**January 4, 2006 FEMA Emergency Management Higher Education Project
Activity Report**

\(1\) ASIS INTERNATIONAL BUSINESS CONTINUITY GUIDELINE:

January 4, 2006 \-- Discovered today that I missed this when it came out
in 2005:

ASIS International. Business Continuity Guideline: A Practical Approach
for Emergency Preparedness, Crisis Management, and Disaster Recovery.
Alexandria VA: ASIS, International, 2005 (about 50 pages).

Accessed at:
[[http://www.asisonline.org/store/detail.xml?id=3553563]{.underline}](http://www.asisonline.org/store/detail.xml?id=3553563)

From page 6 Summary:

\"The BC Guideline is a tool to allow organizations to consider the
factors and steps necessary to prepare for a crisis (disaster or
emergency) so that it can manage and survive the crisis and take all
appropriate actions to help ensure the organization\'s continued
viability. The advisory portion of the guideline is divided into two
parts: (1) the planning process and (2) successful implementation and
maintenance. Part One provides step-by-step Business Continuity Plan
preparation and activation guidance, including readiness, prevention,
response, and recovery/resumption. Part Two details those tasks required
for the Business Continuity Plan to be maintained as a living document,
changing and growing with the organization and remaining relevant and
executable.\"

Recommend reading in conjunction with this NFPA-1600 as well as the
Business and Industry Crisis Management Course material found on the EM
HiEd Project website \-- Free College Courses section.

\(2\) EASTERN KENTUCKY UNIVERSITY \-- INVESTIGATING HOMELAND SECURITY
BACHELORS DEGREE:

January 4, 2006 \-- Called Dr. Larry R. Collins, Chair of the Department
of Loss Prevention and Safety, to offer congratulations on the recent
NIMS-related grant received by EKU. Dr. Collins noted that EKU is
investigating the development of a Homeland Security Bachelors Degree.
Further noted that a back burner item is the development of an Emergency
Management Masters. For additional information, Dr. Collins can be
reached at: <larry.collins@eku.edu>.

\(3\) HAZARDS/THREAT RISK ANALYSIS/ASSESSMENT:

Scalet, Sarah D. \"Risk Analysis - Spinning the Wheel of Misfortune.\"

CSO Magazine (Chief Security Officer), January 2006. Accessed at:

[[http://www.csoonline.com/read/010106/wheel_misfortune.html?action=print]{.underline}](http://www.csoonline.com/read/010106/wheel_misfortune.html?action=print)

Scalet, Sarah D. \"Three Not-to-Miss Risks.\" CSO Magazine, January
2006. Accessed at:
[[http://www.csoonline.com/read/010106/three_risks.html?action=print]{.underline}](http://www.csoonline.com/read/010106/three_risks.html?action=print)

\(4\) INTRODUCTION TO EMERGENCY MANAGEMENT ELECTRONIC TEXTBOOK
DEVELOPMENT PROJECT:

January 4, 2006 \-- Reviewed 2nd draft of Chapter 6, \"Hazard,
Vulnerability, and Risk Analysis,\" and provided review comments to lead
book developer, Dr. Michael Lindell, Texas A&M University. This chapter
has been forwarded to the EMI Webmaster for upload to the Project
website \-- Free College Courses and Books section. Chapter abstract:

\"This chapter describes how pre-impact conditions act together with
event-specific conditions to produce a disaster\'s physical and social
impacts. These disaster impacts can be reduced by emergency management
interventions. In addition, this chapter discusses how emergency
managers can assess the pre-impact conditions that produce disaster
vulnerability within their communities. The chapter concludes with a
discussion of vulnerability dynamics and methods for disseminating
hazard/vulnerability data.\"

\(5\) MCENTIRE PRESENTATIONS \-- JUNE 2005 EMERGENCY MANAGEMENT HIGHER
EDUCATION CONFERENCE:

January 4, 2006 \-- Received from Dr. David McEntire, University of
North Texas, corrected transcripts we had provided him of two
presentations at the June 2005 EM HiEd Conference \-- 1., His defense of
\"Evolutionary Change\" during the June 8 Plenary Panel on \"Evolution
or Revolution Needed in U.S. Emergency Management,\" and 2., his defense
of the term \"Comprehensive Vulnerability Management\" during the June
9th Plenary Panel on \"What Should We Call What We Do.\" Both
transcripts have been forwarded to the EMI webmaster for upload to the
Project website \-- HiEd Conferences section \-- 2005 EM HiEd Conference
subsection \-- click on \"Agenda\" and scroll to the appropriate
presentations and click on Dr. McEntire\'s name.

