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TOOLS: SPECIAL FEATURE ARCHIVE

 


Pandemic Preparedness Decentralized Operational Capabilities

 

by James Rush [written first in 2008 - brought back to Big Med for another run on September 14, 2009]

 

 

Public Health officials tell us that a Pandemic is only a matter of “when” and not “If.” If organizations plan to require employees to work from home during a Pandemic, it just makes sense to periodically test an organization’s ability to function in a decentralized mode before the actual Pandemic. Social distancing is a tried and true method of limiting contagion, so

 

1. Develop standard office procedures for decentralized work, establish standards and measurements for working from home, including expected work outputs. Train all employees on working from home procedures. Prepare Management Information Systems (MIS) division to relocate to an alternative site using hardened, redundant communication systems.

 

2. Select a division (or other operating unit) monthly and announce all employees will "Work from Home" and will sign on to their electronic workspace from home for a week.........Afterward, determine what worked well and what did not. Learn, implement corrective actions, and re-test in 30 days.

 

3. Once a quarter have a multi-divisional (or Total Program) "work from home week"....Determine what worked well and what did not. Learn and re-test as soon as practical.

 

4. Once a year have an agency-wide work from home week.  Learn, implement corrective actions and replace ineffective managers and executives as necessary. Firing ineffective employees may be distasteful and unfortunate, but the Nation's future and the lives of millions of American's may depend on organizational Readiness.

 

It makes no sense to me to identify a few "Mission Essential" functions like the Executive Command Group and then find out in an actual disaster that the Executive Command Group cannot effectively control the necessary functions of the Agency. It would seem a little late to say to Americans "Your Social Security checks will be discontinued until further notice." ...or tell hospitals "We'll process your reimbursements as soon as the pandemic is over."

 

I really do appreciate how hard this effort will be, but I don't see any real alternative to hard work and proactive measures. I believe that problems experienced by one Division during a "Work from Home Week" would almost certainly be common problems that can be corrected for all future Divisions exercising the "Work from Home" program. Thus, the learning curve may be much shallower than initially expected. These exercises will be extraordinarily challenging but they are the stuff of true Readiness and the essence of real Emergency Management.

 

Advanced Policy Directives

 

Imagine how many hospitals in America will fail if the Centers for Medicare and Medicaid Services (CMS) and major American healthcare insurance companies fail to  implement simplified reimbursement and billing procedures to hospitals for use during a Pandemic. The saddest aspect of this would be the same Agency that predicted the Pandemic failed to prepare for it. It needs to be said that HHS and DHS both have wonderful dedicated folks working hard and serving America with distinction. This paper is not intended as a criticism to any agency or firm.  I am simply concerned about our overall lack of National Readiness as evidenced by a lack of advanced policy directives.

 

The same concept of Readiness applies to many other Private and Public Sector organizations providing critical products and services. How many Americans have sufficient financial reserves to survive a 12-18 month Pandemic if their place of employment should fail and work is scarce? Are state unemployment offices prepared to pay the number of unemployment claims associated with a Pandemic?

 

The fact is checks have to get out, payroll has to be electronically transmitted, Healthcare and Public Health services need to be provided, Public Safety, and Public Works (like waste management) services have to be performed. We had better understand how essential services will be provided using a decentralized paradigm before Disaster Day (D-Day).

 

I know I have been harping on things for a long time now; like developing a patient evacuation system and a citizen relocation and resettlement plan for select Federal Planning Scenarios where relocation is necessary.  New Orleans during hurricane Katrina taught us how critical emergency services were, especially for persons with disabilities, patients and seniors. I hope those very sad lessons were in fact learned and not just observed (as one IAEM-Lister put it). A repeat of that 2005 experience would be a failure of historic proportions and a repeat of what was already a National disgrace.

 

Also, we need to develop Federal Reserve Inventories (FRI) of food (Meals Ready to Eat), medical supplies and equipment, over the counter (OTC) medications, chronic condition pharmaceuticals, test kits and supplies and life's necessities ..........like the things everyone seeks to purchase just prior to a forecasted hurricane or major snowstorm. 

 

There is nothing America can’t do when it puts its collective mind to it.  We proved this point in 1969 when we put a man on the moon and we can do it in Domestic Preparedness. It is time to set lofty goals and to achieve them for America’s sake.

 


Economic Consequences of Swine Flu Outbreak

by Geary Sikich [August 24, 2009]

Introduction

A paradigm is broadly defined as: a philosophical or theoretical framework of any kind.  A paradox on the other hand, is an apparently true statement or group of statements that leads to a contradiction or a situation which defies intuition.  A paradox, while seemingly self-contradictory or absurd in reality expresses a possible truth.

At the time of this writing H1N1 known as Swine Flu has spread through much of the world.  Its low mortality rate has made it a relatively mild pandemic.  Yet to be determined is what will happen when the flu season arrives in the northern hemisphere this fall.  The World Health Organization (WHO) and Centers for Disease Control (CDC) have been revising much of their guidance and we are seeing almost daily some revelation from the WHO, CDC and the popular media.

Far Greater Immediate and Long Term Impacts?

The economic impact of the swine flu virus in some countries may be drastic, the chief economist for the International Monetary Fund has warned.  Chief economist Olivier Blanchard said the tourism industry in some countries may be negatively affected during a speech at the Carnegie Endowment for International Peace in Washington.

Thomson Reuters reported recently that fears of a deadly swine flu pandemic wrecking an already wobbly global economy.  These fears have materialized with a vengeance in the commodities markets.  Hog futures dropped dramatically and cascaded to share prices of U.S. meat companies which also dropped.  Egypt reported that it will slaughter its entire pig population of approximately 300,000 in an effort to stem the Swine Flu virus.  Early sell-offs in commodities recall market reactions to the SARS and H5N1 bird flu in 2003. Those outbreaks also raised concerns over demand for food commodities.

Economic Impacts are already being felt

The impact of Swine Flu on the markets combined with the current financial crisis and an already weak world economy could make Asia’s experience during the Severe Acute Respiratory Syndrome (SARS) outbreak in 2003 pale by comparison.  This is partly due to the fact that the current Swine Flu virus is spreading faster than SARS did.  Secondly, we have seen a much quicker reaction by the WHO and CDC, raising the Pandemic Phase from 3 to 5 in rapid succession.  The cascade effects will be seen in commodity prices, stocks of food companies, energy prices, pharmaceutical company expenditures to find a vaccine and any measure of things to come, the region's economies may find themselves in a much deeper hole should swine flu spread.  Economists and industry leaders are closely watching the spread of the swine flu.  Should a severe outbreak of the flu occur in Asia, economists and industry executives fear the economic damage would be worse than that of the Severe Acute Respiratory Syndrome outbreak in 2003.

In an article entitled, “Matthews borrows against turkeys” (By Iain Dey, Sunday Telegraph, published on 24/06/2007) the following excerpts reveal the economic impact that H5N1 is already having:

Bernard Matthews, the poultry farmer whose eponymous empire was blighted by avian flu earlier this year, has been forced to refinance his business by securing its future against his stock of turkeys.

Sales of the company's "bootiful" turkeys have been hammered by the health scare. Recent research suggested sales of both frozen and fresh turkeys across the UK are down around 30 per cent in the wake of the outbreak. The last figures provided by the company suggested a 20 per cent plunge in sales.

Bernard Matthews has now been refinanced through an asset finance deal struck with Burdale, a subsidiary of Bank of Ireland, and supported by a handful of other major international lenders.

The loans have been secured against some of the company's 56 farms, its plant and equipment, as well as its livestock, according to banking sources.

Matthews founded the business in 1950 with 20 turkey eggs and a second-hand incubator. The business turned over about £400m last year and employs more than 6,000 people worldwide. The company produces 7m turkeys in the UK every year.

The avian flu disaster is estimated to have wiped around £70m from Matthews personal fortune. The business is run from his Norfolk mansion, Great Witchingham Hall, set in 36 acres, which he restored from dereliction.

My colleague, John Stagl and I transcribed some notes as we were preparing to discuss the economic consequences of a pandemic at a luncheon in Chicago in 2006.  We had come to the conclusion at the time, that a pandemic will have a domino effect worldwide.  We all know that a pandemic will create a unique set of conditions that impact society, the business markets and medical support systems.  One of the differentiating characteristics of a pandemic, unlike any other disaster, is its wide-spread impact.  We have already seen that this impact has occurred without human-to-human contagion occurring.  The economic consequences to the poultry industry have been dramatic.

 

However, let’s turn our attention to the human-to-human aspects of the post-pandemic period.  While we know that the medical community will be one of the hardest hit areas, it is by no means the only area that will suffer extensive near-term and severe long term impact.  The medical impact, for that matter it will most probably be the most short-lived impact factor of the pandemic (in terms of deaths, etc.) and post-pandemic periods (people will alter their lifestyles to, perhaps do with less medical services).  The longer term ramifications will be felt economically throughout the world.  Below is a list of some of the various elements that will feel the impact of a pandemic, either directly or indirectly.  Impacts will reverberate through various sectors of the worldwide socio-economic system.  The key point to note is that the reverberation and cascading effect will be painfully uneven.  Some countries will fare better than others.  Some companies will fare better than others.  Collectively though, each will feel the impact of the other as if they were dominos falling creating a cascade effect.  An analogy would be to compare the cascade effect of a pandemic to a tsunami wave.  The initial wave may be hardly noticeable however, as it ripples out it gains strength until it surges over the land causing devastation and destruction.  Current thinking about pandemic generally starts with the recognition of the illness and a projection on its societal impacts.  We know that: 

  • People are affected

  • Society is unprepared

  • Governments are unprepared

  • Private Sector Enterprises are unprepared

  • Medical Institutions will be impacted

  • Economic Sectors Worldwide will be impacted

  • Medical Support Systems are impacted

  • Social Behavior will reflect be Susceptible to Significant Degradation

But what we do not know and can only speculate about is the scalable variables brought about by random chance.  Biological variables (mortality and morbidity rates as a result of the pandemic) can be estimated based on the lethality of the virus (currently at almost 60% versus the Spanish Influenza virus which was around 2 – 3%).  There is an excellent study that has been published regarding the impact of a pandemic on the Life Insurance Industry (I will cite from it later).  With scalable variables, as Taleb says in the Black Swan, “the longer you wait, the longer you will be expected to wait.”  This is as a result of the scalability of random events – randomness runs counterintuitive to conventional logic and the normal bell curve deviations that we are used to. 

So, here are some purely speculative projections as to what the post-pandemic recovery, restoration and realignment may look like.  I have based some of what I am about to project on limited historical evidence from the Plague and Spanish Influenza.  I use the term “limited” as a reference to the differences in technology, population, education, industrialization, etc. that was present at the time of the Plague and Spanish Influenza (a mere 89 years ago as of this writing in 2007).   

Here are some fast facts (courtesy of Maplecroft Index – August 2007) to ponder as we get ready for our journey into post-pandemic speculation.

Nearly two billion people (mostly in developing countries) do not have access to electricity 

Nearly half the world's population (three billion people) have never made a phone call 

Enabling digital inclusion is most urgent in Africa – a continent that houses 1 in 8 people (12%), has only 1 in 40 fixed line telephones (2.5%), 1 in 30 mobile telephones (3%), 1 in 70 personal computers – PCs (1.5%), 1 in 150 Internet users (0.7%) and 1 in 500 Internet hosts (0.2%).

Developing countries now account for almost half (49%) of total telephone subscribers in the world,  up from just 19% in 1990 

Globally only 650 million people have PCs. In the developing world, figures average at about 1/100 people but can be as high as 8/100 in Argentina or as low as 0.18/100 in Burundi 

In 1990 only 20 countries were connected to the Internet.  In 2003 there were 209. 

Consider these aspects of predicting the future.  In the material that follows, I have calculated a possible error rate of 100%.  I could be completely wrong.  Other than that what I am writing is pure speculation based on a random event occurring at some time in the future.  However, I have cleverly, I hope not cast my forecast with any date specific timeframe and therefore could be 100% right – eventually!  Forecasting without incorporating an error rate uncovers, according to Nicholas Taleb (The Black Swan) three fallacies all arising from the same misconception about the nature of uncertainty.  His first fallacy is that variability matters.  I agree; that is why I am not taking my projections too seriously and casting them with a date, hence I propose a range of possible outcomes.  Second, he states that there is the fallacy of failing to take into account forecast degradation as the projected period lengthens.  Here again, I agree; we do not realize the full extent of the difference between near and far futures.  H5N1 is extremely lethal at present.  Viruses mutate in order to survive.  I would speculate that the influenza virus that creates a pandemic will be far less lethal than the current strain of H5N1.  This, however, also allows for the virus to spread faster, longer and to infect more people – because we stay alive longer and can pass it to many others over time (evidence my projection figure from the previous chapter.  Finally, Taleb offers his third, and according to him possibly the most grave fallacy that concerns a misunderstanding of the random character of the variables being forecast.  We do not realize the consequences of the rare event.  It is the lower bound of estimates (worst case scenario) that matters when engaging in a decision.  The worst case is far more consequential than the forecast itself. 

Remember – 

A black swan is a highly improbable event with three principal characteristics: it is unpredictable; it carries a massive impact; and, after the fact, we concoct an explanation that makes it appear less random, and more predictable, than it was.”

Nassim Nicholas Taleb

The Black Swan: The Impact of the Highly Improbable

The following are the initial albeit speculative impacts that we can attribute to a pandemic:

Business (all forms of Private Enterprise) Impact

Reduction in workforce this leads to a reduction in output capacity

Reduction in consumption (people staying at home) leads to a decrease in demand

Reduction in revenue leading to less profit, leading to less taxes being paid

Lack of consumption demand leading to employees being laid off; leading to loss of benefits (healthcare insurance, etc.)

Reduction in disposable income leads to further consumption declines and consumption focused on necessities (healthcare insurance may become a luxury)

Redistribution of family asset spending – necessities only

Food

Medical (if you can pay health insurance, you still have deductibles; will the influenza be covered under your existing plan?)

Housing

Private transportation – if possible

More layoffs due to a worldwide sloughing off of demand and some countries closing borders as they attempt to isolate themselves

Business bankruptcies medium and small businesses will feel the pain because they have limited cash reserves.  Large enterprises will suffer as a result of loss of consumers and suppliers (how dependent is your business on the small to medium size supplier/vendor? Or, is your small/medium size business heavily dependent on a customer (large enterprise) that may experience a drop in demand putting your operations at risk?) 

Medical Support Systems (All Medically Related Endeavors)

Doctors in demand for patient diagnosis – office visits

Hospitals overwhelmed with patients

Patients must be isolated, from traditional patient care

Isolation supplies become limited, if available at all

Respiratory equipment in short supply - for secondary pneumonia

Committees will decide who gets respirator support & who does not

Limited supplies of medication (no vaccine for 6-9 mos.)

Hospital & public pharmacies must increase security for medications

Investments Fall (Anything that can be Monetized)

Redistribution of family assets – reduced investing

Companies need cash for operations vs. reduced investments

Investors seek “safe havens” for investing – no 3rd world investments

Reduced capacity to process investment activity – up to 40% of staff sick

Stock and Bond Markets behave erratically leading to less and less investment in publicly traded stocks, bonds

Private equity investments in companies drops for all the above reasons cited previously and all the subsequent points yet to come  

Commodity Markets

Demand becomes erratic leading to reduced trading

Open pit operations are limited due to physical concerns – exposure to others in the trading pit

Electronic trading (heavier now than ever) becomes erratic as power supply systems and Internet are less consistent

Commodity delivery erratic

Investors seek “safe havens” for investing – no 3rd world investments

Reduced capacity to process investment activity – 30% of staff sick

Business Assets Depleted

Lack of investing

Redistribution of company assets to current expense issues

Growth is replaced with survival strategies

Revenue continues to slip

Unemployment grows

National disposable income declines

Human capital (talent – an overlooked asset) not easily replaceable, long lead times to train, less loyalty, more dependent  on technology

Business Failures Increase

More Unemployment

Loss of personal disposable income

Increased demand for government services (at all levels) 

Government Impact

Substantial drop in revenues (tax base drops)

Quarantine and Isolation requirements will us most of government assets

Limited ability to provide of traditional support services

Increased demand for services

Social unrest ferments – “someone has to help us” mentality      

Bankruptcies

Business failures increase to unprecedented levels

Increase in personal and commercial bankruptcies

Backlog in court processing of bankruptcies

Creditors wait longer for assets from courts

Creditors see drop in assets from bankruptcies

Creditors become more restrictive in loaning money and extending credit

Credit and loan availability drops

More companies fail due to lack of loans & credit

Creditors Fail

Delays in bankruptcy processing & asset distribution results in lender failures

Bankrupt company assets are not redistributed into the market

Business market contracts because of operational asset decline

Lender failures compounds bankruptcy backlog and asset distribution

Opportunities

Large numbers of qualified, trained individuals available for employment

Companies prepared to identify these people will grow stronger & faster

Substantial number of opportunities will exist as a result of company failures

Let’s take a look at one sector, transportation.  Within that sector take the slice dealing with passengers and cargo.  Just on the basis of moving people and stuff you can already project the complexity.  Below are the world’s thirty busiest airports in 2005 ranked by passengers and by cargo.  What was your estimate that a person, who knew that they had a highly infectious form of Tuberculosis, would be capable of flying internationally on several flights?  Now, take that projection and add the variability factor and random character of the event and think about the consequences in the context of flying from any one of these airports with a case of influenza.

 

 

World’s 30 busiest Airports

Total passengers

World’s 30 busiest Airports

Total cargo

1.

Atlanta, Hartsfield (ATL)

85,907,423

Memphis (MEM)

3,598,500

2.

Chicago, O'Hare (ORD)

76,510,003

Hong Kong (HKG)

3,433,349

3.

London, Heathrow (LHR)

67,915,403

Anchorage (ANC)

2,553,937

4.

Tokyo, Haneda (HND)

63,282,219

Tokyo, Narita (NRT)

2,291,073

5.

Los Angeles (LAX)

61,489,398

Seoul (ICN)

2,150,140

6.

Dallas/Ft. Worth (DFW)

59,176,265

Paris, Charles de Gaulle (CDG)

2,010,361

7.

Paris, Charles de Gaulle (CDG)

53,798,308

Frankfurt-Main (FRA)

1,962,927

8.

Frankfurt-Main (FRA)

52,219,412

Los Angeles (LAX)

1,938,430

9.

Amsterdam, Schiphol (AMS)

44,163,098

Shanghai (PVG)

1,856,655

10.

Las Vegas (LAS)

43,989,982

Singapore (SIN)

1,854,510

11.

Denver (DEN)

43,387,513

Louisville (SDF)

1,815,155

12.

Madrid (MAD)

41,940,059

Miami (MIA)

1,754,633

13.

New York (JFK)

41,885,104

Taipei (TPE)

1,705,318

14.

Phoenix, Sky Harbor (PHX)

41,213,754

New York (JFK)

1,660,717

15.

Beijing (PEK)

41,004,008

Chicago, O'Hare (ORD)

1,546,153

16.

Hong Kong (HKG)

40,269,847

Amsterdam, Schiphol (AMS)

1,495,918

17.

Houston (IAH)

39,684,640

London, Heathrow (LHR)

1,389,589

18.

Bangkok (BKK)

38,985,043

Dubai (DXB)

1,314,906

19.

Minneapolis/St. Paul (MSP)

37,604,373

Bangkok (BKK)

1,140,836

20.

Detroit (DTW)

36,389,294

Indianapolis (IND)

985,456

21.

Orlando (MCO)

34,128,048

Newark (EWR)

949,933

22.

Newark (EWR)

33,999,940

Osaka (KIX)

869,474

23.

San Francisco (SFO)

32,802,363

Tokyo, Haneda (HND)

799,073

24.

London, Gatwick (LGW)

32,784,330

Beijing (PEK)

782,066

25.

Singapore (SIN)

32,430,856

Atlanta, Hartsfield (ATL)

767,897

26.

Philadelphia (PHL)

31,495,385

Guangzhou (CN)

750,555

27.

Tokyo, Narita (NRT)

31,451,274

Luxembourg (LUX)

742,766

28.

Miami (MIA)

31,008,453

Dallas/Ft. Worth (DFW)

741,805

29

Toronto (YYZ)

29,914,750

Oakland (OAK)

672,844

30.

Seattle/Tacoma (SEA)

29,289,026

Brussels (BRU)

660,854

NOTES: Total passengers enplaned and deplaned, passengers in transit counted once. Total cargo loaded and unloaded, freight and mail (in metric tons).

Source: Airports Council International World Headquarters, Geneva, Switzerland. Web: www.airports.org. 

There were almost two billion passengers traveling in 2006; that is roughly three million people every day flying from one city or one country or one continent to another.  The potential is obvious for someone with an infectious disease unwittingly perhaps carrying it from one part of the world to another. 

