Introduction to

Public Health
Emergency Management
Panithee Thammawijaya,
Thammawijaya MD PhD
Bureau of Epidemiology
Department of Disease Control
 Outline
• Public Health Emergency
• Public Health Emergency Management
• Incidence Command System
• Emergency Operations Center

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 Public Health Emergency
A definition….

: The Oxford Handbook of U.S. Health Law, 2017 3

 Public Health Emergency
of International Concern: PHEIC
• An extraordinary event that is determined to “constitute a public
health risk to other States through the international spread of disease
and to potentially require a coordinated international response

• Meeting at least 2 of 4 following criteria

• Is the public health impact of the event serious?
• Is the event unusual or unexpected?
• Is there any significant risk of international spread?
• Is there any significant risk of international travel or trade restrictions?

: International Health Regulations 2005, WHO 2007 4

Public Health Emergency Management: 2P & 2R

Event
 Phase 1:: Prevention and Mitigation
• Focuses on reducing hazard losses or risk and controlling
anticipated damage
• Vaccination and related surveillance and control activities to
reduce infectious disease outbreak e ects
• Interventions to improve food handling and sanitation practices,
and other surveillance and control and coordination and logistical
support activities, in disaster settings such as shelters to reduce
potential environmental exposures

: Rose et al, AJPH 2017 7

 Phase 2: Preparedness
• Occur before an event and center on building or maintaining
staff, systems, and infrastructure capacity as well as carrying
out the planning, training, and exercising necessary to
identify gaps and improve emergency response capabilities
• The development, testing,, and evaluation of emergency response
plans, notification and warning systems, and surge staffing
procedures
• Training staff and enhancing physical and information technology
infrastructure such as EOCs and surveillance and reporting systems

: Rose et al, AJPH 2017 8

 Phase 3: Response
• A sum of decisions and actions taken during and after
disaster, including immediate relief, rehabilitation, and
reconstruction
• Response in the emergency management cycle occurs in
recognition of a hazard that threatens to overwhelm day-
today functions or capacities
• Incident Command System (ICS) and Emergency
Operations Centers (EOC) are usually activated and used
in this phase.

: WHO 2008 and Rose et al, AJPH 2017 9

 Phase 4:: Recovery
• Occurs during and after the response and encompasses
efforts to return or adapt to “new”
“ normal conditions
after an event.
• In the public health context, this may include
• efforts to implement an orderly transition of response-
related activities to regular public health programs and
functions
• capacity-building efforts to reestablish or strengthen health
systems, or monitoring long--term sequelae (such as mental
or behavioral health issues in affected populations)
: Rose et al, AJPH 2017 10
 1970’s California Wildfire:
The Origin of Incident Command System

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Types of Incidents
• Planned events
• Fire, both structural and
wildfire
• Hazardous materials incidents
• Search and rescue missions
• Oil spills
• Natural disasters
• Terrorist/WMD events
 What Is ICS?
• Standardized, on-scene,
scene, all-hazard
all incident
management concept.
• Allows its users to adopt an integrated
organizational structure.
• Has considerable internal flexibility.
• A proven management system based on successful
business practices.
• The result of decades of lessons learned in the
organization and management of emergency
incidents.
Weaknesses Addressed by ICS
• Lack of accountability, including unclear chain of
command and supervision.
• Poor communication, including system and
terminology problems.
• Lack of an orderly, systematic planning process.
• No common, flexible, predesigned management
structure.
• No predefined methods to integrate interagency
requirements into the management structure and
planning process.
 What ICS Is Designed To Do
• Meet the needs of incidents of any kind or size.
• Allow personnel from a variety of agencies to meld
rapidly into a common management structure.
• Provide logistical and administrative support to
operational staff.
• Be cost effective by avoiding duplication of efforts.
• ICS has been tested in more than 30 years of
emergency and non-emergency
emergency applications, by all
levels of government and in the private sector.
Five Major ICS Management
Functions
Incident
Command

Finance/
Operations Planning Logistics
Administration
Section Section Section
Section
Expanding the ICS Organization
Incident
Command

Public
Information
Officer
Command Staff:
The Command Staff provide
Safety
Information, Safety, and Liaison
Officer services for the entire organization.