\(6\) STRATEGIC PLANNING FOR CATASTROPHIC EMERGENCIES \-- DHS
(PREPAREDNESS)/DOD JOINT PROJECT:

January 4, 2006 \-- Following up on yesterday\'s activity report on this
initiative, talked with Dr. George L. Tanner, Director, Training,
Education & Professional Development, DHS Preparedness Directorate, who
is the Chairman of the Interagency (DHS & DOD) working group putting the
\"Strategic Planning for Catastrophic Emergencies\" training course
together. Pasted in below is some additional information on this
initiative:

\"Following an exchange between Secretaries Chertoff and Rumsfeld, HSI
was tasked by DHS\'s Directorate of Preparedness to assist an
interagency working group (currently being organized) in developing a
joint 2-3 week course in Strategic Planning for Catastrophic
Emergencies. The course is geared to GS 14-15s and their DOD
equivalents. To the extent possible, the course will use existing
training modules (and venues)\--emphasizing strategic planning as taught
and practiced at DOD and USCG, and emergency management as taught by
DHS/FEMA, USCG, and others. The initial offerings will be presented to
federal participants; however; subsequent offerings will include
state/locals/tribes/private sector.\"

Dr. Tanner notes that his interagency working group is shooting for a
May 2006 roll-out of this course. He also noted that additional
information would be forthcoming as it becomes available \-- so stay
tuned. As noted yesterday, for additional information on this project,
contact Judith Colle at the DHS Homeland Security Institute \--
Judith.Colle@hsi.dhs.gov

\(7\) TERMS AND DEFINITIONS:

January 4, 2006 \-- Made modifications to the \"Select Emergency
Management Terms and Definitions\" 88-page document and forwarded to EMI
Webmaster to upload to the Project website \-- Free College Courses
section \-- Courses Under Development subsection \-- Hazards, Disasters
and U.S. Emergency Management course \-- to replace the previous version
of this document in the Appendix section.

\(8\) TERRORISM:

Wald, Matthew L. \"Even After \'Dirty Bomb\' Exposure, Residents Might
Be Allowed Back In.\" New York Times, January 3, 2006. Accessed at:

<http://www.nytimes.com/2006/01/03/national/nationalspecial3/03cnd-nuke.html?pagewanted=print>

\(9\) URBAN AREAS SECURITY GRANTS 2006:

January 4, 2006 \-- Noted in yesterday\'s activity report the posting on
the DHS website of information on the 2006 Urban Areas Security Grants
and how, this year, natural disaster hazards will be taken into account.

Today read transcript of January 3 press statement followed by a few
Q&A\'s \-- Secretary Chertoff\'s written statement can be found in the
\"Speeches and Statements\" section of the DHS website \-- at:

<http://www.dhs.gov/dhspublic/display?theme=44&content=5320&print=trueHave>

Pasted in below a very relevant short excerpt dealing with natural

hazards:

\"QUESTION:

Can you talk a little bit about how much the risk of natural disasters
plays in and your eligibility along those lines? Say there\'s marginal
terrorism risk in certain areas, like northern Florida, but big
hurricane risk; how does that\...

CHERTOFF:

This program is tied to risk of terror.

So we\'re operating within the terms of the program.

But the kinds of capabilities that we are considering to be appropriate
as needs-based funding are capabilities that would certainly do double
duty in the case of catastrophe. So, for example, capabilities to
evacuate people would obviously have relevance in a terrorism case, with
a certain kind of attack, but would also have relevance in a natural
disaster of a certain kind.

