware and software to support virtual EOC operations? How quickly can that equipment be deployed to EOC staff?
• Are key collaborators (e.g., emergency management, public health, hospitals) using the same or integrated tools to support coordination?
• Are staff adequately trained on virtual communications tools and incident management software to facilitate coordination and information sharing?
• Are appropriate cybersecurity measures being implemented and followed?
• Have you conducted a tabletop training to simulate a virtual EOC?

3. Check your mutual aid agreements and supplier contracts  

Many jurisdictions rely on mutual aid agreements and memorandums of understanding (MOUs) in a disaster. It is important to determine now if the pandemic has impacted these agreements and procedures. Supply chain analyses are typically carried out at the Federal or State level, however at this current time, in light of highly localized availability of food, medical equipment, and personal protective equipment (PPE), supply chain scenario planning carried out at the local level is recommended. In addition, consider:

• States and other governments may limit travel (inter- and intra-state) to limit the spread of infection. Do your plans rely on inter-state resources?
• Do you have the ability to stock shelters with soap, masks, PPE, and other COVID-19 supplies, or is this reliant on a supply chain that is already heavily disrupted? The current chronic shortage of PPE is a hard lesson we must all learn from.
• Consider what medical supplies may be needed based on the risks of each location (for example: burn victim treatment, smoke inhalation, broken bones, etc.) and verify those supplies are still available.

4. Identify new shelter sites, or retrofit existing sites

Social distancing has proven to be a critical tool in flattening the curve of COVID-19 and is likely to continue in some form for the foreseeable future. However, social distancing is not conducive to typical shelter set-ups which are aimed at maximizing capacity.  Additionally, some sheltering sites officially designated for disaster use are currently being used as temporary healthcare facilities for COVID-19 activities.

The choices that should be considered to address these concerns are all centered on expanding the capacity of your sheltering site inventory.  That can be accomplished by either adding sites, retrofitting existing sites, or implementing other measures to reduce the demand on those sites from dislocated populations. In any case, pre-disaster preparations are imperative. It is important to recognize that not just any building can function as a shelter.

Shelter sites are selected by city staff, including engineers and emergency managers, among others, with a range of specific requirements that reflect the hazards posed by high probability events. These include the ability to withstand the hazard at hand, occupancy capacity, and special uses such as sheltering for pets or vulnerable populations. New sites must be identified now to enable fast action when an event occurs. Whether it’s a major event with only a few days warning, such as a hurricane, or a no-notice event such as an earthquake, pre-identifying additional shelters will accelerate the ability to save lives in a disaster.

There are three main questions to ask concerning the logistics of the space, the ability to carry out shelter protocols, and the availability of supplies and personnel. With these in mind, consider the following criteria:

Shelter space logistics

• Can the site maintain the thresholds of social distancing (groups of no more than 10 people)?
• Can spaces be partitioned to isolate groups if necessary?
• Can negative air pressurization be achieved to prevent spread of airborne pathogens?
• Does the shelter have adequate hand washing facilities and space for hand-sanitizing stations to maintain healthy conditions when the shelter is occupied, especially at maximum, COVID-19- compliant capacity?
• If existing shelter sites are still available for use in the event of a new disaster, emergency management teams must review these spaces for the ability to adapt to the new COVID-19 criteria. For existing shelters, determine the revised maximum occupancy of the shelter under COVID-19 social distancing guidelines. This will also help determine how many new sites you may need to accommodate evacuees.

Shelter protocols

• Do typical shelter entry and registration procedures need to be modified to address social distancing criteria?
• What are the alternatives to co-locating asymptomatic individuals with COVID-19-positive individuals? In the event of an outbreak within the shelter, is a separate shelter or contained area needed for people most vulnerable to COVID-19?
• Should all people within the shelter have their temperature taken on entry, and at regular intervals throughout the duration of their stay?
• Consider putting up temporary signage / posters within the shelter explaining social distancing criteria, and related shelter protocols. Examples include six-foot separation when queuing for meals, supplies, handwashing, or hand sanitizing. Visually marking off six feet on the floor, with duct tape for example, is a helpful reminder for all ages.

Availability of supplies and personnel

• With an increase in the number of shelters, are additional emergency management and volunteer personnel identified and available to help run the shelters that are not already mobilized in COVID-19 response?
• Can you obtain sufficient supplies of PPE for evacuees without impacting supplies designated for COVID-19 responders? To help assess your stock, FEMA has created a PPE Burn Rate Calculator that can be used for both COVID-19 response and other disaster response which may be affected by the current PPE supply issues
• Can you procure resources to provide on-demand PPE, such as a 3D printer?
• Are there additional cots, blankets, and other supplies available to stock the new sites?

5. Consider post-event conditions

We can’t predict when we will reach the conditions and metrics necessary before communities can begin the phased return back to normal activities. However, it is likely that COVID-19 will remain a threat for many months. In the event of an additional disaster, it is imperative that communities can get people out of shelters and back to their existing homes or temporary housing as soon as possible. Consider the following:

• Use vacant hotel rooms as short-term temporary housing for displaced people. Many cities have already enlisted hotels to shelter first responders and essential workers who need to isolate from their families, so these buildings may already be operational and equipped with food and other supplies. However, separation of the two groups—COVID-19 responders and disaster responders/victims—will be necessary to avoid potential infection from those on the front lines of COVID-19.
• Other temporary housing solutions include properly anchored mobile homes, higher-education student dormitories (only while all education facilities are still closed) and 3D printed structures.
• If evacuation orders were in place, clear and consistent messaging is needed to properly phase the return of all evacuated people
• Stay informed on the current COVID-19 situation when making decisions on returning evacuees to their homes or temporary housing.

It is hard to visualize what the ‘post-pandemic’ life will look like, or even how we re-mobilize every aspect of our lives again. We have never seen what that looks like before. This will require planning and change management on an unprecedented scale. It will be especially important for communities to leverage the lessons they are learning through their response to COVID-19. Stantec strongly encourages that communities conduct a formal After-Action review of what worked, what didn’t, and what could be improved to support building resilience across your organization. The more we can plan for a quick recovery from the disaster we have already experienced, the faster we can recover from the compounding impacts of the known and the unknown.