yale - tulane esf -8 vmoc special report - ts karen 11 pm edt - 4 oct 2013

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FEDERAL GOVERNMENT FEMA Facebook full site Twitter full site Ready. Gov HHS Public Health Emergency ASPR Twitter | Facebook CDC Twitter | Facebook U.S. Army Corps of Engineers - Team New Orleans National Weather Service National Hurricane Center National Weather Service Lake Charles National Weather Service - New Orleans/Baton Rouge National Weather Service Mobile/Pensacola National Weather Service - Tallahassee STATES LOUISIANA Louisiana Governor’s Office of Homeland Security and Preparedness Facebook | Twitter Louisiana Health and Hospitals Louisiana National Guard Louisiana Dept of Wildlife and Fisheries MISSISSIPPI Mississippi Emergency Management Agency Facebook | Twitter Mississippi Department of Health ALABAMA Alabama Emergency Management Facebook | Twitter Alabama Department of Public Health FLORIDA Florida Division of Emergency Management Facebook | Twitter Florida Department of Health TRAVEL FAA Flight Delays AMTRAK Service Alerts ORGANIZATION American Red Cross POTENTIAL TROPICAL STORM FORCE WINDS CURRENT SITUATION HURRICANE PREPAREDNESS CHECKLIST YALE/TULANE ESF - 8 PLANNING AND RESPONSE PROGRAM SPECIAL REPORT TOPICAL STORM KAREN KEY LINKS MAPS ACTIVE WATCH AND WARNING POTENTIAL HEALTH THREATS FROM HURRICANES PERSONAL HURRICANE PREPAREDNESS ACTIVITIES 72 HOUR RAINFALL FORECAST PREPARATIONS DECISION MATRIX STORM SURGE 4 OCTOBER 2013 2100 EDT

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In light of Tropical Storm Karen the Yale-Tulane ESF #8 Planning and Response Program has produced this special report. The Yale-Tulane ESF #8 Program is a multi-disciplinary, multi-center, graduate-level, program designed to produce ESF #8 planners and responders with standardized skill sets that are consistent with evolving public policy, technologies, and best practices. The group that produced this summary and analysis of the current situation are graduate students from Yale and Tulane Universities. It was compiled entirely from open source materials. Please feel free to forward the report to anyone who might be interested.

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Page 1: Yale - Tulane ESF -8 VMOC Special Report - TS Karen 11 pm EDT -  4 OCT 2013

FEDERAL GOVERNMENT

FEMA

Facebook full site

Twitter full site

Ready. Gov

HHS

Public Health Emergency – ASPR

Twitter | Facebook

CDC

Twitter | Facebook

U.S. Army Corps of Engineers - Team New Orleans

National Weather Service

National Hurricane Center

National Weather Service – Lake Charles

National Weather Service - New Orleans/Baton Rouge

National Weather Service – Mobile/Pensacola

National Weather Service - Tallahassee

STATES

LOUISIANA

Louisiana Governor’s Office of Homeland Security and Preparedness

Facebook | Twitter

Louisiana Health and Hospitals

Louisiana National Guard

Louisiana Dept of Wildlife and Fisheries

MISSISSIPPI

Mississippi Emergency Management Agency

Facebook | Twitter

Mississippi Department of Health

ALABAMA

Alabama Emergency Management

Facebook | Twitter

Alabama Department of Public Health

FLORIDA

Florida Division of Emergency Management

Facebook | Twitter

Florida Department of Health

TRAVEL

FAA Flight Delays

AMTRAK Service Alerts

ORGANIZATION

American Red Cross

POTENTIAL TROPICAL STORM FORCE WINDS

CURRENT SITUATION

HURRICANE PREPAREDNESS CHECKLIST

YALE/TULANE ESF-8 PLANNING AND RESPONSE PROGRAM SPECIAL REPORT

TOPICAL STORM KAREN KEY LINKS MAPS

ACTIVE WATCH AND WARNING

POTENTIAL HEALTH THREATS FROM HURRICANES

PERSONAL HURRICANE PREPAREDNESS ACTIVITIES

72 HOUR RAINFALL FORECAST

PREPARATIONS

DECISION MATRIX

STORM SURGE

4 OCTOBER 2013 2100 EDT

Page 2: Yale - Tulane ESF -8 VMOC Special Report - TS Karen 11 pm EDT -  4 OCT 2013