So we are broadening our sense of what is need and what is an investment
justification to take account of things that may do some double duty.

QUESTION:

But eligibility and how they apply \-- they wouldn\'t be applied citing
their risk for a natural\...

CHERTOFF:

Correct, although common sense is going to tell you that consequence \--
there will often be a lot of overlap. For example, where you have
critical infrastructure that\'s a risk to terror, it may also be at risk
for natural disasters.\"

Related news articles (amongst many that could be sited):

Amen, Rob. \"New Grant Formula May Mean Less Money for Area.\"

Pittsburgh Tribune-Review, January 4, 2006. Accessed at:

<http://www.pittsburghlive.com/x/tribune-review/trib/regional/s_410157.html>

McGlone, Tim. \"Region Passed Over Again on Homeland Security List.\"

The Virginian-Pilot, January 4, 2006. Accessed at:

[[http://home.hamptonroads.com/stories/print.cfm?story=97635&ran=170043]{.underline}](http://home.hamptonroads.com/stories/print.cfm?story=97635&ran=170043)

New York Times (Editorial). \"Risk Wins a Round Over Politics.\" January
4, 2006. Accessed at:

[[http://www.nytimes.com/2006/01/04/opinion/04wed1.html]{.underline}](http://www.nytimes.com/2006/01/04/opinion/04wed1.html)

\(10\) ADDENDUM \-- MIDDLESEX COMMUNITY COLLEGE AVIAN INFLUENZA PANDEMIC
CONFERENCE NOTES:

Received from Terrence Downes at Middlesex Community College in Lowell,
MA, notes from a December 6, 2005 conference on Avian Influenza Pandemic

\-- pasted in below, and to be uploaded to the Project website in
complete version \-- Articles, Papers, etc. section \-- where they
should be accessible shortly.

MIDDLESEX COMMUNITY COLLEGE \-- The Program On Homeland Security \--
Terrence B. Downes, Esq., Executive Director \-- Lowell, MA 01852 \--
<downest@middlesex.mass.edu>

Avian Influenza Pandemic Conference, Tuesday, December 6, 2005

Conference Notes by: Edwin Jewett

A conference for emergency response & health planners on the possibility
of an Avian Influenza Pandemic was conducted on December 6, 2005, at
Middlesex Community College in Lowell, MA. The presenters were all
top-flight, well-recognized, well-credentialed Centers for Disease
Control, Commonwealth of Massachusetts, and local public health, medical
and emergency services experts.

The presenters included (inter alia):

DAVID G. SIDEBOTTOM, M.D.

Infectious Diseases Consultant at both the Lowell General Hospital and
the Saints Memorial Medical Center, Lowell, MA

HOWARD K. KOH, M.D., M.P.H.

Associate Dean for Public Health Practice, Harvard School of Public
Health, Boston

PASCALE M. WORTLEY, M.D., M.P.H.

National Immunization Program, Centers for Disease Prevention and
Control (CDC), Atlanta

ALFRED DeMARIA, Jr., M.D.

Chief Medical Officer, Massachusetts Department of Public Health, and
Director, Massachusetts Bureau of Communicable Disease Control

\"Everyone is a public health practitioner.\"

pandemos - of all the people

50-100 million died in the 1918 pandemic (called the \"Spanish Flu\"

because Spain was a neutral country during World War I and thus had the
only uncensored news, and was responsible for the early reports of the
outbreak).

influenza \-- medieval Italian for \"influence of the stars\"

The world suffers from \"cultural amnesia\" (Mike Davis, 2005) about the

1918 pandemic because there are few alive today who were alive then.

This is also relevant in terms of immunity.

In addition to death and disability, pandemic flu shortens life spans
among survivors by as much as 10 years.

The H5N1 virus will impact young and middle-aged healthy individuals far
more than normal seasonal flu due to the severity of the inflammation or
cytokine storm it induces in healthy lungs. (See below for more on
cytokine storms.)

