State of Delaware Department of Health and Social Services Division of Public Health Standard Operating Guideline NATURAL DISASTERS TABLE OF CONTENTS 1.0 Purpose 2.0 Planning Assumptions 3.0 Concept of Operations 3.1 Pre-Disaster Phase Checklist 3.2 Impact Phase Checklist 3.3 Post Disaster Phase Checklist 4.0 Hurricane Preparedness Standard Operating Guidelines 5.0 Weather Bridge Call Procedures Tab A Glossary of Terms Tab B Natural Disaster SHOC Quick Reference Guide Tab C Weather Measurement Scales Scale 1 - Saffir/Simpson Scale for Hurricane Scale 2 - Fujita Tornado Scale (F Scale) Scale 3 – North East Snowfall Impact Scale (NESIS) Scale 4 - Modified Mercalli/Richter Intensity Scales for Earthquake Scale 5 – Heat Index 1.0 Purpose 1.1 To provide guidance and actions steps for the Division of Public Health (DPH) before, during and after a potential natural disaster that causes a major public health emergency. 1.2 Examples of Natural Disasters are: 1.2.1 Hurricane (wind) 1.2.2 Flooding 1.2.3 Tornado 1.2.4 Drought 1.2.5 Winter storm and/or hail 1.2.6 Severe thunderstorm 1.2.7 Major earthquake 2.0 Planning Assumptions 2.1 A natural disaster may cause significant health and medicals issues such as inadequate sanitation, dehydration (due to lack of clean potable water) disease, injuries, or fatalities. 2.2 Disruption of sanitation services and facilities, loss of power, and massing of people and shelters may increase the long-term potential for additional disease, injury and mental health and crisis counseling. 2.3 The Division of Public Health (DPH) may work with Delaware Emergency Management Agency (DEMA) to establish Disaster Recovery Centers (DRCs) in areas that have been affected by a Natural Disaster (See Delaware Emergency Operations Plan, State Recovery Centers). 3.0 Concept of Operations The Division of Public Health utilizes the concept of “Phased Planning” (Pre-Disaster, Impact, and Post Disaster). The following concept of operations consists of a series of checklists with action steps during the Pre-Disaster, Impact, and Post Disaster Phases for a Natural Disaster. The actions steps are design to provide guidance and suggested actions for DPH. These action steps may take place with or without a state of emergency declared by the Governor. 3.1 Pre-Disaster Phase Checklist 3.1.1 The State Health Operations Center (SHOC) may be activated prior to impact of the natural disaster to monitor the threat potential and to begin planning efforts. 3.1.2 The Pre-Disaster Phase Checklist ‘Action Steps’ provides guidance and suggested actions steps that should be taken or considered. 3.1.3 Depending on level of SHOC activation and pending natural disaster, Pre-Disaster responsibilities may fall to the Public Health Preparedness Sections (PHPS) and/or SHOC Operations until SHOC is activated at a Level 2. 3.1.4 DPH should refer to the Hurricane Preparedness Standard Operating Guideline in the event of an impending hurricane (See Section 4.0). PRE-DISASTER PHASE CHECKLIST ACTION STEPS RESPONSIBILITIES 1) Monitor the National Weather Service (NWS) for information regarding flood, tornado, PHPS winter storm/hail or severe thunderstorm threats. 2) Evaluate SHOC activation level to ensure coordination assessments and preparatory Command Staff/ Ops Chief actions are advancing. SHOC staffing should be adjusted as required. 3) Participate in Weather Bridge Calls with DEMA when it has been determined that Planning/PHPS a significant storm may affect Delaware. 4) Develop Situation Awareness Reports (SITREP) based on information from the Planning/PHPS Weather Bridge Calls. 5) Fill out all appropriate ICS forms and conduct all briefings and meetings according Planning/PHPS to the SHOC Planning Cycle. 6) Ensure all vehicles and back-up generators have sufficient fuel levels and are Logistics/PHPS in proper working condition. 7) Preposition Modular Medical Expansion System (MMES) trailers, if possible. Logistics/PHPS 8) Issue Delaware Health Alert Network (DHAN) and Facility Resource Emergency Database Public Affairs/PHPS (FRED) alerts as necessary. 