The Front Line Track

2008 Natural Hazards Research and Applications Workshop

Dealing with the Dead in Pandemics and Disasters

Moderator
Joseph Scanlon, Carleton University
Panelists
Erik Auf der Heide, U.S. Agency for Toxic Substances and Disease Registry Kristina J. Peterson, University of New Orleans; Merritt Schreiber, UCLA Center for Public Health and Disasters
Tamiza Z. Teja, Los Angeles County Emergency Medical Services Agency
Recorder
Marg Verbeek, Royal Roads University

Summary
The panelists were asked to focus on the following questions:

  • What is the difference in the experience of mass death as opposed to individual death?
  • How are people affected when it takes weeks, months, or even longer for a missing person to be identified?
  • During the 1918 Spanish flu pandemic, many communities banned death rituals such as visitations and funeral services because of the danger of public gatherings. What impact does this have on the death experience?

While disaster death planning falls under police responsibility, pandemic planning is the responsibility of public health authorities. This means mass death planning does not follow the usual all-hazards approach to emergency planning. Kristina Peterson said Hurricane Katrina presented many challenges for the funeral and faith communities in dealing with the magnitude of loss.

There were also extensive logistical problems in gathering information for families and difficulty with family members finding morgues. Before Katrina, the City of New Orleans and a wide spectrum of religious leaders discussed how they would deal with mass deaths. The Multifaith Action Society of British Columbia has a religious calendar that can benefit communities in pandemic preparedness planning.

Tamiza Teja described the pandemic preparedness activities undertaken by Los Angeles County and provided an overview of issues emerging from a series of tabletop exercises related to a pandemic flu death surge. If the death rate matched that of the 1918-20 pandemic, there would be 63,000 deaths in a future pandemic. Los Angeles County Emergency Medical Services Agency partnered with Public Health, the coroner’s office and private mortuaries to alleviate burdens on the system.

The county has created a guide for hospitals in establishing mortuary service plans. Hospitals that receive funding from the County EMS are required to have a written plan for these services, however, only eight of the 103 hospitals do. The final version of the guide will be available on the County’s EMS Web site in late 2008. Mass gathering and collaboration with the Department of Mental Health will be addressed in 2009.

Merritt Schreiber said the psychosocial impacts from mass deaths can be tremendous. Hundreds of thousands of deaths are predicted for California, presenting challenges of temporary storage. While most people (90%) have uncomplicated bereavement from the loss of a loved one, traumatic grief, which greatly reduces individual resiliency to deaths, will be more prevalent in a pandemic. Uncomplicated bereavements would be expected in only 30-40 percent of the population. Given the very small ratio of mental health providers to the population (1:100,000 in California), there is a need for state officials to push psychosocial care pamphlets describing how to look for and treat post traumatic stress syndrome to teachers and the public.

Erik Auf der Heide said the U.S. Center for Disease Control and Prevention (CDC) recognizes the unique issues that terrorism and pandemic present in mass death. It is a myth that dead bodies are a threat to public due to pandemic, although there could be a possibility of chemical contamination from a deceased person that requires the use of appropriate precautions by emergency responders and hospital personnel.

In the United States, where family members are often geographically dispersed during a disaster, convergence behavior is an issue as families attempt to reunite. Telephone lines are overloaded and it’s imperative that families contact out-of-state liaisons for family reunification. Another problem is family members searching multiple hospitals near a disaster area to find loved ones. Hospitals are authorized to provide information to those seeking family unification Under the U.S. Health Insurance Portability and Accountability Act (HIPPA).

In mass death disasters, there is a need to bridge the gap between implementing federal legislation at the local level and providing a normal standard of care. Professional associations and groups need to be involved in pandemic planning and advise other stakeholders on moral and ethical standards of care during a pandemic. There is also a need for communities to better understand what bottlenecks will exist in their systems to manage mass deaths.

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Climate Change and Hazards Mitigation

Moderator
Sue Ellen Smith, Florida Catastrophic Storm Risk Management Center
Panelists
Michael Boswell, California Polytechnic State University
David L. Feldman, University of California at Irvine
Recorder
Sherry M. Elmes, University of North Carolina at Charlotte

Summary:
Panelists in this session focused on climate change and its impacts in California. Of the top 12 climate concerns in California, seven are related—greenhouse gases, air quality, drought, extreme heat, wildfires, floods, and water quality/scarcity.

Much has been said about the failed levees in New Orleans and the Midwest; however the central valley of California has 1,600 miles of levees that have been given an “F” rating. This situation puts 11,000 homes in the Sacramento area at risk of being inundated by 20 feet of water.
There has been a 10 to 35 percent increase in wildfires due to drought, a situation that points to increased life and property loss. Many communities without experience dealing with hazards are being challenged to address climate issues.

California state law requires all counties have local plans. Most plans were in process before the greenhouse gas (GHG) mandate was signed into law in 2006. Frequently, plans are prepared by a select group of consultants who use similar templates. This results in good quality plans, but a lack of funding and resources at the local level. A review of local plans revealed climate change was not indentified in even one of the mitigation plans. San Diego, for instance, recognized wildfire is a major problem, yet didn’t fund a local fire department.

