By Sherline Lee

Even for an epidemiologist who works in public health preparedness and response, being asked to explain to the public what we do at CDC can be difficult.  

That said, sometimes opportunities to talk about public health drop into your lap.   A few months ago I was catching up with my friend Austin, an engineer for a large corporation.  It turned out that while on long-term assignments he and his team had recently taken to playing the board game, “Pandemic.”   One might think that an infectious disease would make for a strange game premise, but to my surprise it’s been gaining a loyal fan base. Of note, the game has recently profiled by Wil Wheaton on his “Geeks and Sundry” tabletop videocast seen by more than 350,000 viewers and positively reviewed on many board game sites.

What? You Think Public Health is Fun?

When I asked Austin about why his teammates enjoyed Pandemic, he pointed out that the game differed from many others in that it was designed to make players collaborate, not compete.  In addition, players had to learn not only their own roles but the roles of other players in order to attempt to outsmart the disease as it tried to spread city to city across the globe. 

Finding out that your job is the premise of a game your friend likes to play is amusing.  However this conversation provided me with an opportunity to reflect further.  As it turns out, I had played this game several years ago with a fellow CDC epidemiologist who had a connection to one of the developers.  She asked my team, who was also working on developing educational activities, to play the game with her to provide feedback on potential new roles for a planned expansion to the game and the gameplay itself.  

I remember our team talking to her about how well the game reflected the reality and values of public health.  We also discussed how the game forced players to think beyond themselves and about the other people around their game table.  Public health response, after all, is all about the collaboration of multiple disciplines that function best when they do it together.  Public health professionals know that containing a pandemic requires practitioners all over the world to be well equipped and to be able to communicate just as well as game players around the same table.

Something’s Missing…

If there was one thing that did bother me, it was that among the five roles which players could pick from (i.e., archivist, medic, operations expert, scientist, and researcher), there was no epidemiologist.  However, as I looked at the new version my friend Austin was playing, I was relieved to see an epidemiologist had finally joined the ranks in the expanded form of the game.  That role, alongside seven new ones, became part of the “Pandemic” game world. 

While I’m sure these additions were made to change the gameplay and offer new things for fans to play, I also think it reflects a subtle message about public health. We continue to plan with many specialists inside the agency along with local, state, national and international partners on a daily basis, getting ready to respond and “beat disease at its game.” 

On a more personal note, I keep hoping to run into other friends and acquaintances that have played the game.  After all, each fan of “Pandemic” I encounter represents another opportunity to talk about what we do in public health preparedness.  And every game player might someday also become a fan of public health.

Sherline Lee is a CDC epidemiologist works in the Healthcare Preparedness Activity program (http://www.cdc.gov/phpr/healthcare) in the Division of Strategic National Stockpile and collaborates on developing tools with public health, healthcare, and emergency management partners.

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Are you a fan of Pandemic? Do you have other public health related games you love playing with your friends? Tell us!

By Cate Shockey

This blog is part of a series, covering a preparedness topic each month from the Do 1 Thing Program. Join us this month as we discuss preparedness at work, school, and in your community.

No matter where you are, you need to know how to make sure you and your loved ones are safe in an emergency. If you’re not at home during an emergency, do you know what the plan is for your work, child’s school, or community?

In our office, we practice shelter-in-place and building evacuations quite often. We have signs posted in the hallways and have mandatory safety training every year. What we do not practice, however, is earthquake drills. To make it fun and engaging, we held an earthquake drill in our break room and called it the Harlem ShakeOut. In just a few minutes, everyone learned what to do in an earthquake in a room surrounded by glass.

My mom’s second graders really got into the earthquake drills back in March, and jumped on the chance to practice another drill this month! With storm season in full swing, the class practiced tornado drills in the hallway. The students lined up along the interior wall, huddled on the ground with their knees up under them, and used their hands to cover the back of their heads.

Here are a few things you can do this month to make sure the people who count on you are prepared for an emergency:

• Make sure emergency procedures are in place at your workplace or child’s school. Are evacuation routes and tornado shelter locations clearly marked? How will you be provided emergency and warning information?
• Hold emergency training and drills for different situations (earthquake, tornado, fire drill, etc.).
• Know where fire extinguishers and automatic external defibrillators (AEDs) are located in the building.
• Give emergency kits to people who count on you (elderly parents and neighbors, college students, etc.)
• Find out if your community has designated evacuation routes or shelter locations.