9) Conduct an inventory of safe drinking water, food, medical supplies and medicine Logistics/PHPS to determine if sufficient supplies are on hand to support Neighborhood Emergency Help Centers (NEHC), Medical Needs Shelters (MNS) and Emergency Response Teams (ERTs). 10) Establish communications with key federal, state and local partners. SHOC IC/Ops Chief 11) Alert Delaware Medical Reserve Corps (DMRC) and Interpreter Corps of potential DMRC Coordinator/ deployment. F& A Credentialing Unit Leader. 12) Coordinate with ESF 1 (Department of Transportation) and the Delaware National Operations Guard (DNG) for evacuation of hospitals, nursing homes and individuals with special medical needs that live in their own residence. 13) Coordinate with ESF 1 to activate Medical Evacuation Transportation Plan to Operations support healthcare facility evacuation and patient movement through the MMES. 14) Coordinate shelter resource needs to include for shelter management personnel Operations (DPH Nurses) with the American Red Cross (ARC). 15) Consider activating MMES. If evacuating, MNS may be required. Planning 16) Coordinate with the ESF-6 liaison to assist in movement of dialysis patients Operations (See Emergency Dialysis Transportation Standard Operating Guidelines). 17) Coordinate with DEMA for activation of SART and/or a local animal group such as, the Logistics SPCA or the Humane Association, to assist with the care of animals while their owners are being cared for in alternate care facilities. 18) Coordinate use of the In-State Stockpile of pharmaceuticals as necessary. Planning/Logistics 19) Coordinate with Delaware Hospital for the Chronically Ill to support SHOC Logistics Operations (i.e. Family Support, Lodging, Meals and Security) as necessary. 20) Determine the need to evacuate or shelter in place. SHOC IC 21) Prepare and issue health and medical advisories to the public on such matters as: Public Affairs 1. Emergency Water Supplies or 2. Waste Disposal Joint Information Center, if activated 3. Mass Feeding Services 4. Dialysis Center Locations 5. Immunizations 6. Disinfection 7. High Heat Indices 8. Cooling Techniques 9. Location of Cooling Centers (if established) 10. Ways to Conserve Water 11. Water Restrictions 12. Health and Safety Related Winter Storm Advisories 13. Location of MMES Components 14. Location of DRCs 15. Location of Pet Shelters 16. Prepare an Emergency Kit 17. Shelter-in-Place Recommendations 3.2 Impact Phase Checklist 3.2.1 The Pre-Disaster Phase transitions into Impact Phase when the natural disaster is in the midst of striking an area in the state. 3.2.2 The State Health Operation Center will be activated during this phase. Depending on the natural disaster SHOC may be relocated for safety purpose. 3.2.3 The below Impact Phase Checklist ‘Action Steps’ provides guidance and suggested actions steps that should be taken or considered. IMPACT PHASE ACTION STEPS RESPONSIBILITIES 0 Continue to follow the procedures in State Health Operations Planning Cycle and fill All SHOC out ICS forms accordingly. 0 Deploy rescue teams, medical support and other life saving activities as needed. Operations 0 Evaluate the SHOC activation level to ensure coordination assessments and preparatory actions SHOC IC are advancing. SHOC staffing should be adjusted as required. 0 Continue to monitor the NWS for weather information. Planning 0 Continue to issue DHAN and FRED alerts as appropriate. Public Affairs/Operations 0 Continue to maintain communications with federal, state and local partners. SHOC IC/Operations 0 Develop plan of action for damage assessment of DPH facilities Planning 0 Re-evaluate resources needed to include medical equipment and supplies, personnel, and Planning/Logistics food and water. 3.3 Post Disaster Phase Checklist 3.3.1 There are several categories of public health activities that may need to occur in the aftermath of a natural disaster. The following action steps should be considered for natural disasters that have caused a significant impact on public health and safety: POST DISASTER PHASE ACTION STEPS RESPONSIBILITIES 0 Assess situation and activate one or all of the MMES components to manage medical needs Planning/Operations of those who are sick or injured. 