Avian Flu Diary: HHS ASPR: Major Earthquakes & Cascading Events

https://files.asprtracie.hhs.gov/documents/aspr-tracie-major-earthquakes-and-cascading-events-potential-health-and-medical-implications.pdf

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When a major earthquake strikes, a CAT 5 hurricane makes landfall, or a `Carrington'-class CME slams into our planet, the initial destruction sets into motion innumerable cascading events that can either do more damage, or can significantly hinder recovery efforts.

A simple example comes from our recent bout of major hurricanes. Thousands of downed trees and flooding across roadways can prevent emergency vehicles from reaching the trapped or injured.

But of course, it is always more complicated than that.

In Puerto Rico, damaged port facilities and other infrastructure after hurricane Maria significantly disrupted recovery efforts. Power was out, roads and bridges were washed away, and communications were down all over the island.

While many people think they only need to make it through the storm, or the initial shaking of an earthquake, the real test comes surviving in the aftermath. As Hurricanes Maria and Katrina have showed us, even achieving some semblance of normalcy after a major disaster can take months, or sometimes even years (see Post-Disaster Sequelae).

Although destroyed infrastructure is the most obvious impediment to recovery, there can be cascading events even without physical destruction.

A severe pandemic wouldn't level buildings or collapse bridges, but a high enough infection or fatality rate could either prevent (through attrition) or dissuade (due to fear, or lack of effective PPEs) medical personnel from working, police or fire departments from responding, or utilities workers from keeping the water and power on.

As the number of available responders drop, and the work load increases, the odds of a systemic collapse increases.

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The likely collapse of the economy, manufacturing capacity, just-in-time deliveries (food, medicine, fuel), and the inevitable short supply of medical resources, would only exacerbate the situation. And being a global problem, unlike with a localized natural disaster, help won't be pouring in from unaffected regions.

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Last May, Johns Hopkins held a day-long pandemic table top exercise (see CLADE X: Archived Video & Recap). If you don't have the time to watch the entire 8 hour exercise, I would urge you to at least view the 5 minute wrap up video. It will give you some idea of the possible impact of a severe - but not necessarily `worst case' - pandemic.

While the mechanisms of destruction may vary, major disasters all have the ability to produce cascading events that must be overcome before recovery can commence.

The HHS's office for ASPR (Assistant Secretary for Preparedness and Response) is charged with preparing for Public Health and Medical Emergency Support during any crisis or emergency.

As such, they must plan for a wide variety of disasters, including pandemics, radiological emergencies, tsunamis, and earthquakes. Each of these scenarios can produce unique, wide ranging, and challenging cascading events, which must be addressed as well.

One of the reasons I stress personal, family, and neighborhood preparedness so much in this blog is that in a big enough disaster, emergency responders may be overwhelmed, and people may have to fend for themselves for days or weeks without power, water, groceries, r accessible medical care.

I've been perusing some of the preparedness documents on ASPR's TRACIE website (Technical Resources, Assistance Center, and Information Exchange), and the following 56-page document on the challenges likely to occur after a major earthquake provides an excellent glimpse at the kind of planning that must be done in advance of any major disaster.

While this report is written for local officials tasked with dealing directly with the aftermath of an earthquake, it should also provide some food for thought for anyone living in earthquake country on what challenges they might have to face following such a disaster.

And while most of the scenarios in today's document are earthquake specific, the impacts (loss of power, water, communications, limited access to food resupply, diminished medical care, etc.) can occur across a wide range of disasters.

Anyone who is tasked with corporate or business disaster recovery planning can probably glean some ideas from this report as well.

Since we can't know what the next disaster will be, preparedness should be geared primarily for the impacts, not for the cause. Obviously, with 56 pages, I can't excerpt a meaningful amount in the blog.

So follow the link to download the PDF, and while you are on the ASPR TRACIE site, you might want to look around at some of the other documents available.

Major Earthquakes & Cascading Events: Potential Health and Medical Implications

October 2018

This ASPR TRACIE resource provides an overview of the potential significant health and medical response and recovery needs facing areas affected by a major earthquake with or without additional cascading events.

The list of considerations is not exhaustive, but does reflect a thorough scan of publications and resources available that describe past incident effects and response. Earthquakes do not pose a significant risk for every community and those communities that could be affected by earthquakes have different risk levels, different hazards or cascading events, and different levels of existing community preparedness and mitigation. Those faced with planning for—and leading the response to and recovery from—an earthquake may use this document as a reference. Planners and responders should integrate jurisdiction-specific risk assessments and issues specific to their communities in their planning efforts.

Please note that the focus of this document is on human health and the healthcare system response to earthquakes, however, the health of people, animals, and the environment are all interconnected, so general considerations for animals and the environment are included,
where applicable to human health or to the overall mission of Emergency Support Function 8.

For additional resources specific to earthquakes and related health effects, please access the ASPR TRACIE Natural Disasters Topic Collection. The ASPR TRACIE Hazard Vulnerability/Risk Assessment Topic Collection and the Evaluation of Hazard Vulnerability Assessment Tools can assist with performing a jurisdiction-specific risk assessment.