CURRENT SITUATION

WHERE: Gulf Coast region of eth United States WHEN: Developing Situation. SITUATION: TROICAL STORM KAREN As of the 5:00 PM (CDT 2100) advisory, the center of Tropical Storm Karen was located near 25.9N 90.3W about 235 miles southwest of the mouth of the Mississippi River. Maximum sustained winds are currently at 50 mph with higher gusts. Karen remains highly disorganized with most of its shower and storm activity displaced to the east of the center. This is likely to continue with environmental conditions promoting strong wind shear and dry air near the center. Beyond that time, some additional strengthening will be possible on Saturday night and Sunday before it makes landfall. Karen is presently moving toward the north-northwest at 7 mph. Minimum central pressure is currently 1003mb. Karen is expected to make a turn toward the north and a decrease in forward speed are expected by early Saturday. A turn toward the northeast is expected on Sunday with an increase in forward speed. TS WARNING: Morgan City Louisiana to the mouth of the Pearl

River TS WATCH: Metro New Orleans; Lakes Maurepas & Pontchartrain;

East of the Mouth of the Pearl River to Indian Pass, Florida

WINDS: • 25-35 mph over land and Lake Pontchartrain • 40-60 mph near immediate coast and off shore • Hurricane force gust possible in hurricane watch area STORM SURGE:

• 1-3 feet West of Mississippi and Lake 3-5 feet East of river and Mississippi coast

• Highest on East and Southeast facing shores

RAIN: 4 – 8 in over central & eastern Gulf; isolated 12 inches

SOURCE: NATIONAL HURRICANE CENTER FEMA DAILY OPERATIONS BRIEF – 4 OCT 2013 NOAA

Page 3: Yale - Tulane ESF -8 VMOC Special Report - TS Karen 11 pm EDT -  4 OCT 2013

TS KAREN PREPARATIONS - LOUISIANA

• Governor declared a State of Emergency Oct 3

• GOHSEP - activated to Level III (Crisis Action Team)

• 650 National Guard personnel activated Oct 3 additional 7,000 on

standby

• Preparatory actions underway; working with USACE & staging assets

• Grand Isle, located on a barrier island, is under a state of emergency. The mayor called for voluntary evacuations

FEMA DAILY OPERATIONS BRIEF – 4 OCT 2013

• Plaquemines Parish authorities have called a mandatory evacuation for the east bank of the Mississippi River, as well as for Plaquemines communities on the west bank that are not protected by levees

• New Orleans says it's monitoring the storm and asks residents to call 311 for preparation info

• Louisiana’s price gouging laws are in effect: prices must remain the same as they were before unless the increase is to offset reasonable extra costs incurred by the business because of the state of emergency.

• The Louisiana Department of Health and Hospitals have closed oyster harvest areas 1-23, which are located from Lake Borne in St. Bernard Parish to Oyster Bayou in Terrebonne Parish, effective on Friday, October 4, 2013.

LINKS

Louisiana Health and Hospitals

Department of Public Health

http://www.dhh.louisiana.gov/index.cfm/subhome/17/n/173

Louisiana Governor's Office

Homeland Security and

Emergency Preparedness

http://gohsep.la.gov/

Twitter http://twitter.com/#!/GOHSEP

Flickr http://www.flickr.com/photos/lagohsep/

Facebook http://www.facebook.com/gohsep

NOAA Weather Radio for LA http://www.nws.noaa.gov/nwr/Maps/PHP/Louisiana.php

National Weather Service Watches,

Warnings and Advisories http://www.weather.gov/alerts-beta/la.php?x=1

Page 4: Yale - Tulane ESF -8 VMOC Special Report - TS Karen 11 pm EDT -  4 OCT 2013

TS KAREN PREPARATIONS - MISSISSIPPI

FEMA DAILY OPERATIONS BRIEF – 4 OCT 2013 MSEMA – 4 OCT

• Traffic at the mouth of the Mississippi River stopped at 6 a.m. Friday as coastal Louisiana prepares for a possible strike.

• A spokesman for the Port of New Orleans says cargo operations will continue as scheduled Friday, despite the river's closure at Southwest Pass. The Associated Branch Pilots, who guide ships through the river's twists and turns, are shutting down at daybreak.

• MDOT moving equipment (front end loaders, bull dozers, etc.) to the coast to stage them; immediately after the storm they can start removing sand from U.S. Highway 90.

• Miss. Department of Humans Services county directors in the potentially affected counties are working closely with local EMA Directors and Red Cross to open and staff shelters as requested.

