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Ali Jandal

I think what surprised me the most is just how many policies there are (and that it too) to establish the powers that public health has. For something so important, it is really surprising that it took so many different large scale events for government officials to accept the fact that local communities need to be supported and that that support should be facilitated - and that certain rights that are available during normal non-emergency periods may need to be sacrificed. It also surprises me that trying to fund emergency preparedness is so difficult.

Vince - I agree that I really appreciated learning about the structures of emergency response as well as how complicated it still is. It has definitely taken me multiple attempts to try and figure out who is actually in charge during what kind of emergency. It makes me thankful for the public health and emergency response and prepardeness officials around me.

Amelia - I agree that the Chicago heat wave report was a really enlightening  case study. After reading the title I thought to myself "who dies of a heat wave" because I had never heard it before. It was really helpful to see just how surprising, but obvious in hindsight some of these emergencies can be.

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@Mel: I also had never considered the role of medical examiners during disasters. It is such an important job though, especially for them to take care of the bodies and help provide peace to remaining family members. There are definitely many aspects to disaster planning/management that I had not considered before this course!

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@Elena: I agree that debriefing and assessing the emergency response system after a disaster is critical. Being able to learn from our experience and understand what went well and what went wrong helps us improve ourselves for next time.

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One thing I have learned so far in this course is how much federal infrastructure is in place for dealing with disasters and emergencies. There are several federal agencies with the purpose of providing support to any area of the country facing an emergency. The vast array of these agencies and their potential is impact is amazing. I know that after each disaster or emergency our country faces these teams work together to fix any gaps in coverage and be better for next time.

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@ Helen: I too have just been overwhelmed with how many teams are involved in disaster response. I did not realize there was this level of coordination between agencies and thus have a new appreciation for the importance of each team having a clearly defined role and effective communication between teams. - Elena Kurudza

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Elena Kurudza: I think one of the main take aways I have gained at this point has been the importance of debriefing and assessment of the system after a disaster. I feel like going into this course, when I heard disaster response, I always thought about "disaster planning." While it is great to have a well functioning system in place, each disaster brings a new set of challenges with it and thus, new learning opportunities and new ways to improve the system. The more data the better.

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Mel Ricker: I too am impressed by how many teams are involved in responding. I was glad to hear that there are some specific mental health teams, as people are surely affected greatly emotionally, including those who are attempting to provide care. I had also never considered the role of coroners/pathologists/morticians in identifying bodies and providing some closure to families- that's an incredibly tough, but critical, job. I also found it fascinating that there's a National Stockpile of supplies! @Ryan: I agree that communication is the absolute key, especially having a way that different leaders can communicate reliably and quickly, such as a central command center. @Anonymous (I'm sorry I'm not sure who posted the comment...) I agree that expanding the definition of a "reportable condition" following the Chicago Heat wave was important. The thing that struck me the most about the Heat Wave in Chicago was that it was not initially recognized as a public health emergency. It's important for all providers to report suspicious patterns that they are observing, because there's a chance that it might be the start of a new public health emergency.

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Gisele - I was also surprised to see how much of the planned responses were not medical based. It brought to my attention how important other things that I took for granted such as working roads were to an emergency response. Lastly, I was also very happy to see how much pets' well being was considered in the responses too as pets are truly a part of families.

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Danika - I agree that its really important to have proper systems to prevent and manage disasters. The Chicago case really put it into perspective how one disaster can overwhelm all the systems that are already put into place if there isn't much organization or structure set up to manage something at that large of a scale.

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So far in this course, I have learned quite a bit about the different agencies that the government has to manage disasters. Though I always assumed there was something in place, it has been really interesting to learn about what those things exactly were and all the issues they cover in addition to medical care. I have also learned about how with so many groups that are set up to manage the issues that may come up after a disaster, coordination among them is key. Otherwise, it can lead to inefficient use of resources as well as missing some of the needs that arise. I also enjoyed reading about the Chicago heat wave and how the aftermath was in a way used as a case study for the city to change their infrastructure on how things were done so that they could best respond to future disasters.

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Ryan- I completely agree that communication seems to be a key theme here. I also appreciate your point about the importance of tailoring disaster preparation to the community size and/or resources available to it.