0 Evaluate the SHOC activation level to ensure coordination assessments and preparatory actions SHOC IC are advancing. SHOC staffing should be adjusted as required. 0 Monitor the NWS for weather conditions to determine when it is safe to proceed outside. Planning 0 Continue to follow the procedures in the State Health Operations Planning Cycle and fill out ICS All SHOC forms accordingly. 0 Continue to issue updates to hospitals via DHAN and FRED. Public Affairs/Operations 0 Coordinate with ARC for blood and blood products as necessary. Logistics 0 Disseminated Public Information regarding natural disaster per the Crisis and Risk Communication Public Affairs Plan. 0 Coordinate to provide Mental Health and/or Crisis Intervention Services for people affected Operations by a natural disaster. 0 Establish Mental Health and Crisis Counseling in each MMES component as needed. Operations 0 Disseminate information to the public regarding mildew, mold and fungi abatement, and Public Affairs/Communication Unit recommendations to use a licensed asbestos removal company to remove asbestos from dwellings that have been deemed habitable. 0 Coordinate with ESF 3 (Public Works) for engineering and architectural staff to evaluate structural Operations integrity of hospitals after a natural disaster. Pest Control: 0 Coordinate with DNREC, Division of Fish and Wildlife to implement actions to prevent or control Planning vectors such as flies, mosquitoes and rodents which may cause an increase health risk. 0 Coordinate with HSP who may be able to provide basic information on ways to control pests. Planning Immunizations: Following a natural disaster, SHOC should target efforts to prevent certain preventable diseases that are commonly associated with a natural disaster. 0 Monitor tetanus among persons working or living among structural damage and debris, hepatitis Planning/Operations A, and influenza among persons living in crowded conditions in emergency shelters. 0 Conduct communicable disease surveillance and needs assessment activities following the event. Planning/Operations • For the diseases that people are at risk of contracting. • To determine if a disease outbreak has occurred or the potential to occur. If these efforts determine that a large number of persons may be at risk, DPH should conduct targeted community level mass vaccination activities (See NEHC Plan). 0 Provide immunizations against diseases associated with natural disasters to first responders, relief Planning/Operations workers followed by evacuees. 0 Provide accurate and timely information to the public regarding the risk of vaccine-preventable Public Affairs diseases and the need for immunizations. Excessive Heat Safety: Hurricane Season (June 1 through November 30) occurs during the hottest months of the year. During that time, the NWS may issue many heat advisories and excessive heat warnings. 0 Issue a Heat Advisory (monitored during a 24-hour period) when the heat index reaches or Public Affairs exceeds 105 degrees for two consecutive days. 0 Shelter or accommodate people who are displaced from their homes or without power due to Planning/Operations a natural disaster. 0 Activate Delaware Health Alert Network (DHAN) for high heat indices. Message recipients should Public Affairs be alerted to the need for cooling techniques for the highest risk categories: the elderly, the young, and people with mental illness and chronic disease. 0 Established cooling centers to provide an air conditioned place for individuals congregate and Planning/Operations/Logistics reduce incidence of morbidity and mortality due to heat stress. 0 Provide drinking water at cooling center facility to prevent dehydration and/or heat stress. Logistics Water Safety: Flood water may carry untreated sewage, dead animals, disinterred bodies and hazardous materials. Additionally, flooding compromises the safety of water supplies and the integrity of sewage disposal, leading to threats of food and waterborne illness. 