Air New Zealand had an unexpected downturn in revenue of 11% while cities with SARS were transformed by the SARS outbreak.  Sherry Cooper from Toronto explains: 

During its four-month run in Toronto, ending in June, SARS killed fewer than 50 people.  Even China and Hong Kong, the two places hardest hit by the virus, suffered ‘only’ 648 deaths in total.  On April 23, the WHO sent out a warning against all unnecessary travel to Toronto, Beijing, and China’s Shanxi province.  Travel to and from Toronto plummeted overnight.  Overall SARS cost the city’s hotel industry more than $125 million Canadian; more generally, the tourism industry in the province of Ontario lost more than $2 billion Canadian in income and jobs.

In another example, an article titled, “Just plane gross” published on August 14 2007 in the Wall Street Journal (WSJ): 

This summer, rampant flight cancellations and delays are forcing many travelers to languish, sometimes for hours, before they can board their flight.  Unfortunately, that's nothing compared with what may await them on the plane.

Airplanes may be some of the best breeding grounds for illness.  The WSJ article further cited the following incident:

Indeed, delays can affect cleanliness and comfort, particularly with planes now flying fuller.  The percentage of on-time flights fell to 74.5 percent in July from 76.4 percent a year earlier, according to flightstats.com.  Summer thunderstorms have been to blame, as have technical glitches like the Federal Aviation Administration computer snafu on June 8.

On Saturday, more than 20,000 international passengers were stranded for hours at Los Angeles International Airport, waiting on airplanes and in packed customs halls while a malfunctioning computer system prevented U.S. officials from processing the travelers' entry into the country.  The U.S. Customs and Border Protection system went down around 2 p.m., forcing some planes to sit on the tarmac for so long that workers had to refuel them to keep their power units and air conditioning running.  Maintenance workers ran trucks around the airport hooking up tubes to service lavatories.
 

So what does this mean from a pandemic and post-pandemic perspective?  Just take a look at what the article reveals regarding the cleaning schedule for airplanes: 

JetBlue says its planes undergo a "maximum deep clean" once a month, same as before, a process that includes a thorough cleaning of the lavatories and galleys, vacuuming of carpets and cleaning of seats, seat trays and side walls.  Southwest Airlines says its deep-cleaning cycle is 30 days too.  American Airlines says it also keeps a 30-day average.  Continental Airlines, like many airlines, says its planes also undergo an overnight cleaning, which includes replacement of soiled pillows and blankets, vacuuming of cabin floors and cleaning of lavatories and passenger seating areas.

Between flights, though, the cleaning tends to be cursory.  American says it picks up trash and cleans seat-back pouches between flights, but it doesn't wipe down tray tables or vacuum while at the gate unless there's an obvious mess that must be addressed.  ATA Airlines also says it doesn't wipe down tray tables between flights unless there's a clear need because of the limited ground time.

I am sure that after reading this, you are probably thinking about carrying disinfectant wipes with you on your future travels!  If the above examples are common practice, the spread of viral illness could extend the post-pandemic meltdown for the transportation industry, or the industry could be required to employ more stringent cleaning standards to their fleets of aircraft.  And this is only one example of only one segment of one industry sector! 

Business Impacts – How Long Can You Survive? 

Impacts can be immediate and expensive.  It is therefore prudent that your pandemic planning efforts consider the dynamic nature of the world’s markets as part of your overall strategy.  This makes good business sense.  It can be readily applied to situations other than a pandemic.  With this broader perspective in mind your pandemic preparations can be leveraged into greater management awareness and perhaps, more of a competitive edge for your enterprise.  This is true, for public sector entities too.  Government can be more competitive and forward thinking and gain leverage with the constituents (taxpayers) whether they are individuals or businesses. 

One key issue that businesses face with a pandemic that is different from other disasters is that multiple locations could be affected simultaneously.  This is complicated by loss of personnel that could occur for several reasons – sickness, caring for sick individuals, school closures, fear of contamination at the workplace, etc.  Most of the current business continuity models are based on the recovery of technology and facilities (“brick and mortar” type structures).  Few are addressing the human component and if they do they are not doing it very well.   First and foremost a basis for ensuring that communication and information flows seamlessly vertically and horizontally throughout the enterprise is essential.  This means that you have to have common terminology within and with all the external touchpoints (customers to vendors) that is clearly understood by all.  Most organizations come up short when an analysis of the communication and information flow is undertaken.  The general finding is that fragmentation and a lack of seamlessness exists. 

Decision making regarding governance issues can only be addressed by senior executives.  Senior executives will establish and manage voluntary compliance mandates as well as ensure compliance with regulatory driven requirements. 

Strategy requires management engagement in order to achieve 3600 coverage.  This coverage consists of: 1) forward looking capabilities “active analysis” and situational awareness; 2) awareness of challenges; 3) executable goals and objectives and 4) ability to capitalize on experience and past successes.  Operating in a pandemic will require that your organization have a flexible and responsive strategy.  Incorporating business strategy elements into the management decision making process at all levels of contingency planning can facilitate greater flexibility. 

A tactical focus on processes rather than a strategic focus that is broader based – business goals, objectives and response to market demands can equal less than effective business continuity. 

Pandemic – Business Continuity Planners what are you doing?
 

We, as business continuity planners seem to be wary of addressing the issue of a pandemic as a viable scenario for planning.  I recently did a tabletop simulation for a client and a presentation on pandemics at a business continuity summit for another client.  The tabletop participants reflected on the experience and uniformly expressed to me that the tabletop was one of the most stressful and frustrating experiences that they had participated in.  The business continuity summit attendees and many of the speakers who followed me, continued to comment on the material presented, stressing that they needed to rethink their plans.  Participants in both events expressed the hope that a pandemic would not materialize.

 

Pandemics cause major economic losses due to absenteeism.  Experts predict that during a pandemic up to 30% of the global workforce could either be off work due to sickness or stay away due to fear.  Absence levels at the expected rates would cause severe problems.

The economic impact of H5N1 will be felt around the world.  The impact will initially appear in two primary aspects of business.  The first will be the availability of the workforce, the second and more unique impact will be in the market place. 

Helen Branswell of the Canadian Press wrote on August 17, 2005 in her article entitled, “Flu pandemic could trigger second Great Depression, brokerage warns clients”:

A major Canadian brokerage firm has added its voice to those warning of the potential global impact of an influenza pandemic, suggesting it could trigger a crisis similar to that of the Great Depression. 

Real estate values would be slashed, bankruptcies would soar and the insurance industry would be decimated, a newly released investor guide on avian influenza warns clients of BMO Nesbitt Burns.  

"It's quite analogous to the Great Depression in many ways, although obviously caused by very different reasons," co-author Sherry Cooper, chief economist of the firm and executive vice-president of the BMO Financial Group, said in an interview Tuesday.

"We won't have 30-per-cent unemployment because frankly, many people will die. And there will be excess demand for labour and yet, at the same time, it will absolutely crunch the economy worldwide." 

A leading voice for pandemic preparedness said the report is evidence the financial and business sectors - which have been slow to twig to the implications of a flu pandemic - are finally realizing why public health and infectious disease experts have been sounding the alarm.  

"I think that this particular report really signifies the first time that anyone from within the financial world, when looking at this issue, kind of had one of those 'Oh my God' moments," said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.  

"The financial world is finally waking up to the fact that this could be the boulder in the gear of the global economy," he said, suggesting a pandemic could trigger an implosion of international trade unlike anything seen in modern history.  

"All the other catastrophes we've had in the world in recent years at the very most put screen doors on our borders. This would seal shut a six-inch steel door," Osterholm said.  

Cooper, a highly influential figure in the Canadian financial sector, wrote the report with Donald Coxe, a global portfolio strategist for BMO Financial Group.

They warn investors the economic fallout out of a pandemic would inflict pain across sectors and around the globe.  

Airlines would be grounded, transport of goods would cease, the tourism and hospitality sectors would evaporate and the impact on exports would be devastating, Cooper wrote.  

"This would trigger foreclosures and bankruptcies, credit restrictions and financial panic," she warned, suggesting investors reduce debt and risk in their portfolios to be on the safe side.  

Absence of purchases due to illness and psychological reactions to a pandemic will present a new form of business impact that is currently not assessed as part of the traditional business impact assessment; and as such, it is not addressed in any business continuity, disaster, crisis management or recovery plans.  Another area that has not been addressed in impact assessment or plans is the loss or restriction of a company’s revenue.  Traditional plans start with an assumption that the marketplace is still viable; a potentially false assumption.  Traditional plans are designed to get an organization back into their market as quickly as possible – RTO, RPO and MTO come to mind (RTO = Recovery Time Objective, RPO = Recovery Point Objective, MTO = Maximum Tolerable Outage).  In the case of a pandemic markets may no longer be viable.  If your market is materially impaired, a consequence is that the revenue that is derived from that market may be restricted and/or completely gone. 

In another article, published on October 7, 2005 (NewsTarget.com) entitled, “Economic Shock Waves From Avian Influenza Spreading Faster than the Disease the following is pointed out: 

The Avian influenza crisis in Asia has already caused more than $10 billion dollars in damage in the economies of the most-seriously affected countries, but this is just the tip of the iceberg compared with the possible global economic consequences of a human influenza pandemic according to a study, Thinking Ahead: The Business Significance of an Avian Influenza Pandemic, released today by Bio Economic Research Associates (bio-era™). 

“According to the quantitative measures we developed for assigning relative economic risk exposure to infectious disease outbreaks for countries in Asia, Hong Kong and Singapore are especially vulnerable to the initial economic shock waves that would ensue from a pandemic,” said James Newcomb, Managing Director and principal author of the bio-era report. “However, the secondary impacts on other countries, especially China, could have far-reaching impacts for economies around the world, including the US,” he added.  

Other key findings in the report include:  

Avian influenza is the latest in a series of major livestock disease outbreaks that have caused more than $60 billion in economic damages worldwide over the past 15 years.

Concerns about a possible influenza pandemic are already providing stimulus for increased spending and accelerated research and development efforts in some parts of the economy, ranging from custom microarray chips for rapid diagnostic testing to antiviral drugs.

Governments around the world have recently made commitments totaling an estimated $1.4 billion to stockpile oseltamivir (Tamiflu)—an antiviral drug produced by pharmaceutical giant Roche.

Manufacturers of flu vaccines are gearing up for what may be an unprecedented global demand for a vaccine effective against H5N1 variants, but it is not known whether the vaccines being developed now would be effective against the influenza strains that might emerge.

New “DNA vaccines” offer an alternative to conventional production technologies and could speed the vaccine industry’s ability to respond, but these technologies are not yet approved by FDA.

“We’ve been looking at how things might unfold under six very different but highly plausible scenarios for the evolution of the outbreak,” said Stephen Aldrich, President of bio-era. “In the process, we’ve made assessments of potential outbreak risk by country, the relative economic exposure by country — and how selected industries and companies are likely to be affected.” 

We have not experienced this type of business problem in our lifetimes.  The last generation to have to address such a widespread issue was that of our grandparents and parents during the Great Depression. 

During the Great Depression the revenue component of the free enterprise system was significantly impaired.  Just as important, today on a worldwide basis we do not have any leadership in business or government who has lived through the 1918 Spanish Flu Pandemic or the Great Depression and so that experience base is lost to us.  Our best option, therefore, is to start to think about the possible problems we may have to confront and take steps to avoid or deal with them in our businesses.  If we wait until the pandemic starts, it will be too late. 

Even if a pandemic were mild, it is estimated that about a third of the world's population would fall sick over a period of months and millions would die.  If the strain is virulent, the death toll could mount to several million, over a relatively short period.  If we look at previous pandemics (Spanish Flu 1918 – 1919, Asian Flu 1957 – 1958, Hong Kong Flu 1968 – 1969) they generally run their course in 18 to 24 months.  As an example, the economic consequences could be staggering; SARS wreaked economic devastation on affected cities and countries in a relatively short period.  

The Health and Human Services Department plan outlines a worst-case scenario where more than 1.9 million Americans would die and 8.5 million would be hospitalized with costs exceeding $450 billion. 

Current Forecasts – Business Continuity Planners where can you add value? 

We often use the phrase “value added” when we promote business continuity planning.  We say that we “add value” to an organization by preparing it to respond and recover from incidents.  At this time I think that we can earn our keep, so to speak, by providing that “value added” service that we speak of.  Current forecasts predict that the H5N1 pandemic will spread around the world in a historically short period of time.  One expert stated that if this pandemic is identified on the west coast of the United States it will spread across the country in a week.  When SARS spread from China just a couple of years ago, it was in 5 countries in 3 days and in 24 countries in 3 months.  Time to react will be virtually non-existent.  And if we are to earn our merit as business continuity planners, we need to react now!  The companies that survive this extraordinary disaster when it occurs will have heeded the words of Sun Tzu centuries ago, “Victorious warriors win first and then go to war, while defeated warriors go to war first and then seek to win.”  Planning today will prove to be the only viable strategy to ensure a company’s “victory”. 

What If…? 

What if the pandemic does not materialize?  Do we have the proverbial “egg on our face”?  In the event that this pandemic does not materialize, your planning will not be lost.  Most of it will be transferable.  There will be future pandemics (and they occur approximately every 30 – 40 years) and to the ever present threat of terrorist attacks using chemical/biological/nerve agents.  Business survivability in the face disasters is imperative to the economic strength of the world community. 

We as continuity planners have an obligation to be forward thinking and to see what others choose not to recognize until it is upon them.  

Steps to take…Now 

The ability to effectively respond to and manage the consequences of an event in a timely manner is essential to ensure an organization's survivability in today’s fast paced business environment.  With the emergence of new threats, such as cyber-terrorism and bio-terrorism; and the increasing exposure of companies to traditional threats such as, fraud, systems failure, fire, explosions, spills, natural disasters, etc. an “integrated” approach to Business Continuity Planning is essential.  The “integrated” approach, as presented in this article, is based on the concept of graceful degradation and agile restoration.  “Graceful degradation” refers to the ability of an organization to identify the event, classify it into a level of severity, determine its consequences, establish minimal stable functionality, devolve to the most robust less functional configuration available and to begin to direct initial efforts for rapid restoration of services in a timely fashion. 

Several steps can be taken to prepare your organization.  First, put in place an effective surveillance program; meaning, expand your business impact assessment activities.  In my article, “"Futureproofing" - the Process of Active Analysis” written in 2003, I recommended that we rethink the business impact assessment process: 

Traditional analysis such as that performed at the initiation of the business continuity plan development is recognized as necessary to develop a baseline of information.  However, it should also be recognized as having certain limitations: 

·         Pre-Event - Best guess as to what could occur

·         Static - Best guess based on available facts and models 

Traditional analysis creates undecidability due to the inability to predict all behavior in a dynamic environment.  Therefore one should adopt an Active Analysis methodology, such as that developed by Logical Management Systems, Corp. (LMS).  LMS' methodology is based on the U.S. Military's "Joint Special Operations Targeting and Mission Planning Procedures" (JP 3-05.5 10 august 1993).  It is detailed herein. 

The advantages that can be realized by adopting this methodology and maintaining an active analysis process are: 

·         Uses Static Analysis as a basis

·         Touchpoint complexity factors

·         Dynamic - based on creating a mosaic

·         Time Factors (Time Critical, Time Sensitive and Time Dependent) act as drivers 

Termed "Futureproofing" by LMS the active analysis process is designed to create a mosaic that enhances decision making by identifying behavior patterns in a dynamic environment. 

Active analysis can be subdivided into three categories of possible threats/occurrences that could befall an organization.  Dr. Ian Mitroff refers to the three categories as Natural Accidents, Normal Accidents and Abnormal Accidents.  I have renamed them and to differentiate the three aspects of each.  That is, the threat, the actual occurrence and the consequence of the occurrence. 

·         Natural Threats/Occurrences/Consequences consisting of such things as drought, floods, tornadoes, earthquakes, fires and other naturally occurring phenomena.

·         Normal Threats/Occurrences/Consequences consisting of such things as Economic Disasters, such as:

·         Recessions

·         Stock Market Downturns

·         Rating Agency Downgrade, etc.

Personnel Disasters, such as:

·         Strikes

·         Workplace Violence

·         Vandalism

·         Employee Fraud, etc.

Physical Disasters, such as:

·         Industrial Accidents

·         Supply Chain

·         Value Chain

·         Product Failure

·         Fires

·         Environmental

·         Health & Safety

·         Abnormal Threats/Occurrences/Consequences consisting of Criminal Disasters, such as:

·         Product Tampering

·         Terrorism

·         Kidnapping & Hostages, etc.

Information Disasters, such as:

·         Theft of Proprietary Information

·         Hacking, Data Tampering

·         Cyber Attacks, etc.

Reputation Disasters, such as:

·         Rumors

·         Regulatory Issues

·         Litigation

·         Product Liability

·         Media Investigations

·         Internet Reputation, etc. 

Please note Abnormal Threats/Occurrences/Consequences are becoming more of the norm than abnormal as we see the normalization of threats such as hacking and data tampering. 

Five key assumptions were used as a basis to for the developmental framework of the "Futureproofing" methodology.  These are: 

·    Assumption # 1: The modern business organization represents a complex system operating within multiple networks 

·    Assumption # 2: There are many layers of complexity within an organization and its "Value Chain" 

·    Assumption # 3: Due to complexity, active analysis of the potential consequences of disruptive events is critical 

·    Assumption # 4: Actions in response to disruptive events needs to be coordinated 

·    Assumption # 5: Resources and skill sets are key issues 

Based on the above assumptions and the results of the baseline analysis (static analysis) one realizes that the timely identification, classification, communication and response, management and recovery from a disruptive event are critical.  As depicted in the graphic on the next page over time uncertainty will decrease, as will available options for response and recovery. 

This is contrasted with increasing numbers of issues and higher and higher costs associated with response and recovery efforts.  As such, an organization should seek to continually analyze situations so as to develop a clear picture of the current state of the business system network.  Referred to as "Data Fusion - Constructing a Mosaic" by LMS; this is a process of getting enough bits and pieces of information in place in order to transform seeming chaos into recognizable patterns upon which decisions can be made.

Second, recognize that you cannot depend on public authorities (read this as government at all levels) to be there for your organization.  They will have too many issues to deal with and they will also be impacted by the pandemic – remember that 30% of the population could be affected; that means that civil authorities are just as susceptible to contracting the disease.   Your organization and its “value chain” must its own comprehensive plan for dealing with the business consequences of a pandemic.  Rethink the basis on which you developed your plan – talk to the risk management and strategic planning personnel in your organization and find out what they are looking at with regard to business expansion, contraction, risk mitigation, etc.  They should be very conversant as a result of the recent hurricanes, earthquakes, tsunami and general competitive forces in the economy.  Revise your business continuity plan.  Develop the ability, as an organization, to sequence back your operations while ensuring that your business system and its network (“value chain”) can maintain level of functionality while operating at reduced capability.  When your business system and its network reaches the state of minimum functionality, the organization can begin to conduct a campaign of "agile restoration" until it achieves a state of full functionality and a return to normal operations. 

If you do the first step, putting in place an effective surveillance system, you will develop "detectors and indicators of change" metrics that can be employed to facilitate the constant analysis of the state of the business system and its complex "value chain" network.  The "detectors and indicators of change" provide the early warning basis for event classification at the lowest (least severe) levels. 

Third, train, drill, exercise.  All the planning in the world is never going to be effective unless it can be implemented.  One key to implementation is having a trained organization.  That means that we have to train not only the primary position holders in our organization, but we have to train the secondary and even a third level within the organization.   

If Only We Had Known…A New Paradigm for Planning Strategists 

In my latest book, “Integrated Business Continuity Planning: Maintaining Resilience in Uncertain Times” I asked: 

"Is Business Continuity integrated into your business operations as a way of doing business; or is Business Continuity an adjunct to the business that you are involved in?" 

As you ponder this question, you need to reconsider the value proposition offered by having an integrated approach to business continuity. 

I offer the following definitions for the purpose of this article and as a basis for developing an “integrated” approach to continuity: 

Crisis: "A disruptive event that is amplified, elevated and magnified." 

Business Continuity: "All initiatives taken to assure the survival, growth and resilience of the enterprise." 

Executives have an obligation to their stakeholders to assure that everything that can reasonably be done to protect the business and ensure its competitiveness in the marketplace is done.  Unless executives rethink the relationship between how they do business (strategy, competitive intelligence, etc.) and the way they currently address business continuity (managing disruptive events, security, etc.), the imbalance between "security" and competitiveness will not be resolved.  Therefore, businesses must rethink their recovery strategies to be able to deal with and survive pandemics.  This is a whole new paradigm for planning strategists. 

The table below is a look into the proverbial “crystal ball” at what could be some of the possible outcomes when the pandemic strikes.  

Economic Effect of a Pandemic – Business Continuity Planning Analysis

Segment

Short-term Effect

Long-term Effect

Analysis

Commercial Real Estate

 

Demands for office space will potentially decline in affected areas.  Suburban areas may see an increase in demand due to businesses relocating from areas that have been quarantined.

Fixed costs for businesses holding leases will remain the same, even in the face of declining occupancy and declining revenue.