Because of this abnormal and obverse peak of mortality across the
demographic curve, the pandemic threatens social paralysis and
disruption, will have a severe impact on familial and daily care (esp.
for toddlers and the elderly), have a severe impact on the functionality
of industry, government, health care et al, and will generate
significant issues surrounding burial practices, social gatherings, and
more.

The Top Ten Things You Need to Know\...

1\) Avian flu is not necessarily pandemic flu. The development of a

pandemic is dependent on the degree of pathogenicity in the virus.

2\) We are globally interdependent.

3\) Flu pandemics are recurring events; we are on the brink of one

now.

4\) When a pandemic arrives, there will be widespread illness and

death,

5\) Current medical supplies are inadequate or insufficient.

6\) Economic and social disruption will occur.

7\) We need to build \"surge capacity\" into our health care systems.

8\) Education is critical and will generate trust and confidence in

> government, planners, medical care providers, etc. Such trust and
> confidence will emerge and sustain itself only if there is
> \"transparency in communications\".

9\) All planning must be local.

10\) A rejuvenation of the public health system is required.

The H5N1 virus is highly pathogenic and has the potential to create a
pandemic if:

\* A new sub-type will emerge (this has occurred);

\* It will infect humans (133 documented human deaths thus far as

of 12/5/05);

\* It spreads easily and sustainably (this has not yet been confirmed)
as a result of viral reassortment, adaptiveness and mutation.

The current situation is the most severe poultry outbreak on record,
already resulting in the deaths of 150 million birds (directly or
through preventive culling) in five Asian countries. Vietnam is the
epicenter, where probable human-to-human transmission has been reported.

The 1918 pandemic killed approximately 25-30% of the population.

Mortality occurs in about 25-55% of those infected.

\[Note: to place this into perspective, take a moment to mentally walk
through your locale or community and see one out of every four
individuals falling sick with 48 hours of onset, and one-quarter to
one-half of those dying over the course of a week. In a city of 100,000
people, 25,000 will likely not report to work, and 6-12,000 will die.\]

The World Health Organization is conservatively estimating that 2.0-7.5
million will die worldwide. In the US, the worst-case scenario is that

1.9 million will die, and that 8.5 million will require hospitalization.

There will be high rates of absenteeism, and the disruption of essential
services.

Businesses are urged to undertake immediate continuity of operations

planning.

There is a need to build strong social capital.

Planning must proceed on the basis of \"space, staffing and supplies\".

Every home should develop an emergency plan.

Education about cough etiquette, the necessity for respiratory and hand
hygiene, and the use of \"increased social distance\" must be
undertaken.

Infection occurs before symptoms present themselves. Infected
individuals remain contagious for 2-7 days (longer in children!).

There is scientific unanimity about the fact that we are overdue for
such a pandemic.

The disease will spread rapidly and affect an entire nation pretty much
at the same time. Thus the ability to call on outlying regions for
support, supplies, manpower, etc. will not exist. We live in a
Just-in-Time distribution economy, and this distribution chain will be
affected by absenteeism etc.

Urban crowding drives up the attack rate of the disease.

Low socio-economic status also drives up the attack rate of the disease.

The disease has been shown to infect European cats.

The SARS virus, a relative slow-mover, moved from Honk Kong to Vancouver
in one month.

Preparedness

1\) Get the right people involved.

2\) Define how coordination among entities will occur.

3\) Move beyond \"planning to plan\".

4\) Define who is in charge.

5\) Review legal authority as pertinent.

6\) Think through whether the plan addresses the entire population.

7\) Consider special ways to deal with the isolated, chronically

ill-at-home, mass child care needs, and more.

There are a large number of unknowns with regard to this disease:

\* Epidemiology;

\* Demographics;

\* Severity;

\* Absenteeism rates across demographics;

\* The effectiveness of vaccines and anti-virals;

\* The production/supply/distribution of vaccines and anti-virals;

\* The possible effect of the use of adjuvant extenders in

vaccines.

