Sars Lessons For American Cities
Train and prepare for biological threats such as SARS just as you would prepare for other threats to homeland security, says a group from the National League of Cities (NLC) that studied Toronto’s SARS experience.
Officials from the National League of Cities met with public health experts in Torontoand with American public health experts earlier this year to learn how to prepare for SARS (Severe Acute Respiratory Syndrome) and other biological threats. As a result, the League issued the following lessons that American cities can learn from the Toronto experience:
Treat epidemics and biological threats like other threats to homeland security. Public health workers should be considered first responders along with police and firefighters. Just as 9-11 reinforced the importance of preparing police, firefighters, and emergency response workers, the SARS experience in Toronto demonstrated the important role of public health workers.
Train and prepare for biological threats. Training will help the key people understand what might be required to screen people, quarantine and transport infected people, and determine what resources at various levels of government and in the private sector would be needed in the event of a threat. Don’t leave out law enforcement, the business community, employers, schools, and community and religious groups in training and preparation efforts.
Review and establish clear legal powers and lines of authority to respond to an infectious disease or biological threat. Know what legal steps might be required to respond quickly to a need for quarantines or restrictions on travel, balanced against the need to respect individual rights.
Create a protocol to separate frontline health workers from other emergency personnel to prevent infection of the full response system. In combating an infectious disease, there is a risk of exposing and infecting emergency response and medical personnel. In Toronto, more than 100 medical staff were quarantined because of exposure.
Develop a system for recording and tracking all unbudgeted costs associated with the emergency. In order to receive full and appropriate reimbursement from other levels of government and private sources, it is critical to track all expenditures at the time they are made to create a recognized audit trail.
Get all levels of government in the loop quickly Make sure the right officials in all levels of government are aware of an emerging problem. This will help to marshal the resources needed to monitor and contain a biological threat.
Create a task force of key offices and stay up to date and in communication. This may require teleconferences, use of cell phones, or emergency communications channels. Make sure these lines of communications are established beforehand in response protocols. Be sure to include law enforcement.
Manage medical information about infected people. This will require a database for case management especially if mass quarantines are required, as was the case with SARS in Toronto, where 8,500 people were quarantined.
Engage city employees and unions as soon as possible, and set up a mechanism to update them. Frontline workers will need to have information about and confidence in the process. Getting information to the frontline medical workers is essential for their health and the health of their families and others with whom they had contact. Bring unions and other employee representatives into the information loop quickly.
Coordinate messages to ensure they are consistent, correct, and frequent. Public safety and confidence depends on clear communications. Be sure to provide a steady, frequent flow of information from a medical authority that is correct, consistent, and clear, even if it becomes repetitious. An information vacuum is quickly filled with speculation and misinformation.
Target communications to key constituencies and audiences. Notify those affected by the threat, including the business community, the travel and convention business, employers, schools, and community and religious groups as well as the general public. Try to put the health risk in context.
Prepare for an onslaught of questions that require both medical and practical answers. The demand for information may require use of automated telephone information systems as well as informed medical staff to answer calls. Be prepared for non-English speakers. Post updated information regularly on web sites.
Stay on guard. Biological threats, including SARS, often prove to be stubborn and elusive. Even thorough efforts to contain threats are not always foolproof.
A delegation from the National League of Cities traveled to Toronto in May to meet with the city’s public health doctors, emergency personnel, elected officials, and economic development experts. Last week, the NLC’s Working Group on Homeland Security met to discuss biological threats, public health readiness, and other security issues with health and security experts. The National League of Cities is the largest national organization for American cities. NLC serves as a resource and advocate for 18,000 cities, towns and villages of all sizes, from New York City to Bee Cave, Texas, which collectively serve 225 million people.