Presidential Executive Order: Amendment to E.O. 13295 Relating to Certain Influenza Viruses and Quarantinable Communicable Diseases

Subsection C added:

"(c) Influenza caused by novel or reemergent influenza viruses that are causing, or have the potential to cause, a pandemic.".

Utilities

(Electric, Gas and other infrastructure  power supplies)

Potential loss of worldwide workforce could see system degradation due to lessened ability to respond to normal maintenance and emergency situations.

Loss of expertise within the workforce could result in a permanent destabilization of the energy sector, leaving it more susceptible to disruption than at present.

Utilities in general, need greater business continuity assistance due to the lack infrastructure being replaced.  Integrated grid systems are susceptible to disruptions that can cascade throughout a system quickly.

Energy Industry

(Oil & Gas)

 

Potential loss of employees worldwide due to pandemic could cause inability to meet demands resulting in higher prices for energy and related products.

Potential long-term demands may not reach current levels as a result of loss of life worldwide.  Fixed costs for businesses would remain the same regardless of utilization or demand.

Worldwide refining capacity is currently under pressure.  A pandemic could see facilities forced to shutdown either by quarantine or due to lack of workforce.

 

Dependence on information systems to operate facilities, pipelines, etc. creates security vulnerabilities for this industry.

 

Communications Industry (Voice, Data and other information systems, etc.)

 

Potential increase in demand due to pandemic causing more people to work remotely, greater need for information, greater need to communicate with others.  Potential loss of worldwide workforce due to pandemic.

Fixed costs remain unchanged regardless of demand.  Due to potential loss of workforce, system reliability may be impaired.

Heavy dependence on information systems for operations creates security vulnerabilities for this industry.  Loss of skilled workforce creates potential system vulnerabilities.

Banking & Finance

 

Potential demands for cash can outstrip the amount of cash in circulation.  Credit and Debit systems (cards) use could decline as a result of pandemic.  Volume based businesses could see a decline in revenue (i.e., SARS created decline in volume for many car companies).

 

Potential for significant short term disruption to economies worldwide.

Potentially having to live in a cash society (i.e., earthquake aftermath) could create continued high levels of demand for cash.  Potential for inflation remains high.  Businesses impacted due to loss of workforce and falling revenue.  Markets worldwide could see significant declines that will last for long periods.  Potential for long term disruption to economies worldwide.

Heavy concentration in large metropolitan areas, dependence on information systems for operations, low reserves of cash could create vulnerabilities.   Loss of workforce due to pandemic could create inabilities to function effectively.

Transportation

 

Pandemic could be the single most devastating event for this sector ever. Quarantine, flight restrictions, lack of workforce, inability to ship goods to markets, lack of security of Intermodal systems could create havoc with businesses and consumers.  Shortages would occur immediately (i.e., hurricane effects)

Air, land, sea transport potentially effected in such a way that they never recover.  Cargo security will be a high profile area. Port, distribution and staging areas will receive heightened scrutiny due to the high potential for transmission of virus tainted produce at these touchpoints.

Quarantine could have devastating effects. Difficult to ensure security, information systems are vulnerable. Human resource issues will be ongoing concern.

 

 

Economic Effect of a Pandemic – Business Continuity Planning Analysis (continued)


Segment

Short-term Effect

Long-term Effect

Analysis

Water Supply Systems

 

Potential loss of worldwide workforce could see system degradation due to lessened ability to respond to normal maintenance and emergency situations.

Loss of expertise within the workforce could result in a permanent destabilization of the energy sector, leaving it more susceptible to disruption than at present.  Water systems would remain highly vulnerable due to a lack of security resources.

Water systems need greater business continuity assistance due to the lack infrastructure being replaced.  Potential loss of workforce has long term impact on water systems resulting in degradation to service.

Emergency Services

 

Potential loss of worldwide workforce could see system degradation as demand for service would escalate to unprecedented levels.  Hospitals worldwide could not manage the amount of patients.  Possible collapse of medical systems worldwide.  Lack of antiviral drugs would have immediate impact.  Police, fire and other services could be severely impacted due to loss of workforce at a time when demand escalates.

Potential loss of worldwide workforce could see system degraded for a long period even in the aftermath of the pandemic.  Demand for general services would be impacted.  Hospitals worldwide would take long periods to recover.  Possible long term collapse of medical systems and healthcare worldwide.  Lack of antiviral drugs would have long term impact.   Police, fire and other services would be short of employees for long period.

Degradation of Emergency Services combined with degradation Transportation could present significant infrastructure concerns for continuity planning efforts.  Possible return to late 19th century medical services capabilities due to loss of skilled workforce.  Significant regional and local impacts for continuity planning.

Continuity of Government

 

Potential collapse of governmental control worldwide.  Use of military by governments worldwide to maintain order could result in negative effects.  Loss of workforce could create inability to implement current pandemic plans.  Possible inability to protect population and infrastructure.

Demands for action will grow; lack of antiviral medication could have major negative impact.  Potential chaos with targeting of government facilities for disruption.  Worldwide tensions as scarce resources are in demand and loss of population leave governments vulnerable.

Disruption of government could happen, although it is difficult to foresee a total collapse.  Governments worldwide would be under tremendous stress.  From a continuity planning perspective, the need for collaboration would never be greater.  Government could invoke orders to force business cooperation (i.e., U.S. Presidential Executive Orders)

Conclusion: Seize the Initiative - It Makes Sense

A Chinese proverb states that "Opportunity is always present in the midst of crisis."  Every crisis carries two elements, danger and opportunity.  No matter the difficulty of the circumstances, no matter how dangerous the situation… at the heart of each crisis lays a tremendous opportunity.  Great blessings lie ahead for the one who knows the secret of finding the opportunity within each crisis. 

Today business leaders have the responsibility to protect their organizations by facilitating continuity planning and preparedness efforts.  Using their status as “leaders,” senior management and board members can and must deliver the message that survivability depends on being able to find the opportunity within the crisis.   

Market research indicates that only a small portion (5%) of businesses today have a viable plan, but virtually 100% now realize they are at risk.  Seizing the initiative and getting involved in all the phases of crisis management can mitigate or prevent major losses.  Just being able to identify the legal pitfalls for the organization of conducting a crisis management audit: can have positive results. 

We cannot merely think about the plannable or plan for the unthinkable, but we must learn to think about the unplannable.  Business continuity planning must be overlapping in time, corrective in purpose complimentary in effect. 

 

References 

Drabek TE, Tamminga HL, Kilijanek TS, Adams CR. Managing multi-organizational emergency responses: emergent search and rescue networks in natural disaster and remote area settings. Natural Hazards Research and Applications Information Center. University of Colorado, Boulder CO, 1981 

Harris, Gardner, October 8, 2005 – New York Times; Bush Plan Shows U.S. Is Not Ready for Deadly Flu  

Meyer, Gerald C., "When it Hits the Fan: Managing the Nine Crises of Business," 1986 

Mittelstadt, Michelle, Dallas Morning News, Sunday, September 11, 2005 “Four years after 9-11, Katrina reveals flaws in emergency planning” 

Mitroff, Ian, I., Avoid "E3" Thinking, Management General, 1998 

Mitroff, Ian, I., Smart Thinking for Crazy Times: The Art of Solving the Right Problems, 1998 

Sikich, Geary W., The Financial Side of Crisis, 5th Annual Seminar on Crisis Management and Risk Communication, American Petroleum Institute, 1994 

Sikich, Geary W., Managing Crisis at the Speed of Light, Disaster Recovery Journal Conference, 1999 

Sikich, Geary W., Business Continuity & Crisis Management in the Internet/E-Business Era, Teltech, 2000 

Sikich, Geary W., What is there to know about a crisis, John Liner Review, Volume 14, No. 4, 2001 

Sikich, Geary W., The World We Live in: Are You Prepared for Disaster, Crisis Communication Series, Placeware and ConferZone web-based conference series Part I, January 24, 2002  

Sikich, Geary W., September 11 Aftermath: Ten Things Your Organization Can Do Now, John Liner Review, Winter 2002, Volume 15, Number 4 

Sikich, Geary W., Graceful Degradation and Agile Restoration Synopsis, Disaster Resource Guide, 2002 

Sikich, Geary W., “Aftermath September 11th, Can Your Organization Afford to Wait”, New York State Bar Association, Federal and Commercial Litigation, Spring Conference, May 2002 

Sikich, Geary W., "Integrated Business Continuity: Maintaining Resilience in Times of Uncertainty," PennWell Publishing, 2003 

“It Can’t Happen Here: All Hazards Crisis Management Planning”, Geary W. Sikich, PennWell Publishing 1993. 

Sikich, Geary W. and Slavik Nelson S., Industry Expectations Concerning Healthcare Response to OSHA 1910.120 "Hazardous Waste Operations and Emergency Response"; Environmental Health Manager; Spring Issue 1990, VOL. 4, No. 1. 

Sikich Geary W., "The Emergency Management Planning Handbook", McGraw Hill, 1995.

Sikich Geary W., Stagl, John M., "The Economic Consequences of a Pandemic", Discover Financial Services Business Continuity Summit, 2005. 

Zuckerman, Mortimer B., New York Daily News, 20 June, 2005, “A Nightmare Scenario – H5N1 Pandemic” 

Economic Shock Waves From Avian Influenza Spreading Faster than the Disease Source: http://www.prweb.com/releases/2005/3/prweb220610.htm 

The following citations are taken in total from The Lancet carried an article entitled,H5N1 influenza pandemic: contingency plans(The Lancet 2005; 366:533-534 DOI: 10.1016/S0140-6736(05)67080-8): 

1. World Health Organization. Cumulative number of confirmed human cases of avian influenza A/(H5N1) since 28 January 2004. May 4, 2005 http://www.who.int/csr/disease/avian_influenza/country/... (accessed May 8, 2005)

2. Ungchusak K, Auewarakul P, Dowell SF, et al. Probable person-to-person transmission of avian influenza A (H5N1). N Engl J Med 2005; 352: 333-340. CrossRef

3. Zeitlin GA, Maslow MJ. Avian influenza. Curr Infect Dis Rep 2005; 7: 193-199.

4. Kirkbride HA, Watson J. Review of the use of neuraminidase inhibitors for prophylaxis of influenza. Commun Dis Public Health 2003; 6: 123-127. MEDLINE

5. World Health Organization. National influenza pandemic plans. 2005: http://www.who.int/csr/disease/influenza/nationalpandem... (accessed May 8, 2005).

6. GlaxoSmithKlineRelenza datasheet. Issue number 5. June 8, 2000. Evreux, France: Galxo Wellcome Production, 2000: http://www.msds-gsk.com/uk_presc/11057406.pdf (accessed June 1, 2005).

7. Hoffmann-La RocheTamiflu datasheet. Core data sheet version 1.5. May, 3 2004. Basel: F Hoffmann-La Roche, 2001: http://www.medsafe.govt.nz/profs/Datasheet/t/Tamiflucap... (accessed June 3, 2005).

8. The MIST (Management of Influenza in the Southern Hemisphere Trialists) Study Group. Randomised trial of efficacy and safety of inhaled zanamivir in treatment of influenza A and B virus infections. Lancet 1998; 352: 1877-1881. Abstract | Full Text | PDF (80 KB) | MEDLINE | CrossRef

9. Treanor JJ, Hayden FG, Vrooman PS, et al. Efficacy and safety of the oral neuraminidase inhibitor oseltamivir in treating acute influenza: a randomized controlled trial. JAMA 2000; 283: 1016-1024US Oral Neuraminidase Study Group. MEDLINE

10. McKimm-Breschkin JL. Management of influenza virus infections with neuraminidase inhibitors: detection, incidence, and implications of drug resistance. Treat Respir Med 2005; 4: 107-116. MEDLINE

11. Kiso M, Mitamura K, Sakai-Tagawa Y, et al. Resistant influenza A viruses in children treated with oseltamivir: descriptive study. Lancet 2004; 364: 759-765. Abstract | Full Text | PDF (95 KB) | CrossRef

12. Tran TH, Nguyen TL, Nguyen TD, et al. Avian influenza A (H5N1) in 10 patients in Vietnam. N Engl J Med 2004; 350: 1179-1188. CrossRef

13. Imuta F, Toyoda M, Toyoda T. New application method of zanamivir with a straw. Pediatr Int 2003; 45: 366-367. MEDLINE | CrossRef

14. Murphy KR, Eivindson A, Pauksens K, et al. Efficacy and safety of inhaled zanamivir for the treatment of influenza in patients with asthma or chronic obstructive pulmonary disease: a double-blind, randomized, placebo-controlled multicentre study. Clin Drug Invest 2000; 20: 337-349.

15. Cass LM, Brown J, Pickford M, et al. Pharmacoscintigraphic evaluation of lung deposition of inhaled zanamivir in healthy volunteers. Clin Pharmacokinet 1999; 36 (suppl 1): 21-31.

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Editor's note: Big Medicine is very proud to present a sneak preview of the first chapter of W. David Stephenson's upcoming book 'Democratizing data to transform government, business & daily life'. I had the privilege of hearing/seeing David in action over the past several days at the Ogma gathering at NPS in Monterey, California. His thoughts on social media provide a compass heading for many of us as we consider where we need to go and how we're going to get there. - HN [July 4 2009]

     1

Access to data
triggers transformation

by W. David Stephenson

When many of us go to Washington D.C., we like to visit historic landmarks.

We don’t necessarily like carrying maps and guidebooks, especially since most try to be comprehensive, while you might be particularly interested in one aspect, such as Lincoln, so the other material would be irrelevant to you. Now you can use the D.C. Historic Tours application on your iPhone[i]. Just type in “Lincoln,” and it instantly creates a walking tour only of Lincoln-related places, then guides your actual path block-by-block. As for the content of that tour? Your author and other willing volunteers located the places to include in the tour and uploaded the data and photos about them to the Web for use in the application!

In New Zealand, Aukland drivers use an application that uses real-time data from the government’s InfoConnect program[ii] to show where there are traffic jams & then zero in on a local traffic cam. They can change their routes to steer around the jams.

In the Netherlands, companies have the option of filing a single set of numbers instead of the multiple reports to multiple agencies that they formerly had to file. Participating companies can save up to 25% on their reporting costs, and the agencies can actually do a better job regulating the companies.[iii]

What makes these innovation work?

Free, real-time access to unfiltered, valuable data.

Data pervades our lives.[iv]

Government agencies and companies collect data around the clock about our births, deaths, education, jobs (or lack thereof), our race and gender, our spending and saving, our health. Then they use that data to make decisions affecting our incomes, our buying options, even whether we qualify for special benefits.

Data determines how much governmental assistance our communities receive.

Data determines which services companies will market to us, and where they’ll build stores to deliver them, as well as which they will scuttle because data says there’s not enough demand.

Data determines where roads will be built, then our GPS devices process data from government satellites to guide us down those roads and help us find services.

Yet, for all of data’s influence on our lives, you and I have surprisingly little direct access to it ourselves to use as we might like.  That’s particularly true with the most valuable type, real-time data. Because it is made available as it is gathered, this data can be used to automate equipment and services and/or help us make decisions, rather than simply analyze the past, as can be done with historical data.

Despite those benefits, this data is more likely to remain buried in data warehouses and be costly and/or difficult to obtain. When we do get it, it’s often in a form that is difficult to use.

That’s outrageous.

As you will see, if you did have access to that data we could do our work more efficiently and cheaply, engage in more productive political debates, and even contribute directly to new ways to deal with some of our era’s most pressing problems, such as global warming or health care cost containment.

Yet, there’s little sense of public concern, and even less outrage, about our relative lack of unfettered access to critical information.

Frank DiGiammarino, former vice-president of strategic initiatives at the National Academy for Public Administration and now the Obama Administration’s deputy coordinator for Recovery Implementation, says that’s a major problem in the United States (and worldwide, for that matter):

“We as a country need to treat data as a national asset and resource. It is a valuable commodity but we don't treat it that way. We don't think in terms of where it is. In current structures, it is stovepiped but, needs to be moved fluidly  …. The default question has to be why can't we share it? Data has to become a core component of how government works and how leaders think of dealing with issues.”[v]

We’ve been in this situation regarding critical information before: in the 16th century when it was the written word that was inaccessible to all but a few.  How that situation changed – in less than a decade – may provide us some valuable insights into how direct access to data could come about in far less time, and the revolutionary change it would bring.

 

Luther provided a roadmap

In 1517, Martin Luther’s theology, especially his 95 Theses attacking the practice of selling indulgences and other forms of corruption in the Roman Catholic Church, created controversy. It also mobilized the church establishment to defend the status quo.

In hindsight, the means Luther used to spread his Reformation message had as much lasting global impact as the message itself.

Gutenberg invented the printing press in 1439.  In 1502, a printer opened shop in Wittenberg, where Luther wrote and taught,[vi]  but printed materials were still relatively rare in 1517.

In 1514-5, Luther began to lecture on the Psalms. He had psalters printed for his students, with wide margins so they could write notes.  He removed medieval priests’ commentary, forcing the students to interpret the Bible themselves. [vii]

Thus began Luther’s efforts, crowned by his translation of the New Testament into German during 1521-2[viii] (and eventually all of the Old Testament as well) to make the Bible directly accessible to the lay public, through printed copies they could own and interpret themselves, instead of having to rely on the priesthood as intermediaries.[ix]

Printing and distribution of his revolutionary message was immediately effective, at least as measured by the amount of printed matter. In Germany alone, 390 editions of Luther’s works were published just in the year of 1523. By 1525, about 3 million copies of pamphlets relating to Luther were printed.[x]

Making the Bible changed the very nature of scholarship. As Diarmaid MacCulloch observed in The Reformation: a history:

"Now that printed copies of texts were increasingly available, there was less copying to do, and so there was more time to devote for oneself … Copying had been such a significant activity that in previous centuries of Christian culture, it had been given a privileged place against original thought.  Now the order was reversed, and original thought became more important.[xi]

In a tangential result of the impact of the newly-empowered congregations, some of the early seeds of democracy were planed that were to flourish in the New World. Zwingli, another of the early Reformation leaders, won the right of each parish in a village to decide by majority vote of the male members which religion they would adopt.[xii]  

Management consultant Wendy Jameson pointed out to the author the parallel between Luther’s impact and what might happen if we liberate data:

"Martin Luther was effective because he both translated the Bible into language that the general public could understand and made it widely available through printed versions.   The confluence of translation and availability enabled the transformation. A literate person in a home or community could now read it to the other community members, the genesis of the empowered layperson.

“The Internet today serves as the analogous means for widespread distribution of data, combined with new tools that make data understandable to everyone.  For the first time, data will become a valuable tool for many to whom it was an impenetrable mystery in the past."[xiii]

However, we tolerate a mind set regarding data not all that different from what was commonplace with the written word before Luther. Sara Wood, a leader in the nascent movement to make data both available and understandable to the general public, says that:

 “It may not be obvious to everyone, but there exists an important problem of data apathy.  No one cares about data. And by no one, we mean in the democratic sense…. “Good data should affect policy - but politicians don't care because they know their voters don't care. People who vote don't care because data is not engaging, not to mention accessible, usable, and relevant to their lives.”[xiv]

Data apathy is no longer tolerable. Data is so important to our lives that we must all care about data and demand access to it.

 

The transformation from democratizing data

The time has come to emulate Luther’s example and make data as freely available as he made the printed word ubiquitous

The results, as demonstrated by the limited examples from around the world where democratizing data has taken hold, are astonishing.

Take some simple steps to transform your organization’s raw data into a more versatile and usable form, place that data at the center of your organization’s operations, make it accessible to everyone who really needs it, and everything changes.

Data that has been “processed, organized, structured or presented in a given context so as to make [it] useful” is elevated to the status of information.[xv] It is this more elevated, valuable sense of data as information that will be used throughout this book.

 

A handful of tools that you will learn about in this book, none of them radically innovative by themselves but revolutionary when combined, make it simple for organizations to make valuable information available to those who need it, when and where they need it, to improve their decision-making and actions. Since that was never possible before, the potential for change in every aspect of how we work and live is profound and pervasive.

Let us call this transformation democratizing data:

"Democratizing data makes it automatically available to those who need it (based on their roles and responsibilities), when and where they need it, in forms they can use, and with freedom to use as they choose -- while simultaneously protecting security and privacy."

It seems audacious to claim that an act as modest as modifying the way you treat your organization’s raw data can lead to sweeping economic, governmental, and social change.

That is precisely what Democratizing Data will demonstrate.

For far too long, we have been more concerned with creating data warehouses in which to store data than we have been with actually using that data to its full potential. In fact, it’s rather astonishing that organizations have prospered to the extent they have, considering how limited access to real-time, actionable information has been.

This remained true even recently, when we have had powerful computers to gather, accumulate, and disseminate data. It still remained costly and difficult to deal with data, so access to it was typically limited to management, analysts, and other elites. Even these power users rarely had access to the most important data, in real-time, non-aggregated form, which allows the user the most freedom and makes its ability to affect current actions most powerful.