There is a need to link plans to climate change. Local plans should implement best practices using existing programs. Adaptive measures should be developed to deal with climate change hazards. Regulations for development and growth should be shifted from the state to local government. Decision-makers must understand tradeoffs between longer-term predictions at local/regional scales and potential decreases in accuracy. Scientists should aim to generate accessible findings to stakeholders. Researchers can help decisionmakers understand that uncertainty does not make a forecast scientifically flawed, only imperfect.

Can we use solutions advocated in the 80s and 90s today? The answer is yes if we use adaptive management. We must recognize population growth and urbanization. We must be aware of decaying infrastructure, especially when related to water management and climate change. Water lines are underground and not easily inspected. Repairing or replacing is often put off because of cost and lack of political will.

What about watershed management? Water use has increased with population growth and energy expansion. Watershed councils can put needs into an understandable context, such as a workshop. Local-level decisionmakers should be involved. A bridge-building approach should be used to bring together all end users: agriculture, power generation, forest, rangeland, etc. There is overwhelming evidence of climate change affecting the end user and changing the demand side. A bottom-up approach, starting with individuals, would help people understand we cannot build our way out of this situation.

Water and energy conservation go hand in hand. We must develop a set of conscious values—two policy universes that need to addressed in tandem. Water is a relatively inexpensive commodity. Increased energy demand affects water globally. What can be done to keep water from being a “socialized commodity?” It starts with broadening the contingency of grass roots groups recognizing the benefits of ubiquitous water resources and leads to the management of local rivers and streams.

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Working the Legislative Process

Moderator
Avagene Moore, Emergency Information Infrastructure Project
Panelists
Dale W. Shipley, Emergency Information Infrastructure Project
Eric E.Holdeman, ICF International
Jim Kastama, Washington State Senate
Maria G. Honeycutt, Office of Senator Bill Nelson
Recorder
Nancy K. Grant, University of Akron Center for Emergency Management

Summary
Panelists were asked to focus on the following questions:

How do we as citizens and professionals work the legislative process?
We have to have legislation in place, is there a way to help write it? To get it enacted?
What practical information can you give on how the natural hazards community can influence needed legislation?

Panelists included a member of the legislature; a congressional intern; former state, federal, and local emergency management directors; and professionals in the field. The panelists agreed on major points and shared a hope that more conference participants would become active in the legislative process.

The first thing to keep in mind is that getting legislation passed is a long process. Do your homework before approaching legislators. The following list can serve as a guide:

  • Target your activities
  • Identify which committee is responsible for the topic you champion or learn who is reviewing the legislation you’re interested in
  • Identify the chairperson and committee members of your targeted committee
    • The chair has considerable power and can halt or delay an issue 
    • Learn about each member’s professional, personal, and political background and use that information to speak to their concerns and interests
  • Remember that members who represent you directly are the ones most likely to listen
  • Learn the House and Senate bill numbers and know the correct titles
  • Familiarize yourself with the legislators’ staff and build relationships.

Once you researched the states of the legislation, where you can gain support, and where you could encounter opposition, gather and prepare the information needed to support your request. As you prepare, keep the following in mind:

  • Always tell what you know, not what you think
    • If you don’t know, find out and get back quickly
    • Be responsive to inquiries
    • Be considerate to congressional staff
  • Design a brief message to convey your position—one page or less
  • Create a message that targets supporters, as well as opponents; representatives of directly affected districts; as well as those not affected
    • Address specific concerns and situations of the individual members
    • Keep the fundamental message the same, but identify how it benefits individual districts and constituents. For example, support for levees is directly relevant to districts with flooding issues but in other districts it could result in levee breach costs being borne by their constituents
  • Show representatives how your request is in the best interest of their constituents. Be prepared to explain how it will affect them. Sell the representative on how meeting your request can make them look good.

Once you have identified who to approach and gathered your information, you’ll need to gain access. This is challenging because legislators are very busy and often have 15-minute appointment windows. One of the best ways to get access is through the assistance of a constituent in the legislator’s district—especially one who’s already formed a long-term relationship. Individuals that provide financial supporters are especially useful in gaining access, since legislators generally hope to be reelected. It is important, however, that the issue never be tied to any promise or expectation of financial support.

It is sometimes easier to gain access to members of congress during constituent visit days, although it’s also easy to get lost in a sea of faces. Keep your information clear and direct and leave something behind. Get to know the staff and send thank-you notes.

One panelist classified the knowledge to successfully work the legislative process into three areas: policy, procedure, and politics. Know how to develop policy and work with staff and legal council, know the legislative process noted above, and understand the role and influence of politics. As another panelist said,  “Politics will win over a good idea.”

The final word of wisdom offered by the panelists was to make use of a disaster to get your point across. Two members reported that a new state Emergency Operations Centers (EOC) was supported when the governor witnessed the conditions they work under during a disaster. Getting—and keeping—a legislator’s attention long enough to get policy through can be difficult. However, because of the nature of the hazards field, you can positively influence policy and make a difference—if you are ready when opportunity (or disaster) strikes. Be prepared to influence policy, as well as deal with a disaster.

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