Check out Do 1 Thing for more tips and information, and start putting your plans in place for unexpected events. Are YOU ready?

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Tell us how your work place stays prepared for the unexpected or what your child’s school does to keep parents informed. If you are part of a community group that would help in a disaster, we want to hear about it!

Taking on the role of interim CDC director can be an intimidating task, but an impending pandemic can make the position exponentially more daunting. This is the situation Dr. Richard Besser faced in 2009 when he stepped into his new job. But Besser took the task head on and guided the country’s premier health agency through the H1N1 outbreak with skill and confidence. Through this experience Besser saw first hand how important communication is to building the publics’ trust and improving health behaviors.

When it was time for Besser to hand over the reins, his next career choice made perfect sense, Chief Health and Medical Editor for ABC News. He would be able to continue his work communicating important health information to the public, and hopefully help improve the lives of his viewers.

Of course, Besser often calls upon his past experiences when covering stories and the ongoing outbreak of H7N9 is no exception. Just like during H1N1 Besser realizes there is a fine line between reporting on a story and unnecessarily raising the publics’ fear. In the beginning, ABC News was the only network covering the story, which raised concern in Besser.  Were they overhyping?  Or was this threat real?  

Understanding that there are usually many nuances any outbreak, he connected with CDC for a reality check on H7N9.  After confirmation from the CDC Influenza Division and WHO that the emergence of the new H7N9 virus was a legitimate cause for concern, Besser’s team started to strategize the best way to cover the story.  One of their first decisions: get on the ground in China.

Getting in to mainland China proved to be more difficult than Besser had imagined, as gettings visas for journalists can be challenge.  Instead, Besser headed to Hong Kong to cover the story from there.  Hong Kong was familiar territory for Besser, being the hotbed of activity for the 2003 SARS outbreak, and it was a great place to do preparedness reporting for H7N9.

What Besser found was a part of China that was very aware of the threat posed by H7N9 and incredibly prepared.  They were taking this new strain seriously.  Hospital wards were full of empty beds, ready to receive sick patients and markets and ports of entry were under tight scrutiny.

Because this is a bird flu virus and most cases of bird flu generally happen after contact with infected poultry or surfaces contaminated with the virus, the biggest concern was live poultry. China is a country where the cultural practice is to buy live chickens at the market and have them killed on the spot in order to have the freshest chicken possible.  After SARS, China reduced the markets and started testing every chicken shipment at every border.  If a chicken tests positive, all chicken shipments stop immediately.

In addition to testing chickens for bird flu, China has enacted an interesting way of screening people for H7N9.  Besser reports that in Hong Kong they are using infrared sensors to spot a person with an elevated body temperature out of a crowd.  If a person is spotted, they are brought in for testing.  This screening is being done at all ports of entry, including train stations and airports.

With the preparedness measures in place, the people of Hong Kong were clearly aware of the threat through the media, but there was no real fear of an outbreak. The newspaper headlines kept people informed about H7N9 cases, and the government dispelled fears through preparedness efforts.  They are ready to respond quickly and minimize the impact to the public’s health.

For Besser, the trip to Hong Kong served to tell the story back home. “The people I met in Hong Kong were reassured that I was there to illuminate the issue and not hype it.  My background with public health certainly opened doors, but my purpose was to share a message.”  Besser says that the same emphasis on preparedness seen in Hong is also the approach being taken in in the United States. By getting the preparedness and response message out there, CDC has been very clear about the steps the agency is taking to prepare for H7N9 and urging travelers returning from China to report flu-like symptoms to a doctor. 

For more information on H7N9, visit CDC’s Flu website.

One of the many roles of public health is to protect consumers from threats like foodborne outbreaks. Much of this hinges on quickly getting out clear messages to the public that provide simple steps to help stem the spread of disease. This is something public health professionals have been doing for over a hundred years, but a recent outbreak of Salmonella Heidelberg got us wondering, “Are we doing enough to keep the public safe? Are we too slow? And, How can we improve?”

That’s not to say there weren’t triumphs in this outbreak, but like most responses we had a moment of self-reflection when the crisis was over and we were able to take a step back and consider our methods. What we found was a need for stronger policies and faster messaging to the public.