Putting data squarely at the center of everything we do, and making it usable – and shareable -- by everyone, not just those with statistical skills, is a dramatically different approach from how we’ve regarded data in the past.

 

Democratizing data sparks wide range of change

 

Making data automatically available when and where it is needed triggers widespread and fundamental changes.

 

To begin with, with easy access to real-time data, we can make better decisions. As we will explore in Chapter 3, for the first time groups can easily analyze data collaboratively. The result is fundamentally different from when an individual analyzes it in isolation. Different perspectives come into play, assumptions are challenged, and the chances of uncovering problems in advance that might otherwise only be discovered after a decision is reached are increased.

 

Because this data is machine-readable, i.e. encoded in a way that a computer or machine can automatically scan or process, it can provide the real-time information necessary to operate a wide range of devices, which has both economic and quality-of-life benefits.

 

Perhaps the most common example today of real-time data spawning an entirely new industry would be global positioning systems (GPS). Location-based services (LBS), just one components of the range of businesses made possible by GPS, are expected to grow by 104% through 2011.[xvi] Can you imagine the potential economic development and quality-of-life opportunities if all of the non-confidential geospatial data compiled by government agencies was routinely released on a real-time basis?

 

In the political realm, debate and disagreement will always be with us, so one should not over-estimate the benefits of access to data. However, beginning debate on proposed legislation from a pool of data that was accessible to all on a simultaneous basis  might increase the chances of reaching consensus or at least isolating the most extreme positions that were clearly not supported by data. The more data is analyzed and debated before passage of legislation, the less likely it will be that critical data that only comes to light after passage would undermine the law itself, or significantly alter public opinion.

 

Similarly, when data on government operations, campaign finance and “earmarks” are made public, it is much harder to conceal corruption or unjustified disbursements. For example, making campaign contributions public allows watchdog groups and the media to create visualizations that explore possible correlations between contributions and votes that might favor a particular contributor. 

 

Equally important, although few organizations have tried it so far, making real-time, actionable data available to your entire workforce (with the exact amount and type available filtered depending on your role: this is not a one-size-fits-all approach) can elevate all workers to the status of “knowledge workers.”  That will help workers increase their efficiency and reduce costs. They will be able to see which other employees have access to the same data and therefore are likely to share tasks, responsibilities and oversight and interests, engage in the kind of “collaborative data analysis” mentioned above. They can see potential synergies, overlaps, and gaps between programs that must be addressed.

 

 

Democratizing data essential today

The lack of broad public access to real-time data was regrettable in the past. Given the unprecedented worldwide organizational and social changes facing government, the global economy, and our personal lives today as a result of the global crisis that began in 2008, it is intolerable.

We need every potential tool and piece of information at our disposal to deal with these conditions.

For business people, given the massive layoffs over the past few years, it is essential that your remaining workers be able to be as efficient and effective as possible. As mentioned above, democratizing data will make it possible for the first time to give your entire workforce the raw, real-time information needed for them to work more efficiently, new tools to help them better analyze that information, and to collaborate as never before.

Businesses will also be able to significantly reduce their non-labor costs when data is democratized. They will be able to improve business process management (BPM) and supply-chain management because all of those needing to coordinate procedures, procurement, and logistics will be able to communicate more readily.

In addition, embedded-devices[xvii] activated by real-time data will have access to it at the same time, automating previously manual processes. Data will give us usable information on everything from traffic to our personal carbon footprints to our health conditions in applications and devices that will allow us to act on that data and improve our lives.

The regulatory system, in shambles after revelations of lax enforcement in the past decade, was at least in part to blame for the sub-prime mortgage scandal and its cascading effects on the overall economy. Regulation can be reinvigorated through a shift to “smart” regulation, which substitutes a single data file for countless traditional forms. All of the agencies responsible for reviewing a company’s operations will be able to share data simultaneously, allowing coordinated review and enforcement for the first time. This should improve the quality of regulatory review and uncover suspicious activities sooner. The same single-business reporting approach will allow companies to reduce their regulatory compliance costs, perhaps as much as 25%.[xviii]

In the past, effective regulation would inevitably have driven up corporate reporting costs, because the only way to have increased scrutiny would have been to require filing more forms. Now a radically simplified, but more informative and integrated, system can benefit government, the public, and corporations.

Equally important, government agencies and corporations alike must rebuild public confidence after widespread revelations of shoddy management, lack of oversight, and imprudent investments that brought the global economy to the brink of disaster in 2008-9. They will be able to do so through democratizing data.

Demeaning, “trust us” platitudes are no longer enough in the face of consumer and voter outrage. Instead, by releasing large amounts of unedited data directly to stockholders, voters and watchdogs, they can take a “don’t trust us, track us” approach, inviting unfettered scrutiny by watchdogs, the media, and the public.

The soaring federal budget and deficit have united the political spectrum in demands to cut out waste and inefficiency, and to open up the legislative process so that the public can be heard.

Vivek Kundra, the former District of Columbia chief technology officer, named by President Obama as the first chief information officer of the United States, refers to this approach as the “digital public square.”[xix]

“… technological advances now allow people from around the world unfettered access to their government. Through these advances, constituents can hold their government accountable from the privacy of their own homes. The District of Columbia is bringing people closer to government through collaborative technologies like wikis, data feeds, videos and dashboards.  We’re throwing open DC’s warehouse of public data so that everyone—constituents, policymakers, and businesses—can meet in a new digital public square. “[xx]

Kundra, incidentally, was originally to Democratizing Data’s co-author. His new responsibilities required that he recuse himself, so he didn’t actually write or edit any of the book. However, because of several long Saturday discussions of the democratizing data philosophy during the fall of 2008 --- long before he assumed his new job -- and a small project on the future of transparency that the author did for him in his prior job, Kundra’s  thinking is a powerful influence throughout the book.

Finally, and perhaps most exciting, democratizing data can lead to innovation.

It is now possible, by allowing free access to real-time data streams, to unleash “crowdsourcing” of new services for government and industry alike, better serving diverse groups’ needs at low or no cost.

Crowdsourcing, as explained in the book by the same name by Jeff Howe,[xxi] is the phenomenon in which communities, whether intentional or ad hoc ones, come together using Internet resources, especially open-source software, to accomplish a task collaboratively, by each providing a small portion of the overall solution.[xxii]

Even better, the more organizations embrace this revolution, the more the benefits will multiply, because democratized data inherently fosters linkages and synergies between programs and services that share the same data, and open source solutions that all can share and improve upon. Because these programs use global standards, free to everyone, the revolution can and must be global in nature, benefitting nations of all sizes and development status.

stumblesafely: the revolution in microcosm

Democratizing Data will introduce you to some revolutionary examples of the democratizing data transformation. One, for instance, integrates all data to help a state handle natural disasters or terrorist attacks. Another provides emergency room doctors with critical information in life-or-death situations. A third gives soldiers dealing with the unprecedented challenges of asymmetrical warfare all of the data they need to both fight battles and wage “soft peace.”

But to get a basic introduction to the approach and its power, let’s begin with a far more modest example.

A group of young Washington D.C. application developers developed “stumblesafely” to help them and their friends navigate home on foot safely after a convivial evening in bars in the city’s Northwest section. While stumblesafely wasn’t intended to change the world, it turns out to tell us a lot about democratized data’s power to transform every aspect of our lives.

Illustration 1.1 Stumblesafely

 “stumblesafely” was an after-hours product of DevelopmentSEED, a leading D.C. web development firm that does ambitious online projects for clients such as the World Bank, the UN Millennium Campaign, and the American Institute of Architects.

In fall 2008, Kundra announced a first-of-its-kind contest that caught the company’s attention.

The Apps for Democracy Contest (“Apps” being developer-shorthand for computer applications) offered nominal prizes for developers who took one or more of the real-time data feeds that the city issues as part of its “Citywide Data Warehouse,[xxiii]” and developed an “open-source” application that others are free to use or improve upon that, in some way served the public interest.  How the entries served the public interest was intentionally left vague to encourage creativity.

Oh, and the teams had only a month to prepare their entries.

The DevelopmentSEED team jokingly called Apps for Democracy “Iron Chef for developers,” referring to the TV show in which chefs are given a limited number of ingredients and length of time to create dishes.  Their “ingredients” were the 270+ data feeds the city issues through the Citywide Data Warehouse, and the time frame the one-month deadline to submit applications. Given those limits, the team decided to have some fun, and do an “Apps for Democracy” entry that they’d like to use themselves.

According to firm strategist Eric Gundersen, stumblesafely, which they call a “guide to bars and avoiding crime in NW [Washington]”[xxiv]:

“.. was one of those ideas that happened when we were working late one night. We figured it would be cool to show off some of our favorite drinking spots in DC. We like to joke that it doesn't matter when or where you start drinking for stumblesafely to help you, since you can see crime data based on daytime, evening  or night.”[xxv]

As you can see from the screengrab, stumblesafely is attractive, resembling an aerial view of the neighborhood at night, with large squares that represent popular bars (“stumblesafely” is very popular with bartenders!), gray circles that show the location of recent robberies, red x’s that show assaults. Following the map are phone numbers to call a cab (for those who really had too much of a good time), and the right sidebar lists real-time Twitter “Tweets” referring to nightlife in the area, re-enforcing the message that this isn’t just a canned, static map, but a real-time tool.

Cute, and probably fun for pub-crawlers, but a closer analysis of stumblesafely shows that it combines most of the important elements regarding free access to valuable data that this book will explore, and which underlie much more serious work:

·         Creatively use data formerly inaccessible to the public.
The District of Columbia issues more than 270 “structured” data feeds from their massive city databases (Structuring data, as we will explore in the next chapter, means bracketing the data with “tags” that describe it and give it context,” such as <description> or  <phone>. DevelopmentSEED used 6 of the feeds, most of which are delivered automatically as new data is entered, so they are always current.
The names illustrate the wide range of data, especially geo-spatial data, that agencies compile and could be valuable to the public or within agencies as well (since, as we will see, most workers also didn’t have real-time access to it in the past):

·                     DC Crime Data

·                     DC Road Polygons

·                     DC Liquor Licenses

·                     DC Water Polygons

·                     DC Parks

·                     DC Metro Stations

·         Use universal standards.
The DC data is valuable because it is identified by a standardized “tag” system that attached additional information to the data so it can be recognized and processed by any program or any device that is programmed to draw in that data. Those tags are based on global standards that are free and accessible to all, which increases their versatility, and makes it easier for others to copy and improve upon pioneering applications.

·         Visualize data & evaluate it collaboratively, which makes it valuable.
Most of this data would be incomprehensible to non-statisticians in its traditional tabular form. However, when presented graphically, the data instantly becomes understandable to the general public.

Also, the fact that the DevelopmentSEED staff examined the DC data feeds collaboratively rather than individually improved the quality of results. When many perspectives examine the same information, the interpretation will be richer and more nuanced than what even the most brilliant individual could do in isolation.

·         Use open-source software.
Open-source software (i.e., software whose source code is freely available to use and improve) is usually cheaper than proprietary alternatives, and built on open standards, just as the structured data feeds are. DevelopmentSEED only used open-source applications to create stumblesafely, increasing this versatility and ease of adapting the program to other cities. Gundersen said, “A couple of years ago we could not have done this kind of stuff with government data because the tools were not there. Now open-source tools are more powerful and more secure than proprietary applications. We were able to build this in a couple of days with the only cost being our time.”[xxvi]

·         Create 0pen-source solutions to encourage constant improvement.
One of the contest rules required that the solutions themselves be open source, so that others could copy and/or improve on them. This will significantly speed adoption of democratized data solutions worldwide, because other governmental entities that begin to offer the necessary structured data feeds can easily examine then share or improve on the work of the pioneers.

·         Create mashups.
Each data stream by itself would only provide a small part of the information needed to create interesting and informative maps. However, when all 6 of them were combined – “mashed up” (in developers’ lingo) -- the picture was comprehensive and valuable.

·         Don’t prejudge what data to not release. Someone may find it valuable.
Management may be tempted to decide that certain data doesn’t need to be released because it would be of little interest to others. However, it was combining 6 of the data feeds that DevelopmentSEED used that made stumblesafely possible. Some data feeds may be appealing only to a relatively small number of people, but may be invaluable to them (the long-tail phenomenon at work[xxvii]), so access shouldn’t be arbitrarily limited.

·         Partner for innovation.
DevelopmentSEED’s Eric Gunderson learned after the Apps for Democracy that stumblesafely had some unexpected users: the DC Police. The city administrator told him that the police “… were using our map to better visualize crime hot spots near bars to improve their coverage during the key times of the day when it mattered. This is a great example of a positive externality coming from open data… open data will have many benefits for taxpayers that we can’t even imagine now. It is not like the government would have ever paid us to build a drinking site!”
[xxviii] When government agencies – or private companies, for that matter – release data, others will use them in creative ways that may create new revenue streams for the company or help a government agency better serve the public interest.

As an added bonus, Gundersen says that the project for fun directly benefited some of their prestigious regular clients: “the same mapping tools powering the bar site are also being used to help USAID map [food security operations in Africa] and by non-profits like New America to map public health data in the U.S. In fact it was New America that helped pay for a lot of the mapping work with Drupal that gave us the tools to do this.  Everything we do ends up getting reinvested back in. It feels great.”

On further examination, stumblesafely looks like much more than a group of friends’ fun little project for themselves and their buddies.

It’s a harbinger of a new era in which free access to data leads to innovation in every aspect of our lives.

Democratizing data happening now

stumblesafely isn’t the only example of democratizing data in practice today. This is not just a vision of possible transformation in the future. True, the amount of innovation is severely limited by the lack of freely-available structured data that is the underpinning of democratizing data.

Despite those limits, pioneers in government and industry worldwide are already realizing tangible results with innovative data-centric strategies that would have been impossible only a few years ago.

In the Netherlands, companies now have the option of filing a single data file with the government instead of the traditional 30-40 quarterly and annual reports to a wide variety of agencies. The change is possible because all of the agencies have reprogrammed their mandated reports so that they can automatically access relevant data from the unified file.  Multiple agencies can examine the company’s filing simultaneously, improving the quality of regulatory scrutiny. Participating companies can cut 25% off of their compliance costs. Australia will follow the Dutch government’s lead with a similar program in 2010.[xxix]

Wacoal, the Japanese apparel firm, had 32 different legacy IT systems in place, which it had added over a number of years. The company went to a new system based on universal access to the same data. As a result, they consolidated their financial reporting, shortened the closing of accounts by two days, and added real-time cash management.[xxx]

In the District of Columbia, Aki Damme, director of the District of Columbia’s IT ServUs team, had to manage a project to buy and install 6,000 computers in city classrooms for a high-visibility new program. The original estimate was that the project would take an entire year to complete. However, an expedited purchasing program and his ability to plan the installations using a Google Maps mashup cut the total length to only 7 weeks, and saved thousands of dollars in costs.[xxxi]

Agencies responsible for disaster preparedness and response in Alabama can now access “Virtual Alabama,” a comprehensive, integrated array of real-time geospatial information – right down to the layout of individual classrooms – that helps them change emergency evacuation routes, know instantly where response vehicles are located, and monitor real-time sensors locating chemical releases and their plumes.[xxxii]

The US Patent Office now allows individuals outside its staff to participate in the review of patent applications under the trial “Peer to Patent system” designed in part by NYU Law Professor Beth Noveck, now an Obama Administration official. The project promises to reduce the “patent thicket” that slows innovation.[xxxiii]

Although these examples are impressive, the organization that perhaps epitomizes the use of democratized data better than any other at the time of this book’s publication is the District of Columbia’s Office of the Chief Technology Officer (OCTO).

Under former CTO Vivek Kundra, OCTO pioneered numerous innovations, including:

·         publishing a wide range of real-time data streams to invite public scrutiny and allow mashups[xxxiv]

·         introducing rigor and accountability to project management by treating each project as a “stock”[xxxv]

·         treating every worker as a knowledge worker, and giving them real-time data to do their jobs more effectively[xxxvi]

·         running the precedent-setting “Apps for Democracy” contest, which resulted in an astonishing array of crowd-sourced open source applications—and reaped a return on investment of 4,000% [xxxvii]

Now that Kundra has become the first CIO of the U.S. government, his innovations at OCTO will provide valuable clues to the kinds of changes he has already begun spreading throughout the US government. Those in turn will likely stimulate similar initiatives in the private sector and other governments worldwide. Accordingly, an entire chapter of the book will be devoted to a case study of his accomplishments there.

All of these examples, and more, will be discussed throughout the book.  Since, as mentioned above, these pioneering examples are made possible by international, open-source standards for handling data, it becomes very easy for other companies and agencies to launch their own programs of these sorts, building on the experience of the pioneers and adding to the “library” of data-based solutions to complex problems.

That will mean that those who begin democratizing data now can directly benefit from the case studies detailed in the book. The benefits, should other government agencies and companies move quickly to take the basic steps required, should increase exponentially because of the synergies between initiatives worldwide.

 

Keys to the strategic shift

Effective democratizing data initiatives require a paradigm shift from past ways of regarding data. The book will explain in depth these key goals:’

·            Make your organization data-centric.
 In the past, because the tools to distribute and use data were primitive, it was understandable that access to data was primarily second-hand. It was usually warehoused, embedded in proprietary software, and/or interpreted by an elite group of analysts and executives. Today, open source software, metadata and other tools that we will examine allow the data to remain independent, accessible to all whose jobs require access to it. Truly, data must be thought of as at the heart of everything the organization does.

·            Treat all workers as knowledge workers.
When data was hard to access and the software to interpret it costly, limiting access to real-time data to a relative few was justifiable. Now it isn’t. Every worker’s job performance and satisfaction can be increased by direct access to data (the exact mix of data delivered to individual workers will be determined on the basis of his or her role.)

·            When appropriate, release real-time data for outside use and scrutiny
Government agencies and businesses accumulate vast amounts of data that could be used externally, not only to earn public trust through transparency, but also (especially with real-time and geo-spatial information) to create valuable new services that can complement what the agencies and companies do themselves, or, in its machine-readable form, to drive embedded devices in a wide range of products. That data is also more valuable when it is released in the original, granular form in which it was collected, rather than as interpreted and aggregated by others.  Today the default must be to release data. Exceptions to that rule must be justified.

·            In no way does a democratizing data strategy justify breaches in personal privacy and/or security standards.
In fact, as we will see, establishing the right access standards can mean people ranging from those with no security clearance at all to top-secret clearance may all access portions of the same data set based on the situation and their roles, but with widely-differing specific levels of access. A comprehensive democratizing data strategy should in fact help uncover security and privacy breaches rather than encourage them.

·            Above all, adopt a new collaborative attitude toward data.
In the past, if data was shared at all, it was usually sequentially, because data was effectively captured and altered by various proprietary programs. Now, with open-source, open-access programs and structured data, data can be more effectively analyzed and used if it is shared on a real-time basis. Collaborative data analysis is fundamentally different than analysis by individuals, harnessing different perspectives and expertise to yield a richer, more comprehensive picture that benefits from all of these perspectives and is more nuanced and balanced.

Democratizing Data’s overall goal is to introduce you to the benefits of democratizing data and to the simple tools you can use to structure and automatically distribute data, the fundamental building blocks of the democratizing data approach.

Along the way, you’ll learn that democratizing data is both a process and an attitude. The more people who can access data and use it, the more valuable the data will become, the more workers will be able to improve their performance, government and corporations will become more accountable and transparent, and average people will become both better consumers of data and be able to use it to become active participants in creation of goods and services.

Let us begin to explore this profound transformation and its implications for our government, our workplaces, and our daily lives.

Given the monumental challenges facing us today, we don’t have a moment to spare, and data, used in innovative ways, can provide many of the solutions.


[i] Boalt Interactive, “DC Historic Tours,” http://www.dchistorictours.com

[iii] Schneider, Bob. “Dutch Taxonomy Project Cuts Red Tape,” Hitachi Interactive. http://hitachidatainteractive.com/2007/03/17/the-dutch-taxonomy-project-cuts-red-tape/

[iv] Strict grammarians remind us that data is the plural of datum in Latin. However, has become common practice to use a singular verb with data, so that will be the practice observed in this book.
In case you’re interested, here’s the argument:
“The word data is the plural of Latin datum, “something given,” but does that mean you should treat it as a plural noun in English? Not always. The plural usage is still common enough Sometimes scientists think of data as plural, as in These data do not support the conclusions. But more often scientists and researchers think of data as a singular mass entity like information, and most people now follow this in general usage.” The American Heritage® Book of English Usage.A Practical and Authoritative Guide to Contemporary English. New York: Random,  1996..

[v] DiGiammarino, Frank. Interview with author, December 05, 2008.

[vi]MacCullogh, Diarmaid. The Reformation, a history. New York:  Viking, 2004., 113.

[vii] Ibid., 114.

[viii] Ibid., 128.

[ix] Ibi.d., p. 72.

[x] Ibib., p. 147.