Prioritization for the Use of Vaccines and Anti-Virals (current draft
working plan in the US):

1A Manufacturers and Distributors of Vaccines and Anti-Virals

1B Highest Risk 16 million(age 65+ with chronic disease, \< age 65 with

two or more chronic diseases)

1C Pregnant Women and their Household Contacts 1D Public Health

Emergency Responders Key Government Officials

2A High Risk 58 Million

2B Personnel from Public Safety and Critical Infrastructure

3 Other Key Decision-Makers; Funeral Officers

4 Healthy Children and Adults

This is a critical and difficult social triage question, given the
unknowns, given the debatable effectiveness of vaccines and anti-virals,
given the expected high fatal impact on young health adults due to
cytokine storms, and given the lack of supplies and resources to handle
intensive health care needs (esp. acute respiratory issues). Many
\"first responders\" and health care personnel feel that they and their
families must be far higher on the prioritization list.

If the pandemic is of a moderate to severe nature, our response to it
will be \"qualitatively different\".

The challenges:

\* The magnitude;

\* The severity;

\* Staff shortages;

\* Limited ability to call in extra-regional resources;

\* Other services will be disrupted.

The disease features:

\* a short incubation period (1-4 days, 2 on average),

\* abrupt onset, with peak infection curve arriving early, and

\* the clinical illness from flu infection is non-specific.

There is a great deal of attention and energy being focused on the
ability of the world to contain or slow down the spread of the pandemic
at its source.

Planning must and will consider:

\* School closures (to prevent spread and incubation);

\* The cancellation of all large gatherings;

\* \"Snow Days\" (or asking businesses to allow workers to stay home
from work) though this has serious implications re: timing, loss of
service/income, the effect on the business and the economy, etc.)

\* Deferring travel to involved areas;

\* The widespread use of masks (Effectiveness ?, supply ?);

\* Communications (the development of phased messaging to the

public);

\* Risk Communication to the public.

\* The best role for those who have survived the illness (the

\"deployment of the immune\").

What and where is the triggering point or mechanism that will swing
planning into action?

A Massachusetts public health expert looked at the newspapers in Boston
from the 1918 pandemic, factored in the population data from today, and
said that \"The Boston Globe will run 12-14 pages of death notices for
weeks\". In 1918, on one day in Philadelphia, over 700 people died.

If we ask major segments of the population to stay home for days on end,

Who will provide the services? Who will provide day care to the children
if they are not in school and the parent(s) is/are sick or dying?

\* There will be very little warning.

\* There will be simultaneous outbreaks.

\* There will be a shortage of supplies of all types.

\* Facilities will be overwhelmed.

\* Health care workers et al will be at highest risk.

\* There will be widespread illness and a shortage of workers.

\* There may be more than one wave of infection.

\* All planning and response will have to be local. (You\'re on

your own.)

\* Critical attention must be paid to the legal, public health and

> socio-psychological aspects of the collection, identification and
> disposal of bodies.

Planning should seek to improve health care systems and public health
\"surveillance\" through monitoring of data, etc. Clinicians at all
locations and levels will be \"sentinels\". Syndromic surveillance
should be improved and extended.

\"Exercises and simulations are a very good way to elicit critical ideas
and suggestions.\"

More specifically, business continuity planning must address:

\* Forecasting of employee absences;

\* The dissemination of information to employees;

\* The establishment of policies for employees who

Have been exposed;

Are expected to become ill;

Become ill at the worksite.

\* The impact of the pandemic on the business;

\* The impact on employees and customers;

\* The allocation of resources to protect employees and customers;

\* Communication and education for employees;

\* Connection with external organizations and communities.

\"Destiny should not be confused with poor planning.\"

Cytokine Storms

\"As concern mounts over the potential spread of avian flu to humans,
researchers believe they\'ve discovered one reason why the infection can
prove so deadly. Experiments with human cells have found the H5N1 virus
can trigger levels of inflammatory proteins called cytokines and
chemokines that are more than 10 times higher than those that occur
during a bout of the common flu. This massive increase in cytokine and
chemokine activity can inflame airways, making it hard to breathe. It
also contributes to the unusual severity of the avian flu, which can
result in life-threatening pneumonia and acute respiratory distress.\"
\[Medicine.Net \"Health Day\"\]

