Track 4: Enhancing Public Health, Healthcare, and Emergency Management Systems
Part A: Transforming Challenges into Learning Experiences: Lessons Learned from WASH Emergency Preparedness and Response
Recent complex emergencies and outbreaks associated with drinking water, sanitation, and hygiene (WASH) have highlighted the spectrum of discernible and serious public health consequences that both natural and man-made events can have in a community. Often local health departments are at the forefront of responding to such events in a timely and effective manner, demonstrating the need for comprehensive planning, training and exercise.
Recognizing the current gaps in WASH emergency preparedness and response, the National Association of County and City Health Officials, in collaboration with the Centers of Disease Control and Prevention, established, in 2017, the WASH Emergency Preparedness and Response workgroup, comprised of local health departments, academic institutions and federal agencies.
In this learning session, speakers will highlight the work of NACCHO’s WASH Emergency Preparedness and Response workgroup, present on recent WASH-related emergencies from a local public health perspective, and share best practices and lessons learned. This session will include presentations on the impacts of chemical and biological water contamination, disaster sanitation, natural disasters and aging infrastructure. Participants will be able to engage in an interactive discussion about challenges, lessons learned and gaps in WASH emergency preparedness and response.
Part B: Water Emergencies & Outbreaks: Tools and Guidance for Preparedness and Response
Complex environmental health emergencies and outbreaks associated with drinking water trigger public health responses because of their potential for causing community-wide illness and disruption. These emergencies can be caused by emerging pathogens, chemicals, toxins, natural disasters (e.g., floods, hurricanes), or aging infrastructure. If these events are not preceded by sufficient planning, training, or exercises, the rapidity and efficiency of response by local and state health departments is compromised. Coordinated emergency risk communication to the public is particularly important to providing clear public health guidance on preventive measures.
During this session, participants will hear about specific tools that public health professionals can use to effectively prepare and respond to water-related emergencies and participate in discussions about current gaps in water preparedness, needed tools and resources and strategies for improving collaboration between local public health, water utilities, and emergency management.
This session will highlight:
- -Drinking water advisory communication toolbox. This tool helps water systems and public health departments communicate effectively with partners, stakeholders, and the public in the event of a drinking water advisory in order to protect public health. It includes instructions on how to prepare for communication activities before an incident, how to communicate during an incident, templates and tools to use, and recommendations for follow-up actions and assessments after an incident.
-Table Top Exercises for water-related emergencies. These exercises provide opportunities to evaluate preparedness programs, identify planning and procedural deficiencies, and improve coordination between health departments, local water utilities and emergency managers.
-Emergency water supply planning guide for healthcare facilities. The guide includes resources to prepare for, respond to, and recover from a total or partial water supply interruption; addresses patient safety, quality of care, and facility operations; outlines needs for response and recovery; and provides guidance to assess water usage, response capabilities, and water supply alternatives
-Crisis and emergency risk communication for water emergencies. Good crisis communication is critical during water emergencies to clearly present health risk information to the public. This is challenging with complex water systems and emerging contaminants.
-Multidisciplinary (i.e., epidemiology, environmental health, laboratory, and communications) resources for Legionnaires’ disease outbreak response and prevention. This includes revised online outbreak and prevention tools and a laboratory toolkit.
-Responding to water-related challenges during the hurricanes and floods in 2017 and 2018.
-Overview of a new protocol developed by the CDC and EPA for the sample collection of pathogens and biological contaminants in large volumes of water. This overview will include a demonstration of one of the sampling methods featured in the protocol.
The goal of this session is to:
-Describe and demonstrate the value of existing water-related tools and guidance for state/local health departments to respond to complex water emergencies.
-Develop concrete actions to integrate the public health preparedness planning and response into the overall emergency response framework in these emergency events in concert with water utilities, environmental regulatory agencies and emergency management organizations.
Identify gaps in the existing tools and guidance that discuss ways to address these gaps.
Part C: Emerging issues in Water Systems and Public Health
According to the CDC, “Water, sanitation, and hygiene (WASH)-related emergency preparedness and outbreak response has become one of the most significant and crucial public health issues in recent history” (2017, n.p.). Water system emergencies include natural disasters (hurricanes, floods, and droughts), man-made disasters (chemical spills and contaminations), and disease outbreaks (infections linked to water exposure including those occurring after a disaster). (https://www.cdc.gov/healthywater/emergency/index.html). Events such as drinking water contamination in Flint, Michigan and Toledo, Ohio can serve as exemplars and call attention to the challenges. Natural disasters such as hurricanes and floods disrupt water supplies and contaminate systems while more routine breaks in systems and loss of pressure lead to boil water advisories. The American Society of Civil Engineers estimates that a water main breaks in the US every two minutes.
This panel discusses the emerging risk factors and issues associated with water system emergencies and their relationship to public health. In addition, the panelists will present some approaches and tools for managing water-related emergencies.
Challenges include aging infrastructure, coordination between waters systems and public health, risk communication, lack of trust, and emerging health risks. Aging infrastructure, including lead pipes, corrosion, and shrinking cities, has made the delivery of safe water more difficult. The public’s interactions with these systems are restricted, often for security concerns. Limited interactions mean that the public is largely not engaged, unaware and uninformed about how these systems function and the risks they face (Bipartisan Policy Center, 2017). Water infrastructure is out of sight and there are few requirements for public reporting or communicating risks.
Coordination between waters systems and public health agencies is challenging especially during emergencies. Water systems have become increasingly disconnected from public health systems that once considered water quality one of public health’s greatest accomplishments. Both systems have become more complex with additional regulations, functions, and demands Risk communication around water issues is complicated by the often invisible nature of contamination and the fact that water is a critical resource. Recent high visibility cases have undermined trust in water systems which sometimes results in long-term reliance on bottled water. Emerging health risks, including waterborne-disease outbreaks associated with drinking water include both gastroenteritis and acute respiratory diseases.
Water and water related emergencies can be expected to become more common and many emergency management professionals will confront these kinds of events. This panel will help professionals prepare for and respond more successfully for a relatively common form of emergency.