Apr 052015

Below I’ve listed the officially recognized Ebola Treatment Centers in the United States as of February 14th 2015.  If we have a case of Ebola, we know where to take the patient.  If the patient has Anthrax, Botulism, Plague, Small Pox, Tularemia or other highly virulent disease, the patient and care givers are still out of luck.

The reason I mention this is there are grant funds for Ebola preparedness are available through the Hospital Preparedness Program (HPP) Ebola Preparedness and Response Activities program. The cutoff date for application is April 22nd, 2015.

I can’t come up with a good reason why the program is one disease specific and not address all CDC Category A agents, or highly contagious and virulent organisms. Are we planning on waiting until after we get a significant outbreak of pneumonia plague to start getting ready just for plague?  I undoubtedly will benefit from this ignore the forest and focus on the tree approach with the PPE Course I offer, but even in my course I mention the critical need for universal application of proper PPE selection, donning and doffing and sanitizing.

We know that Hospital Acquired Infections (HAI) are a huge problem in the United States and obviously we are moving disease from one patient to another.  We also know Ebola is not a huge problem in the United States and I would argue if we dramatically decrease our efforts to decrease HAI we in turn make our staff and patients safer from all disease.

I’d love to hear your thoughts on this focused funding effort.


                        Ebola Treatment Centers, as of February 14, 2015

Jurisdiction City Hospital/Facility
AZ Phoenix Maricopa Integrated Health Systems
AZ Tucson University of Arizona Health Network
CA Oakland Oakland Medical Center
CA Sacramento South Sacramento Medical Center
CA Sacramento University of California Davis Medical Center
CA San Francisco University of California San Francisco Medical Center
CA Orange University of California Irvine Medical Center
CA San Diego University of California San Diego Medical Center
CHI Chicago Rush University Medical Center
CHI Chicago Ann & Robert H. Lurie Children’s Hospital of Chicago
CHI Chicago University of Chicago Medical Center
CHI Chicago Northwestern Memorial Hospital
CO Denver Denver Health Medical Center
CO Aurora Children’s Hospital Colorado
DC Washington, DC MedStar Washington Hospital Center
DC Washington, DC DC Children’s National Medical Center
DC Washington, DC George Washington University Hospital
GA Atlanta Emory University Hospital
GA Atlanta Grady Memorial Hospital
LAC Los Angeles University of California Los Angeles Medical Center
LAC Los Angeles Kaiser Los Angeles Medical Center
MA Boston Massachusetts General Hospital
MA Boston Boston Children’s Hospital
MA Springfield Baystate Medical Center
MA Worcester UMass Memorial Medical Center
MD Baltimore Johns Hopkins Hospital
MD Baltimore University of Maryland Medical Center
MN Fridley Allina Health’s Unity Hospital
MN St. Paul Children’s Hospitals and Clinics of Minnesota – Saint Paul Campus
MN Rochester Mayo Clinic Hospital – Rochester, Saint Mary’s Campus
MN Minneapolis University of Minnesota Medical Center, West Bank Campus
NE Omaha Nebraska Medicine – Nebraska Medical Center
NJ New Brunswick Robert Wood Johnson University Hospital
NY Glen Cove North Shore System LIJ/Glen Cove Hospital
NYC NYC New York-Presbyterian/Allen Hospital
NYC NYC The Mount Sinai Hospital
NYC NYC NYC Health and Hospitals Corporation/HHC Bellevue Hospital Center
NYC NYC Montefiore Health System
OH Cleveland MetroHealth
PA Philadelphia Hospital of the University of Pennsylvania
PA Philadelphia Children’s Hospital of Philadelphia
PA Hershey Penn State Milton S. Hershey Medical Center
PA Bethlehem Lehigh Valley Health Network – Muhlenberg Campus
TX Houston Texas Children’s Hospital
TX Galveston University of Texas Medical Branch at Galveston
VA Charlottesville University of Virginia Medical Center
VA Richmond Virginia Commonwealth University Medical Center
WA Seattle Harborview Medical Center
WA Seattle Seattle Children’s Hospital
WA Spokane Providence Sacred Heart Medical Center
WI Madison UW Health – University of Wisconsin Hospital, Madison,and the American Family Children’s Hospital, Madison
WI Milwaukee Froedtert & the Medical College of Wisconsin – FroedtertHospital, Milwaukee
WI Milwaukee Children’s Hospital of Wisconsin, Milwaukee
WV Morgantown West Virginia University Hospital
Mar 292015

