Emergency Management Planning Research Articles

International expert consensus statement on the diagnosis and management of congenital nephrogenic diabetes insipidus (arginine vasopressin resistance).

Congenital nephrogenic diabetes insipidus (NDI; also known as arginine vasopressin resistance) is a rare inherited disorder of water homeostasis, caused by insensitivity of the distal nephron to arginine vasopressin. Consequently, the kidney loses its ability to concentrate urine, which leads to polyuria, polydipsia and the risk of hypertonic dehydration. The diagnosis and management of NDI are very challenging and require an integrated, multidisciplinary approach. Here, we present 36 recommendations for diagnosis, treatment and follow-up in both children and adults, as well as emergency management, genetic counselling and family planning, for patients with NDI. These recommendations were formulated and graded by an international group of experts in NDI from paediatric and adult nephrology, urology and clinical genetics from the European Rare Kidney Disease Reference Network and the European Society of Paediatric Nephrology, as well as patient advocates, and were validated by a voting panel in a Delphi process. The goal of these recommendations is to provide guidance to health care professionals who care for patients with NDI and to patients and their families. In addition, we emphasize the need for further research on different aspects of this potentially life-threatening disorder to support the development of evidence-based guidelines in the future.

Investigating the performance of PBL parametrizations in WRF model for front enhanced SES simulation in istanbul megacity

Sea-effect snow (SES) is a meteorological phenomenon resulting from cold air moving over warmer waters. Accurate prediction of SES is vital for emergency management, transportation, and water resource planning. A thundersnow event in Istanbul from 17–19 February 2015 caused significant disruptions, with traffic and flights affected, highways temporarily closed, and trees falling due to heavy snowfall. This study investigates the influence of different parameterization schemes in the Weather Research and Forecasting (WRF) model on SES simulations. Six distinct PBL parameterization schemes were used in a series of WRF simulations. In addition, the following factors pivotal to SES event have also been investigated: 1000–500 hPa thickness, total and latent heat fluxes, radar and satellite analyses, temperature gradients, wind shear, inversion levels, and atmospheric stability indices. Additionally, the formation of SES during the cold front transition further contributed to these elements in the Black Sea region. The simulations displayed notably high total heat flux and latent heat flux values, particularly following the passage of the cold front. Furthermore, the northeast-southwest oriented SES cloud, distinguished by its banded structure, was successfully validated using radar and satellite imagery. However, it's worth noting that the model positioned it farther west than its actual location. This study highlights the challenges in precise prediction and analysis of such convective activities. In this thundersnow event, the local closure schemes, particularly MYNN in first place and second MYJ, demonstrated superior performance compared to non-local schemes within the parameterization options.

Supporting recovery, healing and wellbeing with Aboriginal communities of the southeast coast of Australia: a practice-based study of an Aboriginal community-controlled health organisation’s response to cumulative disasters

BackgroundThe recent crises of bushfires, floods, and the COVID-19 pandemic on the southeast coast of Australia were unprecedented in their extent and intensity. Few studies have investigated responses to cumulative disasters in First Nations communities, despite acknowledgement that these crises disproportionately impact First Nations people. This study was conducted by Aboriginal and non-Aboriginal researchers in partnership with Waminda, South Coast Women’s Health and Wellbeing Aboriginal Corporation, an Aboriginal Community Controlled Health Organisation (ACCHO). It investigated the collective experiences of people affected by cumulative disasters to identify the practices that support healing, and recovery for Aboriginal communities. The study addresses a knowledge gap of how Waminda, designs, manages and delivers responses to address complex health and social issues in the context of cumulative disasters.MethodsUnderpinned by practice theory this study employed Indigenous-informed, narrative inquiry. Culturally-appropriate, multiple interpretive methods were used to collect data including: observations; yarns with Aboriginal community members, yarns with Waminda practitioners, management and board members; interviews-to-the-double, visual images and documentation. The data were collated and analysed using the phases of reflexive thematic analysis.ResultsThe paper articulates a suite of culturally safe and place-based practices that enhance social, emotional and spiritual well-being following cumulative disasters. These practice bundles include: adopting a Country-centred conception of local communities; being community-led; viewing care as a collective, relational, sociomaterial accomplishment and having fluid boundaries. These practice bundles ‘hang together’ through organising practices including the Waminda Model of Care, staff wellbeing framework and emergency management plan which orient action and manage risks. The paper demonstrates the need for disaster responses to be community-led and culturally situated. ACCHOs are shown to play a crucial role, and their local responses to immediate community needs are grounded in contextual knowledge and use existing resources rather than relying on mainstream system-wide interventions.ConclusionsThe paper suggests crafting responses that focus on assisting communities (re)gain their sense of belonging, hope for the future, control over their lives and their capacities to care for and to be cared for by Country, are key to both enhancing healing, health and well-being and harnessing the strengths of communities.

