The word “reconnaissance” conjures the image of sizing up the enemy and making a plan. Behind medieval history and WWII films about military battles across seas and foreign lands, military forces and commands strategized the battle with efforts revolving around reconnaissance. For many of those who diligently formulate and coordinate emergency response, planning, preparedness, mitigation, and recovery, and those who came out of the Civil Defense Era to build and mold modern emergency management, this pandemic response has elicited feelings of anger and a struggle between opinions and facts.
Pandemics are nothing new and yet lessons have still not been learned. Pandemics have profoundly affected communities, which have inevitably lived through them, albeit at great cost. Each of these has had devastating effects on humanity, lessons were supposedly learned, and preparations for the next pandemic began. At the end of each of these events, communities found a root cause mitigation, identified a measure of medicine or technology, or gained enlightenment on how to deal with the virus by advancing the human condition. Despite significant loss of life, extraordinary advancements have been made in healthcare coordination to manage future events.
Not Heeding The Call
Somehow though certain stakeholders have not heeded the call to do better. Those in emergency management strive to learn from the devastation of past disasters and ensure a better response in the future. They bridge the disciplinary gaps and encourage collaboration. However, some agencies have not heeded emergency management’s calls to integrate healthcare and the basic tenets of incident command into coordination efforts during an emergency. Those who have been responding to devastating wildfires have efficiently and effectively used incident command for 50 years and the fire service and emergency management have implemented and used this effective system. It works because the stakeholders and response agencies coordinate on vision, determination, and a common pathway to recovery.
Forest fires require rapid decisions as the flames spread with a virulence, force, destruction, devastation to life, environmental ravages, etc. that can happen in minutes. Scientists and epidemiologists in the throes of a pandemic must also make rapid decisions, although not necessarily at the same speed as other disasters. Even so, much can be learned about incident command and applied to any disaster, including pandemics.
For months, the highest levels of decision making at the state health care level conducting pandemic status briefings have handed down orders that have left communities of dedicated healthcare providers at the local level devastated. The simplest of duties in an all-hazards situation is to communicate and understand that all disasters happen locally, and resolutions made by conversation can actually solve problems. In many healthcare settings, there has been a lack of understanding those affected and their needs: the bed count, those clinically fighting the virus, the personal protective equipment (PPE) needs, the resources available, the unused communication networks, the extended wait for information, the ideas for efficiency, local defined programming, and requests for just a simple answer. For many, the efforts felt futile and requests were not heard. Effective communication and a multi-level governance are necessary for navigating emergencies.
Looking Through The Wrong Lens
Data, technology, information, and towering display screens (some in high definition) all draw clear pictures when, and only when, it is scientifically populated with scholarly prescience and are used to represent the threat. This invaluable visual can be used to create a dashboard and summarize a threat matrix of the hazard and risk analysis to help prioritize the decision and create a clear vision of the path forward.
Unfortunately, some academics and agencies around the world utilized what is akin to a theatrical digital “apocalypse” showing the virus globally blotting out civilization. These visuals that promote situational awareness are nothing more than a representation of life imitating art. Pandemic movies and series show this virus spreading cinematically for effect in 102 minutes or less. However, portraying COVID-19 through this lens is wrong. True representations of the spread should not be used to create fear. Emergency management is not about fear, but rather about plans and recovery – making communities whole again and returning life to or better than pre-disaster conditions.
When there is an earthquake, flood, forest fire, hurricane, or other manmade or natural hazard where damage assessments are immediately happening, the worst and hardest hit areas are identified and illustrated in emergency operation centers (EOC) or command posts. The number of casualties – real casualties – and those who may be affected and need care or assistance are all carefully defined, and resources are acquired and dispatched accordingly. Emergency managers can quickly draw an intimate map of what they know, what they think they know, and what they still need to know. Each EOC offers stakeholders a view of the true crisis map and consequential decision-making process for the event: the current situation, the next operational strategy, identified gaps, unmet needs, etc.