• American Red Cross staff is communicating with local emergency managers and Department of Human Services to coordinate shelter openings if needed. Volunteers, shelter teams, and 11 emergency response vehicles have been placed on alert.

• Search and Rescue teams have been sent to support Jackson, Harrison and Hancock counties.

• State Emergency Response Team has deployed to the Combat Readiness Training Center in Gulfport.

• 300 Mississippi National Guard troops with high water vehicles have been deployed to affected areas.

Mississippi Department of Public

Health

http://www.healthyms.com/msdhsite/index.cfm/44,0,122,292,html

Mississippi Emergency

Management Agency

http://www.msema.org/

Twitter http://twitter.com/msema

Facebook

http://www.facebook.com/home.php#/pages/Pearl-MS/Mississippi-Emergency-Management-Agency/81599105731?ref=sgm

NOAA Weather Radio for

Mississippi

http://www.nws.noaa.gov/nwr/Maps/PHP/Mississippi.php

National Weather Service

Watches, Warnings and

Advisories

http://www.weather.gov/alerts-beta/ms.php?x=1

MS - LINKS

As Tropical Storm Karen approaches the Gulf Coast and is expected to affect Mississippi with rising storm surge, high winds and torrential rains, state agencies are making preparations in anticipation of landfall.

• State EOC is at Level I (Fully Activated)

• Mississippi Governor Phil Bryant declared a state of emergency as Karen approaches the state on October 3MEMA has asked people in flood-prone areas to start thinking about a evacuation plan.

• Mississippi Dept. of Marine Resources said oyster reefs that had opened earlier in the week were closed as a precaution.

Page 5: Yale - Tulane ESF -8 VMOC Special Report - TS Karen 11 pm EDT -  4 OCT 2013

TS KAREN PREPARATIONS

ALABAMA • Alabama Gov. Robert Bentley declares state of

emergency on 4 Oct.

• Mobile Ferry will not run Friday

• Dauphin Island Sea Lab Estuarium will be closed Friday

• Organizers of the Bayfest music festival say the show will go on as much as possible

FEMA DAILY OPERATIONS BRIEF – 4 OCT 2013 THE WEATHER CHANNEL – 4 OCT 2013 6:11 PM EDT

FLORIDA • State EOC is activated to Level II (Partial Activation)

• National Guard personnel activated

• Tropical Storm emergency declaration for 18 counties:

Escambia, Santa Rosa, Okaloosa, Walton, Holmes, Washington, Bay, Gulf, Calhoun, Jackson, Franklin, Liberty, Gadsden, Wakulla, Leon, Jefferson, Madison, and Taylor Counties.

Alabama Department of Public Health

http://www.healthyms.com/msdhsite/index.cfm/44,0,122,292,html

Alabama Emergency Management http://www.ema.alabama.gov/

Twitter https://twitter.com/alabamaema

RSS Feeds: http://www.msema.org/wordpress/?feed=rss2

Facebook https://www.facebook.com/AlabamaEMA

NOAA Weather Radio for Alabama http://www.nws.noaa.gov/nwr/CntyCov/nwrAL.htm

National Weather Service Watches, Warnings and Advisories

http://www.weather.gov/alerts-beta/ms.php?x=1

AL - LINKS

Florida Department of Health http://www.doh.state.fl.us/

Florida Division of Emergency Management

http://www.floridadisaster.org/index.asp

Twitter https://twitter.com/flsert

RSS Feed http://floridadisaster.org/feeds/pressreleases.asp

Facebook https://www.facebook.com/FloridaSERT

NOAA Weather Radio for Florida http://www.nws.noaa.gov/nwr/CntyCov/nwrFL.htm

National Weather Service Watches, Warnings and Advisories

http://alerts.weather.gov/cap/fl.php?x=1

FL - LINKS

Page 6: Yale - Tulane ESF -8 VMOC Special Report - TS Karen 11 pm EDT -  4 OCT 2013

TS KAREN PREPARATIONS - FEMA

FEMA HEADQUARTERS: • National Response Coordination Center (NRCC) -

activated to Level III (Day only)

• National Watch Center - Enhanced Watch Level (8:00 pm to 8:00 am EDT)

• Resource Support - Atlanta Distribution Center (DC) has been activated

• National Processing Service Centers - activated from 7:00 a.m. to 1:00 am

• National IMAT-East - deploying to Florida EOC today

• Urban Search & Rescue - on Advisory status

FEMA DAILY OPERATIONS BRIEF – 4 OCT 2013 NOAA

FEMA REGION IV:

• RRCC activated to Level III w/ ESFs 1,3,6,8

• LNOs deployed to Florida, Mississippi & Alabama

• Region IV IMATs deploying to AL & MS today

FEMA REGION IV:

• RRCC activated to Level III w/ ESFs 1,3,6,8

• LNOs deployed to Florida, Mississippi & Alabama

• Region IV IMATs deploying to AL & MS today

Page 7: Yale - Tulane ESF -8 VMOC Special Report - TS Karen 11 pm EDT -  4 OCT 2013

ACTIVE WATCH / WARNINGS

National Weather Service

Severe Thunderstorm Warning Severe Weather Statement Civil Emergency Message Blizzard Warning Winter Storm Warning High Wind Warning Tropical Storm Warning Flood Warning Gale Warning

Freeze Warning Red Flag Warning Hurricane Watch Tropical Storm Watch Winter Weather Advisory Coastal Flood Advisory Dense Fog Advisory Small Craft Advisory For Hazardous Seas Small Craft Advisory For Winds

Small Craft Advisory Lake Wind Advisory Wind Advisory Blowing Dust Advisory Frost Advisory Rip Current Statement Winter Storm Watch Hard Freeze Watch Freeze Watch

Fire Weather Watch Special Weather Statement

Marine Weather Statement Air Quality Alert Hazardous Weather Outlook Hydrologic Outlook

Page 8: Yale - Tulane ESF -8 VMOC Special Report - TS Karen 11 pm EDT -  4 OCT 2013

ACTIVE WATCH / WARNINGS

Tropical Storm Warning Hurricane Watch Tropical Storm Watch Coastal Flood Advisory Small Craft Advisory Rip Current Statement Hazardous Weather Outlook

LAKE CHARLES BATON ROUGE/NEW ORLEANS

MOBILE/ PENSACOLA TALLAHASSEE

Page 9: Yale - Tulane ESF -8 VMOC Special Report - TS Karen 11 pm EDT -  4 OCT 2013

72 HOUR RAINFALL FORECAST

Image Source: http://www.nhc.noaa.gov/refresh/graphics_at2+shtml/144417.shtml?rainqpf?large#contents

• Karen is expected to produce rainfall amounts of 3 to 6 inches over portions of the Central and Eastern gulf coast through Sunday night, mainly near and to the right of the path of the center.

• Isolated storm total amounts of 10 inches are possible.

Tropical Storm KAREN Public Advisory #7

Page 10: Yale - Tulane ESF -8 VMOC Special Report - TS Karen 11 pm EDT -  4 OCT 2013

STORM SURGE

The combination of storm surge and the tide will cause normally dry areas near the coast to be flooded by rising waters.

The water could reach the following heights above ground if the peak surge occurs at the time of high tide: • West of the Mississippi river to Terrebonne Bay 1 to 3 feet • Mouth of the Mississippi River to Mobile Bay 3 to 5 feet • East of Mobile Bay to West of Apalachee Bay 1 to 3 feet • Apalachee Bay including Cedar Key 2 to 4 feet • South of Apalachee Bay to Tampa Bay 1 to 2 feet

The highest water will occur: • Along the immediate coast near and to the east of where landfall occurs. • Where the surge will be accompanied by dangerous waves .

Tropical Storm KAREN Public Advisory #7

Page 11: Yale - Tulane ESF -8 VMOC Special Report - TS Karen 11 pm EDT -  4 OCT 2013

POTENTIAL TROPICAL STORM FORCE WINDS

Image Source: http://www.nhc.noaa.gov/refresh/graphics_at2+shtml/205419.shtml?tswind120#contents

• Tropical storm conditions are expected within portions of the tropical storm warning area on Saturday.

• Hurricane conditions are possible in portions of the hurricane watch area by Sunday morning.