Three articles caught my eye this past week that I think are worth you taking a look at.  The first involves a partnership to produce a better shelter.  I think any reader who has helped put together a piece of furniture from Ikea will appreciate this idea.  I understand as a prototype the cost is close to $10,000 each but they hope to get it down around $1,500 when mass produced.  I like the idea of a 40′ truck rolling up and inside are 48 shelters which could be set up using an inmate work crew in hours.


The next article looks at a partnership between Toyota and Tahara City in Japan.  This sounds bad but when I think of Toyota what comes to mind are all the various insurgent groups you see who are driving around in Toyota pickups.  This could get Toyota some good PR.  I think it sets an example for many major corporations to enter into specific agreements with local government prior to disasters on how best to support one another.  It’s good for the immediate response and certainly good for the local economy and a return to normalcy.


The last article outlines what I think we should be doing more of.  Robust pre-planning to get sufficient assets onsite post-earthquake to be of value in the life-saving phase.  This current plan calls for some 137,520 Self-Defense Forces personnel, police officers, firefighters and other responders nationwide would be dispatched to damaged areas within three days.  This is similar in concept with the catastrophic earthquake planning I did with FEMA Region V. Predesignating specific assets to go to specific location without request or having complete situational awareness.   Unfortunately in a massive earthquake if you hesitate to deploy resources until you have a complete picture, trapped survivors will become body recovery statistics.


Any questions, thoughts or ideas contact me at abetteremergency@gmail.com.

Mar 192015

I’ve helped a number of jurisdictions develop sheltering plans and exercise them so I understand current regulations in the United States. If you and your family are going to be residing in a shelter for an extended period of time you want some assurance of minimum standards.

The downside is the current regulations can limit the number of organizations willing to open their doors to the public in times of need.  “…Selecting the Shelter State codes and standards must, at a minimum, meet the Federal requirements, but can be more comprehensive. The ADA and other Federal laws, including the Stafford Act, the Rehabilitation Act, the Fair Housing Act, and the Architectural Barriers Act, provide affirmative obligations and prohibitions of discrimination on the basis of disability. No State or local government, or its contractors, may, by law, policy, or contract, provide services below those standards without violating Federal law.

Japan is going to be revising their national shelter guidelines to include ‘temporary stay facilities” which will not be required to meet all the guidelines of typical shelters.  The recent earthquake and tsunami events having given policy makers unique first-hand experience we can learn from.  They are concerned that their current regulations could end up leaving thousands of people left outside during the next major event.  Hypothermia becomes a real life safety threat in a matter of hours and without shelter could result in preventable deaths during disasters.

Life safety is the number one priority and incident stabilization the number two priority according to the Incident Command System (ICS) as referenced in the National Incident Management System (NIMS).  We are all supposed to be NIMS compliant if we want federal grant money.  It seems counter productive to have regulations so stringent they actually can impact our ability to address our top two priorities.  By revising the rules in Japan, they are actually allowing for a graduated approach to meeting the immediate and intermediate needs of disaster survivors.

The short video clip below shows people in a temporary shelter in Japan, which would technically be in violation of the laws here in the United States.  I’m a firm believer of the old adage “any port in a storm” .  I would like to see a federal definition of a temporary shelter to allow more organizations to open their doors during major events without fear of legal repercussion.  What’s your opinion?