Emergency Preparedness/Bioterrorism

Introduction

The events of September 11, 2001, the subsequent global war on terrorism, and a series of major natural disasters over the past decade have significantly elevated awareness on the importance of emergency preparedness both within the United States government and the American public. Medical planning is an obvious and key component to an effective, coordinated disaster response effort. As a result, the increase in available resources, grants and information in this area offered by the federal government, academic centers, independent organizations and medical specialty societies have been rapid and dramatic. The purpose of this summary is to highlight readily available, high-quality Internet resources to assist healthcare organizations and planners with their ongoing efforts to plan and coordinate emergency responses to a disaster. Websites that provide high-quality content on the recognition and management of natural disasters, nuclear, biological and chemical casualties and current research opportunities in these areas are also highlighted.

Last Update: November 2009 

Search

A Google^TM search was performed using the following terms: "disaster planning" and "medicine," "disaster preparedness", "emergency preparedness," "disaster research," "bioterrorism"  and "disaster management."  A minimum of five pages of sites were reviewed for each key word search, and available links on searched sites were also surveyed for high-quality information. The most helpful sources were generally government agencies, followed by medical specialty societies and academic medical centers. The sites varied from comprehensive online content, to a listing of organizations and Internet resources, to educational opportunities and publications generally available only by purchase.

Best Websites

Department of Health and Human Services (USDHHS); Disasters and Emergencies

This particularly well organized website was created by the Department of Health and Human Services to provide a comprehensive emergency preparedness resource with specifically designed areas and links for families, businesses, healthcare providers, federal, state and local providers. Specific areas are also dedicated by subject to provide a comprehensive list of materials for various types of natural and man-made disasters.

1. Authority: The USDHHS is the US government’s principal agency for protecting the health of all Americans and providing essential human services. Rating: 5

2. Currency: The homepage has a link to the most current headlines and also has an up-to-date national threat advisory listing. Many of the updates listed also provide links to sites that can provide further information if desired. Rating: 5

3. Accuracy: The website utilizes the expertise of other trusted national organizations to provide much of its data. Although every aspect of the website references are not critiqued, the information is regarded as accurate given the authority of the authors (mostly Centers for Disease Control and Prevention (CDC)). Rating: 5

4. Navigation & Readability: Excellent navigation. There is a concise listing of the target audience on the left-hand side of the screen that then links the web viewer to a series of quick links that are divided into specific subcategories. Weather alerts, contact information for local authorities, and disaster plans are all consolidated on a single page for ease of navigation. Rating: 5

5. Utility: This website is a great resource for all audiences interested in learning about better ways to prepare for national disasters. Although much of its data refers the reader to other websites, CDC, Federal Emergency Management Agency (FEMA), Red Cross, etc., it is an excellent consolidation of these sites and resources. Rating: 5

Summary: This is an excellent site for all individuals interested in gathering information regarding national or local emergency preparedness. Although much of the data refers the reader to the other sites listed above, it does so in a very concise and easy-to-navigate fashion. It is also one of the few sites reviewed that has a section dedicated entirely to the mental health of disaster victims and response workers, as well as communication during public health emergencies.

World Health Organization (WHO)

The World Health organization (WHO) is the chief authority for directing healthcare within the United Nations system. This includes directing research, developing standards of care, providing technical support as well as assessing health trends and much more.

1. Authority: This site was created by the WHO, which represents 193 nations and 2 associate members employing more than 8000 public health experts. Established in 1948, the organization has played a key role in almost every international health initiative in the last 60 years. Rating: 5

2. Currency: The main page is a central location that provides multiple hyperlinks to various regions and other resources, many of which are updated on a daily basis. Rating: 5

3. Accuracy: The majority of the information on this website is strictly factual and based on current data and statistics. The publications that are provided have been produced by some of the world’s foremost experts in disaster management. Rating: 5

4. Navigation & Readability: As with most of the websites reviewed, this website is very well designed and easy to navigate. Depending on the area that the viewer wishes to access, there are alphabetical listings as well as topic-based hyperlinks making data gathering very simple. Rating: 5

5. Utility: For all healthcare providers, from physicians to administrators, this is an excellent resource. There are multiple links to various types of publications covering the entire spectrum of emergency preparedness ranging from community and state level to national level planning as well as resource management on the most current treatment guidelines for clinicians to follow. For the research community, there is a page that lists all the collaborating research institutes and links to their websites. Rating: 5

Summary: This is a phenomenal website with an overwhelming amount of global expertise and advice. This is perhaps the most all inclusive compilation of data and information available for all levels of healthcare professionals on the internet.