Emergency preparedness in the central sterile supply department: a multicenter cross-sectional survey

ObjectiveTo investigate the current situation of emergency preparation and emergency drill in the CSSD, and analyze its influence on the nurses’ emergency attitude and ability.MethodsThis study employed a multicenter stratified sampling method, conducted from January to June 2023 using the online survey, participants completed the general data, emergency preparedness and drill questionnaire, public health emergency response questionnaire and emergency capacity scale. An independent samples t test or Kruskal-Wallis test was used to analyse differences in nurses’ emergency capacity and attitudes.ResultsThe data from 15 provinces 55 hospitals in China. Overall, 77.58% of participants’ institutions set up emergency management teams, 85.45% have an emergency plan and revise it regularly. 92.12% store emergency supplies. All survey staff participated in the emergency drill, which predominantly consisted of individual drills (51.52%), with 90.30% being real combat drills, 49.09% of participants engaging in drills every quarter, and 91.52% of the drill’s participants exceeding 50%. The respondents’ emergency attitude score was (29.346 ± 6.029), their emergency ability score was (63.594 ± 10.413), and those with rescue experience showed a more positive attitude (Z = -2.316, P = 0.021). Different titles, education levels, rescue experience and the frequency of emergency drill affected the emergency rescue ability of the respondents (P < 0.05).ConclusionsMost medical institutions establish emergency management systems and plans, yet the content lacks geographical specificity.The duration and participation of emergency drills are high, but the effectiveness of the drills needs to be further improved, and the response capacity and attitudes of CSSD nurses are low. It is recommended that agencies develop comprehensive and targeted contingency plans to strengthen the inspection and evaluation of team strength, equipment and safeguards against the contingency plans, so as to ensure that the measures mandated by the contingency plans can be implemented promptly after the emergency response is initiated.

Cross- and Context-Aware Attention Based Spatial-Temporal Graph Convolutional Networks for Human Mobility Prediction

The COVID-19 pandemic has dramatically transformed human mobility patterns. Therefore, human mobility prediction for the “new normal” is crucial to infrastructure redesign, emergency management, and urban planning post the pandemic. This paper aims to predict people’s number of visits to various locations in New York City using COVID and mobility data in the past two years. To quantitatively model the impact of COVID cases on human mobility patterns and predict mobility patterns across the pandemic period, this paper develops a model CCAAT-GCN ( C ross- and C ontext- A ttention based Spatial-Temporal G raph C onvolutional N etworks). The proposed model is validated using SafeGraph data in New York City from August 2020 to April 2022. A rich set of baselines are performed to demonstrate the performance of our proposed model. Results demonstrate the superior performance of our proposed method. Also, the attention matrix learned by our model exhibits a strong alignment with the COVID-19 situation and the points of interest within the geographic region. This alignment suggests that the model effectively captures the intricate relationships between COVID-19 case rates and human mobility patterns. The developed model and findings can offer insights into the mobility pattern prediction for future disruptive events and pandemics, so as to assist with emergency preparedness for planners, decision-makers and policymakers.

