You may be asking yourself, "What does police work have to do with a public health emergency? I work for the police department, not the board of health." Well, in today's world of unified response and command to emergencies and disasters, a public health emergency is also a matter for law enforcement.
A public health emergency can best be described as an event that overwhelms the resources of the local health care system. This usually applies to non-traumatic events as opposed to a plane crash or terrorism attack delivered with force. A public health emergency can cover the range from a large-scale food poisoning outbreak at a summer picnic, a disease epidemic, to an intentional aerosol release of a toxic agent by terrorists. While these event can be accidental or with criminal intent, there are some similarities in how they are handled.
The acute phase
First is the acute phase, the response to the initial event. The report could come in as a simple call of a single person who does not feel well and is requesting an ambulance, or it may be a report of several people reporting the same symptoms at the same time. The first priority in this response is the same as in all other calls for service: your own safety comes first. While responding, think: does this call sound a little bit different than the other times you went on such a call? At the scene, do a quick size-up for scene safety. Do you see several victims with the same symptoms for no apparent reason? Are there dead birds or animals in the area? Will a quick entry into a contaminated area result in you becoming contaminated or killed? Police officers did not get the name "blue canaries" for no reason. This is a reference to the canaries that miners used to bring into the mines to detect deadly gas. Now is the time to be using Personal Protection Equipment (PPE), if you have it. PPE can be as simple as latex gloves when dealing with a patient to a full Haz-Mat suit and self-contained breathing apparatus.
It is also possible to be responding to assist a victim of a public health emergency where its original location is not yet known. An example would be if a chemical agent were released in a major bus or train station and the victims did not show any signs or symptoms for several hours or more. It would be difficult to immediately pinpoint the location of the release, as the victims could have traveled hundreds of miles and through several states during this time.
Syndromic surveillance
Our first notification of a public health emergency might be the result of syndromic surveillance. This process, performed in the public health and medical communities, involves the routine monitoring and analysis of data on disease patterns and deaths. This data is tracked to see if there is any unusual outbreak of illness and disease that is out of the norm. Pharmacies are also monitored to see if there is a spike in the sale of prescription and over-the-counter medications for a specific ailment, such as stomach problems or "flu-like symptoms."
The point of these examples is that local law enforcement would most likely be taking the initial lead response role. If the incident turns out to be bioterrorism, it will be transferred to the FBI. If it is a non-criminal matter, it returns to the local health system.
The initial assessment needs to include these questions:
- What is the size of the area affected?
- How many people are victims?
- Can the local EMS system handle the patient load, or does mutual aid need to be activated?
- Are there escape routes for people to leave the area, or do they need to be contained and decontaminated? Last month, an entire train in Canada was quarantined with its passengers when one person died and other complained of flu-like symptoms. It turned out to be a series of unrelated illnesses.
- What are the weather conditions?
- What other emergency services are responding?
- Who is the Incident Commander (IC)?
Once the above questions have been answered, there is still a lot more that needs to be done. The local health agency needs to be notified if they haven't been already. The chief elected official needs to be notified, as well as the appropriate medical or crime lab. The incident needs to be treated as a criminal matter or act of terrorism until it has been clearly established otherwise, and the scene must be protected to prevent the loss and contamination of any evidence. Just controlling the entry of first responders at the scene is a very difficult task. Public leaders, first responders and public health need to work all together from the start in a public health emergency. These events will last for days or weeks in comparison to the more traditional incidents local law enforcement responds to.
Your Emergency Operations Plan (EOP) should include public health emergencies as part of your comprehensive, all-hazards planning. Part of the planning process also calls for your plan to be tested through an exercise. Think what agencies would be needed to be included in the exercise to realistically represent what would occur in a real event.
Start using your pandemic flu planning as a starting point for discussion on how your agency would respond to recover from a public health emergency. How many of your officers and their families may be impacted, preventing them from reporting to duty?
There are many other sources of planning and response information available online, or with your local and state Offices of Emergency Management and Health. They will be more than happy to assist you now, rather than when a public health emergency occurs.
