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Emergency Management BC has developed some excellent resource materials for BC residents.  One of which is the attached "Earthquake and Tsunami Smart Manual" - a guide for families to understand the science of earthquakes and tsunamis and to prepare by putting together an emergency supplies kit and create a family disaster plan. The staff and faculty at the National Center for Disaster Preparedness bring a diverse set of expertise to contemporary issues in disaster preparedness, response and recovery.
Lessons for confronting future outbreaks and why the President’s proposal for emergency Ebola funds is a step in the right direction. Globalization has presented unprecedented challenges to the prevention and control of disease outbreaks.
Although the current outbreak is likely to remain restricted to isolated cases in the United States, it has presented an opportunity to learn important lessons about confronting future outbreaks of this and greater magnitude. Next, as the current situation in Liberia, Sierra Leone and Guinea clearly demonstrates, fragile health systems don’t have the capacity to effectively respond to emergencies like Ebola. Finally, while globalization has brought many new challenges, new opportunities are also emerging for confronting future health emergencies. In a globalized society, the success or failure of the nation’s ability to respond to such health emergencies will depend on our health system’s preparedness, as well as our commitment to strengthening health systems worldwide and fostering successful collaborations with stakeholders from government, non-profit and industry domestically and abroad. As Ebola continues to grab the public’s attention, the political and the clinical aspects are commanding the largest headlines in the media. In addition to corporate donations and social responsibility campaigns, there are also significant business implications in manufacturing goods to support the response. In the impacted areas of West Africa, there are stories of companies and trade organizations taking steps to protect their staff and their livelihoods. Businesses are also looking at preparedness programs to keep their workers safe, and if necessary, compensated if they become exposed or ill [9]. In the reality of global supply chains, community-based manufacturing, and privatized health services, being bottom-line oriented and humanitarian do not need to be in conflict with each other. This week, the story of the first person diagnosed with Ebola in the United States ended tragically, when Thomas Eric Duncan passed away succumbing to his illness.  Our thoughts go out to his loved ones, and to all of those impacted by this disease around the globe. With this tragic event, the West African Ebola outbreak became something much less distant and theoretical for Americans. The most critical step in being able to recover from a disaster is being prepared for one in the first place. Anyone who has actually managed a business' recovery from a disaster knows that the most critical factor when it comes to business and operation continuity is having a plan in place before the disaster strikes. In an emergency, the most wasteful use of workers' time (and sometimes their safety), is in setting up makeshift IT triage—that is, on-the-fly access to data and applications after a disaster.
Disaster preparedness means having, at the very least, the data and apps that are required to keep day-to-day operations already running in a remote location and ready to access. Also it's practically guaranteed that, after experiencing a disaster, a company will not be running with its full staff.
In short, IT contingency in wake of emergencies should be as seamless, as compliant with corporate security policies, and as easy for end-users to access as possible. Easier Than Ever Such disaster preparedness is easier than ever for companies to deploy because of changing trends in technology. So, why are many organizations still not on-board with creating strong disaster preparedness plans? Over the last 10 years, NCDP has tracked US attitudes on preparedness —focusing on the extent of personal and family preparedness, confidence in government, and perceptions of community preparedness.
As the Ebola outbreak continues to evolve, their perspectives will be shared here in support of a broader national dialogue.
While diseases such as smallpox and measles were already able to travel around the globe within a year by the time of the European colonization of the Americas [1], in today’s interconnected world infectious diseases can reach virtually any location within days. The nation’s ability to rapidly and effectively respond to such threats will require a comprehensive long term approach that incorporates improved domestic preparedness with considerations of the key stakeholders involved and various local and global factors that may exert complex influence on the disease epidemiology. The Ebola outbreak revealed substantial gaps in preparedness that call for urgent measures. Furthermore, the unprecedented Ebola outbreaks in these countries have led to the collapse of the local health systems and have evolved into humanitarian emergencies that will have long lasting and devastating consequences for public health, education and economic development [7,8,9].  Beyond the moral obligation to assist countries affected by Ebola, the United States can benefit from such actions because reducing impacts in the affected countries is essential for minimizing the likelihood for new cases at home. In particular, global and cross-sectorial partnerships play an increasingly important role in the Ebola outbreak response and technological advances are improving surveillance capacity.