Managing Active Shooter Events in Schools: An Introduction to Emergency Management

Active shooter events involving an armed perpetrator(s) on campus are one of the main risks facing K-12 schools. Defined as planning for and responding to emergency situations, emergency or crisis management allows for an ‘acceptable’ level of risk to be achieved. This paper will go through the four principles of emergency management, detailing what each stage involves and how it can reduce risk. The first of these is mitigation, which prevents crises occurring in the first place. Effective risk and threat assessment are pertinent to this stage. Secondly, there is preparedness, which enhances the capacity of an organization to respond to various incidents. This involves drafting emergency management plans and practicing these to ensure readiness to respond. The next principle is responding to a crisis, denoting the actions taken during and immediately after a crisis, should one transpire. The final facet of emergency management planning is recovery, referring to the short-to-long-term phase of restoring a community following an incident. This paper will share insights obtained from a recent event, The Briefings, held by the I Love U Guys foundation, one of the leading school safety organizations in the United States. Specifically, the paper will focus on a possible training approach to active shooter events and other emergencies, the organization’s emergency management framework called the ‘Standard Response Protocol’. Additionally, this paper will incorporate relevant scholarly readings in order to provide an introduction to the topic of emergency management.

Animal health emergencies: a gender-based analysis for planning and policy.

There has been increasing recognition of gender-based inequity as a barrier to successful policy implementation. This consensus, coupled with an increasing frequency of emergencies in human and animal populations, including infectious disease events, has prompted policy makers to re-evaluate gender-sensitivity in emergency management planning. Seeking to identify key publications relating to gendered impacts and considerations across diverse stakeholders in different types of animal health emergencies, we conducted a non-exhaustive, targeted scoping review. We developed a matrix for both academic and policy literature that separated animal health emergencies into two major categories: humanitarian crises and infectious disease events. We then conducted semi-structured interviews with key animal health experts. We found minimal evidence of explicit gender responsive planning in animal health emergencies, whether humanitarian or infectious disease events. This was particularly salient in Global North literature and policy planning documents. Although there are some references to gender in policy documents pertaining to endemic outbreaks of African swine fever (ASF) in Uganda, most research remains gender blind. Despite this, implicit gendered themes emerged from the literature review and interviews as being direct or indirect considerations of some research, policy, and implementation efforts: representation; gendered exposure risks; economic impact; and unpaid care. Absent from both the literature and our conversations with experts were considerations of mental health, gender-based violence, and intersectional impacts. To remedy the gaps in gender-based considerations, we argue that the intentional inclusion of a gender transformative lens in animal health emergency planning is essential. This can be done in the following ways: (1) collection of disaggregated data (race, gender, sexual orientation, etc.); (2) inclusion of gender experts; and (3) inclusion of primary gendered impacts (minimal representation of women in policy positions, gender roles, economic and nutrition impacts) and secondary gendered impacts (gender-based violence, mental health, additional unpaid care responsibilities) in future planning.

Pets are family, keep them safe: a review of emergency animal management in remote First Nations communities

Planning for and considering animals is a growing area within emergency and disaster planning. As people adapt to the changing risks of disaster events that are increasing in magnitude and frequency, communities, particularly those in regional and remote areas of Australia, face challenges that are very different from other more populated areas. These communities are often home to pets, which pose unique challenges during evacuation, response and recovery phases of emergency management. Australian state and territory government emergency management plans give varied considerations to animal management. In the Northern Territory, the Territory Emergency Plan (Northern Territory Government 2022) serves as a base for animal management in disasters. However, significant reform is required to fill gaps in considerations of animals in remote communities, especially First Nations communities, given the strong socio-cultural connections within family structures and contributions to wellbeing under First Nations health worldviews and the human-animal bond. Such reform requires consultation and collaboration with First Nations Australians to promote ‘right-way’ science, build local capacity and support community resilience. Considerations of the interplay between people and their pets in disaster planning, response and recovery contributes to ongoing advances in the ‘One Health’ and ‘One Welfare’ paradigms.

Disparities in COVID-19 vaccine uptake, attitudes, and experiences between food system and non-food system essential workers.