Page 12: Yale - Tulane ESF -8 VMOC Special Report - TS Karen 11 pm EDT -  4 OCT 2013

Water-Borne Disease Vector-Borne Disease Rodent-Borne Disease Molds/Allergens Infections Infectious Diseases Food safety HAZMAT Exposure

Patient Evacuation Patient Care Drowning Waterborne Illnesses Foodborne Chronic Diseases Infectious Disease CO Poisoning

Acute Respiratory Infections Meningitis Measles Dehydration Diarrhea Chronic Disease

Hurricane

Environmental

Infrastructure

Socio-Economic

Loss of Assets

Contamination of Drinking Water

Sanitation

Health Facilities

Utilities

Road Networks

Loss of Employment

Essential Services

Displacement

Loss of Shelter

Surveillance

- Water Quality

- Air Quality

- Spills/Releases

- Breeding Sites

- Harborage Areas

- Health Services

- Shelters

- Food Service

- DNBI

- Animal

Assessment

- Operational Risk

Coordination

- Who

- What

- Where

- When

- How

Fill Gaps

- Health Services

- Vet Services

- Immunizations

- Pharmaceuticals

- Medical Supplies

- Vector Control

- Rodent Control

- Sanitation Inspections

- Outbreak Response

- Transportation

- Evacuation

Build Capacity

- Education

- Training

Airports/Sea Ports

Loss of Access To Food/Water

Government

Emergency Services 911 Public Health Homecare Animal Control

Increased Morbidity & Mortality

TIC/TIM

Debris and Waste

Flooding

Services

Command and Control

Info - Communication

Coordination

POTENTIAL HEALTH

THREATS FROM HURRICANES

Page 13: Yale - Tulane ESF -8 VMOC Special Report - TS Karen 11 pm EDT -  4 OCT 2013

1

Decision Point 1: (TROPICAL STORM)

Prepare

PRIOR TO IMPACT

Primary Activities: • Monitor the developing situation • Review appropriate plans and policies • Consider activation of Emergency Operations • Contact headquarters and subordinate organizations • Consider cancellation of elective procedures and early discharge • Consider executing evacuation operations • Consider if it is safe to Shelter in Place • Consider reducing the patient population within the facility using

early discharging and cancelling elected procedures • Determine staffing/material needs based on eth threat and the

selected COA • Initiate and complete buildings and grounds preparations • Communicate

THREAT INFORMATION REQUIREMENTS CRITICAL INFORMATION REQUIREMENTS

Has an alert or warning been issued?

Has the situation altered in any way?

What are the characteristics of the threat?

Size and magnitude

Strength

Duration

What is the geographic area likely to be impacted?

At what time will the threat impact the area?

What is the threats expected impacts on the :

Population

Utilities

Healthcare Systems

Infrastructure

Security

What are the possible cascading effects

Has the time for impact changed?

If flooding is possible, what is the predicted depth of the

flooding?

What security issues will arise because of the threat?

What is the evacuation or SIP status of neighboring

facilities (hospitals, facilities, etc.)?

Have shelters been established, if so where?

Have any APOEs and APODs been activated for evacuation,

if so where?

Has a state of emergency been declared?

Have local and State EOCs been activated?

What is the status of local municipality response

elements?

What mandatory evacuation procedures are being

considered?

Have evacuation resources have been requested

AC

TIO

NS

COMMAND OPERATIONS PLANNING FACILITIES/LOGISTICS ADMIN/FINANCE

Consider full activation of the

Emergency Command Center

Consider cancellation of elected

surgeries

Consider cancellation of

appointments

Consider early discharge of patients

Consider evacuating

Consider evacuation procedures for

staff, employee , and family

members

Approve the IAP for next operational

period

Maintain close coordination with

departments and address

requirements

Establish approved methods of

updated information dissemination

(e.g. website) to inform staff and

patients of the hospital’s status

Provide regularly scheduled status

updates to staff

Maintain full operational status

Run available models based on

current track/intensity forecasts

Monitor for any alerts or

warnings

Monitor current and developing

weather conditions including

areas vulnerable to flooding

Synchronize activities with

appropriate agencies.

Determine status and needs,

coordinate relief as necessary,

continue regular conference

calls

Initiate C2 structure for

response

Execute evacuation operation if

necessary

Execute shelter in place

preparations if it is possible.

Evaluate the developing

situation

Develop Incident objectives

Recommend courses of action

(COA)

Identify which resources will be

needed to achieve the

objectives.

