Kansas Department of Health and Environment, Kansas
August 29, 2014
Kansas Department of Health and Environment, Kansas
August 29, 2014
During the last week in September 2012, the states of Kansas and Missouri hosted the “Amber Waves” full-scale population monitoring exercise in the Kansas City metro area to prepare for a response to a radiological terrorism event. Amber Waves was a series of events surrounding a radiological dispersal device (dirty bomb) incident. In addition to the full-scale population monitoring exercise, Amber Waves included a tabletop exercise, a workshop focusing on agricultural issues, and a workshop focused on interfacing with federal responders. The events successfully helped participants strengthen their capacity to respond to a radiological event and highlighted areas for improvements in future exercises.
Planning for a tri-state and federal radiological exercise began in 2009, bringing together representatives from Kansas, Missouri, and Iowa. However, following the Fukushima nuclear incident in Japan in 2011, the focus of the initial exercise framework evolved from a single full-scale radiological exercise to multiple events focusing on particular areas of a response. One important area of focus was the need to monitor affected residents for potential radiological contamination and provide for decontamination as needed. The Amber Waves population monitoring exercise took place in September 2012 and was hosted by Wyandotte County (KS) Health Department. Participants included subject matter experts from the Kansas Department of Health and Environment along with many partner organizations including the Kansas State Animal Response Teams, volunteers from the Kansas Radiation Response Volunteer Corps (RRVC), the U.S. Centers for Disease Control and Prevention, and many local health departments in the Kansas City Metro area. While the entire event provided a valuable opportunity to test radiological capabilities, a number of lessons learned emerged from the population monitoring exercise.
Several logistical challenges were present during the initial planning for the exercise, including finding a facility large enough to serve as a Community Reception Center (CRC) to host all 100 victim actors, 12 dogs they brought with them as pets, approximately 50-75 vehicles they drove to the facility, approximately 150 responders, and 25 exercise controllers. Wyandotte County Health Department secured a National Guard armory in Kansas City, which was an older facility and not ADA compliant. Trying to map out the flow of the exerciseto accommodate vehicles, animals, and those with functional needs was extremely challenging with this facility. Wyandotte County modified their plan numerous times before a workable flow was developed.
In addition, Wyandotte County Health Department brought in numerous partners from other neighboring local health departments to serve as workers at the CRC, and those workers had no background or training in population monitoring. This was a challenge which required detailed “just in time” training on the day of the exercise. There were also numerous law enforcement representatives providing security at the CRC. These individuals also required just in time training and were identified as a target audience for future trainings. Planning for the exercise was a busy and stressful time, bigger than the exercise design team expected.
While the building itself presented some planning challenges, the exercise planners did the right thing by making several visits to the location and doing multiple “dry runs” because a lot of people came up with different ideas. The day of the population monitoring exercise there were about 300 people involved. The building did prove problematic since there were only four bathrooms which was not enough to accommodate everyone. However, the victim actors didn’t seem to mind since drinks and snacks were provided. To accommodate for the tight space, there were multiple entrance and exit points.
The Wyandotte County staff were organized with player packets. They had ICS charts, action sheets, the facility flow diagram, and an external evaluation guide. They had also borrowed portal monitors from local fire departments and the U.S. Environmental Protection Agency. The exercise controllers also served as evaluators in the various areas of the CRC and they were provided with evaluation guides to help them. Each victim actor including the dogs received a sheet which described that person’s condition and level of contamination. For the just in time training, job aids were developed for each station in the CRC, and for each piece of equipment which was used by the responders.
The exercise tested the objectives which were initially laid out. These included establishing a location for a CRC; coordinating resources and staff for the CRC, including the integration of the Kansas RRVC with the other local responders; setting up the CRC in a timely fashion; monitoring all the residents who came to the facility, along with their pets and vehicles, for radiological contamination, decontamination of any which were contaminated; preventing the spread of contamination to the facility and the workers; documenting the use and replacement of resources, as well as any exposure and contamination; and demonstrating long-term tracking ability.
We learned a lot of lessons from the “Amber Waves” exercise which will help us as we plan for and conduct future exercises. Accountability and security/control of the facility was a big challenge since there were some mix-ups between observers and players. Improving the process to verify who is truly a responder is an action item on which we will focus. Additionally, there needs to be a specified escort/security for observers at exercises because at times they interfered with play or got in the way, and it was pretty chaotic. Further, identifying a facility which will successfully serve those with functional needs is critical.
Improving the just in time training with a focus on the target audience of individuals new to radiological concepts and CRCs is also critical. With pets, more planning and training is needed overall. During the exercise, only 12 well behaved dogs were used, but there will be numerous pets of all types showing up at the facility which will need to be monitored and possibly decontaminated in a real event.
And as mentioned earlier, there is a definite need for more people trained in population monitoring. The Kansas RRVC is a registry for those volunteers who have received training and agree to volunteer to assist with the monitoring and decontamination activities at a CRC. During this exercise, there were 30 individuals with radiation expertise working as responders at the facility in addition to over 100 public health and law enforcement individuals. This was not enough. The workers were somewhat overwhelmed with only 100 victims and 12 pet players. To help get more staff trained in radiation response, the Kansas Department of Health and the Environment is currently applying for a grant to provide funds to support training and assist another local health department in Kansas with planning for establishment of a CRC for population monitoring and developing and conducting another population monitoring exercise.