The COVID-19 pandemic has disproportionately affected the health of food system (FS) essential workers compared with other essential and non-essential workers. Even greater disparity exists for workers in certain FS work settings and for certain FS worker subpopulations. We analyzed essential worker respondents (n = 151,789) in May-November 2021 data from the National Immunization Survey Adult COVID Module (NIS-ACM) to assess and characterize COVID-19 vaccination uptake (≥1 dose) and intent (reachable, reluctant), attitudes about COVID-19 and the vaccine, and experiences and difficulties getting the vaccine. We compared rates, overall and by certain characteristics, between workers of the same group, and between FS (n = 17,414) and non-food system (NFS) worker groups (n = 134,375), to determine if differences exist. FS worker groups were classified as "agriculture, forestry, fishing, or hunting" (AFFH; n = 2,730); "food manufacturing facility" (FMF; n = 3,495); and "food and beverage store" (FBS; n = 11,189). Compared with NFS workers, significantly lower percentages of FS workers reported ≥1 dose of COVID-19 vaccine or vaccine requirements at work or school, but overall vaccine experiences and difficulties among vaccinated FS workers were statistically similar to NFS workers. When we examined intent regarding COVID-19 vaccination among unvaccinated FS workers compared with NFS counterparts, we found a higher percentage of FMF and FBS workers were reachable whereas a higher percentage of AFFH workers were reluctant about vaccination, with differences by sociodemographic characteristics. Overall, results showed differences in uptake, intent, and attitudes between worker groups and by some sociodemographic characteristics. The findings reflect the diversity of FS workers and underscore the importance of collecting occupational data to assess health inequalities and of tailoring efforts to worker groups to improve confidence and uptake of vaccinations for infectious diseases such as COVID-19. The findings can inform future research, adult infectious disease interventions, and emergency management planning.

Assessing the household burdens of infrastructure disruptions in Texas during Winter Storm Uri

In February 2021, severe winter weather conditions associated with Winter Storm Uri triggered an energy infrastructure failure in Texas. Most Texans lost electricity, some lost potable water, natural gas, and suffered other infrastructure-related service disruptions that had profound household consequences. Although several studies have documented the disparities in terms of the types and extent of disruptions Texans experienced during Uri, there is little information about the impact of these disruptions in terms of their burdens on households. Guided by the Capabilities Approach framework, a survey of Texan households was conducted to identify the outage characteristics and capability losses for different household types, as well as the burdens that those disruptions posed to households using both objective and subjective measures. Our results indicate that households that endured longer and constant electricity outages suffered more severe impacts across all measures, including more disrupted household capabilities, increased time, and financial costs to cope during the outages, as well as greater declines in reported life satisfaction. We found that low-income households, households with children, and households with disability challenges suffered more severe objective burdens during the storm, although subjective results for these households were mixed. Households with members over the age of 65 fared better in terms of objective measures, yet suffered more in terms of subjective well-being. Moreover, households that had prior experience with a prolonged outage reported significantly smaller reductions in well-being during the storm than other households, despite not showing any difference in objective measures. Ultimately, our results offer context-specific, post-event information about the impacts and needs of different types of households during Uri that are important for informing emergency management and community resilience planning.

Managing pediatric-onset multiple sclerosis in an austere setting: A case report.

Pediatric-onset multiple sclerosis (POMS) is the most common demyelinating disease in children. Patients suffer from physical disability, cognitive impairment, and psychosocial challenges. Management requires a multidisciplinary care team. Here we present a case of an 11-year-old boy with POMS who relocated to Guam prior to initiation of a disease-modifying treatment and who experienced a flare without immediate access to an MRI or a child neurologist. Care required the combined efforts of ophthalmology, pediatrics, and emergency medicine in Guam, real-time remote guidance by child neurology, and asynchronous collaboration with cardiology and child neurology. As a result, the immediate flare was accurately diagnosed and treated with steroids, the patient was started on Fingolimod, and an emergency management plan for future flares was constructed. This case illustrates the nuances of both the acute and chronic management of multiple sclerosis in a resource-limited setting and how a combination of synchronous and asynchronous telemedicine was able to achieve a satisfactory treatment plan.