Department of Homeland Security; Federal Emergency Management Agency

This website was created by the Department of Homeland Security through the Federal Emergency Management Agency. It provides an authoritative resource for preparedness, current threats and the steps involved to seek federal assistance for recovery efforts. It also provides a relatively complete list of currently available federal grants for disaster planning and research.

1. Authority: The author, just as those listed above, is a federal agency that seeks to assist the public and healthcare professionals in preparing and better managing national disasters. Rating: 5

2. Currency: The homepage has a link to the most current headlines and has an up-to-date national threat advisory listing. Perhaps the most useful aspect of the website is the data and research gathered from previous events. For healthcare providers there are links to events over the past seven days, current month and dates back several years. Unfortunately, not all of these links were active at the time of our review. Rating: 5

3. Accuracy: The website has the most accurate data available for the current state of national threats in a multitude of areas. There is also helpful information about the National Incident Management System, National Response Framework, National Integration Center, Incident Management Integration Center and more. Rating: 5

4. Navigation & Readability: Although there is a large volume of information on this website, it is somewhat difficult to navigate the site at times to locate desired information. The number of quick links that are required to get to your chosen location can be cumbersome. Rating: 3

5. Utility: This website is most useful for clinicians who are trying to monitor and create disaster management/emergency preparedness plans. Although there is information about the various types of threats that Americans face, specific information about these threats is not available on the site. Additionally the site has links to each state’s mitigation plan status but does not go into detail about what those mitigation plans are. Rating: 4

Summary: This is a good site to utilize as a means of monitoring the current threats that are facing our communities throughout the nation. The site also provides historical data of previous disasters and access to the publication “Are You Ready?” an excellent state-of-the-art summary of preparedness considerations (2004).

Centers for Disease Control and Prevention (CDC)

The goal of the CDC Emergency Preparedness and Response site is to help increase the nation’s ability to prepare and respond to health emergencies. It provides a well-synthesized summary of pertinent information on a variety of disaster scenarios and terrorist threats using conventional, biological and chemical weapons.

1. Authority: This site was created by the CDC, which has some of the world’s foremost experts in disease prevention and management. There is contact information on the homepage for the CDC. Rating: 5

2. Currency: The site is updated on a regular basis to include the most up-to-date research as well as recent outbreaks and incidents. Rating: 5

3. Accuracy: The website has data and information for both the general public and healthcare professionals. There are literally hundreds of threats that are listed and reviewed on this site, making it difficult for us to comprehensively survey the content. Major pertinent areas examined (blast injury, bioterrorism) were very accurate and helpful, with appropriate level of detail for healthcare providers in need of a review of disease processes or assistance in diagnosis and management of common associated injuries and illness. Treatment options are also reviewed and potential side effects and precautions listed. Rating: 5

4. Navigation & Readability: This is a very well-organized site with a plethora of quick links that refer the web viewer to specific aspects of each disaster. For a nonclinician the site could be overwhelming given the amount of information that is available. Rating: 5

5. Utility: This is an extremely useful resource for healthcare professionals for disaster preparations, and an excellent reference during and after an event in order to review the most up-to-date research of disease pathology, diagnosis, treatment and prevention. Rating: 5

Summary: This is a well-organized site with an enormous amount of information for the healthcare professional to review. There are also links for the general public to find information on establishing a plan in case of a local health disaster.

International Strategy for Disaster Reduction – The Americas

The International Strategy for Disaster Reduction is an organization commissioned by the United Nations to further assist in implementing the Hyogo Framework for action. Although the site listed is specific to the Americas, there are links to the other regions covered and the ISDR main page.

