Suchergebnisse

Abstract
In April 2017, the Centers for Disease Control and Prevention (CDC) participated in the Gotham Shield Exercise, led by the Federal Emergency Management Agency (FEMA) and in collaboration with other federal agencies to test the federal, state and local government's ability to respond to an improvised nuclear device (IND). With active engagement from CDC leadership, 266 scientific and support staff from across the agency participated in the Gotham Shield exercise. The scenario involved a 10-kiloton detonation near the Lincoln Tunnel in New Jersey. This nuclear detonation scenario provided CDC with the opportunity to test some of the all-hazards tools the agency uses during response to other national or international emergencies, such as Geographic Information Systems (GIS) and mapping tools, and apply these tools to a nuclear emergency. Geospatial analysis associated with real time data can provide near real time information for individuals and entities associated with response and recovery activities. This type of analysis can provide timely data in regard to maps and information used to properly place staging areas for Community Reception Centers (CRC), mass care locations, and other medical care and countermeasure related services. Maps showing locations of power loss, such as locations of lost or inoperable main electrical grid and substations, combined with real time data on where power is available provides valuable information for first responders and emergency managers as well as responders engaged in communicating critical public messages to affected populations in these areas. By using real-time information, response officials can direct the response, allocate scarce resources, aid in coordination efforts, and provide a more efficient means of providing critical public health and medical services. The results of the exercise highlight the importance of using geospatial analysis for response planning and effect mitigation before, during, and after a public health event of this magnitude, and the value they represent in informed decision making.

In 2015–2016, the U.S. Department of Health and Human Services led 23 U.S. Government (USG) agencies including the Centers for Disease Control and Prevention (CDC), and more than 120 subject matter experts in conducting an in-depth review of the U.S. core public health capacities and evaluation of the country's compliance with the International Health Regulations using the Joint External Evaluation (JEE) methodology. This two-part process began with a detailed "self-assessment" followed by a comprehensive independent, external evaluation conducted by 15 foreign assessors. In the Radiation Emergencies Technical Area, on a scale from 1-lowest to 5-highest, the assessors concurred with the USG self-assessed score of 3 in both of the relevant indicators. The report identified 5 priority actions recommended to improve the USG capacity to handle large-scale radiation emergencies. CDC is working to implement a post-JEE roadmap to address these priority actions in partnership with national and international partners.

Resilience and the ability to mitigate the consequences of a nuclear incident are enhanced by (1) effective planning, preparation and training; (2) ongoing interaction, formal exercises, and evaluation among the sectors involved; (3) effective and timely response and communication; and (4) continuous improvements based on new science, technology, experience and ideas. Public health and medical planning require a complex, multi-faceted systematic approach involving federal, state, local, tribal and territorial governments, private sector organizations, academia, industry, international partners, and individual experts and volunteers. The approach developed by the U.S. Department of Health and Human Services Nuclear Incident Medical Enterprise (NIME) is the result of efforts from government and nongovernment experts. It is a "bottom-up" systematic approach built on the available and emerging science that considers physical infrastructure damage, the spectrum of injuries, a scarce resources setting, the need for decision making in the face of a rapidly evolving situation with limited information early on, timely communication and the need for tools and just-in-time information for responders who will likely be unfamiliar with radiation medicine and uncertain and overwhelmed in the face of the large number of casualties and the presence of radioactivity. The components of NIME can be used to support planning for, response to, and recovery from the effects of a nuclear incident. Recognizing that it is a continuous work-in-progress, the current status of the public health and medical preparedness and response for a nuclear incident is provided.