Held in the grip: Political status, governing institutions, and emergency management procedural arrangements in the cases of Florida and Puerto Rico

AbstractTo what extent do institutions governing the relationship of the U.S. Federal government with U.S. states and U.S. territories affect their emergency preparedness and response operations? States retain more legislative autonomy and representation than territories in the U.S. Congress, which is responsible for the emergency management budget. The advocacy capabilities of territories may be limited, and greater budget constraints are expected to affect the capability of territories to implement federal emergency management plans and perform effective response operations. This work focuses on a comparative case study between responses to Hurricane Maria in Puerto Rico and Hurricane Michael in Florida. The multi‐technique qualitative approach combines content analysis and interviews. Findings suggest that neither Florida nor Puerto Rico was prepared to respond to hurricanes of such magnitude, but the procedural arrangements of the Florida emergency management system resulted in a more effective response to Hurricane Michael if compared to Hurricane Maria in Puerto Rico.Related ArticlesLiu, Zezhao, and Zhengwei Zhu. 2021. “China's Pathway to Domestic Emergency Management: Unpacking the Characteristics in System Evolution.” Politics &amp; Policy 49(3): 619–50. https://doi.org/10.1111/polp.12407.Neill, Katharine A., and John C. Morris. 2012. “A Tangled Web of Principals and Agents: Examining the Deepwater Horizon Oil Spill through a Principal–Agent Lens.” Politics &amp; Policy 40(4): 629–56. https://doi.org/10.1111/j.1747‐1346.2012.00371.x.Zang, Xiaowei. 2021. “Environmental Accidents and Environmental Legislation in China: Evidence from Provincial Panel Sata (1997–2014).” Politics &amp; Policy 50(1): 77–92. https://doi.org/10.1111/polp.12446.

Living in-between: Implications of local risk perceptions for the management of future eruptions at the Calbuco and Osorno volcanoes (Ensenada, Chile)

Since the perceptions of communities at risk play a central role in managing future emergencies, contingency plans must consider the appropriate involvement of the perspectives of exposed populations. This article addresses the case of Ensenada (Puerto Varas, Chile), a settlement located in the area of direct influence of the Calbuco and Osorno volcanoes. They respectively rank 2nd and 8th in the list of highest-threat Chilean volcanoes. Here we depict the multiple risk perceptions of the inhabitants of Ensenada and the integration of human perceptions into volcanic emergency management through qualitative research, based on semi-structured interviews and documentary analysis. Our results illustrate that Ensenada represents a settlement critically exposed to multiple hazards from both volcanoes, intertwined with a series of social conditions that influence individuals’ self-perception as vulnerable to future eruptions and, simultaneously, as capable of acquiring conditions to strengthen disaster preparedness. Moreover, the locals are eager to participate in future emergency management planning and adopt preventive attitudes at community, household, and individual levels. Based on these results, we highlight the advantages of a better understanding of the causes of perceived risk and its integration into emergency management strategies for future eruptions, in order to visualise how people make sense of daily life and disaster preparedness in the midst of active volcanoes.

Seasonal rockfall risk analysis in a touristic island: Application to the Tramuntana Range (Mallorca, Spain)

Rockfalls are an ever-present possibility in the mountainous context of the Tramuntana Region (Mallorca, Spain). Recent events have shown the high potential for direct and indirect impact on the safety of people and economic activities, lasting for weeks or even months. In the present study, we start from a probabilistic assessment of the rockfall hazard (spatial propensity and temporal recurrence), based on a detailed historical record of occurrences and rockfall modelling, which is subsequently superimposed on three exposure scenarios and on a social vulnerability assessment. Exposure considers the floating population at three seasons of the year, given the area's high tourist aptitude. Vulnerability considers on the one hand the intrinsic characteristics of individuals and, on the other, the characteristics of the surrounding territory that act to facilitate emergency operations, mitigate the immediate impact and enhance rapid recovery. Due to the characteristics of the island and the spatial distribution of tourism, the results show that the highest density of rockfall trajectories potentially affect areas of high exposure, whose access by emergency services is complex. Not being, in general, the areas of highest individual criticality, those areas have in most situations low support capability installed or nearby.The results constitute a useful tool for emergency and risk management planning in multiple sectors linked to risk governance. Despite the high geographic detail of the analysis, these studies do not replace exposure and vulnerability analysis at the building level, for which the contribution of georeferenced Census data is fundamental.

Mass Decontamination of Companion Dogs in Disaster: Planning for Personnel, Water, and Time Requirements.