The Outbreak

Between June 2012 and January 2013 epidemiologists with Oregon Public Health, along with the Washington State Department of Health, CDC, and the US Department of Agriculture independent of each other, began noting increases in the number of Salmonella infections. Thanks to surveillance systems like CDC’s Pulsenet and National Retail Monitoring System (NARMS), epidemiologists were able to narrow down the specific genetic make-up of the Salmonella in question (Salmonella Heidelberg) and link it to raw or undercooked Foster Farms brand chicken.

The Pros and Cons

For decision-making and public information, we did several things right. Including:

1. Communicating with the company responsible for the tainted chicken, which helped provide critical information needed to confirm the source.
2. Developing simple messages that explained the outbreak and how individuals could prevent Salmonella were developed. These messages followed the Crisis & Emergency Risk Communication  framework, which encourages the use of transparent messaging that provides the public with meaningful actions to protect themselves from harm.
3. Growing a strong partnership between our epidemiologists, leadership, and risk communication officer over the course of the investigation provided a basis for mutual trust and respect. This rapport led to faster message development.
4.  Finally, by following Incident Command System principles we were able to better coordinate communication activities across the several agencies involved.

Although we were successful in getting the message out, there were several factors that we felt slowed this outbreak response down:

1. Despite having several state and federal agencies collecting clues, we weren’t doing it together, which meant more time was spent on the backend to get everyone on the same page.
2. Not all staff had been trained on the laws and policies related to release of information, which was needed for rapid decision-making during the outbreak.
3. Oregon Public Health (as we suspect is the case with many state health departments) has no risk communication policy, which meant not everyone was on the same page about how and when we would share information and release information to our partners and the public.
4. Political happenings unrelated to the outbreak ended up blocking the release of important health messages by two days—another all too common experience for many risk communicators.

How Can We Improve?

Given these pros and cons, we still think much can be done to improve decision-making and risk communication during an outbreak. The federal Food Safety and Modernization Act of 2010 was an important step toward improving the safety of our nation’s food supply.  However, our experience responding to Salmonella Heidelberg outbreak in Oregon also suggests that additional state and federal policies are needed not only to prevent outbreaks, but also to help public health authorities implement best practices in risk communications and public health responses when outbreaks do occur.

No state health department funded with federal dollars—CDC or otherwise—should be without a well-developed risk communications plan that can be operationalized at a moment’s notice. Similarly, states should be held accountable to ensure information about emerging outbreaks is shared between epidemiologists, other partners, and response staff, and to identify the triggers for public warning and messaging about health risks. Depending on the risk, even a one day delay in response could mean more sick people, and in turn more health care and social costs.

We do know from our own experience that state and local public health agencies sometimes face unique challenges in balancing the need to be right and credible with the public’s need to know about potential health threats. In many states, there are laws that—very appropriately–prevent public health agencies from releasing certain types of identifiable or highly sensitive information. However, there are almost no laws that ensure public health officials with information about a health risk be allowed or even required to warn the public, free from interference by political forces or threats of litigation by the food industry.

Policies that encourage health departments to share what they know, possibly by providing immunity from lawsuits when warning the public about risky food products, are needed. Policies that ensure that all parties work together as early as possible in a suspected outbreak are needed, along with policies that ensure that health care technologies can capture and send essential data from the health care setting to public health officials.

Our Responsibility

The public health system is under more pressure than ever to be relevant, timely, and right. While important progress has been made over the past decade, identifying outbreaks, analyzing them, and disseminating information to the public requires the expertise of highly trained professionals with the tools and policies that enable them to do their jobs.

Health officials too must sometimes strike the difficult balance between the political realities of our work and the public’s health and safety. As Dr. Martin Luther King, Jr. said “[T]here comes a time when one must take a position that is neither safe, nor politic, nor popular, but he must do it because Conscience tells him it is right.” As public health professionals, we have a responsibility to our colleagues, constituents, friends, families and ourselves to improve the quality and performance of our public health systems and services.

More Information

For more on this topic check out the Pew Charitable Trust report, “Too Slow” analyzing the detection and response to a 2011 outbreak linked to ground turkey.