Develop an IAP for next

operational period

Disseminate approved IAP

Begin buildings and ground

preparations

Contact necessary vendors

and ensure that all

necessary supplies are fully

stocked prior to landfall

Ensure generator fuel

storage is at full capacity

Ensure that the following

supplies are sufficient to

support partial or full

operational for at least 72

hours

Medical Supplies

Linen

Water

Food

Pharmaceuticals

Medical Gases

Blood

Coordinate for the back-up of

critical files and materials to a

safe location outside the

impacted zone

Capture cost

Implement emergency

financial procedures

Obtain current patient census

Monitor changes to Medicaid,

Medicare due to the

emergency

Page 14: Yale - Tulane ESF -8 VMOC Special Report - TS Karen 11 pm EDT -  4 OCT 2013

2

Decision Point 2: (TROPICAL STORM)

Prepare

24 hours to 12 hours prior to impact

Primary Activities:

Complete evacuation operations

Execute Shelter in Place activities

Complete early discharge activities

Harden facility through protective measures

Monitor facility and area conditions as impact occurs

Finalize staffing arrangement Take appropriate actions to maintain operations

THREAT INFORMATION REQUIREMENTS CRITICAL INFORMATION REQUIREMENTS

What is the level of the threat?

How large is the area projected to be impacted?

How much of the populations are projected to

be impacted?

Is the facility located in the impacted zone

Has the facility been impacted?

Have services been impacted?

Which ones?

To what degree?

Are any of your remote facilities in the impacted

zone?

Do any of your employees or staff live in the

impacted zone?

AC

TIO

NS

COMMAND OPERATIONS PLANNING FACILITIES/LOGISTICS ADMIN/FINANCE

Review all policies, plans and procedures to

ensure that they are current and reflect any

changes to the facility or infrastructure since

last season

Review Shelter in Place and Evacuation

decision-making requirements

Review various agreements with area

hospitals, agencies and vendors

Ensure that the staff is familiar with the All

Hazards Plan

Ensure that families have a care plan in case

of emergencies

Conduct/review hazard vulnerability

assessment for each activity. Include

specific projects and research vulnerability.

Prioritize resources for response and

recovery efforts based on cost-benefit

analysis.

Monitor forecasted flood areas,

track current, impending, and

potential impact

Begin movement to secondary

facilities for operational integrity

if severe flooding is imminent

Synchronize activities with

appropriate local/regional/State

agencies

Determine status and needs,

coordinate relief as necessary,

continue regular conference calls

Test redundant communications

systems

Implement facility physical

security plan

Draft and maintain IAP for next

operational period

Disseminate approved IAP

Review all applicable plans

Review gap analysis

Review dormant contracts

Identify requirements for

sheltering in place (SIP)

Identify requirements for

evacuation

Vertically

People

Specimens

Primates

Review MOUs, MOAs and Mutual

Aid Agreements

Elevate the generator, furnace,

water heater, and electric panel

if susceptible to flooding.

Inventory stockpiles to determine

(and augment) self-sustainability

when municipal systems are

inoperable

Inspect Alternate Sites

Review Regulated Medical Waste

disposal surge contract s and

processes

Review Trash disposal/storage

plan

Review mortuary plans

Capture cost

Ensure continuity of

current staff throughout

operational period

Page 15: Yale - Tulane ESF -8 VMOC Special Report - TS Karen 11 pm EDT -  4 OCT 2013

3

Primary Activities:

• Assess damages to the facility and injuries to employees and staff • Maintain accountability • Safety for employees and staff • Make emergency repairs • Take appropriate actions to maintain operations • Evacuate if necessary • Move to an alternate facility if necessary • Information Dissemination • Report status

Decision Point 3 (TROPICAL STORM)

Response

Impact +24 Hours

THREAT INFORMATION REQUIREMENTS CRITICAL INFORMATION REQUIREMENTS

Have/When will adverse conditions subside?

How large was the impact?

What are the cascading effects as a result of

the threat?

What is forecasted for the next 24 hours?

What additional information is being

provided by the local weather forecasters?

Has criminal activities increased?

What is status of your facility?

What is the status of your remote facilities?

What services have been impacted?

What capabilities have been degraded?

What is the status of your staff and their families? Are all accountable for? Any

fatalities?

Has the disaster generated a mass casualty incident?

What is the status of municipal utilities, water and waste water?

What roads are closed due to the impact?

What is the status of local emergency response agencies?

Has NDMS been activated? If so, which portions

Has the FEMA ambulance contract been activated?

What information is being provided to the public?

What is the status of airports being used for additional evacuations?

What resources are available to assist your facility?

What capability shortfalls are there?

Has patient care been compromised?

AC

TIO

NS

COMMAND OPERATIONS PLANNING FACILITIES/LOGISTICS ADMIN/FINANCE

Assess the threat and the damage

Determine the need to evacuate the facility,

continue Sheltering in Place

Is an alternative care sites for patient treatment

needed?

Is an effective patient ID and tracking system in

place?