[xi] Ibid.

[xii] Ibid., p. 171.

[xiii] Wendy M. Jameson, CEO, Potentiate, email to author, March 30, 2009.

[xiv] Wood, Sara. “Breaking the Vicious Cycle,” Tasty Data Goodies blog, July 14, 2007. http://blog.swivel.com/weblog/2007/07/breaking-the-vi.html

[xvii]Embedded systems are special-purpose computer systems designed to perform a single or a few dedicated functions on a real-time basis, which increasingly drive equipment and processes.

[xviii] Schneider, Bob. “The Dutch Taxonomy Project Cuts Red Tape.” Hitachi Daata Interactive blog. March 17, 2007. http://hitachidatainteractive.com/2007/03/17/the-dutch-taxonomy-project-cuts-red-tape/

[xix] Kundra, Vivek. “Building the Digital Public Square,” Oct. 15, 2008. http://www.appsfordemocracy.org/building-the-digital-public-square/

[xx] Kundra, Vivek. “Building the Digital Public Square,” unpublished essay.

Chief Technology Officer, District of Columbia Government

[xxi] Howe, Jeff. Crowdsourcing: why the power of the crowd is driving the future of business.” New York: Crown Business, 2008  310 pps.

[xxii] Arrington, Michael. “Search for Steve Fawcett Extends to Amazon’s Mechanical Turk.” TechCrunch, Sept. 8, 2007. http://www.techcrunch.com/2007/09/08/search-for-steve-fossett-expands-to-amazons-mechanical-turk/

[xxiv] DevelopmentSEED.”Stumble Safely.” http://www.outsideindc.com/stumblesafely

[xxv] Eric Gundersen, email to the author, March 17, 2009

[xxvi] Ibid.

[xxvii] As detailed by Chris Anderson in his book The Long Tail: Why the Future of Business is Selling Less of More,  the long-tail refers to a strategy in which you serve a large aggregate number of customers with products (in this case, data streams) that each serves a small niche.

[xxviii] Gundersen, op. cit.

[xxix] Schneider. op. cit.

[xxx] Wacoal Case Study, XBRL.org. http://www.xbrl.org/nmpxbrl.aspx?id=90

[xxxi] “OCTO Delivers Computers to Every DCPS Classroom,” News Release, District of Columbia Office of the Chief Technology Officer, Jan. 31, 2008. http://tinyurl.com/5wkarl

[xxxii]Alabama Department of Homeland Security, “Virtual Alabama Fact Sheet,” http://www.dhs.alabama.gov/virtual_alabama/home.aspx

[xxxiii] Scola, Nancy. “Better Patents Through Crowdsourcing.” Science Progresss, http://www.scienceprogress.org/2008/08/better-patents-through-crowdsourcing/   President Obama appointed Noveck as deputy director of open government in the Office of Science and Technology Policy.

[xxxiv] Office of the Chief Technology Officer. “Citywide Data Warehouse.” http://data.octo.dc.gov/

[xxxv] Harris, Blake. “Vivek Kundra: Engineering a Radical Transformation.” Digital Communities, March 5, 2009. http://www.govtech.com/dc/articles/625346

[xxxvi] Peirce, Neal. “A High-Tech Czar’s Scorecard.” Washington Post Writers Group, March 15, 2009. http://www.postwritersgroup.com/archives/peir090315.htm

[xxxvii] Collective Insight. “ROI on Apps for Democracy?” Collective Insight blog, Jan. 28, 20089. http://collectiveinsight.net/2009/01/roi-on-apps-for-democracy/

 

Creative Common: Attribution Non-Commercial No Derivatives


 

Editor's Note: June 2009 - Hurricane Season is upon us and many of the lessons learned post-Katrina still ring true today. This should be required reading for emergency managers and community leaders. - HN

 

Post-Katrina Emergency Messaging for the Disability Community

 

Brenda Phillips, PhD

Jennifer Mincin, MPA

[December 2005]

 

National Emergency Management Resource Center

NEMRC 2.0 www.nemrc.net

Overview

The purpose of this document is to provide a general overview of ideas, principles, research and basic strategies to assist emergency managers and public health planners to better communicate with the disability community during disasters.

Accurate information and aggressive outreach prior to, during and after emergencies improves the ability of individuals and communities to prepare for, mitigate, and cope with the impact of a disaster. People with special needs may have a variety of limitations that prevent information from getting to them, which could be a matter of life and death. Additionally, people with special needs may be particularly vulnerable if their service providers, home health services, outpatient clinics, etc. are impacted by the disaster and they are unaware of alternatives.

The development of the information itself, what is addressed and what is not addressed is very important. Sometimes what is adequate for the general public does not address the specific concerns of many individuals with special needs. The information that is critical will change from stage to stage of an emergency. Disability communication planning should address dissemination of information among special needs communities and professionals. This must include:

• Preparedness messages prior to disasters

• Notification and warning just prior to and during emergencies

• Critical information resulting from an emergency

• Recovery and re-entry information.

Challenges

The following is a list of challenges most emergency management and public health agencies face when planning for and considering communicating with the disability community during disasters:

• Providing accurate and timely information to professionals and to the public;

• Utilizing alternative formats (Braille, large font, plain language) and multiple modes (TV, radio, call-down systems, etc.) to disseminate information to the most people possible;

• Determining when special needs sheltering or other information should be shared with the public;

• Involving communities at risk to help themselves;

• Involving agencies and organizations that work with those at risk;

• Coordinating the dissemination of information with different healthcare, long term care agencies and other organizations providing daily or regular services;

• Ensuring that agency/organizations press officers are attuned to special needs issues and can present accurate information that is helpful and clear.

Limitations of the Research

A small body of scientific, empirical research exists on disasters and persons with special needs. Use of that body of knowledge, though helpful, is nonetheless limited in several ways (Tierney and Petak 1983; Parr 1987; Jones 1987; Mansour 1993; Ragsdale and Simpson 1996). First, because the research is relatively small, verification of research findings by repeated studies is a concern. Second, the body of research tends to be generic rather than specific to certain populations of interest. Third, the size of the samples (numbers of persons or organizations studied) tends to be relatively small; a related concern is that the much of the research is not generated from randomly selected, representative samples, which raises questions about its broader application to all persons with special needs. Fourth, the research is scattered across the phases of emergency management although most does address preparedness and response. Fifth, the research rarely addresses the intersection of such issues as disability, age, income, gender and culture. For example, research about the deaf may not acknowledge that deafness may originate in birth or later life. Each situation carries different challenges and different solutions. Sixth, research is produced by a variety of scholars across a range of disciplines.

To illustrate, warning messages may be addressed by social scientists, meteorologists, communication specialists and disability researchers, all of whom present research from different perspectives. Finally, limited research exists on specific channels for communicating messages. For example, is text messaging more effective than closed captioning? What circumstances, such as type of disaster, target population characteristics (income, literacy levels) and cellular service ranges might affect a choice to use text messaging versus closed-captioning?

The good news is that general research findings tend to overlap with those from studies on other vulnerable populations (the poor, women, the elderly, children). Further, research has tended to support recommendations from governmental reports, including those generated recently on Hurricane Katrina. Consequently, it is possible to use the body of research, including well-done governmental studies, to generate principles for this report.

Conceptual Model for Warning Messages

The conceptual model most frequently acknowledged in scholarly research is the "Source-Channel-Message-Receiver-Effect-Feedback" model (Lasswell 1948 as cited in Tierney, Lindell and Perry 2001). This multi-stage model should be viewed as a process that may be experienced differently, at any stage, by various populations. To illustrate, the source (emergency manager, media) may be seen as credible or not; the channel (text message, phone call-down) may be accessible or not; the message may be understood in varying degrees; the receiver may not receive the message; the message may generate desired behavior (as possible) within the target population; receivers may then seek additional information to onfirm the message content (Tierney, Lindell and Perry 2001). What is key to understand is that emergency messaging takes time to deliver, interpret, and act upon.

Research Derived Principles for Disability-Related Emergency Messaging

This section employs the conceptual model described above to organize research-generated principles for disability-related emergency messaging.

SOURCE (media, emergency manager, groups, organizations, friends/family/neighbors): the vehicles through which communications are transmitted vary from formal to informal sources. Those sources vary in terms of their credibility to the public, their abilities to transmit information accurately, and their experience in reaching out to the target populations. A number of principles can be derived from the existing research to enhance the source’s abilities to transmit messages.

Build trust and credibility. Direct connections between the source and the recipient can enhance credibility and build trust. Emergency managers, media personnel, advocates and social service providers can all reach out to target populations through direct media campaigns, presentations at public meetings, targeted brochures, service on each other’s boards, and working with community groups. The more frequent the contact, the more likely it is that trust and credibility can develop. However, it is crucial that the person(s) involved in the direct connection be able to connect with the target population in a sincere fashion. Doing so may take considerable time with some populations reticent to shed decades of mistrust.

Educate the media. The media can serve as an important and crucial point of dissemination for warning messages. However, media personnel rarely have enjoyed the benefit of training or education in such information dissemination. Further, in the urgency of the moment, crucial details can be glossed over or reported inaccurately. To address these concerns, it is important to develop prior relationships with the media, to engage in mutual training workshops with authorities and the target population, and to practice warning transmission. Mutual aid agreements with the media, though unusual, may serve as a useful public service activity between all parties.

Link with advocates and service providers. Typically not involved in warning dissemination, preparedness, and response initiatives, researchers concur that local community organizations and service providers should be more fully involved. Local providers and advocates know their populations well and can serve as resources for preparing and assisting target populations. Their expertise as important linking organizations to the target populations cannot be overlooked.

Use social networks (family, friends, neighbors). Warning research consistently demonstrates that receivers confirm the warning message with those they trust: their family members, friends and neighbors. Such social networks can be used to help with buddy systems, delivery of prophylactics, information dissemination, transportation, evacuation to emergency shelters and more. Authorities an motivate connections to social sources too, such as asking the media to have neighbors check on each other. Disaster research also shows that gender matters, in that women tend to want to respond to warning messages at higher levels than men. Women also tend to be more likely to shoulder responsibility for the target populations. Thus, engaging in outreach to women’s organizations (faith-based, civic, neighborhood, workplace) is a potential way to increase awareness and enhance the usefulness of social networks.

Transmitters should be similar to the target population. Receivers tend to listen more closely—and to trust—persons that are similar to them. This principle of homogeneity can be used when selecting a source. Consider, for example, using a person with a disability in a public service announcement and in a warning message. As another example, a local emergency manager could involve the elderly in direct outreach to each other, such as through building a Community Emergency Response Team at a local senior center.

CHANNEL (audio, print, technologies, authorities in uniform): a variety of media can be used to transmit information including radio, television, e-mail, text messaging, call-down systems, electronic billboards, communication boards, newspapers and even individuals going door-to-door. No one single channel is the perfect solution for an audience diverse in how it may access, interpret and respond to information.

Employ diverse means to reach populations. Multiple and redundant systems tend to reach more persons over a broader stretch of time. Thus, using a combination of channels to reach persons is key. Pre-established messages can be activated expeditiously as a strategy to reduce effort during a response time frame.

Recognize that technologies are not necessarily available, affordable or used by populations at risk. To illustrate, consider that text message served as a popular communication strategy for persons that are deaf during Hurricane Katrina. However, text messaging requires that an individual be able to afford, read and understand that text. Elderly persons who are hard of hearing are less likely to use text messaging, e-mail or web sites. Thus, in order to truly reach the deaf and hard-of-hearing community, it is necessary to use not only technologies but traditional vehicles as well. Post Katrina, persons that are deaf used newspapers and web sites as a major source as well.

Understand that federal policies do not guarantee that emergency messaging will be delivered. Although FCC policies expect that closed-captioning will occur during emergencies, a number of exemptions have been granted to cable and satellite channels. Further, research suggests that even local networks experience difficulty in affording or providing caption during emergencies, especially rapid-onset events.

Involve well-trained first responders. Firefighters, police, EMS and other uniformed personnel tend to carry higher levels of credibility especially when direct, face-to-face communication is the medium of communication. Involving such first responders can increase warning compliance. However, Hurricane Katrina revealed a number of gaps in how first responders understand and interact with the targeted populations including communication, evacuation strategies, assistive devices and service animals. Thus, involving first responders as a channel through which to transmit information requires training, preferably in concert with the organization sending the message and representatives from the receiver population.

MESSAGE. The content of a warning message is crucial. It must carry certain components: (1) identify the hazard (2) locate the warning area (3) specify actions to be taken (4) be understandable to the target population (5) apply to the target population. In writing and transmitting a message, it is important to follow certain principles:

Develop and test message content for specific scenarios and populations with those populations. Research indicates that those at risk represent a useful source of information for message content. Accordingly, messages should be written, tested, assessed and revised in concert with those at risk.

Be specific, giving actions to be taken appropriate to the population. Audiences require that the source give specific information on actions that need to be taken. It is not enough, for example, to direct receivers to a location. Rather, specific information on the route and the resources that can be used to reach the location must be included. Or, if shelter-in-place is the recommended action, instructions on the best location or strategy to SIP is required. For a population that is unable to take the preferred action, alternatives must be given including the activation of social networks, linking organizations, and other viable, pre-established connections to the target population.

Repeat a consistent message through multiple sources and channels. All sources and channels used must give consistent, correct information. Variations from the official warning message cause confusion, increase confirmation behavior, and delay compliance. Pre-event training of sources should be undertaken to increase compliance with this principle.

Rehearse, exercise and assess message relays. Drills and exercises can include test messages coupled with an assessment or research component. Use opportunities to test content, for example, testing a message with a representative group during a severe but non-life threatening weather event.

RECEIVER. Reaching those at risk and motivating the desired behavioral compliance is the goal. Although a fair amount of research exists on behavioral response in general, only a limited amount exists on persons with disabilities.

Acknowledge and address diversity. Assume that any given population is considerably diverse. Persons with mobility, cognitive and sensory limitations may vary from low functioning to high functioning levels. Persons from varying backgrounds will filter their understanding of the message through their cultural frameworks.

It’s just another challenge. Disasters, for persons with disabilities, may represent just another of life’s many challenges. Preparedness consequently may take a back seat to other requirements of daily survival. For those with a limited income, preparedness and mitigation may be simply impossible. Response to warnings may occur only after the person at risk becomes convinced that the message applies directly to them and that the risk is imminent.

Expand efforts to reach those at risk. People do not simply live with one life circumstance, such as using a wheelchair. For a low-income elderly paraplegic, for example, a warning device or television access may be financially impossible. If that person is also hard-of-hearing or socially isolated (more common with elderly men), expanded efforts may be necessary to reach the individual. Community and civic groups may be a source to raise funds and deliver assistive devices such as pillows attached to vibrating devices, visual smoke alarms, text messaging devices, protective kits, emergency bags, etc.

Develop multiple means to communicate beyond English and Spanish, including Braille, audio, and visual (i.e. for non-literate or non-English/Spanish speakers). Materials should be developed for use by the source and receiver. Understand that Spanish sign language differs from English sign language and that persons capable in those languages must be involved in message development.

Empower those at risk and build their capacity to respond. Vulnerability researchers concur that the least used and most effective strategy is to work with those at risk to design, test, and refine warning messages, to develop preparedness materials, and to motivate self-initiated response. In the aftermath of Katrina, for example, schools for the deaf organized student volunteer crews. In Pittsylvania County, Virginia, a deaf CERT has been formed. Assuming that persons with disabilities cannot be an active part of preparedness and response efforts further disables that population.

Develop educational and outreach programs. Those who understand their risk are more likely to take action. People who know what to do and who have undergone frequent training are more likely to take action. Empowering those able to respond may also reduce unwillingness to register as having special needs out of fear of privacy invasion or loss of independence.

EFFECT. This section addresses how persons with disabilities might respond to warning messages. Although it is anticipated that many persons will be motivated to comply with warning messages, it is also true that delays can and will occur in behavioral compliance.

Anticipate disbelief. Research indicates that most people, regardless of disability status, tend to not believe a warning message. Typically, most persons delay compliance until they have confirmed the message content with another source, usually a trusted social contact. To motivate compliance, those at risk must understand that the message applies directly to them and that their life is in immediate danger. Sources must connect to their target population.

Anticipate reluctance or inability to respond. Persons with disabilities may be tied to the locations, persons and routines that sustain their lives. It is therefore understandable that they may be reluctant or unable to respond as desired. Providing alternatives to the recommended action may be necessary. Providing resources to those able to alter the living arrangements, social networks and routines may increase compliance. Multiple interactions from trusted social contacts may be necessary before the desired behavioral response is reached. Consider, for example, persons that were deaf in New Orleans who never received or understood the hurricane message. Buddy systems could have made a difference. Working through schools or religious organizations for the deaf and blind could have made a difference as well.

Anticipate that the target population will question whether message pertains to them. Research indicates that receivers in general delay response while determining if the warning applies to them. Specifying areas by zip code as well as specifying populations can clarify this. For example, after the Three Mile Island nuclear incident, messages that targeted pregnant women motivated higher levels of evacuation.

Anticipate delays in appropriate response. Motivating the most rapid and appropriate response is the desired goal. Yet, many warning recipients delay response. Delays occur for varying reasons. During Hurricane Floyd, some persons with disabilities did not evacuate because their one "buddy" was absent or because they did not believe that shelters could provide appropriate accommodations. Elderly may respond more slowly due to "Delayed Response Syndrome" or because of hyperthermia or hypothermia. The effects of the evacuation for Hurricanes Katrina and Rita for future events remain unknown. It is likely that the horrific scenes may motivate higher compliance but it is also possible that non-governmental linking organizations may need to be increasingly involved to overcome issues of trust and credibility.

Anticipate that the target population may not be able to respond as desired, including shelter-in-place or travel restrictions due to their circumstances (dialysis, inappropriate shelter location). Inabilities to travel to a given location for prophylactics or shelter may be due to a lack of transportation resources, mobility limitations, connections to life-sustaining devices, fear of the unknown or not knowing if a location is accessible, or even fear of urban areas or highway driving.

Rehearse the desired behavior. Linking organizations, civic and community organizations can work with local authorities to train those at risk in the desired behavior. Persons that rehearse desired behaviors tend to respond more appropriately and more quickly. Such activities have the potential to build and/or strengthen social ties useful during an emergency.

Anticipate altruism. Research clearly indicates that in a disaster situation, people help each other. In the 9/11 attacks, co-workers stayed behind to help colleagues with disabilities. In the aftermath of Katrina, deaf students mobilized to help those left homeless. In most disasters, the first person most likely to reach you will be a neighbor. Emergency managers and authorities can assume that, in most cases and most circumstances, people can and will help each other. Planning, preparedness and response activities can be based on this principle.

FEEDBACK. The final part of the conceptual communication model addresses feedback. There are several dimensions to this including the need to solicit feedback from target populations prior to an event and the behavioral reality that people will solicit feedback from socially significant others prior to taking action.

Solicit feedback prior to actual implementation from target populations. The audiences they seek to reach should review warning messages for content. Focus groups can be used for this effort. Assessment of the focus group conversations and refinement of messages should follow.

Anticipate confirmation behavior and time messages accordingly. Do not delay messaging. Because confirmation behavior routinely occurs, emergency managers and local authorities should not delay warning messages. A number of research studies document deaths and injuries when officials have chosen not to act expeditiously.

Encourage interaction among family, friends and neighbors to activate and spur confirmation behavior. Activating social networks spurs feedback behavior. Messages should include requests for people to contact friends, family and neighbors.

Existing Practices and Strategies in Use

In general, and as expressed above, there is not much data supporting various and existing practices. In addition, it is also clear that in the area of special needs planning, there is a serious deficit on the local, state and federal planning and response levels. However, there are generally accepted strategies that are employed in certain jurisdictions. Plans should be designed to address accessibility and accommodations so that special needs issues are incorporated into all aspects of disaster planning. In addition, emergency management offices should provide, when feasible, emergency information to the special needs population through the following methods:

• Public information materials, which may be provided in alternate formats including audiotape, electronic, and written materials in large type.

• Public Service Announcement (PSA) should be Closed Captioned for the hearing impaired.

• Coordination with the disability community in establishing trainings and alternate format of materials should be considered.

• OEMs and other government agencies should have functioning Telecommunications Device for the Deaf (TDD) as well as a public email address. These numbers and addresses should be published in all public information materials and websites.

According to a National Organization on Disability (NOD) and Harris Poll Interactive1, incorporation of special needs issues on local and state levels have increased.

However, these plans are not comprehensive and lack adequate planning for children with disabilities, do not utilize experts with disabilities, and have limited training and funding (NOD, 2004). In addition, the survey found that vital information was not in accessible formats (NOD, 2004). In many regards, special needs issues are more complicated than general population issues. However, special needs issues are equally important and cannot be disregarded simply because they are more challenging. A 2004 NOD survey revealed that 66% of people with disabilities do not know whom to contact regarding emergency plans, 61% have not made plans to evacuate their homes, and 32% say no plans have been made to evacuate the work place (NOD, 2004). This survey points to the need to better educate, provide more information, and establish outreach methods to the disability community. In addition, the disability community must become more prepared themselves. This level of preparedness within the disability community must be considered within planning and exercise initiatives.