Disclaimer: This blog post does not represent the official views of the Oregon Public Health Division or the Oregon Health Authority

Thanks to contributing authors:

Jean O’Connor, JD, DrPH, Former Oregon State Public Health Deputy Director (July 2011-April 2013) and Adjunct Associate Professor of Health Policy at Emory University.

Kathleen Vidoloff, PhD, Emergency Risk Communication Officer, Oregon Public Health Division and Adjunct Professor University of Oregon.

By Cate Shockey

This blog is part of a series, covering a preparedness topic each month from the Do 1 Thing Program.  Join us this month as we tackle “food.”

A delicious topic – food!  As a super picky eater with minimal cooking skills, a prepackaged stockpile is right up my alley.  

The Do 1 Thing task of the month is to work on your emergency food supply.  CDC encourages storing enough food for at least three days if you have to evacuate, and a two week supply for your home.  You’ll want to store foods that you eat regularly that require no refrigeration, preparation, or cooking. 

For me, cereal hoarding has finally paid off.  I added some soup, crackers, dry pasta, some candy, and a manual can opener to my supply.  I also added in an extra gallon bag of dog food for the pup.  (Make sure you consider the dietary needs of your family and include pets in your food storage plan!)

The key is to buy ahead of time.  Look for sales.  Use coupons.  Replace items before they run out or expire.  Be aware of the food you have and how long it will last.  

My coworker Maggie is taking a fresh approach to her emergency food supply. Raising backyard chickens, Maggie and her husband collect an average of 18 eggs a week from their 3 chickens.  They also use the chicken bedding for compost, which they add to their garden that supplies them with fresh veggies. Growing a garden ensures that you have nutritious food, but also greatly improves your self-sustainability in an emergency.

Another option is to stock your food supply with MREs (Meal Ready To Eat), ensuring easily-prepared meals when in an emergency. The food in an MRE is already cooked and does not require added water, with the added benefit of being nutritionally-balanced. Coworker  Alanna keeps her MREs with her Red Cross emergency backpack, making her emergency food supply accessible as well as portable.

There are so many different options for getting your food supply ready.  Here are a few additional steps you can take this month for your food supply:

• Install a thermometer in your fridge and freezer. In case of a power outage, the appliance thermometers will indicate the temperatures in the refrigerator and freezer to help you determine if the food is safe.
• Pick up a sealed storage bin for your emergency supply.  This will help keep the food fresh for longer and also keep out little critters looking for a snack.
• Store your food in a cool, dry spot – out of the sun.  
• Wrap any perishable foods, like cookies or crackers, in plastic bags and put them in sealed containers. 
• Add a manual can opener to your food supply kit. You never know when there will be a power outage and you’ll need it!

If there is a power outage, remember this rule:  Eat the food in the fridge first, the freezer next, and then your stockpile.  This should help make your food supply last longer.

See Do 1 Thing’s food checklist for more tips and information, and start putting your plans in place for unexpected events.   Are YOU ready?

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What foods do you have in your emergency kit? What can’t you live without? Tips on how to plan ahead for certain dietary restrictions like diabetes or gluten allergies? Share them in our comments section!

James Vaughan, founder of Ndemic Creations, spoke to CDC staff on March 20, 2013 about his new mobile app, Plague Inc.  Within the game, players select a pathogen and strategize how to evolve symptoms, transmit the disease, and counter actions taken by world governments and scientists. With a successful disease, players can watch as governments fall and humanity is wiped out.

I became interested in Vaughan’s game as a tool to teach the public about outbreaks and disease transmission because of how it uses a non-traditional route to raise public awareness on epidemiology, disease transmission, and diseases/pandemic information. The game creates a compelling world that engages the public on serious public health topics.

For PHPR, using non-conventional methods to communicate with the public has worked really well in the past through social media and blogs posts.  We were very excited to welcome James to CDC and learn more about using other digital platforms to reach a general audience.

“CDC uses digital media to raise awareness on health issues that the nation faces today,” says Katherine Lyon-Daniel, PhD, Associate Director of Communication at CDC. “Meeting with industry leaders is a great way to learn more about reaching new audiences through mobile apps.”

I sat down with Mr. Vaughan to learn more about the game, its creation, and what he plans to do next.

How did you come up with the idea of Plague Inc.?
I made Plague Inc. as a hobby.  I was a strategy consultant in my day job, but I wanted to give myself a creative challenge in my spare time.