0 Manage all minor water quality assurance activities. Office of Drinking Water (ODW)/Planning 0 Activate an ODW Strike Team if there are areas that have been severely impacted by flood. Planning ODW Strike Team The ODW Strike Team should obtain information about areas that have been identified as severely impacted. This information should be used to identify the public drinking water systems that are located in the impacted areas. If telephone lines are operational, the ODW should contact each identified public drinking water system in the affected area by phone to determine the following, (if relevant to the event): • If water supply system has power. • If the water system is without power. • If the system has an operational back-up generator. • If the water system has adequate water pressure. • If the water system was flooded or if the well was flooded. 0 If telephone lines are not operational, inspect the identified water systems to determine Planning ODW Strike Team each of the above. 0 If a water system is determined to have Planning ODW Strike Team/Planning/Public Affairs 1) no power and no back-up generator, 2) inadequate water pressure and/or 3) a flooded system/well, issue a “Boil Water Order” or “Do Not Use Order” to residents using the water system. 0 Once the system has been chlorinated and/or flush, perform testing to determine if contaminants Planning ODW Strike Team/Planning/Public Affairs are present. When no contaminants are determined to be present, lift the Boil Water Order. 0 Encourage residents to test private wells for contaminants. Planning should provide Public Affairs instructions and, when warranted, assistance to residents to facilitate testing. This assistance may include providing testing samples (e.g. water bottles), and arranging sample drop-off locations. 0 Coordinate with other state agencies to make clean water available to the public. Operations 0 Coordinate with DNG to dispatch water "buffaloes" or mobile potable water tanks. Operations 0 Coordinate with private companies to make clean bottled water available. Logistics/Finance & Administration Food Safety: Long-term power and utility outages can impact food quality and, if occurring during times of extreme temperatures, can result in an increased risk of food borne related illnesses. Health Systems Protection (HSP) or planning coordinates food safety activities. 0 Manage all minor food safety issues due power and utility outages. Planning/HSP 0 Activate Investigative Response Task Force (IRT) if there are areas that have been severely Planning impacted by long-term power and utility outages. IRT should obtain information about areas that have been identified as severely impacted. Within this information, HSPS should identify the food establishments that are located in the impacted areas. 0 Contact selected food establishments in the affected areas to determine if they have power. IRT/HSP If telephone lines are not operational, visit selected food establishments to determine the status of their power. 0 Work with each food establishment determined to be without power to ensure that food that must IRT/HSP remain cold is condemned if the power outage looks to be sustained and if alternate cold facilities are not available. Inspectors should observe the destruction of identified food. 0 Provide relevant information and education regarding food safety to food establishment IRT/HSP personnel throughout the event. 0 Ensure that the public receives timely, accurate, and relevant information regarding Public Affairs/Planning food safety. Unattended Children and Children in State Care: 0 Coordinate with DSS and DSCYF to provide medical, mental health and healthcare services to Operations/Planning meet the needs of unattended children and children in state care. 0 Assign interpreters to communicate with non-English speaking children. Operations 0 Ensure medical and mental health professionals have appropriate forms and Logistics office supplies as necessary. Dialysis Patients: In the event of a natural disaster, (impeding, current or post) DHSS assists with providing DSS representatives for the ESF-6 liaison position in the State EOC during activation. 