Teamwork is critical to any sports team in any team sport. However, team work off the field beyond your immediate circle with multiple parties seems to be an exercise in futility. When large events using multiple groups kick into high gear, even the simplest of tasks becomes a major piece of work. The ordering of lunch seems to take hours. We all know the saying about a camel; it was a horse designed by a committee. I have a story that contrasts that notion and relates to a problem lurking over the horizon yet again. Committees can work at times.
My story deals with the setting up of a POD (point of dispensing) operation by 80 representatives from 25 different agencies and how it ran successfully. The volunteers picked up medical supplies from the strategic stockpile, moved it to the POD, and simulated the giving out of the drugs. The work that occurred had not been done in this area by this scale. It proves multiagency work can succeed but not easily. To make it work, a framework has to be established in advance. This framework provides a forum which allows new projects, like the POD program to advance.
I know many are scratching their heads and asking what does this has to do with continuity. This deals with the most recent of several threats that fill up our TV news channels. As Abraham Lincoln said, âWe live in the midst of alarms, anxiety beclouds the future; we expect some new disaster with each newspaper we read.â
That quote seems like it was written today was much as it was when Lincoln said it in 1858. It seems like every newspaper unveils a new risk every day, overseas or here in the states. Stories of violent and numerous cases of terrorism, massive tornados, destructive hurricanes, or exploding factories fill newspapers and TV broadcasts. Business owners and managers of other large organizations fight a constant battle trying to stay ahead of this new disaster explosion. Everyone is trying to figure out how to weather the storms they see on TV and survive. This article is about a new way the federal community in Kansas City created to deal with some of these new events.
The latest problem that has cropped up in the news is an old one: the pandemic. This is a problem as old as time itself. Everyone is aware of the bubonic plague or the Black Death. This was one of the more deadly pandemics in history. The flu killed anywhere between 75 to 200 million people in Europe between 1348 and 1350. The plague disappeared almost as quickly as it arrived. Pandemic isnât just for history class. This is a problem that has affected America significantly in recent history. The 1918 flu epidemic is a recent example of the dangers of a pandemic. Nearly 500 million were infected worldwide. Historical reports say anywhere between 50 to 100 million people died from the flu, more than the body count from World War I. All of this occurred in a mere two years. Nothing in current times has come close to killing as many people in such a short period of time.
These events have huge impacts on culture. They are more than just numbers on a page. These deaths have second and third order effects that shape the succeeding culture in many different ways. Naturally the labor supply for industry drops. It is hard to meet quotas if you are dead. The skills those people who are sick or caring for a sick family member are lost for a period of time if not forever. Communication systems, food networks, retail stores, trash pickup, and just about everything else just jams up and/or becomes useless from lack of people. Each sick case or death creates a burden on the health care system and families. The birth rate immediately dropped significantly after these plagues. That leads to a cyclic birth trend spread out over generations.
Pandemics have other impacts. The large numbers of deaths from the pandemic creates a hysteria that paralyzes the community. Any social interaction stops. People dig in and donât leave homes. They donât interact in any meaningful way. Commerce crawls to a stop. The fear of getting the disease drives everything in life. These descriptions do seem like a movie because there have been several movies about this horror.
This problem might be raising its head again in multiple ways. A pandemic might be coming up in China and a separate one in the Middle East. Reuters reports on May 7, 2013, that China has 129 cases of a mysterious H7N9 bird flu. Thirty one of those cases have resulted in death. The cases are spreading out across China and now moving into Taiwan. The cases have public health people nervous all over the world. The CDC recently issued a travel warning to citizens who are traveling to China about this disease. That isnât the only pandemic problem. A SARS-like coronavirus virus has cropped up in Saudi Arabia. The kingdom reports that they have had five deaths from this new SARS virus. That disease has jumped this week over to France. A traveler going back home from the Middle East carried the virus from the Middle East to Europe.
Now to the million dollar question of the hour after reviewing those facts; how does an organization respond to these events? Should everyone dig a hole and dive in? Should organizations run around screaming? No, there are more practical ways to mitigate this threat. Solutions might be right around the corner and you donât even know it. There is the obvious which is on every government web site. The work force needs to know to cover their mouth when they sneeze. People in emergencies should increase the social distance between people. They should stay home when sick and not come to work to be brave but end up infecting the whole office.
