Best Practices and Lessons Learned from Conducting a Shelter Surveillance Tabletop Exercise

BACKGROUND: Conducting health surveillance during a large scale incident or disaster provides essential information on the health of residents and provides situational awareness for emergency management and public health professionals.  In December 2012, the City of Nashua, NH Division of Public Health and Community Services and the New Hampshire Department of Health and Human Services (DHHS) convened a Shelter Surveillance Work Group to develop guidance and protocols for conducting health surveillance in emergency shelters that aligns with the Centers for Disease Control and Prevention’s Public health Emergency Preparedness Capability 7, Mass Care, Function 4: Monitor Mass Care Population Health. Since then, NH has implemented a training program for staff and volunteers and most recently conducted a tabletop exercise following a winter storm in November 2014.

METHODS: A tabletop exercise was developed to test the shelter surveillance guidance, more specifically, to identify the roles and responsibilities of participating agencies, identify existing laws and plans, evaluate current shelter surveillance guidance and ability to provide infection prevention and control recommendations. In addition, the exercise evaluated the communication flow and information sharing between emergency shelters, the State Emergency Operations Center and the New Hampshire Department of Health and Human Services. The scenario was based on a major storm that created large scale power outages and partners from the local, regional and state level were invited to participate.

RESULTS: Nineteen individuals from ten organizations, including the American Red Cross, NH Homeland Security and Emergency Management and local and regional health departments attended the tabletop exercise. Strengths included strong partnerships among various agencies, the training of staff and volunteers and the epidemiological capacity to analyze data and respond to outbreaks at the NH DHHS. Areas for improvement include continued work with emergency management, including language in the guidance that includes information on identifying information and the need to develop an epidemiology strike team to support emergency shelters in the field.

CONCLUSIONS: This tabletop exercise provided an opportunity for planning and response agencies to test NH’s ability to conduct shelter surveillance and share information with emergency shelters during a disaster. The best practices and lessons learned from this tabletop exercise can be shared with other local and state health departments to inform their process as they implement a shelter surveillance plan.