Many emergency plans call for the establishment of special facilities – each serving a primary function(s) to protect the population – in order to fulfill the public’s needs during or after a disaster. Following a terrorist attack involving a bioweapon such as smallpox, for example, mass inoculations would require establishing one or more points of distribution (PODs). When setting up an emergency public facility, emergency managers must make quick decisions that have cascading effects.
The first step in setting up facilities is to define each facility’s primary function(s), which in turn dictates the potential number of people and the length of time they are likely to use the facility. This information then helps emergency managers determine which support services the facility will need to provide, with the understanding that the longer people remain in the facility, the more services they may require.
For a bioattack, the facility should include an area where staff can vaccinate entire families as well as interview family members, while maintaining confidentiality, to collect information about contact they may have had with other people. Since the scope of this example is simply to provide vaccinations and gather information, the facility’s function would be relatively short-term.
Transportation, Security & Other Specific Services Whether planning for a short-term or long-term facility, transportation to and from facilities is an important consideration. In cases where families or individuals drive to a facility, there is a need for parking spaces. In other circumstances, such as a tornado incident, the survivors may have lost their vehicles and, therefore, require transportation to a shelter or other public service facility.
Maintaining order and safety within and around facilities, particularly during times of crisis and stress, are critical. It is important to maintain a perimeter to keep out those who do not belong in the facility, which may include the media, and allow entry to those who require facility services.
Before staff members officially admit or process people arriving at the facility, there must be a process for members of the public to follow as they wait for services. Facilities such as PODs, where the public is not likely to spend much time, may benefit from a queue line rather than a large waiting area. In contrast, facilities where the process takes many steps – for example, when forensicallyentifying remains from a mass fatality – a waiting area may be more appropriate. The decision to use a waiting area or a queue also may depend on the facility’s physical location and floor plan.
The longer people are onsite, the more services – such as food, lodging, childcare, and medical support – the facility must provide. Although bathrooms must be available for any public facility, the length of time for facility operations would affect the quantity of bathrooms needed.
Even in cases where any of these services may not seem necessary for the people that the facility serves, they are necessary for staff members who are working there. Emergency managers establish these facilities for specific tasks, but losing sight of the fact that people who have additional “off-task” needs are performing these tasks may lead to failure.
Joseph Cahill is the director of medicolegal investigations for the Massachusetts Office of the Chief Medical Examiner. He previously served as exercise and training coordinator for the Massachusetts Department of Public Health and as emergency planner in the Westchester County (N.Y.) Office of Emergency Management. He also served for five years as citywide advanced life support (ALS) coordinator for the FDNY – Bureau of EMS. Before that, he was the department’s Division 6 ALS coordinator, covering the South Bronx and Harlem. He also served on the faculty of the Westchester County Community College’s paramedic program and has been a frequent guest lecturer for the U.S. Secret Service, the FDNY EMS Academy, and Montefiore Hospital.