This current pandemic fear isnât new. The previous round of fear hit back in 2009 over H1N1 bird flu. Back then the World Health Organization and the CDC sounded the alarm about an impending epidemic that was coming around the corner. People in Kansas City decided to do something about it. Several planners from the local HHS office sprang to the front and to the leadership on this project. This critical group of planners looked for ways to get the message out efficiently. They searched for a synergy of action for their work. They decided to coordinate action among the federal community through an existing forum, the Federal Executive Board. This was a group that had the ability to coordinate action across the whole federal community. The FEB also could do this in multiple ways, from the top down or through various committees where the subject matter experts met. The FEB group provided an umbrella that made it easier for the HHS planners to put out their idea.
The next step is to plug into the public health system. All public health programs are run at the retail level of government, at the city and county level. To obtain coverage for federal workers in the next emergency they had to become part of the solution and not just a screaming voice in the wilderness urging action. Their standard plan had the city establishing large PODS where hundreds of thousands of the general public would cycle through to get their ration. City planners obviously had to do something to lighten the load. The City of Kansas City in their health plan called for the establishment of closed PODs, point of distribution centers for drug distribution in emergencies.
City health planners utilized the concept of closed PODs. Closed PODs is where large employers in town would set up and run their own POD. These centers would take those people off of the main POD load. Also, the city could get those organizations to help do the work for setting up these centers. HHS would help the city, themselves, and the federal community by running closed PODs for federal workers. They would be part of the local plan.
Since that plan was written in 2009 momentum on the subject picked up. A wave of events kicked in. President Obama signed an executive order 13527 on Dec. 30, 2009. That order is to establish Federal Capability for the Timely Provision of Medical Countermeasures following a biological attack. This mandated federal cooperation to disburse drugs in the event of a biological attack. Various states and Congress passed Good Samaritan laws to help in the setup and running of these PODs. Agencies crafted their own enabling regulations and rules with regards to PODs.
All of this was put to test recently on April 10, 2013. This was the second test of the concept. HHS and 80 people from 25 agencies gathered to run a POD exercise. I canât think of anything that has gotten people from that many agencies to work together for any reason. The exercise had a broad ambitious goal. The exercise planners wanted a very complete test of concept, from picking up the drugs from the strategic stockpile to distribution in a simulated POD.
The first step was to train more volunteers. The training was done by a mixed staff from HHS, the State of Missouri, and from the City of Kansas City Health Department. It was marvel cake democracy at work, all in the same day in the same room. A few weeks later the exercise started at the basic level. It was started with a simulated movement of the strategic stockpile of bio-terrorism antidote drugs from unknown places on the east coast to Kansas City. Volunteers from the group then conducted a simulated handoff from that larger strategic stockpile to their truck which moved it to the actual location of the POD. All of this was done in a strong security screen from multiple agencies.
The day of the exercise events got real. A reception room had to be set up to handle both the mission of drug distribution and housing of the staff. Setup of the room and the various stations took several hours. At start time the volunteer crew was divided up. Part of the volunteers performed the role of the working crew. Part of the volunteers played the role of the public. Then the fun started after roles were assigned.
The POD had several pieces. People showing up were initially screened. Then their forms were actually filled out. People received a âjust-in-timeâ training video to address questions and purpose. Specialty cases were sidetracked for consultation with Medical personnel. Afterward, they moved into a different room where they actually picked up the drugs. The play drugs actually were empty pill bottles. The paperwork for that drug distribution was actually filled out. Role players representing unique cases were interjected to see how people reacted.
The exercise was a success. Things went off without a hitch. All of the volunteers took turns at being both the public and the POD worker. Volunteers accomplished a process rate of 200 people an hour through the stations. It proved the concept. It proved the multiagency actually worked. It also highlighted that there is much more to do.
The lessons of Kansas City can apply to other organizations. Collective action can work. Several things have to fall in line:
work from points of mutual interest.
work through existing forms or institutions.
plug into existing plans and organizations.
error on the side of too much in terms of information. Advance information helps quell issues and makes people confident about the action.
prior planning helps make things go easier.
Victory goes to the prepared!
Thomas Magee is the GSA regional emergency coordinator for Region 6 out of Kansas City. He is a FEMA approved instructor and a FEMA certified Master Continuity Practitioner. Magee is a 26-year veteran of the Army Reserve with experience in both Desert Storm and Iraq. Right now he is serving as a Reserve ILE instructor for the Army.