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Amelia- I agree that this class has been very enlightening in the pure number of organizations that exist for emergency response. I have also found it interesting to learn more about the policies (even just the ED bypass one was very interesting in how strongly it impacted the Chicago situation) that come to play in disaster responses.

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One of my biggest take-aways this far into the course has been how important organization, structure, communication, and clear roles are for the optimal response to disasters. I agree with many of my classmates that the Chicago Case study was a really eye-opening example of how easy it is for a disaster response to go wrong without the proper systems in place to prevent, prepare for, and react to the disasters. Prior to this course I did not realize just how many specific organizations are involved in community, state, and national responses, and it has been fascinating to learn about the specific roles from medical response teams to mortuary response teams. I have also found it interesting to know where the funding comes from to support many of these organizations, and how that can effect the areas best prepared to respond to disasters.

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Something that I learn so far in this course is learning about certain disaster like the Chicago heat wave of 1995 and the impacts it brought to the community. Reading about the Chicago heat wave helps me to realize how important and integral it is to have an emergency response and what happens when that response is not in place, leading to fragmentation and delay of care. Another important point in thinking about the Chicago heat wave is how the health department expands its definition of reportable disease given that they missed the devastating effect of the heat wave for 3-4 days.

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India Anderson-Carter: I have been pleasantly surprised to learn about all the infrastructure there is in preparing and responding to emergencies. I have enjoyed learning about all of the coordination and communication that goes into planning for the unexpected. For example, learning about the different federal agencies and how they all play a role to ensure public health and safety has been really interesting.

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Gisele Toumi
Previously, I imagined public health departments would solely be in collaboration with health agencies. I was surprised to see that they also take into account things that may not be directly health-related but can still impact the wellbeing of a community, such as property, animals and infrastructure. It was refreshing to see the various agencies they frequently collaborate with to provide holistic interventions for community health.

Brenna - the veterinary response was something I found especially interesting. It might be because the post-hurricane images I see are usually of abandoned pets and destroyed homes. I wasn't aware the government made efforts to protect animals too.

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Kim Vidmar

A huge take-away from the course thus far is the extensive planning and multi-level systems that exist for dealing with public health disasters and emergencies. I was not aware of the NIMS or ICS. I thought it was particularly interesting to learn about the history of our national public health disasters like 9/11 and the Chicago Heat Wave that have lead to the development of such intricate and thought-out systems. There is such a steep learning curve when it comes to disaster preparation, and as much as I hope our nation is prepared for the next big disaster or emergency I am sure there is still so much to learn in terms of preparedness, and our programs and policies still need frequent assessment and modifications as our population and public issues change over time.

Ryan - I totally agree about communication and coordination being pivotal in disaster response. Prior to this course I wasn’t aware of how much effective communication could change the course of an event like the heat wave in Chicago!

Amelia - I was also unaware of the numerous policies, protocols and resource allocations that exist prior to this course. The examples given so far really reinforce the importance of advocacy and policy development, as it can greatly impact the health of a whole community!

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Mariana Montero Jaques
I was struck by the contrast between the successful response and recovery of the Minneapolis bridge collapse compared to the failed, "too little, too late" reaction to the Chicago heat wave. These two examples really emphasize how critical it is to have communication between organizations, a plan in place, and designated leaders in these situations in order to coordinate an effective response. I've been overwhelmed by how many various organizations and teams exist for the purpose of public health preparedness, but it makes sense that they all need to exist.

Ryan - It is interesting to learn about how communities have learned from past mistakes in terms of different communities requiring different kinds of resources. Disaster response for an isolated rural town looks very different from disaster response in a crowded urban city.

Brenna - I was also surprised by how many systems and organizations are in place for the different needs of the community. I love that the NVRT exists, because animal safety seems like it would otherwise be forgotten or thrown to the wayside in times of crisis.

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Brenna - your comments about seeing the big picture really resonate with me. I think this becomes somewhat of a challenge for us because we're so accustomed to thinking about a single patient and how we can address their individual needs. Transitioning to thinking  about populations as a whole is the goal of public health and it's cool to start thinking about healthcare in the frame of mind.