Contact and notify staff of the facility status,

operational capacity and timeline for return to work

Contact higher headquarters with status and relay

needs

Report situation to :

Higher HQ

Local government

Health authorities

Maintain staff and employee accountability

Maintain full activation of the Command Center

Approve the IAP for next operational period

Maintain close coordination with departments and

address requirements

Ensure Shelter in Place needs/provisions are in

place and being met

Determine if it is necessary to evacuate the facility

completely

Determine if it is necessary to close down

operations or limit services

Contact staff to relay needs and operability

Determine if it is necessary to move to some or all

services an alternate facility

Conduct damage, risk and injury

assessments to determine

operational status and capacity of

the facility

Coordinate search an d rescue

activities

Establish triage areas if needed

Synchronize activities with

appropriate local/regional/State

agencies

Ensure EOC is fully operational at

current facility, if necessary

relocate or work remotely

Determine operational status of

remote clinics

Determine status and needs,

coordinate relief as necessary,

continue regular conference calls

Implement redundant

communications as necessary

Account for staff and employees

Review staffing requirements

Coordinate evacuation if

necessary

Establish accountability methods

for patient counts & movements

Issue needed risk communication

messages

Identify critical objectives

based on the planning

requirement, provide a

complete and integrated

picture of the sequence and

scope of the tasks to achieve

the objectives, and ensure the

objectives are implementable

within the time frame

contemplated within the plan

using available resources for

prevention-related plans.

Develop and execute

appropriate courses of action

in coordination with Federal,

state, local, and private sector

entities in order to prevent an

imminent terrorist attack

within the United States.

Maintain an Incident Action

Plan (IAP) for next operational

period

Disseminate approved IAP

Assess the damage

Prioritize and perform repairs

to the facility as necessary

Monitor all departments and

portions of the facility, take

appropriate actions to harden

the facility and take any

protective measures to

prevent damages

Conduct periodic inventory

checks to ensure there is

adequate supply for sustained

operation and allow plenty of

time to obtain additional

supplies if necessary.

Coordinate needs and actions

through the Command Center

Review staffing requirements

Assess facility functionality,

determine operational

capacity and requirements for

repairs

Monitor emergency systems

and determine fuel capacities

to inform sustainability

requirements

Identify most urgent food &

non-food requirements

Capture cost

Ensure continuity of

current staff throughout

operational period

Set up disaster

accounting systems

Work with appointed

authorities to determine

applicant and

reimbursement eligibility

for disaster-related

expenses

Page 16: Yale - Tulane ESF -8 VMOC Special Report - TS Karen 11 pm EDT -  4 OCT 2013

PERSONAL HURRICANE PREPAREDNESS ACTIVITIES

DEVELOP / UPDATE / REVIEW PERSONAL PLAN STOCK DISASTER SUPPLY KIT

Know your home’s vulnerabilities to Storm Surge, Flooding and Wind Locate a safe room or safe area in your home or community for each hazard Determine escape routes and places to meet Have an out-of-state friend or family contact as a single point for all persons in the home Have a place to go for evacuations

Be aware of traffic considerations If using a hotel/motel, make reservations first Ensure that destination is pet-friendly ,if necessary

Plan for what to do with pets if you need to evacuate Post emergency phone numbers and ensure children know how and when to call 9-1-1 Review insurance coverage – flood damage may not be covered Stock non-perishable emergency supplies and a Disaster Supply Kit Ensure First Aid Kits are stocked

Water (1 gallon per person per day) Food for 3 to 7 days

Non-perishable food items Foods for infants/elderly Snack foods Non-electric can opener Cooking tools/fuel Plates/utensils

Blankets/Pillows Medications Ice Chest Matches Clothing First Aid Kit Toiletries Special Items – Babies/Elderly Flashlight/Batteries Radio (Battery Operated NOAA) Phones – Fully Charged w/Extra Batteries Keys Toys/Books/Games Important Documents (In Waterproof

Container) Tools and Tape Pet Care Items

Identification and Photos Ample food and water Medications Immunization Records Muzzle, collar, leash Crate

PREPARE YOURSELF AND YOUR HOME FOR THE STORM

Bring in everything not attached to the house (plants, wind chimes, patio furniture, etc.) Fill clean 2 liter bottles with water and place in freezer Make and store ice (if possible) Refill medications Ensure vehicles are fully fueled Charge all cell phone batteries Board windows Place changes of clothing in plastic bags Fill trash can or tub with water Turn refrigerator and freezer to their lowest setting (coldest) Unplug valuable electronics and turn off gas/electricity to house Place memorabilia in plastic bags Detach propane tank(s) from gas grill(s) Cover pools and super-chlorinate Tie down any boats that are on trailers or move into a garage Get extra cash, ATMs will not work without electricity Gather additional radios, verify battery needs (batteries should be changed every 6 months) Gather lanterns and extra oil (do not use in high wind conditions)