Plague Inc. is a bit like the film Contagion except that you are the disease! The 2008 flash game Pandemic 2 gave me the idea of spreading a disease around the world. I liked the game, but thought it could be even better if it had deeper strategy, a strong narrative, increased realism and a lot more. So – I decided to make it!
 
How long did it take to develop Plague Inc.?  
It took around a year to develop the game. I could only work on it in the evening and on weekends. Because I had never made a game before, it was very much a case of learning as I went.  Luckily, I found three great freelancers who were able to help.

How did you ensure it was a realistic game?
Without a medical background, I did a lot of online research in order to make sure it felt realistic to players.  Luckily, I have always been very interested in biology as well as economics and current affairs.  This helped a lot when I was building the algorithms and models inside the game.

A critical stage in the game is the ‘Infection Cycle’ that dictates how people become infected with a disease and how they infect others. The game revolves around this stage, and I spent months making sure that it worked properly. The core design is based on the concept of ‘basic reproduction rate’ and I found lots of great papers online which taught me more about it.

What kind of audience does Plague Inc. reach and what do they get from it?

Plague Inc. has been downloaded over 10 million times worldwide and over 200 million games have been played to date. As an intelligent and sophisticated strategy game, I think Plague Inc. appeals to people looking for something more meaningful and substantial than the majority of mobile games. It makes people think about infectious disease in a new light – helping them realize the threats that we face every day.

An interesting fact is that it has also become an educational tool – teachers and professors often get in touch to let me know how they used Plague Inc. to illustrate biological and economical concepts to their students.

Were players of Plague Inc. interested to know you had been invited to the CDC?
Yes, the reaction to the news has been extremely positive and people are keen to know more! In the first 24 hours after I announced my visit to the CDC almost 1 million people had seen tweets about it!

I think people were excited to see that a prestigious organization like the CDC was interested in the game. A lot of people also hoped that visiting the CDC would give me ideas for future updates of the game (which it did!)

What did you learn at CDC?
It was fascinating to meet the people who are working hard every day to keep us safe from the type of threats that Plague Inc. features. I got a tour of the Emergency Operations Center and Broadcast Center, as well as a trip to the CDC museum. This gave me a lot of contextual information about how the CDC works, which will help me add a greater level of realism to the game in the future – especially in terms of how humanity reacts to outbreaks.

What are you working on now and what do you have coming out next?
Plague Inc. is still proving to be an incredibly popular game, so my main focus must be to keep improving the game and adding new content for players. Recently, I released an update which added a zombie-themed plague, as well as translating the game into four other languages.  In the next update, I will be adding a new game mode for players, translating it into Japanese/Korean and hopefully adding some CDC content!

By: Ethan M. Riley

Staff meetings for the Arizona Division of Emergency Management (ADEM) Public Information Office (PIO) are pretty run of the mill. We review the past week’s accomplishments, divvy up assignments for the coming week and forecast projects for the weeks ahead. We talk a lot of “shop,” but also make time to dish on our favorite subject …lunch. So it did not come as a great surprise to those who know me or my colleagues that the ADEM PIO office would start a “Whole Community” campaign called the Emergency Kit Cook-Off.

The Kit Cook-Off is a participatory preparedness activity inspired by the nonperishable contents of a 72-hour emergency food kit. Rather than scare, guilt or shame people into getting prepared, our outreach encourages play with preparedness principles. Specifically, to actually practice using the three days’ worth of shelf-stable food and potable water you squirreled away for your family. If the idea of building a kit is new to you, participation in the Kit Cook-Off is a good introduction to what personal preparedness is all about.

You may not consider canned chicken, a jar of curry paste, and single-serving peanut butter packets fine dining. However, in an emergency, these non-perishable ingredients could be used to create a nice chicken peanut curry dish. Simply add some canned sweet potato and as a certain New Orleans chef would say, “BAM! Dinner is served.”

In an emergency, pizza delivery may not be making house calls.  It will be up to you to have nonperishable food and the wherewithal to cook with it. The fun of the Kit Cook-Off is creating a recipe from what you have stowed away in your kit and pantry.  And yes, I used “fun” to describe emergency preparedness outreach.  Join us!

