Ready or Not? A Glimpse into How Public Health Responses are Coordinated

Most of us dream of one day working for the Centers for Disease Control and Prevention (CDC) or World Health Organization (WHO). We often envision ourselves responding to public health events around the globe and being placed in the middle of the action- whatever that action may be…

However, have you ever wondered how the response to an infectious disease outbreak or disaster is organized? Do you know how multiple agencies coordinate people and resources during a response? This blog post will provide a brief overview of functions of the National Incident Management System (NIMS), Incident Command System (ICS), Multi-Agency Coordination Systems (MACS), and Emergency Operations Centers (EOC).

Emergency management professionals are tasked at the local, state, and national level with coordinating responses to incidents- also known as events, natural or human-caused, that require a response to protect life or property, according to the Federal Emergency Management Agency (FEMA). Governmental agencies in the United States are required to follow NIMS, a systematic approach that is grounded in preparedness concepts and supports incident management for a diverse range of hazards, in order to receive preparedness grants or funding. NIMS incorporates standard resource management procedures and includes principles for information management. While NIMS is NOT a concrete plan, it supports the development of plans created by various jurisdictional players- one of the benefits of being a flexible, scalable, and dynamic approach.

The five key areas of NIMS are:

Preparedness– focused on planning, organizing and equipping, training, exercising, and evaluating/improving readiness to respond to an incident. Preparedness is supported by partnerships that are formed between government agencies, nongovernmental organizations, and the private sector before an incident.
Communications/Information Management– based on the concepts of a) Common Operating Picture, b) interoperability, c) reliability, scalability, and portability; and d) resiliency and redundancy. Communications systems should be flexible and adaptable to each incident.
Resource Management– serves as an accountability system for establishing current assets, identifying needs, requesting additional resources as well as organizing and tracking materials and personnel. It also allows for critical resources to be shared across jurisdictions.
Command and Management- consists of three organizational constructs: 1) Incident Command System (includes a management hierarchy that can be integrated into a common organizational structure), 2) Multi-Agency Coordination System (utilized when multiple agencies are involved) and 3) Public Information (processes for sharing timely, accurate, and relevant information during an incident).
Ongoing Management and Maintenance

Emergency Operations Centers (EOC) are used for information collection and evaluation, coordination, and priority setting. These are central locations where officials and personnel from key agencies go to meet, make decisions, and direct response activities. Resources are coordinated at local EOCs, then at state EOCs when there are not enough resources to support an effective response. If state resources are overwhelmed then assistance from the federal government may be requested.

As stated earlier, this is just a brief overview of how a response is coordinated during an incident such as a public health event. In my next blog post, I will share my recent experience applying NIMS from a regional health department perspective.