Risk communication and outreach initiatives must always be ability focused and inclusive in terms of disability type and criteria with planning efforts that assist special needs populations. The following issues may directly affect the special needs population during various types of emergencies and disasters and should be anticipated:

Hesitancy/refusal to evacuate especially if the home is retrofitted (made accessible)

• Emotional trauma and physical discomfort because of an evacuation

• Loss of possessions and/or homes (again, an issue for homes that have been retrofitted or other accommodations were made)

• Disorientation and confusion caused by disaster conditions resulting in a temporary loss of memory or the triggering of other cognitive issues

• Increased need for assistance services to residents at home (meals, at home nursing, chore services)

• Increased demand for placement in residential care facilities

• Increased mortality rate following a catastrophic disaster

• If feasible and appropriate, efforts should be made for local municipalities to consider voluntary special needs registry focused on assisting the most medically vulnerable populations (i.e., those medically dependant and bed bound with little support). This is where a special needs task force will play a crucial role in assisting emergency managers on whether to pursue a registry and if so, how.

Below are some questions and items to consider when initially developing a disability communication component to an emergency plan:

• Are all public information materials accessible and available in alternate formats?

• Are interpreters readily available for meetings and counseling sessions?

• Do outreach workers (disaster staff), first responders and planners fully understanding issues concerning the disability population affected by the disasters?

• Are people aware of sensitivities regarding people with disabilities and terminology? What kind of education are you providing to first responders, disaster staff, and planners regarding disability issues?

• Are disability issues being incorporated and integrated into the whole program?

• How are you ensuring accessibility and "reasonable accommodations?"

Are you incorporating the disability community in the actual development plans and exercise design?

• Needs of each target group (i.e. MRDD, Hearing Impaired, etc).

• Existence of internal service agency disaster plans.

• Communication of member agency disaster plans.

• Existence of inter-agency and community partnerships.

• Information relayed during a disaster from governmental agencies and during the following recovery period as well as having the availability of local, state and federal resources.

• Ongoing identification of service gaps and failures as well as recommended improvements for the overall response and human services disaster system.

• Communication and planning for the needs of people with disabilities during disaster and recovery periods.

• Identify the specific needs of each special needs target group.

• Ensure that member agencies and others develop their own internal disaster plans, and provide assistance with development of individual plans for member agencies and others.

• Establish communication with local emergency management and other VOAD affiliate agencies and planning groups.

• Development of inter-agency and community partnerships.

• Development of a system for making referrals in coordination with other available resources.

• Provide emergency preparedness workshops and presentations for the disability community and train those in the community to provide presentations.

• Identify the specific challenges of each special needs target group.

• Identify ongoing service gaps and failures based on disaster experiences and make formal recommendations on improvements for the system.

• Establish an advocacy group or special needs task force that will identify and support individuals with disabilities and retain the required services from local, state, and federal government entities as well as other social service agencies.

Working with the Disability Community

It is imperative to recognize the importance of reaching out to and incorporating all agencies that provide traditional services (mental health, employment and job training, home health aids, etc.) to the disability community as well as disability advocacy agencies (independent living centers). Coupling advocates with professionals allows for better outreach and delivery of services during a disaster as well as better informing during the planning and exercise design phase. Outreach to the disability community includes holding a special needs meeting with key agency representation and perhaps establishing it as a special needs task force. Disability leaders, experts, and people with disabilities themselves can help emergency managers tailor the planning initiatives and drills to meet the needs of the community as well as instruct how to best reach out to the community to increase awareness on emergency preparedness. The planning and exercise process should include not only disability experts, but people with disabilities to allow for a deeper understanding of the issues and ways to build awareness and resiliency.

It is also important to work with advocacy organizations to discuss ways to conduct meaningful outreach, problems or concerns with the development of emergency plans and exercise design. For example, in New York City during the 2001 terrorist attacks, some independent living centers located in predominantly low-income, minority communities had several different and complex issues to address in addition to disability. Issues of disability, race, economics, and inequity of services around the terrorist attacks became prominent during mental health service delivery. Engaging the independent living centers and similar advocacy agencies was one way to address these types of concerns as well as enhancing outreach, awareness and services to the disability population. A communication plan that specifically considers the needs of people with disabilities during an emergency or disaster should include close working relationships to community and advocacy-based organizations. They have resources and ways in which to communicate and reach out to the disability population that may otherwise be missing.

Lessons Learned from Hurricane Katrina

A number of reports have been issued in the aftermath of Hurricane Katrina, including the White House, the U.S. Congress, the G.A.O., and various researchers and think tanks. It is clear that, even where warning messages succeeded in reaching the populations at risk, the desired response did not always occur. Problems in effecting the desired response include:

• Medical models were used to manage the target populations rather than models that would have retained independence and useful social connections.

• Messaging was not accessible for large numbers of persons.

• Affected states and localities continue to struggle to find sufficient numbers of transportation vehicles with appropriate lifts. Linking with community organizations may be one route to access such vehicles.

• Shelters were overrun in all locations; many were not prepared to admit or work with persons with disabilities.

• Shelters did not have sufficient capacity to communicate with persons with cognitive disorders.

• Shelters did not have sufficient capacity to communicate with persons who were blind, deaf, hard-of-hearing or a combination.

• Shelters did not have appropriate types of food for specific conditions including diabetics, persons with stomach disorders, etc.

• Medications were not available in the types and quantities needed at first aid stations, at evacuation centers or at shelters.

• The target populations died in numbers disproportionate to their percentages in the general population.

• Injuries and deprivation (medications, food, shelter, first aid) were higher among the target populations.

• Many persons with disabilities, who could have remained independent in shelters, were forced to go to special needs facilities.

• Persons with disabilities were separated from their families, friends, neighbors and social networks.

• Hundreds of evacuees were separated from durable medical equipment, assistive devices and service animals.

• Local jurisdictions had not planned sufficiently for both service and companion animals; many residents refused to leave their animals behind or to be separated thus delaying their evacuation.

• Nursing home administrators have the power to decide whether to evacuate their facilities, even under mandatory evacuation orders.

• The transportation-disadvantaged (frequently persons with special needs, individuals with disabilities, the elderly, the poor) were left behind and died in disproportionate numbers.

• Local and state governments exhibited "mixed efforts" at assisting the transportation disadvantaged during the evacuation. Two locations, for example "did not yet have a good understanding of the size, location and composition of the transportation disadvantaged in their communities" (GAO-06-790T, p. 4).

The National Disaster Medical System does not have agreements with nursing homes that could evacuate residents.

• Nursing homes, and presumably other residential settings, are more likely to respond appropriately if they are part of a larger network. Single-owner settings are those most at risk.

• Assisting those without transportation "requires additional planning, time and resources" including "additional planning of pick-up routes; extra time to load and unload evacuation vehicles; and special resources, such as buses equipped with wheelchair lifts.

• Voluntary registries though promising, are expensive and time-consuming to maintain.

• Effective plans involved social service providers.

• Social service providers were underused.

• Katrina financially injured social service providers within the disability community.

• Effective plans tested coordination between evacuating agencies and social service providers through regular drills and exercises.

• The disaster generated new codes and ordinances that are disabling formerly independent persons. Elevation requirements along the coastline mean that those with mobility limitations must relocate or enter a residential care facility.

Ongoing Initiatives that Merit Continued Attention

Some important work that merits continued attention is now being done on emergency communication. Examples include:

National Center for Accessible Media (NCAM)

The CPB/WGBH National Center for Accessible Media (NCAM) is a research and development facility dedicated to the issues of media and information technology for people with disabilities in their homes, schools, workplaces, and communities. NCAM's mission is: to expand access to present and future media for people with disabilities; to explore how existing access technologies may benefit other populations; to represent its constituents in industry, policy and legislative circles; and to provide access to educational and media technologies for special needs students. For more information, please click on the following website: http://ncam.wgbh.org/ 

Access to Emergency Alerts for People with Disabilities Program

(October 2004 - September 2008). The Access to Emergency Alerts project unites emergency alert providers, local information resources, telecommunications industry and public broadcasting representatives, and consumers in a collaborative effort to research and disseminate replicable approaches to make emergency warnings accessible. For more information, please click on the following website: http://ncam.wgbh.org/alerts/

General Recommendations for Planners to Consider

In order to provide equal access to emergency prophylactic medications, equal information to all population groups, meet the highest level of comprehension that each group can receive, and enhance public trust and compliance, the following recommendations are given:

General Preparedness

Preparedness efforts occur at the institutional planning level and the individual planning levels. The goal is to ensure that individuals with special needs are afforded the same safety opportunities as individuals without special needs in the face of disasters or emergencies.

Institutional Planning Level

Special needs issues should be included in all emergency planning for the jurisdiction, workplaces, residential buildings, and other commercial buildings. These plans must be communicated to the public.

Individual Planning Level

Awareness and preparedness messages and material should be customized for groups of people to address specific special needs, and also be available in alternate formats. This includes information about plans that are in place within the community such as evacuation or sheltering plans. Often, when provided adequate resources, individuals with special needs (or their friends/family members) can put plans in place that suit their needs best.

Outreach to Individuals with Special Needs

There are several strategies that can be used to get information to individuals with special needs that may include:

• Coordinating teams in the community to go door-to-door, senior centers or other community meeting places to provide information;

• Implementing a Reverse 9-1-1

• Utilize peer counselors (professionals or paraprofessionals) who have special needs themselves

• Meeting with service providers to plan outreach strategies including a call-tree program (see below Industry call-downs and phone trees).

• Establishing sites with accessible accommodations where information can be provided

• Providing information on websites

• Working with individuals that are deaf, deaf-blind, or hard of hearing to develop communication/outreach plans

• Identify areas in the community such as NORCs where there is a high concentration of people with special needs. Work with leaders in the community (both formal and informal) to address strategies for sharing information with individuals within the area.

• Involve schools, residential care facilities, senior centers and other similar organizations to relay information.

• Send information out through utility bills or with governmental mailings.

• Involve civic and community organizations in door-to-door campaigns.

• Hold events at schools, residential care facilities, senior centers, county fairs, public malls, special Olympics, para-olympics and other events.

• Promote disaster preparedness during Disability Awareness Week events.

• Promote disability awareness during Disaster Day and Emergency Management Month events.

• Invite representatives from disability organizations and the disability community onto LEPC’s, CERT’s and other local committees.

• Serve on boards of disability organizations.

Partners for Preparedness Efforts

Media

The media can be a very important partner in getting emergency massages out to the public at large. Emergency professionals are encouraged to remind these partners that there are things they can do to further ensure members of the community with special needs receive the message.

• Ensure captioning/crawlers/text on television.

• Include sign language interpreters on television.

• Do not block mapping and messaging with crawlers or on-air personnel.

• Include TTY/TDD and fax information when hotlines or other phone numbers are given.

• Ensure website information is in an accessible format.

• Provide information in alternate formats (e.g. Braille, large font, audio cassette, etc.)

• Use Plain Language.

• Be aware of new technological options.

• Providing information that is relevant to special needs populations which includes consideration of a full range of varying circumstances and needs.

• Encourage audience to check on family, friends, neighbors, co-workers, patients—especially those home alone.

Industry (i.e. home health care agencies, dialysis centers)

A phone tree patterned after existing internal notification and call-down systems is a particularly effective way to reach people with special needs. In addition, through a "reverse tree" members of the disability community can alert emergency professionals to issues of which they may not be aware. Emergency mangers should be responsible for initiating communication to the top-level contact persons on each branch of a phone tree. With a well-designed phone tree system in place, a consistent message is communicated, and people with special needs have the opportunity to identify any emergency service gaps that may exist. This must be updated and tested regularly.

Social Networks

During a disaster, friends, family and neighbors will be among the first to engage in search and rescue. Co-workers will often go to great lengths to assist each other, including persons with disabilities. Those at risk can also be involved in helping other persons including those with disabilities. In short, those at risk and their social networks can be employed during all phases of disaster. Because social networks are so important to warning dissemination and confirmation behavior, activating those networks becomes a crucial component of any warning messaging system. Working with and through these social connections (using some of the ideas expressed in these and forthcoming documents) is highly recommended.

Centralized Information and Referral Systems

After an emergency, most jurisdictions will establish centralized information and referral services, such as a hotline or service centers, where residents can call to request assistance and/or information, which is extremely beneficial. These services should be made available in multiple forms to ensure that they are accessible to PSN. Also, hotlines and centers should be staffed with individuals that are knowledgeable about SN issues, and familiar with using alternate communication methods such as TTY, or relay messaging, or interpreters.

References

Administration on Aging, http://www.aoa.gov, downloadable guide on aging and disaster.

Andrews, Jill H. 2001. "Safe in the ‘Hood: earthquake preparedness in midcity Los Angeles." Natural Hazards Review 2/1: 2-11.

Blanck, Peter. 1995. Disaster mitigation for persons with disabilities: fostering a new dialogue. Washington D.C.: The Annenberg Washington Program in Communications Policy Studies of Northwestern University.

Bruyere, Susanne M. ad William G. Stothers. 2002. "Enabling Safe EVACUATIONS." Hr Magazine: 65-67.

Christiansen, Keith et al. 2006/Forthcoming. "The relationship between the design of the built environment and the ability to egress of persons with disabilities." Review of Disability Studies/Forthcoming.

Davis, Keren. 1990. "Emergency Alarms." British Medical Journal 300, pp. 17113-6.

Dow, K., Cutter S.L., 2002. Emerging hurricane evacuation issues: Hurricane Floyd and South Carolina. Natural Hazards Review 3 (1), 12-18.

Fernandez, Lauren et al. 2002. "Frail elderly as disaster victims." Prehospital and Disaster Medicine, April/June, available at http://www.gwu.edu/~icdrm/publications/67-74_fernandez.pdf.

G.A.O. 2006. Disaster Preparedness: preliminary observations on the evacuation of vulnerable populations due to hurricanes and other disasters. AO-06-790T.

Haney, Janell I. And Russell T. Jones. 1982. "Programming maintenance as a major component of a community-centered preventive effort: escape from fire." Behavior Therapy 13: 47-62.

Hanna, James. 1986. "Emergency evacuations in chronic care facilities." Emergency Planning Digest 13/4: 24-27.

Heinz Center. 2002. Human Links to Coastal Disasters, available at http://www.heinzctr.org.

Imperiale, Paul. 1991. "Special needs in emergency planning and preparedness." Networks: 8-10

Jones, Brian K. 1987. "Fire safety for disabled persons." Emergency Preparedness Digest 14/4: 14-18.

Kuba, Michelle et al. 20004. "Elderly populations in disasters: recounting evacuation processes from two skilled care facilities in Central Florida, August 2004." Quick Response Research Report #172. Natural Hazard Center, University of Colorado. www.colorado.edu/hazards

Lasswell, H.D. 1948. "The structure and function of communication in society." Pp. 37-51 in L. Bryson (ed.) Communication of Ideas. NY: Harper.

Litman, Todd. 2006. "Lessons from Katrina and Rita: what major disasters can teach transportation planners." Journal of Transportation Engineering: 11-18.

Loy, Beth and Linda Carter Batiste. 2004. "Evacuation preparedness: managing the safety of employees with disabilities." Occupational Health and Safety 73/9: 112-117.

Metz, W., Hewett, P., Muzzarelli, J., Tanzman E., 2002. "Identifying special-needs households that need assistance for emergency planning." International Journal of Mass Emergencies and Disaster 20 (2), 255-281.

National Organization on Disability. 2005. Report on Special Needs Assessment for Katrina Evacuees (SNAKE) Project. www.nod.org

Ngo, Ehren B. 2001. "When disasters and age collide: reviewing vulnerability of the elderly." Natural Hazards Review 2/2: 80-89.

Parr, Arnold R. 1987. "Disasters and disabled persons." Disasters 148-159.

Parr, Arnold R. 1997. "Disasters and human rights of persons with disabilities."

Australian Journal of Emergency Management: 2-4.

Perry, Ron and Michael Lindell. 1997. "Aged citizens in the warning phase of disasters: re-examining the evidence." International Journal of Aging and Human Development 44/4: 257-267.

Phillips, Brenda et al. 2006/Forthcoming. "Disaster threat: preparedness and potential response of the lowest income quartile." Environmental Hazards (forthcoming).

Proulx, Guylene. 2002. Evacuation Planning for Occupants with Disability. Ottawa, Canada: Fire Risk Management Program, National Research Council Canada.

Ragsdale, Kate and Janice Simpson. 1996. "Being on the safe side." C&RL News: 351-354.

Rahimi, Mansour. 1993. "An examination of behavior and hazards faced by physically disabled people during the Loma Prieta earthquake." Natural Hazards 7: 59-82.

Rahimi, Mansour. 1994. "Behavior of mobility-disabled people in earthquakes." Earthquake Spectra 10/2: 381-401.

Snyder, Janice. 1982. "Special emergency circumstances: helping those who can’t help themselves." Emergency Preparedness Digest, October-December: 21-22.

Tierney, Kathleen, Michael Lindell and Ron Perry. 2001. Facing the Unexpected. Washington D.C.: Joseph Henry Press.

Tierney, Kathleen and Bill Petak. 1983. Disabled Persons and Earthquake Hazards. Boulder, CO: Institute for Social and Behavioral Science.

United States Access Board. 2005; Resources on Emergency Evacuation and Disaster Preparedness. www.acess-board.gov/evac.htm

United States House of Representatives. 2006. A Failure of Initiative. Washington D.C.: U.S. Government Printing Office.

United States Fire Administration. 1999. Removing the Barriers: a fire safety factsheet for people with disabilities and their caregivers." Emmittsburg, MD: Office of Fire Management Programs.

Van Willigen, Marieke et al.. 2002. "Riding out the storm: experiences of the physically disabled during Hurricanes Bonnie, Dennis and Floyd." Natural Hazards Review 3/3: 98-106.

Wagner, Cynthia G. 2006. "Disaster planning for the disabled." The Futurist: 13.

White House. 2006. Federal Response to Hurricane Katrina: Lessons Learned.

Wisner, Ben. 1993. "Disaster vulnerability: scale, power and daily life." GeoJournal 30/2: 127-140.

Wood, Vincent T. and Robert A. Weisman. 2002. "A hole in the weather warning system: improving access to hazardous weather information for deaf and hard of hearing people." American Meteorological Society, 187-194.

Working Group on Natural Disaster Information Systems, Subcommittee on Natural Disaster Reduction. 2000. Effective Disaster Warnings. National Science and Technology Council, Committee on Environment and Natural Resources.

Practical Resources Consulted

EAD & Associates, LLC, "Resources for Emergency Planning Regarding Persons with Special Needs": This is a short list of suggested resources at the institutional planning level and the individual planning level.

IAEM March 2005 Bulletin "A New Perspective: Focus on Limitations that Interfere with Receipt of Information" by Cecily Westermann (p.1,4) "Communicating with Deaf, Deaf-Blind, Hard of Hearing" by Donna Platt (p.10

IAEM April 2005 Bulletin "Community Emergency Response Teams for the Elderly" by Brian Bovyn (p. 5) National Organization on Disability’s "Emergency Preparedness Guide on the Special Needs of People with Disabilities." This guide can also be found at www.nod.org/emergency.

University of New Mexico’s "Tips for First Responders Cards"

Tips on making printed material more legible at http://www.lighthouse.org/print_leg.htm

 

 

 


 

 

Foreword by Donald W. Walsh, Ph.D., EMT-P

International Emergency Medicine & Disaster Specialists

 

FIRE SMOKE!

We need to re-think our course of action in treatment & safety

 

I am happy to introduce three cutting edge educational supplements to Big Medicine. As the Founder and Past President of the Cyanide Poisoning Treatment Coalition (CPTC), a non-for-profit 501(c)(3) organization comprised of fire service organizations, fire fighters, EMS professionals, and physicians; CPTC provides educational and research information through joint strategic initiatives to focus on the awareness and risk of fire smoke cyanide exposure and early recognition and appropriate treatment.

 

The first publication is “SMOKE – Perceptions, Myths, and Misunderstandings” and addresses the unrecognized threat of cyanide to the American fire fighter, air management critical issues, respiratory protection, the importance of prompt recognition and treatment for pre-hospital care EMS operations. This  supplement was first published in 2005 and discusses acute cyanide poisoning of fire fighters in the United States and Republic of France where new treatments are being used to treat fire smoke inhalation cyanide poisoning.

 

The second publication published in March of 2009 is "SMOKE – Cyanide and Carbon Monoxide: The Toxic Twins of Smoke Inhalation” goes even deeper into the fire smoke inhalation issues and new drug treatments now available in the United States. The supplement covers smoke chemistry complications, fire fighter air management needs, mandates, and solutions; in addition to fire fighter rehabilitation, cyanide exposure and recognizing the signs and symptoms and the new available treatment treatments in the United States.