Because the Kit Cook-Off is a web-based activity, participation is open to everyone. There are two ways to participate in the Cook-Off: 1) vote in our online ingredients poll in August and 2) submit a recipe during National Preparedness Month in September.

CAST A VOTE

During the last two weeks of August, the public will vote for the ingredients they want to cook with in September. Voters will select one (1) ingredient in each of five categories: protein; fruits and vegetables; starches, grains and nuts; beverages; and “comfort foods.” The ingredients often reflect a theme. In 2012, the Kit Cook-Off celebrated southwestern flavors with a list of possible ingredients that included canned green chilies, jarred cheese sauce, and salsa.

PLAY WITH YOUR FOOD

While we are not looking for gourmet cuisine, we are also not looking for butter on crackers. Be creative with the ingredients and create a hot or cold dish that you would eat if required to shelter in place. The submission guidelines for recipes are as follows:

1) Create a recipe that highlights one or more of the featured ingredients and uses other nonperishable pantry items, including (but not restricted to): seasonings, condiments, sweeteners, and potable water.

AND

2) Use manual appliances (e.g., can openers and hand whisk) in the preparation where feasible. Microwaves, stovetops and other modern appliances are acceptable, but we challenge you to substitute manual appliances for modern conveniences where you can.

THE WEBSITE

Like that jar of honey in your pantry, www.EmergencyKitCookOff.org has no shelf life. Our website features a Kit Cookbook populated with submitted recipes and searchable by meal, course, and ingredient categories. The Kit Cook-Off “officially” occurs in September, but visitors are invited to submit, print, comment on and rate recipes on a “five-can” scale year-round. You may also share a preparedness tip or suggest an ingredient for the next year’s Kit Cook-Off.

September is National Preparedness Month, but emergency preparedness is not a one-month-a-year activity. In actuality, it requires an abiding commitment to make a plan, prepare a kit, inquire about plans and threats, and inspire others. The Kit Cook-Off starts participants along the path to preparedness and asks how prepared are you? Take a look in your pantry and practice preparedness cooking. When the power is out, your family will be glad you did.

Ethan M. Riley is a Public Information Officer with the Arizona Division of Emergency Management, a branch of the Arizona Department of Emergency and Military Affairs, in Phoenix. Ethan is a native of Lancaster, Pa., a graduate of Millersville University, a former journalist and feature writer, and a graduate student in the Applied Communication program at Northern Arizona University.

By Victoria Harp

When asked, leaders in communities everywhere will say that communication is by far the biggest problem during an emergency. Communication is such a broad term that it does not pinpoint the problem. Is it actual communication systems like phone lines and cell towers? Is it the communication you receive or try to obtain in an emergency? Is it communication to the people you are responsible for? Is it communication from the people you are responsible for? The question becomes how do we go about addressing these issues?  Start small and focus on one solution to one communication problem.  

The New York City Office of Emergency Management (OEM) has instituted the Partners in Preparedness program. OEM’s Partners in Preparedness program is designed to help organizations in the New York City metro area better prepare their employees, services, and facilities and develop a trusted communication system before disaster strikes. To become a Partner, an organization must complete five preparedness activities (three required and two additional) and report their actions through a partner’s survey. Only then will the organization become an official partner and obtain a Partners in Preparedness seal.   

The three required activities are:            

1) Stay Connected – Encourage coworkers and volunteers to sign up for Notify NYC, the city’s free real-time emergency notification system.   

2) Get Prepared – Set up and test an emergency contact plan or call tree for your organization.   

3) Send Preparedness Messages – Use e-mail, Facebook, Twitter, or your website to test and send preparedness messages to your employees.   

To make the process simple and streamlined, the OEM provides marketing materials, samples, and pre-approved messaging for each activity. The end result is a larger pool of people better connected to a trusted information source prior to, during, and after an emergency.  Other added benefits to becoming a Partner in Preparedness include:   

• Highlighting the dedication to the safety and well-being of employees and their families.
• Gaining tools and resources to prepare organizations for all types of emergencies.
• Receiving emergency updates from OEM.
• Displaying an official seal from OEM to demonstrate commitment to emergency preparedness.