The President’s proposal [14] for $6.18 billion in emergency funds to contain and end the Ebola outbreak is a step in the right direction. This is most pressing currently with the development of pharmaceuticals [1] [2] [3] and equipment to protect healthcare workers against bodily fluid exposure [4].
A rubber plantation in Liberia has created a rare sanctuary from Ebola with robust medical support and evidence-based infection control procedures.

It is important for businesses to protect their most valuable asset, and also to provide access to information and assure job security for the individuals employed by them.
In fact, these objectives are often in line with each other when the full impact of prevention and effective response is appropriately valued. It took only the time of an international flight to move this from the international pages of the newspaper, to the US section. Duncan was sent home despite his symptoms and travel history and ask “how could this happen?”. Our national level institutions have served our local practitioners well by ensuring the best possible science is available on this disease, fighting outbreaks overseas to minimize their spread, researching new vaccines and treatments and striving to understand emerging pathogens long before we need to confront them in our home towns.
We will likely see additional cases of Ebola in the United States as part of this outbreak. While disaster recovery will always involve some on-fly decision making and adapting to realities on the ground, both of these can be made orders of magnitude easier by having contingency plans and systems already in place, and staff who are already trained how to implement them.
Disaster recovery (without proper preparedness) may mean IT scrambling to find a place to set up a replacement server, take a copy of the data and applications from the damaged server, and then restore that data and re-install mission-critical apps to give end-users the alternative access they need to continue key operations.
Often, such implementations in the wake of an emergency, are not properly configured, may be insecure, and may not meet required corporate compliances, such as HIPAA. It also means having trained end-users how to access that in-place, contingent data so they can continue to get to the systems they need, whether they are working on company-issued machines or their own mobile devices. IT employees, who would setup these temporary disaster recovery fixes, may not be available or present to implement them, so redundancies need to be built in, and plans clearly documented, so that whoever needs to step in can do so. Cloud computing, virtualization, and the continuing increase of always-connected and relatively powerful mobile devices in the hands of end-users are all key ingredients in deploying a strong and effective disaster preparedness solution. In a recent survey conducted by Symantec of IT decision-makers in small- to-mid-sized businesses, only 26 percent have a disaster preparedness plan in place. It is not only about stockpiles of water and batteries and survival, it is about what people know, what they think, and who they trust. NCDP, in collaboration with The Children’s Health Fund (CHF), has commissioned a series of national and regional opinion polls on preparedness issues, conducted by the Marist College Institute for Public Opinion. But about the same percentage believe that in the event of an attack or other disaster first responders would arrive within a matter of hours (which is often not the case).
Just one example: by documenting a gap in preparedness among Latino respondents, the survey may direct attention, and resources, toward developing a more robust communications strategy for reaching Spanish-speaking Americans.
Irwin Redlener speaks on fragility, conflict, and disaster risk pertaining to children in the global migration crisis at the World Bank Group’s Fragility, Conflict, and Violence Forum on March 1.
Every week, tens of thousands of passengers arrive to and leave from West Africa, the epicenter of the ongoing Ebola epidemic (Figure 1). For instance, although the level of hospital preparedness to Ebola is difficult to assess, a survey of 700 nurses at over 250 hospitals around the country revealed that 80 percent were unaware of a hospital policy regarding the admission of suspected Ebola patients as of last month [5]. Therefore, an ongoing commitment to strengthening weak public health systems in developing countries, with particular focus on disease surveillance and response capacity [10] will likely be especially beneficial in confronting future outbreaks of this kind. The proposal that aims to improve domestic preparedness, enhance global capacity to swiftly and effectively respond to future disease outbreaks and accelerate drug and vaccine development will not only serve the goal of ending the current Ebola outbreak but will also provide a solid foundation for meeting challenges of this or greater magnitude in the future. Beyond the sensational and the clinical, however, there is also coverage that touches upon the vulnerability and potential benefit of a well-coordinated response with the business community. In particular is the sudden surge in demand for the development and manufacturing of products in a business environment that favors highly efficient, just-in-time production and delivery systems in non-emergency times. As the disease has been defeated within their corporate community, they are carefully opening up their services to those affected outside of the plantation workers and their families [5].
With the many teachable moments that Ebola is presenting us with, the nature of our business communities as partners in response is deserving of a more robust understanding. More importantly, in a short period of time it shifted from an overseas response of high profile agencies (CDC, USAID, WHO, and even elements of the US Military), to being under the responsibility of local health departments and healthcare facilities. We can also ask why the contaminated articles were left in his apartment for so long with his friends and family left wondering what to do.