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Amelia - I was also very interested to learn about the severity of the Chicago heat wave. I remember learning about it but didn't fully appreciate the severe toll it took on vulnerable populations in the city. It's unfortunate that it often requires a major event such as that one to lead to changes in policy.

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A common theme that has been present throughout the first week of the course is the need for coordination and communication when responding to public health emergencies. This is because in times of chaos, it becomes even more important to have hierarchical organization and accountability to ensure that tasks are being completed and the proper resources are being deployed in a timely manner. I also appreciate how public health officials have recognized that different areas have different abilities to respond to natural disasters or public health emergencies. The same flooding that could easily be handled by a big city may very well cripple a smaller town in an isolated region. For this reason, it is important to have individualized responses based on the location, type of personnel, and capabilities of the local public health department.

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Amelia Baltes
So far in the progression of this course, I have learned a great deal on this history of certain events (e.g. the Chicago Heat Wave, 9/11) and how this history has influenced current practices and policies. Prior to starting this class, I knew that the 9/11 events sparked a true wave of policy and practice transformation and creation; however, this class has put into perspective just how much national security and emergency response operations have developed since this particular event. Furthermore, this class has put into perspective how many different response teams exist within our infrastructure and how specific their roles are when responding to emergency situations. Lastly, it has been interesting to read about the specific policies that impact emergency response protocols and resource allocations. I have not had much exposure to these policies in the past, but it has been great to learn more about the reasoning behind why decisions are made and who holds specific power over certain decisions.
Vincent: This course has also opened my eyes to the organization of response teams and overall response efforts. The FEMA course was very interesting and provided a lot of useful information that I think anyone would benefit from learning.
Brenna: I agree with you completely about the big picture. A lot of the learning modules, and specifically the case report, really place emphasis on looking at the larger picture and the connections that can be made. It's interesting that you specifically brought up the vet response team - that was one that I had no idea existed but it definitely makes sense after reading it.

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Brenna, I agree that it is important to look at the bigger picture instead of focusing on individuals in the case of public health disasters because, as you mentioned, there are often larger system issues that could be addressed and lead to more meaningful solutions. –Allison Weisnicht

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Vince - I agree with everything you said! I think FEMA was the only organization I heard of prior to this course. I feel like it's a good thing I haven't heard of these organizations though, because it means that we haven't needed their services!

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Allison - I completely agree! I was also especially interested in the role of the Veterinary Response System. I also find the ethical dilemmas that arise during an emergency very interesting as well.

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One thing I have learned so far is the importance of considering the big picture when it comes to a public health disaster. Previously, if I were to think about a disaster such as the heat wave in Chicago, I would probably think "why didn't those people turn on their AC?" or "why didn't they just go to one of the cooling stations?" Now, I have gained insight into how influential systems are in mitigating, or in the case of Chicago, perpetuating the crisis at hand. It is unfair to consider these disasters as individual problems -- these are problems pertaining to an entire population. Also, I have been impressed by the number of organizations involved in different disasters and how diverse they are in their roles. I was completely unaware that a veterinary response system existed, but I definitely agree that this is of the utmost importance for both animals themselves (I'm biased, I love animals!) and pet owners. - Brenna

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Allison Weisnicht

So far I learned about all of the teams involved in responding efficiently and effectively to a public health emergency. I previously did not know much about the Public Health Service Commission Core, National disaster medical system, or Strategic National Stockpile. I though it was especially interesting to learn about the National Veterinary Response System and their efforts in ensuring pet safety in public health emergencies. It was also helpful to see the practice disaster drill performed at UCLA and the level of coordination necessary in this process. In addition to all of the coordination efforts in carrying out a response to a public health emergency, the ethical dilemma articles highlighted how complex these situations can become and the difficult decisions that healthcare providers have to make.

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Something I have learned so far in the course is the organization of response to a disaster or emergency. I was unaware of the detailed structure involved, for example, in a FEMA response. I also was unaware of the Stafford Act and the federal government's response to disasters. It is impressive at the amount of detail given to organization of something that would be a temporary objective, but I can see the reason why.