Toni Reiffe, Shearman & Sterling Continuity Manager

 Shearman & Sterling, LLP, an international law firm with a worldwide presence of some 1000 attorneys in 20 offices around the world, is headquartered in midtown Manhattan and is an official Partner in Preparedness. “During Hurricane Sandy, the support we received from Partners in Preparedness was incredible,” says Toni Reiffe, Sherman and Sterling’s Business Continuity Manager.  Reiffe adds that the information from Partners in Preparedness was constant and reliable before, during and after the storm. “We knew what city services were impacted and were able to get that information directly to our employees. We opened our doors on Wednesday after Sandy because people needed to come back to work in order to continue serving our clients in New York and around the world. Even people with direct hits to their homes came into the office. People needed to get back to normal.” Reiffe states that she knew that the OEM had their work cut out for them with the displacement of individuals, families and businesses that were affected but, thanks to Partners in Preparedness, Sherman & Sterling was essentially self-sufficient and not a drag on OEM’s stretched resources.     

Shearman & Sterling set an example by taking key steps prior to an emergency by becoming a Partner in Preparedness and providing a more resilient organization for their staff and to the community of New York City. Reiffe points out that business continuity has graduated from just the practice of IT system redundancy to all systems and practices of keeping a business operational in an emergency. A big part of that, she says, is the personal preparedness of staff. “In an emergency, someone who is prepared has a better chance to help the firm,” says Reiffe.  She is raising the preparedness awareness level of individuals at her firm one person at a time.   

The Partners in Preparedness program was selected as one of the promising examples of the Whole Community Approach to Emergency Management in 2013. Please go to this website for more information about Partners in Preparedness and the Whole Community Program.

By Daniel Homsey

Often a city‘s identity is attached to a significant event in its past, and for San Francisco that event is the Earthquake of 1906.  That fateful event, in which thousands perished and our City burned to the ground, captured the attention of the whole world. Its legacy forged a commitment in the psyche of every San Franciscan – never again. 

San Francisco’s commitment to resilience efforts began as soon as reconstruction commenced. Over 100 years, the City invested billions of dollars in systems and programs that will be invaluable in mitigating the impact of future earthquakes on our communities. 

In 1989, as millions watched the World Series, the Loma Prieta earthquake struck. San Francisco had reclaimed its title as the “earthquake” city.  The event presented the City with many lessons learned, but two main priorities: bring older building stock (pre 1970’s) up to a higher seismic performance standard and second and empower residents to participate in the response phases for future events. 

The City’s efforts to address building performance started almost immediately and ultimately resulted in the creation of the Earthquake Safety Improvement Program.  A major step in protecting our residents occurred on Tuesday, February 5, 2013, when the first mandatory seismic retrofitting legislation for privately owned buildings was introduced at the City’s Board of Supervisors. To address resident empowerment, the San Francisco Fire Department (SFFD) initiated the Neighborhood Emergency Response Team (NERT) program that trained thousands of San Franciscans to support the SFFD’s response to a major event. 

While these two programs have made critical progress in increasing our resilience, the media coverage of Hurricanes Katrina and Sandy was filled with stories about residents courageously working side by side to meet the needs of the most vulnerable in the their community.  In hindsight, it was apparent that more could have been done to prepare them to respond to these challenges in a more empowered and coordinated manner. 

Members of the Resilient Diamond Heights Project team: Jim Stelly, Betsy Eddy, and Jeannette Oliver.

The San Francisco’s Diamond Heights community initiated a campaign to prepare itself to be able to respond to any challenge with little or no immediate assistance from the City.  In 2010, the community formed a working group called Disaster Ready Diamond Heights that included concerned residents, merchants, faith based leaders and property managers committed to explore potential  challenges after a major event, how best to mitigate its impact, and the response to any outcomes.  The organizational host for this cohort was St. Aidan’s Church which partnered with SF CARD, a local nonprofit that offers faith based and nonprofits institutions support in continuity planning.  Over time, Diamond Heights made substantive progress in advancing on their goals, including convening local stakeholder organizations for workshops on continuity of operations planning and hosting NERT trainings for residents. In spite of the progress made, the community felt there were still looming challenges that would require additional support and resources to address.

In the fall of 2012 Disaster Ready Diamond Heights invited the Neighborhood Empowerment Network (NEN), a cohort of city agencies, nonprofits, faith based organizations, neighborhood organizations and academic institutions, to come and present its Advanced Community Disaster Resilience Project (ACDRP).  Modeled after FEMA’s Whole Community Approach, the ACDRP offers streamlined access to a suite of organizational, financial and political assets that can generate increased levels of resilience in a community.  Through this, the Resilient Diamond Heights Project began.

