The title of this post was inspired by one of the last scenes in one of my favorite movies Kingdom of Heaven. During the scene Balien (Orlando Bloom) is speaking to a crowd of scared residents of Jerusalem during the time of the Crusades of the 12th Century. While his speech focuses on religion and the various claims to pieces of land, the statement “No one has claim. All have claim!” speaks to me about our current COVID-19 predicament, particularly statements by governments, experts and the media that noone has ever thought of preparing or responding to a COVID-19 like outbreak. They are wrong. All are responsible. Noone is responsible.
What does that mean? It means in many, many planning documents from the Local, State and Federal level, there is mention of and prompts for localities, government organizations and even the private sector to prepare for outbreaks of this magnitude. This is where “All have claim!” comes in. Watch early or even recent news briefs and officials have made and continue to make statements like, “Noone could have planned for this” or “Who could have thought of this?”. Yes, we could have, and yes, we did think of this. In fact, some leaders sign a document every year that states we are “NIMS Compliant”. What’s more, it’s usually on official letterhead. So what is NIMS?
The National Incident Management System (NIMS) is a national guiding document for Local, State, Federal, Tribal and Private Sector partners to use to prepare for and respond to all-hazards…ALL…hazards, including pandemics. In the 2017 version of NIMS “Public Health” is mentioned 14 times. These mentions include areas like Public Information, Multiagency Coordination Groups (MAC Group) and how to incorporate Public Health and other partners in Operations within the Incident Command System (ICS).
Hmm…surely a one off, right? No, let’s take a quick gander at another national level document we all take training on and review, the National Response Framework (NRF). What is the NRF? Here’s the opening quote from the document itself, “The National Response Framework (NRF) provides foundational emergency management doctrine for how the Nation responds to all types of incidents.” In the latest version of the NRF from October 2019, Public Health is mentioned 35 times and is often mentioned with Healthcare which has 9 mentions. So what?
So, from about 2011 and throughout my time in Public Health and Emergency Management, I was a bit of an outlier in that I latched onto the principals of all-hazards incident management and felt the importance of preparing myself, my colleagues in the health department and partnering strongly with my Public Safety and General Government partners to discuss, drill and fully exercise a pandemic-like response. To me, these practical skills provided way more value than the lengthy, administratively draining checklists we were required to complete and that deemed us “ready”. Do I think my partners and I at the Local and State level were special? Yes, I believe we were. Why? We prepared together, we argued, we pushed through preparedness and response initiatives like H1N1, Tuberculosis outbreaks and Ebola. But we did it together, and for real.
I’ve found that similar partnerships across the Public Health, Public Safety, Healthcare and Private sector are not equal or efficient. My $.02 on a viable path forward:
- Public Health and Healthcare get a better seat at the table
- I was fortunate in that my Public Safety and Emergency Management partners understood the value of Public Health and Healthcare as partners in emergency preparedness. I also saw where this was not the case, but it’s a two-way street.
- Public Health and Healthcare need to step up in preparing their own staffs for real world responses and with a louder voice among their Local, State and Federal partners
- Require ICS training for all employees up to the 300 level
- This is required for some government employees, but should be expanded to the Private sector also as this course provides more hands-on training than the lower level and sometimes online only ICS courses
- Get rid of the Hospital Incident Command System (HICS)
- HICS is a neat concept, but it doesn’t provide the broader skillset that a solid foundation in the all-hazards ICS principles would (see suggestion above)
- Leaders need to make time
- Leaders see many documents cross their desks. When those documents state a government or business is ready for hurricanes, outbreaks, etc., take a few extra minutes or meetings to dig deeper and get examples of the practical preparations.
- Talk through and plan for uncomfortable topics
- Mass fatality management, medical surge, crisis standards of care and more. At times no one wanted to own these, but now…we have to.
- Work with funeral directors, partner with hospitals, and practice and document how, at the worst of times we’ll have to do “the greatest good for the greatest number” with limited resources
- Practice points of dispensing…for real
- Give annual flu shots as if you’re really responding and providing a cure…you actually are right?
- Set external security, set internal security, create Nursing Strike Teams. manage the logistics of vaccine cooling, etc., but do it full scale and don’t just “check the box”
So, how can we say “No one has claim”? For pandemics like COVID-19 or others, we can never have enough ventilators, masks, gloves, etc. The numbers are just too hard to keep up with. What we can do is prepare our minds and muscle memory to be ready through practice, discussions and exercise. I submit we should also not rush to buy a bunch of stuff that will go bad like we have in the past after 9/11, Katrina, radiation response or active shooter gear that’s gathering dust in the closet. Instead, let’s focus on continuing to shore up our actionable plans to be in place to help us ramp up and coordinate with our PEOPLE together through effective PROCESS that can no doubt help us all make significant PROGRESS.
Kevin Pannell, PMP, PSC3 | Creator & Host, ‘People, Process, Progress’ podcast | Listen on Apple – Spotify – Google – iHeart – Blubrry | Website | LinkedIn | Email | #peopleprocessprogress #peopleprocessprogresspodcast
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