Liaison
Officer

General Staff:
Operations Planning Logistics Finance/ The General Staff are assigned function
Section Section Section Administration authority for Operations, Planning, Log
Section and Finance/Administration.
Operations Section Expanding
Operations
Section Chief

Surveillance Outbreak Case Environment

Unit Investigation Management Management
Unit Team Team
 Incident Commander’s Role
• Has overall responsibility for managing the incident.
• Must be fully briefed, and should have a written delegation
of authority.
• Personnel assigned by the Incident Commander have the
delegated authority of their assigned positions.
• Only position that is always filled.
 Incident Commander
Responsibilities
• Overall command and control.
• Ensures incident responder safety.
• Protects health and safety of the general public and the
environment.
• Provides information to internal and external stakeholders.
• Maintains liaison with other agencies.
 PIO Responsibilities
• Advise the Incident Commander on information dissemination and
media relations.
• Serve as the primary contact for anyone who wants information.
• Serve external audience and internal audience.
• Obtain information from the Planning Section.
• Coordinate with other public information staff.
• Obtain information from the community, the media, and others.
Safety Officer Responsibilities

• Ensures responder safety.

• Advises Incident Command on
safety issues.
• Minimizes employee risk.
Liaison Officer Responsibilities

• Gathers information about support

agencies.
• Coordinates for agencies not in
command structure.
• Provides briefings and answers
questions.
 Operations Section Chief Role
• Develop and manage the Operations Section.
• Develops and implements strategies and tactics.
• Work very closely with other members of the
Command and General Staff to coordinate
tactical activities.
 Planning Section Chief Roles
• Gathers and analyzes information.
• Gathers, analyzes, and disseminate intelligence and information.
• Manages the planning process.
• Compiles and develops the Incident Action Plan.
• Manages the activities of Technical Specialists.
• Works closely with the Incident Commander and General Staff.
Logistics Section Chief: Role
• Provides resources and services to
support the incident.
• Develops portions of the IAP.
• Contracts for goods and services.
 Finance/Administration
Section Chief: Role
• Negotiate contracts.
• Time keeping for personnel and equipment.
• Documenting and processing claims.
• Tracking costs.
Objectives of Operations Under Emergencies
Priorities for incident objectives are:
1. Life Safety (Personnel and
People)
2. Incident Stabilization
3. Property/ Environmental
Preservation
 ICS Organization
• Differs from day-to-day
day organizational
structures and positions by:
• Using unique ICS position titles and
organizational structures.
• Assigning personnel based on expertise,
not rank. For example, a director may
not hold that title when deployed
under an ICS structure.
 Modular Organization
• Incident command organizational structure is
based on:
• Size, type, and complexity of
the incident.
• Specifics of the hazard
environment created by
the incident.
• Incident planning process
and incident objectives.
ICS Management: Unity of Command
• Under unity of
command, personnel:
• Report to only one
incident supervisor.
• Receive work
assignments only from
the assigned
supervisor.
ICS Management: Span of Control
•ICS span of control
for any supervisor:
• Is between 3 and 7
subordinates.
• Optimally does not
exceed 5
subordinates.
 Emergency Operations Center (EOC)
A central command and control facility
responsible for
• carrying out the principles of emergency
preparedness and emergency management, or
disaster management functions at a strategic level
during an emergency
• ensuring the continuity of operation of a company,
political subdivision or other organization.
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 The Role of the EOC
• Provides a central location from which
government at any level can provide
interagency coordination and executive
decision making in support of the
incident response
• Three somponents of EOC
• System: Plans, SOPs, Guidelines
• Stuff: Facilities, equipment
• Staff: Well-trained
trained personnel
 EOC
Event Event
Event Field Team Field Team
Field Team
Event
Field Team

EOC (at
at the province)

Ministry of Public Health Other Sectors

 EOC Purpose
to provide a central
location where Local EOC National EOC

government at any level

can provide interagency
coordination and
executive decision making Incident Incident Incident
Command Command Command
in support of the incident
response.
 Core Functions in an EOC
 Coordination
 Communications
 Resource Dispatch and Tracking
 Information collection, evaluation, and
dissemination
 Direction and control
 Establishment of priorities
 Resource support
US CDC EOC
Thailand DDC EOC

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Thank You

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