0 Coordinate as required to provide additional resources to meet transportation and other Operations/Logistics shortfalls during implementation of this plan. 0 Coordinate any media support with the ESF-6 liaison in the State EOC. Public Affairs 4.0 Hurricane Preparedness Standard Operating Guidelines Pre-Season Phase Implement a minimum of 30 days prior to hurricane season (June 1 to November 30). ACTION REQUIRED SHOC RESPONSIBILITES PLAN REFERENCE 0 Enhance education on Public Health and Hurricane All All Preparedness related issues including personal preparedness. 0 General Population 0 SHOC Responders / Families 0 Health Care Facilities 0 Review, update, and exercise plans: All All 0 ESF-8 0 SHOC 0 DEOP 0 Hazard Specific “Hurricane” 0 Annex (HS-10) 0 MNS 0 DHCI Emergency Plan 0 Review and update entire Hurricane Preparedness Guidelines. All Natural Disaster SOG 0 Review and update resource lists. All Resource Manual 0 Staffing 0 Alert Lists 0 Supplies / Equipment 0 Test and maintain emergency communication systems Logistics COMM and equipment. 0 Deploy MNS equipment trailers to county EOCs Logistics MNS 0 DPH Administration reminds staff of their All responsibility to take care of their families prior to incident/event. Pre-Incident Phase Through Landfall +1 Implement 7 days (168 hours) prior to TS. TS pattern may be unpredictable. Actions should be used as a guide only. ACTION SHOC RESPONSIBILITES PLAN REFERENCE 0 Ensure sufficient copies of Hurricane Preparedness Planning Standard Operating Guidelines have been distributed. 0 Conduct initial assessment group conference call. Assessment Group 0 Evaluate SHOC activation level to ensure IC Staff SHOC coordination assessments and preparatory actions are advancing. Adjust staffing (as required). 0 Review Hurricane Preparedness Guidelines and emergency All SHOC plans. 0 Review and consider actions provided in the previous All phases and complete those actions not performed as appropriate. 0 Alert SHOC Personnel to prepare to report to the SHOC IC Staff/Public Affairs and/or a forward operating location. 0 Review FEMA Hurricane CONOPS. IC Staff DHS/FEMA Region III 2007 Hurricane Season CONOPS 0 Monitor National Hurricane Center and NWS information. Planning, PHPS 0 Initiate/Distribute Situation Report (SITREP). Operations SHOC 0 Initiate Incident Action Plan (IAP). Planning SHOC 0 Coordinate with DHCI to support SHOC activation Planning Operations (to include Family Support). 0 Lodging 0 Meals 0 Security 0 Family 0 Establish contact with state and local partners and Operations set update schedule, to monitor national and regional preparations and coordination efforts. 0 DEMA 0 Hospitals 0 Delaware National Guard 0 DHSS 0 Coordinate and conduct teleconferences for the purpose IC Staff All of identifying potential Federal resource deployment requests (as needed): 0 CDC, Senior Management Official 0 FEMA, Region III, HHS Coordinator 0 NDMS Regional Coordinator 0 Participate in DEMA / NWS weather bridge calls (as scheduled). Operations 0 Review/Update e-mail distribution groups (as necessary). 0 Ensure information is distributed to state and local partners. 0 Issue DHAN and FRED alerts as appropriate. Public Affairs / Logistics / IT 0 DHSS 0 DPH 0 Hospitals 0 Clinics 0 Ensure State EOC ESF-8 Liaison Reports to DEMA State Operations SHOC, ESF 8 EOC (if activated). 0 Consider/Confirm site selection and protective pre- Operations/Logistics SHOC positioning of equipment: NEHC ACC 0 SHOC (Alternate) PPE 0 ACC MNS 0 NEHC 0 MNS 0 Equipment Trailers 0 Vehicles 0 Inventory essential supplies and stock to support Logistics MNS NEHC, MNS, and Emergency Response Teams: NEHC 0 Safe Drinking Water 0 Food 0 Medical Supplies 0 Medications 0 Other: 0 Ensure all vehicles and back-up generators have Logistics sufficient fuel levels (ensure a minimum of 72 hours of fuel for generators). 0 Provide Just-In-Time training for 800 MHz system to Logistics/Training SHOC staff, hospital staff, etc. 0 Conduct test of 800 MHz radios on public health and Operations hospital channels. 