The importance of companion animals in the daily lives of people, and the increasing incidence and severity of natural disasters impacting people and their animals, is very well documented. However, despite the advancement of companion animal response capabilities, decontamination remains an inconsistently implemented component of disaster response. The challenge for local authorities is their need for planning factors and protocols specific to companion animal decontamination which are generally lacking. Data is provided on the average time requirements, water use and containment resources necessary, and the personnel required to decontaminate (decon) a large number of companion dogs. Sixty-three lightly contaminated, medium weight, short to medium coat, highly tractable dogs (Labradors and Hounds) from a State facility colony were used to determine the water requirements, soap effectiveness, and time required to complete decon (washing/bathing). Data were collected over a 6-mo period using 2 personnel that were randomly assigned to wash the dogs. Difference in weight, bathing time, and water use between groups was evaluated using a 2-tailed 2-sample t-test for independent data. The time and water requirements were significantly different between medium coated dogs and short coated dogs. On average, for a short coated dog, the amount of time to complete decon was 7 min, and the amount of water was 8-10 gal. For medium coated dogs, the time increased to 10-12 min to complete the process and 12-15 gal water. The results of this study provide important insights emergency management planners, animal response team members, and community personnel tasked with implementation of mass decontamination of companion dogs following a natural or man-made disaster.

Historical Development of Emergency and Disaster Management Plans

6 Şubat 2023 tarihinde meydana gelen ve asrın felaketi diye isimlendirilen Kahramanmaraş merkezli depremlerin elli binden fazla vatandaşımızın hayatını yitirmesine ve 100 milyar doların üzerinde ekonomik kayba neden olması nedeniyle ülkemizi çok ciddi şekilde etkilemiş ve sürdürülebilir kalkınma hedeflerine önemli bir sekte vurmuştur. Depremin yanı sıra Türkiye başta sel ve orman yangınları olmak üzere farklı tür birçok afete maruz kalmakta her yıl çok sayıda vatandaşımız hayatını yitirmekte, ekonomik kayıplar meydana gelmekte ve sosyolojik, psikolojik olarak bütün toplum olarak afetlerden önemli derecede etkilenilmektedir. Bu sonuçlar bize Türkiye’nin afetlerle istenilen düzeyde mücadele edemediğini, afetlere dirençli yerleşimler yaratamadığını, afete dirençli toplumlar oluşturamadığını göstermektedir. Olası afetlerin etkilerini en aza indirebilmek için olaya bütüncül bakarak farklı konularda farklı alanlarda çok sayıda çalışma yapmak gerekmektedir. Bu çalışmalar arasında acil durum ve afet yönetimi planları önemli bir yer tutmaktadır. 1945’li yıllardan itibaren değişik tarihlerde hazırlanan birçok yasa ve yönetmelikte bu planların yapılması gerektiği ile ilgili birçok düzenleme yapılmıştır. Makalenin amacı afet ve acil durum yönetimi planlarının tarihsel süreç içinde nasıl geliştiğini kronolojik olarak ortaya koymak, eski tarihli ve en güncel Türkiye Afet Müdahale planı hakkında bilgiler vermek, planların hazırlanması hususunda yol gösterici olmak, etkin bir şekilde uygulanmasını sağlamaya katkı vermek ve konunun önemine ve gereğine dikkat çekmektir.

The First Statewide Implementation of a Regional Disaster Teleconsultation System to Expand Critical Care Surge Capacity: A Case Study in Vermont.

Background: In December 2021, the Region 1 Disaster Health Response System, the state of Vermont, and the National Emergency Tele-Critical Care Network partnered to provide statewide access to disaster teleconsultations during COVID-19 surge conditions. In this case report, we describe how a disaster teleconsultation system was implemented in Vermont to provide access to temporary tele-critical care consultations during the Omicron COVID-19 surge. Methods: We measured the time from request of service to implementation and calculated descriptive statistics. Results: Seven of Vermont's 14 hospitals requested the service. Despite a technology solution capable of providing services within hours, mean time to service implementation was 27 days (interquartile range 20-41 days). Conclusions: Integration of disaster teleconsultation systems into state and local emergency management plans are needed to bring administrative start-up times in line with technical readiness.