\"The study, published in the online journal Respiratory Research, might
suggest that if H5N1 does cause a pandemic, it could disproportionately
affect the young and healthy as compared with seasonal flu, which kills
many elderly but few young adults.\" \[MS-NBC \]

\"A recent laboratory study has produced more evidence that infection of
human lung cells with the H5N1 avian influenza virus leads to intense
inflammation similar to what was seen in victims of the 1918 Spanish flu
pandemic\....The H5N1 viruses were \"more potent inducers\" of cytokines
and chemokines-chemical messengers that trigger inflammation-than H1N1
viruses were, says the report by a team led by J.S.M. Peiris of the
University of Hong Kong. A flood of inflammation-triggering chemicals
released by the immune systems has been referred to as a \"cytokine
storm.\" Autopsies of H5N1 avian flu victims in Vietnam and elsewhere
have revealed lungs choked with debris from the excessive inflammation
triggered by the virus. Similar severe lung damage was frequently
reported in victims of the 1918 pandemic, which disproportionately
killed people with the strongest immune systems-young, healthy adults\".
\[CIDRAP News\]

\"This study confirms earlier work that H5N1 induces a cytokine
\'storm,\'\" said Michael T. Osterholm, director of the Center for
Infectious Disease Research and Policy at the University of Minnesota
School of Public Health, in Minneapolis. \"It helps us understand the
pathophysiology of the disease.\" The noted increase in cytokine
production is what distinguishes avian flu from other flu, Osterholm
said. \"The hyperproduction of cytokines is very relevant. It points out
that the way people actually experience severe illness with this virus
is different than what we see with other influenza viruses.\"

\"This is basically a cytokine storm induced by this specific virus,
which then leads to respiratory distress syndrome,\" Osterholm
said.\"This also makes sense of why you tend to see a preponderance of
severe illness in those who tend to be the healthiest, because the
ability to increase the production of cytokines is actually higher in
those who are not immune-compromised. It\'s more likely in those who are
otherwise healthy.\" \[Medicine.net\]

Sources:

General News

<http://www.cidrap.umn.edu/cidrap/content/influenza/avianflu/news/nov1605cytokine.html>

[[http://www.medicalnewstoday.com/medicalnews.php?newsid=34202]{.underline}](http://www.medicalnewstoday.com/medicalnews.php?newsid=34202)

[[http://www.medicinenet.com/script/main/art.asp?articlekey=55295]{.underline}](http://www.medicinenet.com/script/main/art.asp?articlekey=55295)

[[http://www.medicalnewstoday.com/medicalnews.php?newsid=34202]{.underline}](http://www.medicalnewstoday.com/medicalnews.php?newsid=34202)
\[See this link for information and further links to GenoMed.\]

[[http://msnbc.msn.com/id/9994455/]{.underline}](http://msnbc.msn.com/id/9994455/)

[[http://abcnews.go.com/Health/Healthology/story?id=1305156]{.underline}](http://abcnews.go.com/Health/Healthology/story?id=1305156)

[[http://www.michnews.com/artman/publish/article_10676.shtml]{.underline}](http://www.michnews.com/artman/publish/article_10676.shtml)

Related Medical Studies:

[[http://www.biomedcentral.com/1471-2180/4/28]{.underline}](http://www.biomedcentral.com/1471-2180/4/28)

<http://www.blackwell-synergy.com/doi/full/10.1111/j.1365-2249.2004.02415.x?cookieSet=1>

B.Wayne Blanchard, Ph.D., CEM

Higher Education Project Manager

Emergency Management Institute

National Emergency Training Center

Federal Emergency Management Agency

Department of Homeland Security

16825 S. Seton, N-430

Emmitsburg, MD 21727

\(301\) 447-1262, voice

\(301\) 447-1598, fax

wayne.blanchard@dhs.gov

[[http://training.fema.gov/EMIWeb/edu]{.underline}](http://training.fema.gov/EMIWeb/edu)

"Please note: Some of the Web sites linked to in this document are not
federal government Web sites, and may not necessarily operate under the
same laws, regulations, and policies as federal Web sites."