|Pandemic: Are you ready?|
|By Steven C. Kelly, Director Jail and Court Services Bureau (Ret)|
While providing the direction and planning for a correctional facility we often deal with those events that are frequent high risk occurrences which require special efforts, such as suicides, assaults, riots, fires, and escapes; however, how often do we plan for the effects of a serious outbreak of a dangerous illness? Because of the advances of modern medicine, we often regard medical issues as a routine problem, dealt with by our medical providers. We do not often consider the consequences of an outbreak of a disease that does not respond well to treatment and even worse spreads at a nearly explosive rate. It is an event such as this, which this article is intended to address. It is impossible to ponder all of the potential variables of such an event in this article, however, I will provide some questions for consideration for the unique nature of the correctional environment so your staff can begin anticipating the challenges, and creating solutions unique to your facility and environment.
When was the last time you reviewed your emergency plans and, in particular, those related to disease outbreaks, and considered the roles of the security staff and the medical staff? In handling these situations are these roles realistic? Consider this. In larger facilities security staff has a very minimal role in providing medical care. This role is usually limited to making sure that medical personnel are notified when an inmate is suddenly ill or injured, directing medically related requests to medical and making sure inmates respond to “med call.” But have you thought about who will be providing the care if your medical resources are overwhelmed? Most medical units in today’s facilities are operating at, or near, capacity. Where will the seriously ill be housed and treated should you have 20, 30, or more additional cases? Do you have housing that can be re-tasked as an isolation unit in an attempt to control the spread of the illness? Most facilities utilize in-house workers at various security levels to conduct the routine cleaning of the facility. Are you prepared to deploy these crews to manage the needed hospital level cleaning necessary to control the spread of the disease? Will your staff be comfortable in allowing these inmates access to the cleaning supplies not normally utilized in your facility, such as bleach?
One of the serious issues to consider in the event of an outbreak is the impact on staff. We have to realize that (unless were extremely lucky) some of the staff may fall victim to the disease process which will impact the number of employees available to work. Consider the “fear impact”. I know of officers who began calling in sick during a flu outbreak at a facility, not because they were ill, but because they were afraid that they might bring the illness home to their families. One can assume that the bigger the outbreak, the more magnified this issue may become. How will you operate should 25%, or more, of your staff be impacted (either through illness or fear)?
A planning tactic to use in order to identify these problems in advance would be to meet with your jurisdiction’s Emergency Operations Center (or Manager) and plan a tabletop exercise which incorporates representatives from your operational staff, Medical Director, Local Health Department, and, at a minimum, emergency planning staff from the state level. It is important to work the problem through and have some worse case issues thrown at you. Going through a drill such as this can give you some insight as to what problems you may have to overcome should you experience such an event, and allow for a proactive contingency plan that will help mitigate the total impact on your facility.
Another problem that is often forgotten is the impact on the supply chain. When there is an outbreak of a serious contagious disease in your local community, or region, what will that do to your suppliers and their ability to keep your facility adequately stocked? The same fear issues that can affect your staff can reach your suppliers as well. What if the nature of the disease requires a certain medication or equipment, such as medical grade face masks? How many do you have in stock and how soon can your supply be replenished? What will you do if you run out? In recalling the outbreak of the H1N1 virus in 2009, there was not enough vaccine to go around in the community where I was living and the medical community was trying to establish a priority for those who would get it. Make sure your staff is on that list.
Here are some other thoughts for consideration: What is the known mortality rate for the disease? The “Bird Flu” has been rated as high as 50% or more. Fortunately, there is no indication that it is easily transmitted from human to human. Are you prepared to consider the impact if that changes? What is the recovery time for a given disease? According to the Center for Disease Control, the seasonal flu’s most serious symptoms last five to seven days and the contagious period is about the same. But what if the symptoms that require significant care last 14 or 21 days? What if the ill are seriously contagious throughout the entire course of the disease? What would the emotional impact to the inmates be? I was once on a cruise where there was an outbreak of the “Norwalk Virus.” We were at sea for four days straight when the outbreak occurred. The crew was handing out hand sanitizer like candy on Halloween and none of the passengers were allowed to touch any of the utensils in the buffet line. The crew was constantly cleaning all surfaces touched by hands. At the height of the outbreak the formal dining room was half full, and there were two other couples at our table who were quarantined for at least for four days. The second to last port of call would not allow us to disembark. We could not wait to get off of the ship. Once we were at our home port, US Customs took a very long time to clear the ship so we could leave. Many passengers becoming openly hostile before we finally left. It was not a pleasant experience. Now, imagine being an inmate under this type of situation. Would this further complicate how you might manage the event? Do you have any contingency under extreme circumstances that would allow for early release of the non-violent offender to help mitigate your work load?
I understand, that I have raised more questions than answers, but as the old adage says “to be forewarned is to be fore armed”. We as correctional professionals need to be aware of those disease events that start in our communities and regions. With the global reach of transportation, we need to pay attention to these events nationally and internationally as well. The Center for Disease Control provides an information resource at their website at: http://www.cdc.gov/ that can provide current information on the status of, and precautions for, an outbreak. Once we see these things begin to develop we should be asking the questions mentioned here as well as others, so we can make our plans, and maybe avert a disaster.
Corrections.com author, Steven C. Kelly served 25 years at Washoe County Sheriff’s Office retiring as a captain. His last post was as the Jail Director for the Ada County Sheriff's office in Boise, ID. He holds a master degree in Management from the University of Phoenix and attended the FBI National Academy in 2009.
Other articles by Kelly:
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