Although there is still much to learn about Ebola, an actionable set of infection control recommendations, treatment guidelines and other critical tools are being made publically available and updated regularly. We may even see some cases of secondary infection, but we will not likely see a widespread outbreak like we are seeing in West Africa.
These surveys have provided information critical to emergency planning efforts and policy makers on all levels. The survey showed that less than half of Americans feel that their community has an adequate response plan for a disaster that gives no advance warning, such as an earthquake or terrorist events.
NCDP’s survey findings have been cited in numerous publications, as a basis for disaster planning and response, and have recently been used by FEMA’s Directorate of Individual and Community Preparedness to help inform new approaches to preparedness messaging.

Even more strikingly, the time sufficient for a disease to reach any location around the world is often shorter than its incubation period [2]. About 18,000 nurses at Kaiser Permanente-owned hospitals and clinics in California went on strike this Tuesday over a perceived lack of equipment and training to adequately respond to potential Ebola cases [6]. IBM has recently launched an initiative to create a ‘cloud-based Ebola Open Data Repository’, in order to provide governments, researchers and NGOs with access to openly available data that can be helpful in improving disease surveillance and response [13]. While the term “public-private partnership” is used frequently in our national Homeland Security dialogue, the current Ebola Outbreak in West Africa and its impacts domestically offer a glimpse of how a disease outbreak and our business communities intersect.
Companies can, and are, surging to meet this need, but from a step behind if relationships are not pre-established with public health and emergency managers in anticipation of scenarios like this one. Ghana and Ivory Coast, which account for half of the world’s cocoa production, have not been directly affected by cases of Ebola. In response to this, insurance brokers have developed policies to cover revenue interruptions related to Ebola and other outbreaks [10].
A more thorough articulation of the value that is created through these collaborations can speak to the interests of both the shareholders as well the public. But one only needs to wait in a crowded emergency room, or work in an understaffed and over-taxed health department to understand that these are the wrong questions to ask.
However, as a nation, we are also failing our local practitioners by operating as though knowledge and world class national institutions are sufficient to stop an outbreak. These are the dividends being paid by our investment in local health and medical preparedness over the past decade.
In this first of four articles on disaster preparedness, we tell you how to start thinking about disaster preparedness and how to gather the information you will need to create an effective, efficient plan for recovering from whatever fate throws at you.
An important part of NCDP’s mission is to understand the psychology of preparedness in the general public, as well as the critical elements of community preparedness. Yet the proportion of families who lack an emergency preparedness plan has declined since 2003. For instance, the Ebola virus has an incubation period of 2-21 days after infection [3] which, as the recent U.S. In some ways the relationship is direct, whereas in others it is less obvious but similarly important. There is also a business case for this, in that any unmet demand results in an opportunity cost by having an insufficient supply to meet customer orders. However cocoa as a commodity has surged on concerns of what a disruption to the flow of production from small farms in these countries would have on the world’s supply of chocolate [6]. The question is how, as a nation, are we preparing our local institutions to meet these global challenges?
According to US government figures, hospital preparedness funding has decreased by 50% since 2003, and by 30% just in the last year. If we continue the trend of divestment in preparedness, our readiness will be a slow decline, marked by very public failures blamed on institutions and individuals who “should have done things differently”. We are focused on  finding the evidence that will help individuals and communities improve their readiness  and capacity to respond and recover from emergencies of every kind, as individuals, families and communities. Moreover Latino respondents lag behind other groups on all measures of family preparedness. Cocoa producers, recognizing the threat, have taken steps to increase short-term production [7] and to provide support to the fight against Ebola [8].
We will be rich with the knowledge of what we needed to do, but lacking in our ability to mount an effective response.
Not surprisingly, Ebola has caused multiple deaths in Western countries (Figure 2) and even countries like Denmark where risk was thought to be ‘negligible’ [4] have had suspected cases. These examples illustrate how companies can meet humanitarian and economic interests with their operations. Additionally the local public health workforce has been decimated by budget cuts with a workforce reduction of nearly 44,000 jobs since 2008, with more cuts expected. Without local institutions, national knowledge has no vehicle to effect response. Ebola has captured the attention of our nation, and reminded us of how connected we are globally.
It should also serve as a reminder for how we must continue to invest in being prepared to respond locally.

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