0 Test back-up power generator service for: Logistics 0 SHOC 0 ACC 0 NEHC 0 MNS 0 Test and maintain emergency communication systems with Logistics state and other partners. 0 Test and maintain emergency equipment. Logistics Resource Manual 0 Continue reviews and updates of resource lists. All 0 Staffing 0 Alert Lists 0 Supplies / Equipment 0 Develop a timeline for receipt of Federal assets/ IC Staff DHS/FEMA Region III 2007 Hurricane Season CONOPS resources (if federal assets have been requested or deployed) 0 Review/Update safety issues for SHOC personnel and ensure Safety Officer widest dissemination. 0 DPH Administration reminds staff of their responsibility to All take care of their families prior to incident/event. 0 Activate time tracking mechanisms and distribute to Finance & Administration SHOC SHOC staff. 0 Ensure funding is available to support event. Finance & Administration Pre-Incident Phase Through Landfall +1 Implement 6 days (144 hours) prior to TS. TS pattern may be unpredictable. Actions should be used as a guide only. ACTION REQUIRED SHOC RESPONSIBILITES PLAN REFERENCE 0 Evaluate SHOC activation level to ensure coordination IC Staff SHOC assessments and preparatory actions are advancing. Adjust SHOC staffing (as required). 0 Review Hurricane Preparedness Guidelines and emergency plans. All SHOC 0 Review and consider actions provided in the previous phases All and complete those actions not performed as appropriate. 0 Review FEMA Hurricane CONOPS. IC Staff DHS/FEMA Region III 2007 Hurricane Season CONOPS 0 Monitor National Hurricane Center and NWS information. Planning, PHPS 0 Update IAP. Planning 0 Participate in DEMA / NWS weather bridge calls Operations (as scheduled). 0 Ensure information is distributed to state and local partners. 0 Issue DHAN and FRED alerts as appropriate. Public Affairs / Logistics / IT 0 DHSS 0 DPH 0 Hospitals 0 Clinics 0 Ensure State EOC ESF-8 Liaison Reports to DEMA State Operations SHOC, ESF 8 EOC if activated. 0 Coordinate and conduct teleconferences for the purpose IC Staff All of identifying potential Federal resource deployment requests (as needed): 0 CDC, Senior Management Official 0 FEMA, Region III, HHS Coordinator 0 NDMS Regional Coordinator 0 Coordinate and conduct teleconferences for the purpose All All of identifying potential resource shortfalls or issues for: 0 SHOC 0 Hospitals 0 Bay Health 0 Beebe 0 Christiana Care 0 A.I. DuPont 0 Nanticoke 0 St. Francis 0 V A Medical Center 0 State Facilities 0 DHCI 0 Governor Bacon 0 Stockley 0 Emily Bissell 0 Delaware Psychiatric Center 0 NEHC 0 ACC 0 MNS 0 Continue participation in FEMA-initiated Region/State IC Staff conference calls. 0 Begin evacuation and shelter coordination with Operations appropriate agencies. 0 ESF 1 0 ESF 6 0 DNG 0 Coordinate shelter resource needs to include shelter Operations/(SHS/NHS Liaisons) management personnel (DPH Nurses) with American Red Cross. 0 Determine needs for special populations: Operations/Logistics 0 Evacuation/Transportation 0 Food 0 Medications/Equipment 0 Prepare MMES equipment for deployment (as required). Operations/Logistics 0 Develop and maintain roster and organization charts Finance & Administration for deployed personnel (if deployed). 0 Update/distribute SITREP. Planning SHOC 0 Inventory SHOC staff essential supplies and stock Logistics to support 24-hour operations for a minimum of 72-hours: 0 Water 0 Food 0 Cots 0 Blankets 0 Medical Supplies 0 Review/Update safety issues for SHOC personnel and ensure Safety Officer widest dissemination. Pre-Incident Phase Through Landfall +1 Implement 5 days (120 hours) prior to TS. TS pattern may be unpredictable. Actions should be used as a guide only. ACTION REQUIRED SHOC RESPONSIBILITES PLAN REFERENCE 0 Evaluate SHOC activation level to ensure coordination IC Staff SHOC assessments and preparatory actions are advancing. Adjust SHOC staffing (as required). 0 Review Hurricane Preparedness Guidelines and emergency plans. All SHOC 0 Review and consider actions provided in the previous phases All and complete those actions not performed as appropriate. 