1. Authority: This site and its associated organization are comprised of a variety of contributors on both the private and public realm. They serve as a coordinating agency for UN agencies, governments, international organizations, NGOs and the private sector. Rating: 5

2. Currency: Updated regularly with the most current research and publications, the website also provides information about the upcoming meetings and conferences. Rating: 5

3. Accuracy: The data on this site is both accurate and relevant and the regional director has a large volume of experience as well as training. Rating: 5

4. Navigation & Readability: Although there are multiple hyperlinks and tabs that allow for easy navigation, we found it difficult to find specific information without searching the various publications. Rating: 4

5. Utility: This is an interesting site and provides a large amount of information. The site seems to be most useful to less industrialized nations, in contrast to the United States, with our elaborate framework of disaster management systems. Rating: 4

Summary: This is a great website that provides support for nations around the world to become more capable in implementing the Hyogo framework.

Center for Biosecurity, University of Pittsburgh Medical Center (UPMC)

The UPMC Center for Biosecurity is a nonprofit organization that monitors the most current perspectives and publishes papers on disaster medicine with the intent of identifying and ameliorating national security and public health threats.

1. Authority: The Center is led by several world-renowned disaster medicine and public health physicians. The contributing authors are clearly identified and the papers, which are mainly based on expert opinion, are well documented. In addition to the Center’s own position papers on several areas of focus, including bioagents and public health preparedness, there are links to government agencies and other pertinent, non-Center publications. Rating: 5

2. Currency: The material is listed by year. While many of the publications are from the last 2-3 years, several are older though not necessarily less relevant. Rating: 4

3. Accuracy: The information is largely consensus-driven, since there is scant potential for evidence-based medicine in disaster planning. Rating: 4

4. Navigation & Readability: The site is very user-friendly and relies on a format that is consistent between different areas of focus. Rating: 5

5. Utility: The website is a wonderful clearinghouse for the most recent thinking on biosecurity topics. Unfortunately, only some of the publications on the website are free. Most are references to articles that can only be accessed through the publisher’s website and to books that cannot be accessed via the web. Rating: 3

Summary: The Center for Biosecurity website is designed specifically for clinicians and public health practitioners in the biosecurity field. Its data represents the most current thinking on disaster-related topics. The website is easy to use, though many of the papers must be accessed via alternate websites.

Other Important Sites

• National Library of Medicine Disaster Information Management Research Center (DIMRC)
  http://sis.nlm.nih.gov/dimrc.html

  DIMRC’s stated mission is to provide essential disaster health information resources and informatics research for public health officials, healthcare providers, and the public as part of the federal effort to help prepare, respond to, recover from and mitigate the adverse health effects of disasters in conjunction with federal, state, local government, private organizations and local communities. This is a well-compiled resource that draws heavily from many of the sites listed above and is slightly more limited in scope, although the information in general is of high quality and is relevant to health professionals. Available grant and research information is predominantly in the area of informatics.

• American Medical Association Center for Public Health Preparedness and Disaster Response
  http://www.ama-assn.org/ama/pub/physician-resources/public-health/center-public-health-preparedness-disaster-response.shtml

  This site provides a number of helpful hospital and healthcare provider resources, including several basic guides for purchase, the National Disaster Life Support Program and links to the Journal of Disaster Medicine and Public Health Preparedness.

• American College of Physicians (ACP) Bioterrorism and Disaster Preparedness
  http://www.acponline.org/clinical_information/resources/bioterrorism/

  The ACP has assembled a lengthy list of pertinent topics with information summaries, links to other online resources, quick reference PDF files, and useful review articles. Some of this information is limited to ACP members only. Attractive features include several online decision support tools to assist clinicians with the diagnosis of anthrax and smallpox infections, and a search engine to provide contact information for local FBI field offices and state departments of health.

• United States Army Medical Research Institutes of Infectious Diseases and of Chemical Defense
  http://www.usamriid.army.mil/

  Also https://ccc.apgea.army.mil/default.htm. These agencies represent the definitive repository of current knowledge on defense measures for common chemical and biological weapons. These sites provide excellent information and management resources for healthcare professionals for purchase, as well as information on regular educational opportunities on the medical management of chemical and biological casualties.

Disclaimer

The author has no personal or financial interest in any of the websites discussed above. The author has no personal or financial interest in any of the websites discussed above. The views expressed in this review are those of individuals authors and do not reflect the official policy or position of the Department of the Army, Department of Defense or the US Government. None of the authors have any personal or financial conflict of interest to disclose for any of the websites discussed above.