Page 17: Yale - Tulane ESF -8 VMOC Special Report - TS Karen 11 pm EDT -  4 OCT 2013

HURRICANE PREPAREDNESS CHECKLIST

DURING THE STORM AFTER LANDFALL

Listen to the radio or TV for information. Secure your home, close storm shutters and secure outdoor

objects or bring them indoors. Turn off utilities if instructed to do so. Otherwise, turn the

refrigerator thermostat to its coldest setting and keep its doors closed.

Turn off propane tanks Avoid using the phone, except for serious emergencies. Moor your boat if time permits. Ensure a supply of water for sanitary purpose such as cleaning

and flushing toilets. Fill the bathtub and other larger containers with water.

Find out how to keep food safe during and after and emergency. YOU SHOULD EVACUATE UNDER THE FOLLOWING CONDITIONS: If you are directed by local authorities to do so. Be sure to follow

their instructions. If you live in a mobile home or temporary structure – such shelter

are particularly hazardous during hurricane no matter how well fastened to the ground.

If you live in a high-rise building – hurricane winds are stronger at higher elevations.

If you live on the coast, on a floodplain, near a river, or on an island waterway.

READ MORE ABOUT EVACUATING YOURSELF AND YOUR FAMILY. IF YOU ARE UNABLE TO EVACUATE, GO TO YOUR WIND-SAFE ROOM. IF YOU DO NOT HAVE ONE, FOLLOW THESE GUIDELINES: Stay indoors during the hurricane and away from windows and

glass doors. Close all interior doors – secure and brace external doors. Keep curtains and blinds closed. Do not be fooled if there is a lull;

it could be the eye of the storm – winds will pick up again. Take refuge in a small interior room, closet or hallway on the

lowest level. Lie on the floor under a table or another sturdy object. Avoid elevators.

Continue listening to a NOAA Weather Radio or the local news for the latest updates. Stay alert for extended rainfall and subsequent flooding even after the storm has ended. If you have become separated from your family, use your family communications plan or contact

FEMA or the American Red Cross. FEMA has established the National Emergency Family Registry and Locator System (NEFRLS),

which has been developed to help reunite families who are separated during a disaster. The American Red Cross also maintains a database to help you find family. Contact the local

American Red Cross chapter where you are staying for information. If you evacuated, return home only when officials say it is safe. If you cannot return home and have immediate housing needs. Text SHELTER + your ZIP code to

43362 (4FEMA) to find the nearest shelter in your area (example: shelter 12345). For those who have longer-term housing needs, FEMA offers several types of assistance,

including services and grants to help people repair their homes and find replacement housing. Apply for assistance or search for information about housing rental resources

Drive only if necessary and avoid flooded roads and washed¬ out bridges. Stay off the streets. If you must go out watch for fallen objects; downed electrical wires; and weakened walls, bridges, roads, and sidewalks.

Keep away from loose or dangling power lines. Report them immediately to the power company. Walk carefully around the outside your home and check for loose power lines, gas leaks and

structural damage before entering. Stay out of any building if you smell gas, floodwaters remain around the building or your home

was damaged by fire and the authorities have not declared it safe. Inspect your home for damage. Take pictures of damage, both of the building and its contents,

for insurance purposes. If you have any doubts about safety, have your residence inspected by a qualified building inspector or structural engineer before entering.

Use battery-powered flashlights in the dark. Do NOT use candles. Note: The flashlight should be turned on outside before entering - the battery may produce a spark that could ignite leaking gas, if present.

Watch your pets closely and keep them under your direct control. Watch out for wild animals, especially poisonous snakes. Use a stick to poke through debris.

Avoid drinking or preparing food with tap water until you are sure it’s not contaminated. Check refrigerated food for spoilage. If in doubt, throw it out. Wear protective clothing and be cautious when cleaning up to avoid injury. Use the telephone only for emergency calls. NEVER use a generator inside homes, garages, crawlspaces, sheds, or similar areas, even when

using fans or opening doors and windows for ventilation. Deadly levels of carbon monoxide can quickly build up in these areas and can linger for hours, even after the generator has shut off.

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