Neil Muscatiello, M.S.Neil Muscatiello, M.S.New York State Department of HealthNew York State Department of Health

March 23, 2011March 23, 2011Bridging the Gap: Public Health and Radiation Bridging the Gap: Public Health and Radiation

Emergency Preparedness ConferenceEmergency Preparedness Conference

Experiences and Lessons Learned from Experiences and Lessons Learned from “Empire 09” Community Reception Center “Empire 09” Community Reception Center

“ “Empire 09”Empire 09”• DOE-sponsored national level

exercise• RDD scenario• Three phases– Phase I – First 48 hrs., tabletop format– Phase II – 48-120 hrs, simulated real-time field

response, including establishment of Community Reception Center (CRC)

– Phase III – 45+ days, tabletop/facilitated discussion• 30+ agencies (local, state, federal)

Population Monitoring GoalsPopulation Monitoring Goals• Identify individuals who need medical treatment.• Detect radioactive contamination on the body or

clothing.• Assess intake of radioactive materials into the

body.• Remove external or internal contamination

(decontaminate).• Assess the radiation dose received and the

resulting health risk from the exposure.• Track long-term health effects.

““Empire 09” CRC ObjectivesEmpire 09” CRC Objectives

• Establish CRC

• Test CRC flow

• Develop and test CRC forms

• Develop and test criteria for bioassays and laboratory prioritization

Establishing a CRC - ParticipantsEstablishing a CRC - Participants• Public Health • Local DOH– Jurisdictions of simulated

attack–Other regional DOH

• NYSDOH• CDC

• State Fire• Law Enforcement• Medical Reserve Corps

Establishing a CRCEstablishing a CRC• POD Model– Consistent with emergency

preparedness activities– Familiar to LHD staff– Separate “contaminated”

from “less likely to be contaminated” quickly

• “Just-in-time” training for CRC job duties

• Resources/Equipment

Tracking and Epi FormTracking and Epi Form• Assess contamination in the affected population – Who is visiting CRC?– Where was individual at time of event? Consideration

of “Time/Distance/Shielding”?– What symptoms are individuals presenting with?

• Document external contamination ~ indicators of potential internal contamination

• Who needs referral for further treatment/lab testing?

Bioassay CriteriaBioassay Criteria• Detectable external

contamination in face/neck area

• Detectable contamination after shower

• Location at the time of incident 1 mile or less from the incident site

• First Responders

Clean “clothes” provided after

shower

Laboratory Prioritization CriteriaLaboratory Prioritization Criteria• Detectable contamination

in face/neck area after shower

• Presence of open wounds, penetrating injuries, or foreign bodies

• Pregnant women and children (<16)

• First Responders to the scene who did not wear PPE

Lessons LearnedLessons Learned• Use existing resources/infrastructure (e.g. POD

model)

• “Just-in-time” training effective

• Operating more than 1 CRC would be challenging

• Forms were generally thought to be understandable and easy to follow

• Don’t forget mental health

Issues…What we didn’t test…Issues…What we didn’t test…• Communicating with ICP

• Collecting/packaging/transporting bioassays from CRC to lab

• Protocols for reporting lab results to individuals

• Distribution of radiological countermeasures?

• Coordination with health care providers

• Information on individuals who were exposed but didn’t go to a CRC

Current/Next StepsCurrent/Next Steps• Deliverables in next FY Emergency

Preparedness Grant

• Continuing collaboration with internal and external partners

• Enhance/update plans

• Build-out and test CRC in other areas

• Rad Volunteers