In contrast, for COVID-19, decisions have often been dictated by public health professionals engaging elected officials who have never sat in a strategy or planning meeting. These decisions have not been based on ground truths from the disaster and do not delineate between operations, planning, and oversight. Communities need those who know how to heal sick people and make policy decisions, but those subject matter specialists should use that expertise to unify in helping to mitigate the disaster but should not necessarily be the ones to direct the response.
So many graphs, pie charts, trajectories, formularies, spreadsheets, social media graphics, memes, overlays, spread factors, surge charts, threshold limiting, and condition postures have created a lack of situational awareness. Emergency managers do not have consistent health department charts and diagrams for gaining clarity on the current status of the pandemic. Emergency managers have been conditioned to take an objective approach to properly display the current condition and subject threat. It is time to shed some light on this darkness.
Most will agree that many of the people dealing with this pandemic have, in fact, brilliant, passionate minds with thought-provoking ideas that hopefully will help guide future pandemic response and right any wrongs. An appropriate word would be “taciturn,” which is defined as being reserved or uncommunicative.
Some academics and agencies around the world utilized what is akin to a theatrical digital “apocalypse” showing the virus globally blotting out civilization.
During the pandemic response, some elected officials, public health professionals, and emergency management bureaucrats have clearly been taciturn with regards to communicating locally on the disaster. This is not the time for reserved or talking heads who are uncommunicative, say little when questions or strategies are asked of them, share tactics that are nonexistent or poor at best, are non-committal, or lack the ability to make decisions. It should have been time for doubling down on collaboration, communication, and constructive conversations with diligent planning. The time to shine for emergency coordination fell flat. Everyone has to do better and realize that to do good means to do something. However, to do something means being smart and sticking within areas of strength and expertise. Emergency management, elected officials, and public health officials need to understand each other and be force multipliers rather than build a fortress that ignores the threat. These leaders should combine forces to develop best practices in order to strike the threat and fight together.
Reconnaissance can be defined in using the structure and breadth of the Planning P. Illustrated here, it can be called the Pandemic Planning P.
- Incident threat – January 2020, Center for Disease Control and Prevention announced the threat from Wuhan, China.
- Notification – Make the healthcare universe aware of the situation and begin reconnaissance.
- Agency briefing – After identifying a potential threat and doing reconnaissance, all key stakeholders should be brought together for an incident threat briefing. Provide briefing to health departments, government, and those that are adept at coordinating emergencies to set the stage for a unified command, including who the subject matter experts will be and what this will mean to those that affected.
- Unified command – This provides the foundation for the response, including the profound development of thought, the course forward, and setting the objectives.
- Objectives – In order to stop the pandemic, define objectives that are simple, manageable, achievable, realistic, and timely (SMART). Rather than directives and cinematic references to the apocalypse, health departments should develop SMART objectives.
- Initial strategy – Formulate operations and resources and coordinate under the collective decision making of all key stakeholders. During the current pandemic response, a lack of defined objectives, strategy development, and decision-making exacerbated supply chain shortages. Local stakeholders recognized immediately that they must act and, when faced with roadblocks, had to find innovative ways to make their own PPE or repurpose PPE as necessary.
- Coordination – The critical next step in the cycle of emergency management is to perpetuate coordination and lead the scope and scale of the disaster response.
- Tactics meeting – Borne out of information sharing and gathering, the tactics meeting is the keystone to properly manage a disaster using continuous, relentless, coordinated, and collaborative information gathering and sharing.
- Information gathering and sharing – This represents the vessels, the skin, the bone, the blood, the fiber of every incident. It creates life to all strategies, plans, tactics, and operations for effectively navigating through the crisis. Information gathering and sharing must reach all levels, including the local level, which has been lacking in the COVID response.
When governments, health departments, bureaucrats, and subject matter experts stand before those that they are committed to protect and simply denied to or did not understand how to manage a disaster, then the failure is compounded and recovery will be long and arduous. Emergency managers are complicit and need to stress at every opportunity that disasters will happen. It is not necessary to plan for an implicit disaster, but rather be students of all hazards and pioneers of resources. Reconnaissance is information gathering and sharing and the path for responding more effectively for the next pandemic.