0 Review FEMA Hurricane CONOPS. IC Staff DHS/FEMA Region III 2007 Hurricane Season CONOPS 0 Monitor National Hurricane Center and NWS information. Planning, PHPS 0 Update IAP. Planning 0 Participate in DEMA / NWS weather bridge calls Operations (as scheduled). 0 Review/Update e-mail distribution groups (as necessary). 0 Ensure information is distributed to state and local partners. 0 Issue DHAN and FRED alerts as appropriate. Public Affairs / Logistics / IT 0 DHSS 0 DPH 0 Hospitals 0 Clinics 0 Establish and maintain lines of communication with State/ Logistics local authorities daily for incident venues. 0 Continue participation in FEMA-initiated Region/State IC Staff conference calls. 0 Ensure State EOC ESF-8 Liaison Reports to DEMA State Operations SHOC, ESF 8 EOC if activated. 0 Develop and maintain roster and organization charts for Finance & Administration deployed personnel (if deployed). 0 Maintain contact and conduct teleconferences for the IC Staff All purpose of identifying potential Federal resource deployment requests (as needed): 0 CDC, Senior Management Official 0 FEMA, Region III, HHS Coordinator 0 NDMS Regional Coordinator 0 Coordinate and conduct teleconferences for the purpose All All of identifying and mitigating potential resource shortfalls or issues for: 0 SHOC 0 Hospitals 0 Bay Health 0 Beebe 0 Christiana Care 0 A.I. DuPont 0 Nanticoke 0 St. Francis 0 V A Medical Center 0 State Facilities 0 DHCI 0 Governor Bacon 0 Stockley 0 Emily Bissell 0 Delaware Psychiatric Center 0 NEHC 0 ACC 0 MNS 0 MMF 0 Continue participation in FEMA initiated Region/State IC Staff conference calls (as required). 0 Coordinate shelter resource needs to include shelter Operations/(SHS/NHS Liaisons) management personnel (DPH Nurses) with American Red Cross. 0 Coordinate public health inspection requirements for portable Operations water tanks (water buffaloes) with DEMA/DNG. 0 Coordinate, determine and source evacuation capabilities Logistics and ESF 1, ESF 5, ESF 6 with inter-agency and private sector resources needed to evacuate impacted population/pets out of affected areas [Medical/Decon actions may be required]. 0 Confirm transportation (acquisition of transportation Logistics and ESF 1, ESF 5, ESF 6 resources and timeline) requirements: for possible patient evacuation. 0 Coordinate Emergency Pharmaceutical Assistance Program. Planning 0 Plan for establishing Alternate Care Sites. Consider Logistics activating MMES Sites. 0 Coordinate Participate in Temporary Housing Planning Operations/ESF 6 Liaison process with ESF # 6 for Public Health Issues. 0 Be prepared to recommend last minute sheltering of those Operations/Logistics individuals who did not evacuate and are asking where they can go for safety. 0 Implement statewide active daily surveillance system for Planning IRT evacuation shelters, Hospital EDs, MNS, NEHCs, and ACCs for: 0 Chronic Medical Conditions 0 Injuries 0 Mental Health Issues 0 Infectious/Communicable Diseases 0 Review/Update safety issues for SHOC personnel and ensure Safety Officer widest dissemination. 0 Update/distribute SITREP. Planning SHOC Pre-Incident Phase Through Landfall +1 Implement 4 days (96 hours) prior to TS. TS pattern may be unpredictable. Actions should be used as a guide only. ACTION REQUIRED SHOC RESPONSIBILITES PLAN REFERENCE 0 Evaluate SHOC activation level to ensure coordination IC Staff SHOC assessments and preparatory actions are advancing. Adjust SHOC staffing (as required). 0 Review Hurricane Preparedness Guidelines and emergency plans. All SHOC 0 Review and consider actions provided in the previous All phases and complete those actions not performed as appropriate. 0 Monitor National Hurricane Center and NWS information. Planning, PHPS 0 Review FEMA Hurricane CONOPS. IC Staff DHS/FEMA Region III Hurricane Season CONOPS 0 Update IAP. Planning SHOC 0 Confirm arrival of Federal Operational Staging Area (FOSA) Planning Team(s) and FOSA Managers (Public Health Component). 