Over the course of the next few months, leaders from Diamond Heights drafted a community resilience action plan that outlined their goals as well as generated a framework to support their work in the coming year.  An executive steering committee was assembled, comprised of leads from the several working groups that were created to implement the action plan.  These workgroups included Disaster Preparedness, Community Development, Private Sector and Lifelines Resilience.  In just the last few weeks each group has achieved significant milestones and the prospects of achieving a higher level of sustained resilience seems more likely with each passing day.

While there is nothing anyone can do to prevent a major earthquake from striking the Bay Area again, neighborhoods can take meaningful steps today to empower themselves to mitigate the impact of the event and provide for the most vulnerable members of their community. The ACDRP offers cities a framework that leverages existing assets and stakeholders to generate increased resilience at the neighborhood level.  We’re honored to be highlighted as promising example of FEMA’s Whole Community Approach, and are committed to sharing our experience.

Daniel Homsey is the Director of Strategic Initiatives for the City Administrator’s Office of the City & County of San Francisco. A fourth generation San Franciscan, Mr. Homsey is the program manager for the Neighborhood Empowerment Network (NEN), which is a coalition of residents, community groups, CBOs, academic institutions, and government agencies whose mission it is to empower residents with the capacity to build and steward resilient communities. For more information, visit empowersf.org.

This blog is part of a

series, covering a preparedness topic each month from the Do 1 Thing Program.  Join us this month as we tackle “sheltering.”series, covering a preparedness topic each month from the Do 1 Thing Program.  Join us this month as we tackle “sheltering.”

When I was a kid, sheltering immediately conjured terrifying images of Dorothy Gale missing her chance to take shelter in the cellar and being swept away by a tornado and serenaded by munchkins.  In reality, growing up in the Midwest included frequent basement sheltering for tornado warnings and cowering in the hallways at school with a hardback textbook over my head.

This month, as we embark on “sheltering” for Do 1 Thing, it’s important to first know your risks.

From floods to hurricanes, tornadoes to wildfires, severe weather impacts everyone differently.  What threats impact your area?  For me, in Atlanta, the biggest threats are tornadoes, fires, and the potential for flooding.   

In a disaster, you may have to evacuate to a shelter or shelter-in-place.  To shelter-in-place means taking immediate shelter where you are – at home, work, school, or on the go.  To make your immediate location safe, go to a room with as few doors and windows as possible. Take a battery-powered radio or your cell phone with you so you know when the danger has passed and follow emergency instructions carefully.  

With tornadoes a continual threat in Clarksville, Tennessee, my pal Amanda took the opportunity to make sure her kids knew where to go in their house if a tornado warning was in effect or a siren went off.  With windows in every room of the house and no basement, the best option for the family was to hunker down in the hallway.  Armed with sleeping bags, a radio, and something to do, Sean and Mia were ready to wait out a storm.  Everyone has a different sheltering location.  Identify yours and make sure your entire family knows where to go and what to do.

As participants in the Great Central U.S. Shakeout last month, my mom’s 2nd graders in Tennessee practiced an earthquake drill. Mom said her students actually asked to do it again.  And again.  She happily obliged.  The more practice the kids have with the plan, the more comfortable they will be if an earthquake actually happens.

My coworkers also got into the act this month.  We practiced drop, cover and hold on in an earthquake drill and found our nearest shelter-in-place in the office in the event of severe weather.

Remember, sheltering also includes evacuation and where you can find shelter if you need to leave your home. Check out FEMA’s Ready.gov for more information on evacuating yourself and your family.

Here are some sheltering steps you can do this month:

• Identify the best storm shelter in your home.
• Practice sheltering drills with your family so you know where to go and how to shelter in place.
• Learn about your community’s warning signals – such as sirens or messages from the Emergency Alert System on your TV or radio.
• Make an Emergency Go Bag to take with you.
• Call your emergency contact and keep the phone handy.

See Do 1 Thing’s Sheltering checklist for more tips and information, and start putting your plans in place for unexpected events.   Are YOU ready to take shelter?