 

The third publication, “SMOKE – The Toxic Twins: An Advanced Perspective on Cyanide and Carbon Monoxide Poisoning” is a new publication written by Dr. David G. Penney, Professor, retired, and special consultant in toxicology from the School of Medicine at Wayne State University in Detroit Michigan. Dr, Penney addresses the physical properties, sources, and physiological effects of cyanide and carbon monoxide poisoning. The supplement also addresses signs and symptoms, cardiac effects, long term CNS effects, and treatments for cyanide and carbon monoxide poisonings.

 

Together, the three supplements give a cutting edge perspective on this growing issue in America and new solutions to reduce morbidity and mortality through research, science, and education.

 

Note from Big Med: Please download these documents and share them with your colleagues, coworkers, professional organizations, organized labor, and your families. Know the risks. It's in your hands.

 

For more information, please go to www.FireSmoke.org.

 

SMOKE – Perceptions, Myths, and Misunderstandings 2MB

 

SMOKE – Cyanide and Carbon Monoxide: The Toxic Twins of Smoke Inhalation 4 MB

 

 

SMOKE – The Toxic Twins: An Advanced Perspective on Cyanide and Carbon Monoxide Poisoning

1 MB

 

Cyanide Poisoning Treatment Coalition
P.O. Box 301123
Indianapolis, IN

46230-1123


888-517-5554
 

For more information, please visit www.FireSmoke.org
 

Copyright® 2009
 

All supplement photos courtesy of FirefighterSafety.net or FireGroundImages.com

 

Please share these publications with your colleagues, coworkers, and professional organizations

 

 

 Dr. Donald W. Walsh
International Emergency Medicine & Disaster Specialists
A Service of Walsh & Walsh Associates, Inc.
Chicago, Illinois, USA

 

 

About the Author

Dr. Donald W. Walsh has a vast array of experience from his 30-year Chicago Fire Department career, and continues his involvement at all levels in public safety. Dr. Walsh began his career with the Chicago Fire Department’s Bureau of Operations in 1976 where he has served as a Chief Officer and an Assistant Deputy Fire Commissioner until his retirement 2007. His public safety background includes being an Adjunct Faculty Member of the National Fire Academy under the U.S. Department of Homeland Security, and elected Fellow of the Institute of Medicine of Chicago. Dr. Walsh’s extensive background in public safety and private industry has fostered new technologies and programs in the area of antiterrorism training, incident command, rescue equipment development, and disaster management response programs. His most recent research on fire smoke and cyanide treatments has been published in peer review and professional publications. In 2004, Dr. Walsh served as a subject matter expert for the United States Army and NASA on Fire Fighter safety issues in coordination with the US Fire Administration. Dr. Walsh’s most recent publication, "The National Incident Management System Principles and Practices" was a collaboration with six national experts and authors in emergency management and public safety to produce the nation’s first resource education supplement instruction manual to meet the United States Department of Homeland Security NIMS mandated under Homeland Security Presidential Directive Five. Dr. Walsh is currently working on new fire safety technologies and research on the dangers of fire smoke, cyanide identification and treatments protocols, and antiterrorism preparedness programs related to cyanide weapons and disasters.

Dr. Walsh can be reached via email at  drdonwalsh@aol.com 

 


Tracking Human Factors in the Financial Crisis:

Lessons for Pandemic Planning

 

A Special Report from

Extreme Behavioral Risk Management

A Division of ALLSector Technology Group Inc.

 

by Steven M. Crimando, MA, BCETS

and Cynthia L. Simeone, CBCP, PMP

 

[Feb 14 2009]

 

Abstract:

There are significant similarities between the current global financial crisis and a pandemic disease outbreak. These similarities are particularly pronounced in the area of human factors, specifically in the psychosocial response to adverse events that involve elements of uncontrollability, unfairness and loss. The sudden and dramatic onset of the economic crisis resulted in many organizations suspending their pandemic preparedness efforts in order to focus on the dire threat at hand. As the economic situation transitions from a "sudden crisis" to "smoldering crisis", business continuity planners and others charged with an organization’s pandemic influenza preparedness may benefit from identifying, understanding and benchmarking these dynamics to inform policies, plans and preparedness efforts for a pandemic.

Effective pandemic planning must be predicated on accurate assumptions about the individual and collective response to the threat. The global economic crisis, viewed as "pandemic-light", offers a unique opportunity to practice and prepare for the actual event. It may turn out to be the best test of pandemic preparedness possible, if approached in a thoughtful and structured manner.

Pandemic Defined:

Pandemic: From Greek "pan" (all) and "demos" (people): Occurring over a wide geographic area and affecting an exceptionally high proportion of the population.1

While the current financial crisis may have diverted the attention of business leaders, continuity planners and emergency managers away from pandemic influenza planning, the risk of a possible pandemic has not diminished. In recent weeks, avian and human influenza activity in the United Kingdom, China and India have thrust the flu back into the spotlight. As of January 27, 2009, the World Health Organization (WHO) has updated its statistics and now reports 403 human cases of the avian influenza, resulting in 254 deaths worldwide. The H5N1 virus responsible for these deaths is particularly powerful, proving lethal in more than 50% of the known cases. Each new human case heightens the possibility for the virus to make the critical leap in mutating to a deadly pandemic strain.

The H5N1 virus has several significant similarities with the influenza virus that swept the globe during the Great Pandemic of 1918. Not only has the pandemic influenza threat not abated, but communities, organizations and nations may be at even greater risk if the pandemic were to emerge during such vulnerable economic times.

The current economic crisis may in fact have a potentiating affect on the pandemic risk. A standard pandemic planning assumption is that possibly 30-40% of the nation’s workforce may be offline at any one time, due to illness or death, or remaining home out of fear or to care for the ill. If an organization is forced to layoff a substantial number of employees and is already operating with a depleted workforce in a down economy, further diminishing the remaining workforce by another 30-40% during the pandemic may have a paralytic - if not fatal - affect on the organization.

The current economic downturn has resulted in a continued reduction in the Gross Domestic Product (GDP) in the United States and in other industrialized countries. The arrival of a pandemic influenza in the midst of the global financial crisis would represent a "perfect storm" scenario resulting in potentially unimaginable consequences for the global economy, as well as individuals and families, communities and organizations.

Sudden and Smoldering Crises

Sudden crises tend to produce acute stress reactions in individuals, families, communities and organizations. These events can be said to have "bookends", in that it is clear when the event began, when it ended and whether one was directly impacted. A smoldering crisis often lacks these clear markers by beginning slowly, with many of the early warning signs remaining below the radar. Once the crisis begins, it is difficult to know exactly when it will end. It can also be difficult to determine exactly how badly one is affected since they are dynamic and shifting in degrees of severity over time. Smoldering crises tend to result in chronic stress reactions. They exhaust individual, organizational and possibly national resources. A pandemic that circles the globe in two or three "waves" of illness over the course of 12 months or longer may begin with a sudden realization that the outbreak has begun, that it is real and it is bad, but would generally be considered a smoldering crisis. Likewise, the economic crisis, though beginning with the initial "subprime" calamity, reached the sudden crisis phase on one specific weekend in September 2008, but will most likely be remembered as a long, complex and smoldering crisis.

Pandemic-Light

The global economic crisis may be viewed as "pandemic-light", while there is pain and psychosocial disruption, but without the body count.

The national strategy for surviving a pandemic and an economic crisis hinges on three key actions:

Stop, slow, limit spread of crisis  

Mitigate impact, suffering and permanent damage (or death)  

Sustain infrastructure/economy and functioning of society

Comparing the economic crisis to a pandemic can surface many interesting similarities that may inform pandemic preparedness efforts in both the public and private sectors. These similarities can be found in the areas of event dynamics, impact, response, planning and recovery. To demonstrate the similarities between the economic crisis and influenza pandemic useful to planners and decision-makers, the overlapping elements have been delineated in several categories.

Event Dynamics

Both the economic crisis and a potential influenza pandemic share many features, including the twenty identified below:

Global reach

Few, if any, are immune

Contributing factors identified long in advance of the onset of crisis

Small pool of experts warned of impending doom

Threat not fully recognized until reaching dramatic, irreversible levels

General public had little awareness of the risk

Highly technical/exotic factors triggered onset

Slow-moving but unstoppable once in motion

Long, complex crises

Progress in waves or cascading sequence

Disagreement among experts about best way to handle the situation

Remedy or vaccine not readily available, must be developed quickly

Initial attempts to "treat" the problem prove to be insufficient

Intensity and duration of crisis exhausts resources

Distinct social, economic and emotional consequences

Raise many ethical dilemmas

Characterized by loss

Contain aspects of both "sudden" and "smoldering" crises

Increases distrust of authorities

Create a sense of helplessness or powerlessness

Impact

The impact and response to "sudden" and "smoldering" crises differ. A sudden crisis has a definitive beginning and end and while shocking, the human impact is more easily compartmentalized because of the definitive timeline. With smoldering crises, the effects are usually more insidious and difficult to overcome because the emotional and behavioral cycles associated with the crises repeat over a sustained period of time. Recovery from a smoldering crises is often more complicated.

However, both events are characterized by loss and dread. While a loss of life is more likely in a catastrophic disease outbreak, other losses associated with the financial crisis may result in similar emotional and behavioral reactions, possibly further complicating response and recovery.

These losses include, but are not limited to the loss of:

Identity

Sense of community; belonging

Status and role

Control

Security

Trust

Confidence

Beliefs or faith (i.e., patriotism, religious beliefs, etc.)

Future and purpose

In Time Magazine reporter Amanda Ripley’s latest book, "The Unthinkable: Who Survives When Disaster Strikes-and Why", she isolates "dread" as a significant factor influencing the human response to threatening events. She has gone as far as developing a "dread formula" to explain these dynamics. Some, if not all, of the elements in this formula are equally present in both the economic crisis and most pandemic scenarios. Ripley’s dread equation is:

Uncontrollability

+ Unfamiliarity

+ Unimaginability

+ Suffering

+ Scale of Destruction

+ Unfairness

______________________

Dread

One can assign each of the elements of the dread formula to some aspect of both the economic crisis and a pandemic. Many commentators have been liberal in their use of the terms "unimaginable" and "unthinkable" in their descriptions of the financial meltdown. It is likely that those same labels would be recycled and applied to a devastating public health crisis as well.

The impact of both events can potentially reach all corners of the globe and all spheres of our personal and professional lives. Both in the home and in the workplace, there is a foreseeable range of affects, including:

In the workplace

A great deal of time, effort and money has been spent in the U.S. and abroad over the past several years developing plans and procedures to mitigate the effects of a pandemic on the workplace. While a pandemic strain of influenza has yet to emerge, the current financial crisis has triggered many of the same workplace dynamics anticipated by pandemic planners, including:

High levels of stress and fear

Diminished or depleted workforce

Significant reduction in productivity

Loss of capital and/or access to capital

Supply chain disruption (i.e., cargo stacked up or waiting off shore at sea ports)

Drastic decline in retail, travel, entertainment, construction and many other economic sectors

Escalating unemployment

Consolidation among businesses within certain industries

□ Disruption or closure of financial markets and institutions

In the household

The 2008 American Psychological Association (APA) "Stress in America" survey revealed that 8 of 10 Americans identify money matters as a leading source of daily stress (APA, 2008). Since that study was released in mid-2008, the economic climate has darkened substantially. The Conference Board’s January 27, 2009 Consumer Confidence Index documented a steady slide into despair, with the consumer confidence level reported at an all-time low. People are feeling stressed and anxious about their financial future. Many are unsure how they will handle a recession or more economic bad news.

Both the economic crisis and a pandemic will result in the closures of many businesses, lost earnings and many other hardships. In both instances, individuals and households may suffer great financial difficulties, such as:

□ Little or no household income

□ Depletion of savings

□ Increased dependence on credit cards to replace income

□ Risk of default on loans or mortgages

□ Potential for crisis-related financial scams

□ Increase of a overall financial stress/distress

Response

Emotional responses can range from simple distress to diagnosable mental health conditions, including:

□ Extreme fear and anxiety

□ Sadness and depression

□ Anger, blame

□ Helplessness, hopelessness

□ Increased rates of suicide

□ Traumatic stress reactions

□ Complicated grief and bereavement

Trauma and Grief

Grief has been described as our reaction to something (or someone) "good" leaving our lives, while trauma is our response to something "bad" coming into our lives. In the instance of a worker losing a job, baby boomers losing 40% or more of their retirement savings or a family losing their home, loss is loss and our minds and bodies do not necessarily distinguish between loss related to a health crisis or an economic disaster.

Behavioral reactions tied to our appraisal of the situation can lead to:

□ Increased alcohol and drug use

□ Increased irritability

□ Difficulty concentrating, problem solving and/or decision-making

□ Increased risk-taking

□ Increased emotional-eating (esp. sweet, salty and high-fat foods)

□ Social isolation, withdrawal

□ Change in sleep patterns

Many behavioral reactions affect interpersonal relationships in the home and workplace. These can be manifested as:

Increased conflict

Diminished communications

Difficulty parenting or supervising workplace subordinates

Poor spousal/partner and/or peer relations

Planning

Much can be done to reduce and/or mitigate many of the negative consequences identified above through conscientious planning in the home, workplace and community.

Planning in the Workplace

Guidance in pandemic influenza planning has focused on several areas of concern that are equally relevant in the financial crisis. These include ensuring critical processes, communications, physical and mental health issues, ability to travel to or attend work and, finally, developing organizational resilience. Successful consequence management through the economic pandemic will require attention to many of the same concerns.

In planning for a pandemic, it is important to ensure critical processes can continue with a reduction of workforce. If, during the economic crisis workforce reduction is necessary, insure the remaining workforce still retains the core skills and knowledge (corporate memory) to assure essential business functions can be accomplished, or make sure critical processes are documented so unskilled laborers can perform the required function.

"Crisis-sizing" the Workforce

"Crisis-sizing" or temporarily adjusting the size and configuration of an organization’s workforce due to economic pressures rather than illness may be a necessary part of a survival strategy in the face of this new threat. Pandemic planning guides have suggested that leaders should explore creative workforce restructuring for survival. Several businesses have recently received applause for implementing creative alternatives to layoffs, including reduced hours for all rather than lost jobs for some. Other cost-saving alternatives have included shifting some employees to working from home and job sharing to reduce their office space requirements and other fixed overhead costs. These strategies have been discussed in the context of pandemic flu planning as ways to cope with a workforce downsized by disease.

Changes in the workforce and financial health of critical vendors must also be assessed. If the organization is reliant on external resources or services, leaders should conduct business risk and impact assessments to identify critical suppliers, identify alternative sources and negotiate contract terms in advance of any potential disruption.

Communications

Immediately, organizations can provide the most value to their employees by communicating their priorities and survival strategies. In the workplace, survival is a shared responsibility. Clarity regarding roles and responsibilities during a crisis is crucial. To reduce anxiety, leaders should provide employees with two-way communication vehicles. During the financial crisis, as in pandemic preparedness, leaders should let employees know what the business is doing to mitigate risk. If there are serious concerns, it is not only much better from an ethical standpoint to openly communicate these challenges, there is a legal obligation documented in the Worker Adjustment and Retraining Notification (WARN) Act that indicates companies must provide 90 days’ notice prior to plant closure or

mass layoffs, so affected employees can be as prepared as possible for negative outcomes.

Employees may better prepare financially and emotionally for a reduction or loss of income with some degree of advanced notice rather than following a surprise or sudden reduction of work force. Warning enhances a sense of controllability and whenever possible proactive communications are recommended.

Proactive communications may also involve the development of draft "shelf-kits" by creating internal and external communication templates and having them pre-approved by corporate communications officers to help speed the delivery of timely communications for different contingencies. Establishing a "hot-line" can empower employees to ask questions and/or make suggestions to help stabilize their workplace environment.

Training

Many organizations active in pandemic planning had initiated training programs for executives and supervisors, as well as internal crisis management and first responder teams, to raise awareness of the unique physical and mental health challenges associated with an influenza outbreak. Such programs were designed to help decision-makers predict and prepare for a pandemic using accurate information about the disease and its likely impact on society, as well as the organization. Specialized training focused on the unique challenges associated with the financial crisis may be equally important. Understanding the human factor in both a pandemic and financial crisis can give planners an advantage in recalibrating business contingency plans appropriately for the current threat environment.

Sources of Emotional Support

We have previously discussed the concepts of trauma and grief as they relate to both a pandemic and the financial crisis. It is foreseeable that there may be an increased need for psychological support programs for workers and their families. Establishing or enhancing Employee Assistance Programs (EAPs) or community outreach programs can aid and educate employees with financial planning or other related services. A lesson learned is that natural support systems, in the home, community and workplace tend to be the most helpful in other smoldering crises. Promoting peer support programs and other mechanisms for employees to both give and get emotional support may prove invaluable in a long-haul scenario.

At home

Just as it is important for leaders to communicate in the workplace, providing family members with information goes a long way toward an effective response and recovery. The emotional demands of both a pandemic and the financial crisis can erode relationships in the home during a time when the support of loved ones is most needed. Sharing information about the affects of smoldering crises on homes and families can be beneficial and may help those affected anticipate the likely emotional traps that characterize long-term stress situations.

Employers can also provide additional assistance in financial planning and household money management. Those not yet seriously impacted by the financial crisis can modify the home budget and identify ways to curtail unnecessary spending. It is helpful to enlist all family members to watch spending. Even young children can understand the concept of saving for future benefit. Planning ahead will be necessary to ensure that basic needs will be met. Prudence and pragmatism will be of equal importance in both the current financial crisis and a possible pandemic in the future.

Tracking and Benchmarking Through a Smoldering Crisis

There is very little, if any, empirical research from the "Great Influenza Pandemic" or the "Great Depression" that can be applied to predicting human behavior in a smoldering health crisis or financial crisis. So what else can be done by organizations to utilize the lessons learned from the past to address the financial pandemic at hand?

Some organizations have begun to track the impact that employee benefit or wellness programs, such as weight reduction, smoking cessation and exercise programs, have on an organization’s bottom line. It would be beneficial to also document other human factors issues (absenteeism, performance, morale, conflict, others) in the home, business and community as we move through the various phases of the financial crisis. Such tracking can help leaders gain a better understanding how prolonged adversity impacts the "worried well" (those who are still employed or not otherwise derailed by the financial crisis) to inform pandemic flu policies, plans and exercises. Organizational benchmarking of human factor issues can be invaluable in developing the type of accurate behavioral assumptions that will be necessary to sustain productivity and the bottom line during a pandemic or other smoldering crisis.

Recovery

As with event, impact and response factors, the likely psychosocial challenges in the long-term recovery from both pandemic flu and the economic crisis are similar. In a typical disaster, the behavioral response cycle can quickly shift from neighbor-helps-neighbor to neighbor-fears-neighbor to neighbor-compete-with-neighbor as fear escalates. During the recovery period, the cycle gradually returns from self-preservation back toward community cohesion and support. In fact one of the lessons learned in other smoldering crises is that the natural support systems within the home, business or community become the most important and dominant source of help. Knowing this, families, businesses and communities should take every opportunity to bolster and promote cohesion in the early phases of a crisis, since it will become increasingly important as time goes on.

Resilience

Personal and organizational resilience is essential to the recovery from a smoldering crisis. Resilience is often defined as the "human capacity and ability to face, overcome, be strengthened by, and even be transformed by experiences of adversity."

The potential for resilience can be and should be nurtured. Smoldering crises are best approached by applying the discipline and strategy of the marathon runner, not the sprinter. Everyone wants out of a tough situation sooner, rather than later, but both the financial crisis and a pandemic are challenges of endurance. Those who have survived and thrived through smoldering crises in the past identify three common tactics:

Face the sources of their stress directly

Learn from past experiences

Reach out for and use resources

There will be numerous challenges in the wake of the financial crisis, as there certainly will be in a pandemic. These include, but are not limited to:

Overcoming loss or guilt from having survived through the storm

Taking inventory and examining the current state of one’s personal and professional affairs

Addressing both the physical and psychological consequences of the crisis

Developing a reconstruction plans to rebuild or recoup losses

Reaching out to friends and the community to give and get support

In Conclusion

Pandemic planning should remain a priority during the financial crisis. It can be particularly useful to revisit pandemic plans to see what elements can be recalibrated or repurposed for the current financial crisis.

The authors suggest that the current financial crisis may be one of the most realistic and productive pandemic influenza planning exercises business and community leaders may have in that both events are smoldering crises with many similar human factors and economic consequences. While recognizing that a catastrophic disease outbreak could result in a tremendous loss of life, therefore becoming a disaster of a whole different magnitude, there are enough similarities to allow business continuity and emergency management planners to track, benchmark and use their observations of the financial crisis to inform pandemic planning efforts. Likewise, prior pandemic planning efforts may also inform strategy and decision-making in the current financial crisis.