Emergency management short term response to extreme heat in the 25 most populated U.S. cities

BackgroundExtreme heat events are a leading weather-related killer in the United States and are predicted to increase in frequency, duration, and intensity. Emergency managers lead short-term response to heat events as well as other natural and man-made hazards with discretion to develop criteria to activate heat responses, such as opening cooling centers and increasing surveillance activities. We aim to describe and summarize emergency management plans for short-term response to extreme heat events across the U.S. MethodsInformation on hazard mitigation plans (HMP) and heat response plans (HRP) in the 25 most populated cities in the US were collected from the National Science Foundation's Natural Hazards Engineering Research Infrastructure DesignSafe Data Depot; interviews with emergency managers; and Freedom of Information Act requests. Obtained responses and policy documents were analyzed to answer the following questions developed in consultation with the National Weather Service (NWS), Weather Program Office: 1. How many locations have developed an HRP? 2. What are the emergency management heat response activation thresholds and metrics for emergency response? 3. Do thresholds change with cascading hazards? 4. Are heat vulnerability indexes (HVI) and/or social vulnerability indexes (SVI) included, and 5. Are health outcomes considered in the development of thresholds? Results1. There is no statistical difference in the prevalence of HRPs across geographic regions in the U.S. 2. Initial response thresholds vary greatly across locations from an ambient temperature of 80–85F (26–29 C) to a Heat Index of 108F (42 C). Eighty-eight (22 of 25) percent of locations are using the NWS Heat Index and twelve percent (3 of 25) are using the experimental HeatRisk Product. 3. Sixty-Eight (17 of 25) percent of cities consider cascading hazards, such as a power grid outage, in their HMP or HRP. None of the cities, however, lower response thresholds, as explicitly written in the plans, during these events. 4. Forty percent (10 of 25) of municipalities have an HVI or SVI included or addressed in their plans, & 5. Three of the cities (New York, Phoenix, & Boston) have adapted response thresholds based on local epidemiological studies DiscussionThere is little consistency in the advisory, warning, and watch criteria thresholds across cities which may be a source of confusion to the public. If such criteria are to be tailored to each geographic location, local epidemiological studies and vulnerabilities should help inform the criteria.

Operationalising water safety plans for Melbourne - a large city case study.

A wholesale/retail model delivers drinking water to over 5 million residents in metropolitan Melbourne (Australia). Water Safety Plans were implemented in 1999 ahead of being regulatory mandated in 2003. With over 20 years of WSP application, this collaborative paper by the wholesaler and retailer utilities presents practical examples of drinking water quality risk management in challenging operational environments, highlighting lessons learnt, improvements made and outcomes achieved. Melbourne's supply comprises multiple sources, necessitating different tailored treatment configurations. Source waters range from open catchment with multiple treatment barriers, to protected catchment source waters requiring solely disinfection treatment (unfiltered) with gravity driven supply. Potable supply is a combination of unfiltered, filtered, desalinated and blended supplies. This makes for diversity in case studies brought to this paper, and a range of lessons likely to be of interest to the global WSP community. The Melbourne utility experience highlights the importance of developing and continually improving control measures for ongoing (adaptive) risk reduction. A robust emergency management plan is also fundamental to ensure preparedness for complex and unpredictable events. Furthermore, leveraging learnings from audits and incidents has been valuable for process improvement. WSP implementation has also facilitated timely communication with consumers and other stakeholders.

A cross-sectional survey of Australian service providers’ emergency preparedness capabilities

Purpose Emergency and disaster management planning is an emerging role with limited practical guidance on how it should be implemented by community, disability, health and rehabilitation service providers. This study examined the emergency preparedness of service providers and how they viewed their role and contributions to disaster risk reduction, including their capacity and willingness to facilitate preparedness planning with their clients. Materials and Methods A questionnaire was developed and administered nationally. Descriptive statistics, multivariate regression analyses, and thematic analysis of open-ended questions provide insight on the knowledge, tools and training needs of service providers to contribute to preparedness of themselves and the people they support. Results Facilitating emergency preparedness with people with disability was strongly associated with a high level of mental preparedness, household preparedness scores, and completion of Person-Centred Emergency Preparedness (P-CEP) training. Perceived lack of funding, insufficient tools, and exclusion of emergency planning from job descriptions were negatively associated with facilitating emergency preparedness with clients. Conclusions Study findings lay the groundwork for development of the role and capabilities of individual service providers including the need to equip disability, health and rehabilitation service providers with training and tools to prepare themselves and the people they support for emergencies.