Lastly, it is important to reiterate that the pandemic risk is not diminished. This threat is still lurking in the shadows while the world turns its attention to the urgent financial situation. A weakened global economy may in fact leave nations, businesses, communities and families that much more at risk to a public health disaster.


 

UNH/NOAA Report: Arctic Region Underprepared for Maritime Accidents [Feb 2 Washington DC]--The existing infrastructure for responding to maritime accidents in the Arctic is limited and more needs to be done to enhance emergency response capacity as Arctic sea ice declines and ship traffic in the region increases, according to new report released today by the University of New Hampshire and the National Oceanic and Atmospheric Administration.

The report details findings from a panel of experts and decision-makers from Arctic nation governments, industry and indigenous communities convened by the Coastal Response Research Center, a UNH-NOAA partnership housed at the university. The panel, which included representatives from the U.S. Coast Guard and U.S. Arctic Research Commission, assessed the potential threat of maritime accidents in the Arctic and the ability of nations in the region to respond effectively to vessels in distress, oil spills and other situations.

“The reduction of polar sea ice and the increasing worldwide demand for energy will likely result in a dramatic increase in the number of vessels that travel Arctic waters,” said Nancy Kinner, UNH co-director of the CRRC and a professor of civil and environmental engineering. “As vessel traffic increases, disaster scenarios are going to become more of a reality.”

The report’s key recommendations include:

  • Strengthening multinational plans and agreements for all types of responses
  • Improving logistical support capabilities for disaster responders
  • Updating weather data and navigational charts for the Arctic
  • Studying the behavior of oil in cold water and improving technologies for spill response in Arctic conditions
  • Designating potential ports in the Arctic where damaged vessels can be taken to safeguard them against the Arctic’s harsh environmental conditions and reduce the risk of harm to the environment

The report’s findings and recommendations are based on the panel’s examination of five potential emergency response scenarios: a grounded cruise ship whose 2,000 passengers and crew must abandon the vessel; an ice-trapped and damaged ore carrier; an explosion on a fixed drilling rig north of Alaska; a collision between a tanker and fishing vessel that results in a large oil spill; and the grounding of a tug towing a supplies barge in an environmentally sensitive area near the Bering Strait.

"Now is the time to prepare for maritime accidents and potential spills in the Arctic," said Amy Merten, NOAA co-director of the CRRC. "This report clearly indicates that international cooperation and adequate resources are key to saving lives and protecting this special region."

The complete report may be accessed online.

Scenario III from the report:

Cruise Ship Grounding on the Greenland Coast

A. Scenario

The M/V A, with 1400 passengers on board, runs aground while exiting a fjord on the
west coast of Greenland in mid September. Progressive flooding makes the ship unstable, and all must abandon ship. Some passengers and crew were injured in the grounding, requiring special medical attention. Medical concerns for some passengers, approaching darkness, and less than ideal weather outlook require this be treated as an urgent search and rescue (SAR) case. The response will consider the possibility that other cruise ships may be in a position to assist within certain timeframes. It is likely that other such vessels would be available within 24 hours or less, but poor weather might reduce their ability to respond. The vessel has greater than 25,000 bbls of intermediate fuel oil on board, as well as smaller amounts of lube oil, diesel fuel, and various hazardous materials associated with refrigeration, dry cleaning, and other ship services. The initial discharge may be relatively minor, but if the ship is not stabilized within 48 hours, heavy seas may destroy the vessel. The ship is operated by a major cruise line, but under the flag of convenience.

B. Expertise in Cruise Ship Grounding Breakout Group


- John Falkingham; Canadian Ice Service
- Lawson Brigham; US Arctic Research Commission
- Trygve Ertmann; Royal Danish Navy
- Jens Peter Holst-Andersen; Royal Danish Navy
- Nancy Kinner; Coastal Response Research Center
- John Snyder; Strategic Studies, Inc.
- Robert Parsons, Parsons Associates International


C. Assumptions Regarding Cruise Ship Incident


The group assumed that because the major cruise line operates under a flag of convenience, it is difficult to locate and enforce environmental response standards with respect to the responsible party (RP). The ship was assumed to have a crew of approximately 700 and a limited medical staff. Input from group members familiar with the Arctic cruise industry noted that it is likely that most of the cruise ship passengers are between the ages of 50 and 80, some with limited mobility, including a number of wheelchair-bound individuals. The incident is assumed to occur in a portion of Disko Bay that is 50 miles away from the nearest town of Ilulissat, and that likely passenger injuries include broken bones, strains, shock and trauma. With the on-scene weather and water temperatures, passengers would likely have a 4.3 hour functional time, which represents the time at which a person becomes incapacitated due to cold. There is a 67% percent chance of survival within this functional time. The group assumed that although some people fall into the water during the evacuation, none are lost, and
therefore the response consists of rescue operations only, with no search component. It is possible that other cruise ships are in a position to assist within 24 hours, however, poor weather could reduce their ability to respond. The incident occurs in an area that has been designated as a Convention on Wetlands of International Importance, and a World Heritage site due to the unusually fast ice stream and glacier calving rates.

D. 2008 Response to Cruise Ship Grounding

Jurisdiction for the SAR associated with the cruise ship grounding lies with Denmark and Greenland, with a Danish Naval vessel assuming the role of on-scene command upon arrival, and the Danish Maritime Rescue Coordination Center (MRCC) coordinating international involvement. While a clear SAR chain of command exists through international agreements, this incident is likely to overwhelm local resources and thus is likely to be deemed a mass rescue operation (MRO). The pollution response proceeds after victim rescue, and would likely not commence until 48 hours after the incident. The degree of environmental harm will depend primarily on measures enacted to secure the source of spilling oil by the cruise ship salvage and recovery team, and containment and removal of released oil before it impacts sensitive shorelines. If oil is spilled, a best case scenario involves containment within 48–72 hours. SAR response is funded by SAR providers (Arctic governments). The SAR system maintains financial responsibility for passengers until they reach the nearby village of Nuuk.

Environmental cleanup is provided by a cruise ship indemnity insurance company (P&I club), while the ship owners have financial responsibility for vessel salvage. The cruise ship has approximately 15 self-propelled, rigid hull lifeboats and 10 life rafts with no propulsion. The boats contain global positioning system (GPS) navigation systems, very high frequency (VHF) communication capability, as well as at least one crew member per boat. The boats must meet minimum Safety of Life at Sea (SOLAS) standards. Royal Danish Navy vessels can respond from the east coast of Denmark, and although they have SAR and communications capabilities, they cannot take on passengers. The first vessel is likely to arrive within 12 hours of the incident, and the second vessel can arrive within 24 hours. The response from Greenland is quicker, with a 25 m police cutter with a 2-hour response time from the city of Ilulissat.

However, as with the Danish vessels, they have communication and SAR capability, but cannot take on passengers. It is estimated that a second cruise ship capable of taking on passengers could arrive on scene within 24 hours, and fishing vessels in the area could respond within 2 to 3 hours. Pollution response and salvage can be provided by a U.S. Coast Guard (USCG) Strike Team, however, response time is typically 2-3 days. Salvage vessels are available from Halifax, NS or Iceland with a transit time of approximately 7 days.

There are numerous logistical challenges in this response. Due to the freezing weather and minimal protection offered on life boats, responders must attempt to rescue people from the boats and rafts as soon as reasonably possible. The first responders to arrive on scene will be local and therefore they will probably all speak Greenlandic. The magnitude of this response requires an international effort from all Arctic and nearby nations, including the United States, Canada, Iceland, England, Norway, and Denmark.

E. Gaps/Problems Identified in Response to an Arctic Cruise Ship Grounding

The group identified several gaps/problems in the current state of response and recovery. Cruise ships have a minimal capacity for self rescue, and due to their lack of propulsion, current life rafts could not reasonably transit the 50 miles from the incident location to Ilulissat. The passengers are also likely to be ill-prepared for the weather, which decreases their likelihood of survival, if they are not rescued quickly.  Vessels may elect to follow International Maritime Organization (IMO) guidelines on a  voluntary basis. Therefore, capability for self rescue will vary with the degree of adherence.

The group identified several jurisdictional problems, including the fact that although bilateral SAR agreements exist to govern responsibility for response between two adjacent nations, no agreements are currently in place to address response procedures for incidents involving multiple Arctic nations. With no agreements in place, governmental clearance may be required for some SAR operations, which could potentially slow the response. In addition, response operations could also be hampered by dated and incomplete navigational charts for the region.

SAR costs are likely to be significant. Furthermore, Arctic nations need to expend considerable funds developing the infrastructure necessary to support increasing cruise ship traffic in the region. While cruise ships use and benefit from this infrastructure, they have no financial role in its construction and maintenance. Since first responder vessels do not have the capacity to take on a large number of passengers, the only “viable” rescue vessel is a second cruise ship. A 24-hour response time for the ship is unacceptably long in this situation. Further, cruise ship crews receive minimal training for the emergency response in polar conditions.

A number of logistical challenges were identified. Ilulissat has very few hotels, and if another cruise ship cannot respond within a reasonable time frame, the food and housing needs of the rescued will quickly overwhelm such a small town. The ship and town do not have sufficient medical personnel to respond to an incident of this magnitude. As the response progresses and more international SAR resources arrive, language barriers between responders from different countries have the potential to result in an uncoordinated and inefficient response. The response will also potentially be vulnerable to political influence, as the home countries of the passengers with a vested interest in these efforts may attempt to exert control over aspects of victim/survivor management. There will also be great interest from the media and environmental organizations, which may hinder responders.

F. Recommendations for Enhancing Response to Cruise Ship Incidents in the Arctic

The group developed 17 recommendations to enhance response, recovery and restoration for this type of incident.

_ Develop preventative legislation for safe operations in the Arctic. The legislation would revise the Polar code for ship operations above 60º N, and include the development of an agency similar to International Association of Antarctic Tour Operators (IAATO) to manage ship itineraries and maintain real-time cruise ship locations. This legislation would also strengthen and support the Association of Arctic Cruise Expedition Operators (AECO) guidelines, and implement regulations for lifeboats and rafts in the Arctic. Survival craft should meet specifications for acceptable transit distances and have equipment for ample security. Special standards should be implemented for vessels transiting through the Arctic including specifications for cold weather gear.

_ Designate potential ports of refuge and develop guidelines for cruise ships in the Arctic to use them.

_ Adopt an Arctic regional SAR agreement that encompasses all Arctic nations to better manage incidents requiring a international response. The agreement should be designed to avoid delaying response for government clearance. This agreement should encourage transparency and information sharing between cruise ship lines regarding operations in the Arctic.

_ Perform regular drills and exercises to ensure readiness and compliance with regional SAR agreements.

_ Establish vessel exclusion zones within three miles of the coastline to prevent sub-standard ships from operating inside these zones. As an additional benefit, this provision may prompt insurance companies and ship classification societies to enforce compliance with safety regulations.

_ Employ standard environmental cleanup measures. Oil spill countermeasures should be deployed to reduce the impact of oil on sensitive shorelines as soon as possible, and pumps should be airlifted to the site in order to remove fuel from ruptured tanks.

_ Improve and update navigational charts for the Arctic region including cruise ship destinations.

_ Determine recovery and restoration possibilities with a post-incident assessment.

_ Develop a quasi-tariff for Arctic operations. This will provide a mechanism for the cruise ship industry to contribute financially to aid Arctic nations with SAR costs.

_ Encourage cruise ships operating in the Arctic to develop a protocol for mutual aid. The ships should carry extra immersion suits and other cold weather equipment to use when responding to an emergency on another vessel.

_ Improve/use resources for air support. Supplies can be strategically located in the Arctic and sub-Arctic to facilitate air drops for quicker access and response times.

_ Develop salvage plans that can be implemented if dedicated salvage vessels are not available. Icebreakers should be considered for performing a salvage tow.

_ Improve first responder training among ships’ crews.

_ Increase availability of emergency supplies by immediately loading and deploying aircraft from Denmark and Canada with food and water. Local Arctic response agencies and governments should increase stockpiles of emergency response equipment for SAR and spill response in the Arctic.

_ Plan for language issues during an international response. Responders should have translation services available, and fully use bilingual individuals within organizations for international incidents.

_ Conduct a workshop on Arctic SAR. The Arctic Council and the international cruise industry could partner to host this initial dialogue.

The complete report may be accessed online.

 

 


 

Project on National Security Reform

State/Local Issue Team Solution Set

Structure Working Group

 

Submitted by John F. Morton, Team Lead, 25 Nov 2008

“Where the hell is the cavalry on this one?...They keep saying we’re going to get supplies.  For God’s sake, where are they?”  Kate Hale, Director of Emergency Management, Miami-Dade County FL, Day Three Press Conference, Hurricane Andrew Response, 1992         

“[A]t some point we saw there was…nothing for the federal government to stick on to.”  Scott Wells, FEMA Deputy Federal Coordinating Officer for Hurricane Katrina in Louisiana, quoted in Hurricane Katrina: A Nation Still Unprepared, Special Report of the Committee on Homeland Security and Governmental Affairs, U.S. Senate, May 2006 

“The preparation and response to Hurricane Katrina show we are still an analog government in a digital age.”   A Failure of Initiative, The Final Report of the Select Bipartisan Committee to Investigate the Preparations for and Response to Hurricane Katrina, U.S. House of Representatives, February 15, 2006

SOLUTION STATEMENTS

SOLUTION 1:  The PNSR State/Local Issue Team recommends the official merging of the National Security Council (NSC) and the Homeland Security Council (HSC) to end the artificial bifurcation of national security and homeland security at the strategy, policy-development and assessment level.  Because of the non-federal constituencies with whom they interact, the Secretary of Homeland Security and the Attorney General should be made permanent members of the NSC, in part to ensure the inclusion of relevant non-federal input into decisions that have national and not just Federal implications.

SOLUTION 2:  A parallel process is required, similar to that currently used within the national security establishment, led by the Assistant to the President for Homeland Security and Counterterrorism, with the Secretary of Homeland Security as his/her executive agent, to prepare an annual assessment of homeland security risk and capabilities across the Federal government, to include state and local inputs, which measures capabilities and outcomes—not simply activities.  In consultation with Congress and to improve the efficiency of national homeland security efforts, this assessment should seek maximum consolidation of recurring  homeland security capability reporting requirements into one comprehensive, capability-based report, and it should be tied to the annual national security assessment.

SOLUTION 3:  Congress should codify the Secretary of Homeland Security’s overall Federal executive agent responsibility as the Principle Federal Official (PFO) for ensuring coordination of domestic incident management to include prevention, protection/mitigation, response and recovery actions, while respecting the inherent authority and responsibility of other cabinet and agency officials to perform the specific duties and execute inherent operational responsibilities assigned to them.   

SOLUTION 4:  Homeland and National Security budget activities should be combined into a single entity within the Office of Management and Budget (OMB).  Consistent with the review role of the Assistant to the President for National Security in the national security budget process, the Assistant to the President for Homeland Security and Counterterrorism should have similar oversight of homeland security budget submissions across all Federal departments and agencies.

SOLUTION 5:  The Department of Homeland Security should re-establish a single office, acting on behalf of the Secretary of Homeland Security, to oversee and coordinate the policies, programs and activities of the Department relating to state, tribal and local governments to ensure that the relationship between DHS and its partners is well managed and is strong.   

SOLUTION 6:  Congress should consolidate congressional oversight of DHS homeland security functions into one authorization committee and one appropriations subcommittee per chamber

SOLUTION 7:  The PNSR State/Local Issue Team recommends that Congress direct the Secretary of Homeland Security as the Principal Federal Official for domestic incident management to develop by a date-certain a comprehensive National Operational Framework (NOF) that describes how operational integration will occur across all levels of government and the private sector for the full range of prevention, protection/mitigation, response and recovery activities, succeeding the current more narrow National Response Framework. 

SOLUTION 8:  Conforming language in statute and executive order should maintain that the Secretary of Homeland Security is the Principal Federal Official (PFO) for domestic incident management of homeland security threats and events and incorporate language to clarify the chain of directive authority through the appropriate regional Federal structures. 

SOLUTION 9:  The PNSR State/Local Issue Team supports the idea of pre-designated field-level PFOs but believes that regardless of the type of event, the PFO should be the sitting FPC—by whatever title—as the regional DHS representative who can leverage his/her on-going, steady-state, stakeholder relationships in a crisis. 

SOLUTION 10:  The Executive Branch should establish at the appropriate levels formal, up-front, consistent systematic “steering committee” processes and structures for state and local government, private sector and non-governmental organization (NGO) participation to support national security and homeland security policy development for issues where those constituencies have equities.  When appropriate, these processes and structures must provide direct and regular reporting access to relevant cabinet secretaries and the White House advisors.   

SOLUTION 11:  Congress should adjust the current Federal Advisory Committee Act’s (FACA’s) time consuming requirements to facilitate better coordination needed among Federal, state, local, private sector and NGO representatives for both homeland security and national security policy development, especially under exigent circumstances.   

SOLUTION 12:  To further a structure and process for private sector and NGO participation in homeland security/NOF policy development, planning and possibly operational execution, the PNSR State/Local Issue Team encourages the Federal government to support an independent,  private sector-led national mechanism/entity to facilitate public/private collaboration and sustain “continuity of community” approaches for domestic incident management. 

SOLUTION 13:  DHS should resource the Department of Defense’s Task Force Emergency Response (TFER) initiative (or some equivalent) which leverages military planning expertise for the determination of regional capabilities and capability requirements and development and implementation of regional response/recovery plans based on community-based assessments of risk. 

SOLUTION 14:  Further to achieve cost savings and improve efficiency, the Department of Homeland Security must clearly structure and empower departmental-level acquisition, procurement, coordination and resourcing authority and oversight activities relative to its operational components.  By statute, therefore, Congress should empower the DHS Under Secretary for Management via the Chief Procurement Officer to centralize acquisition and procurement authority and acquisition offices in a direct line reporting relationship to leverage the buying power of the Department and to mandate consistent, department-wide policies to guide acquisition and procurement.

SOLUTION 15:  The annual national homeland security assessment (Solution 3 above) should inform a systematic, annual Federal homeland security grant process.  By statute, Congress should transfer from FEMA to the Secretary of Homeland Security executive agent authority for all homeland security grants, i.e., (1) to develop and publish grant goals, guidance and requirements, (2) manage the grant application, review and approval process and (3) fulfill fiduciary responsibilities associated with grant management.  Further, the DHS Secretary should engage non-federal stakeholders, relevant DHS components and other Federal departments and agencies with homeland security. 

SOLUTION 16:  Consistent with the recommendations of the White House Katrina report and Executive Order (EO) 13434, Congress must authorize and resource a professional development process for the Federal homeland security workforce, similar to that of the national security and intelligence communities, which mutually accommodates and reinforces “continuum of service” and to the degree practicable the state and local governmental levels, as well as in the private sector and NGO communities. 

SOLUTION 17:  For the purposes of better coordinating information and intelligence sharing for domestic national security, homeland security situations, the Director of National Intelligence (DNI) should have centralized authority to establish cross-cutting policy to guide the sharing of Federal national security, criminal and incident management information and intelligence with non-federal entities.  Further, the DNI should be responsible for establishing technical and cross-cutting information and intelligence sharing training standards that ensure the ability to share and integrate, when authorized and where necessary, all-source data, including those that necessarily should remain routinely independent.   Furthermore, all Federal Senior Executive Service (SES) and career personnel in positions with actual and potential domestic incident management, information sharing, law enforcement and domestic incident management command and leadership roles should have a consistent prerequisite to be certified under these training standards before being eligible to assume their positions. 

SOLUTION 18:  The PNSR State/Local Team recommends establishment of a dynamic NOF two-way data sharing system, a “platform,” to be used as an Incident Command System (ICS)-enabler, from routine incidents to complex multi-site catastrophes.   

SOLUTION 19:  Congress should provide DHS with authority over an NOF information sharing platform for resourcing and standards and should liaise with the Department to determine the appropriate governmental entity to house and administer it on behalf of the states.

 

WHAT IS “HOMELAND SECURITY?” 

The term “homeland security” entered the American lexicon on September 20, 2001, when President Bush used the term to name a new “Office of Homeland Security” established in the White House that October.  Homeland security generally means the unified national effort to prevent, protect against, respond to and recover from threats and acts of terrorism, as well as other man-made and natural hazards.  To quote from the 2007 National Strategy for Homeland Security, “This Strategy…recognizes that effective preparation for catastrophic natural disasters and man-made disasters, while not homeland security per se, can nevertheless increase the security of the Homeland.”

This national strategy seeks to apply a comprehensive approach to risk management—primarily the risk of high-end terrorist attacks or other catastrophic disasters.  The risk to America can never be reduced to a factor of zero (no more than reducing to zero the national crime rate).  However, by leveraging all national resources, the U.S. can substantially reduce risk.  It is thus crucial to understand that homeland security is far bigger than any one Federal department in Washington or more especially one level of American government.

With regard to the structure and process for homeland security, it is therefore necessary to consider homeland security in relation both to national security and emergency management.

GENERAL ASSUMPTIONS

America’s current national security model—premised on the National