0 Coordinate and conduct teleconferences for identified IC Staff All potential Federal resource deployment requests (as needed): 0 CDC, Senior Management Official 0 FEMA, Region III, HHS Coordinator 0 NDMS Regional Coordinator 0 Continue participation in FEMA-initiated Region/State IC Staff conference calls (as required). 0 Participate in DEMA / NWS weather bridge calls Operations (as scheduled). 0 Ensure information is distributed to state and local partners. 0 Issue DHAN and FRED alerts as appropriate. Public Affairs / Logistics / IT 0 DHSS 0 DPH 0 Hospitals 0 Clinics 0 Ensure State EOC ESF-8 Liaison Reports to DEMA State EOC Operations SHOC, ESF 8 (if activated). 0 Prepare necessary documentation and provide to DEMA for IC Staff / Legal / Safety ESF 8 the Governor to declare a State of Emergency addressing Public Health actions: 0 Standards of Care Regulation/Laws 0 Pubic Health Safety/Hazards 0 Volunteer Healthcare Provider Liability Protection 0 Activate MNS Shelter as determined by SHOC/IC. Operations/Logistics MNS, SHOC 0 Contact Delaware National Guard 0 Activate operational staging areas, outside projected Logistics ACC, NEHC, MNS incident area (MMES). 0 Coordinate shelter resource needs to include shelter Operations/(SHS/NHS Liaisons) management personnel (DPH Nurses) with American Red Cross. 0 Coordinate with ARC on shelters to be opened. Determine Operations DPH requirements. 0 Deploy mobile IT trailer to State EOC, Unified Command Logistics location, SHOC or location as determined by IC staff. 0 Conduct hazard vulnerability assessment based on the All ESFs/DOD storm path. 0 Tidal Surge Modeling (DEMA) 0 Confirm with DEMA the arrival of ERT-A Teams in Delaware Operations (if deployed). 0 Review and consider actions provided in the previous phases All SHOC and complete those actions not performed as appropriate. 0 Secure/safeguard equipment from potential weather IT/Logistics related hazards. 0 Vehicles 0 Equipment Trailers 0 Develop and maintain roster and organization charts for Finance & Administration deployed personnel (if deployed). 0 Review/Update safety issues for SHOC personnel and ensure Safety Officer widest dissemination. 0 Update/distribute SITREP. Planning SHOC Pre-Incident Phase Through Landfall +1 Implement 3 days (72 hours) prior to TS. TS pattern may be unpredictable. Actions should be used as a guide only. ACTION REQUIRED SHOC RESPONSIBILITES PLAN REFERENCE 0 Evaluate SHOC activation level to ensure coordination IC Staff SHOC assessments and preparatory actions are advancing. Adjust staffing (as required). 0 Review Hurricane Preparedness Guidelines and emergency plans. All SHOC 0 Review and consider actions provided in the previous phases All and complete those actions not performed as appropriate. 0 Monitor National Hurricane Center and NWS information. Planning, PHPS 0 Review FEMA Hurricane CONOPS. IC Staff 0 Update IAP. Planning SHOC 0 Continue to coordinate and conduct teleconferences for IC Staff All identified potential Federal resource deployment requests (as needed): 0 CDC, Senior Management Official 0 FEMA, Region III, HHS Coordinator 0 NDMS Regional Coordinator 0 Continue participation in FEMA-initiated Region/State IC Staff conference calls. 0 Participate in DEMA / NWS weather bridge calls Operations (as scheduled). 0 Review/Update e-mail distribution groups (as necessary). 0 Ensure information is distributed to state and local partners. 0 Issue DHAN and FRED alerts as appropriate. Public Affairs / Logistics / IT 0 DHSS 0 DPH 0 Hospitals 0 Clinics 0 Ensure State EOC ESF-8 Liaison Reports to DEMA State Operations SHOC, ESF 8 EOC if activated. 0 Determine if alternate SHOC location will be necessary Logistics SHOC based on possibility of change of direction in hurricane. 0 Make arrangements to maintain operational continuity Logistics SHOC during SHOC relocation (if necessary). 0 Obtain updates from ESF 6 and staging areas (ongoing Operations through TS-24) if MNS are activated. 0 Establish a statewide active daily surveillance system for Planning IRT evacuation shelters, Hospital EDs, MNS, NEHCs, and ACCs for: 0 Chronic Medical Conditions 0 Injuries 0 Mental Health Issues 0 Infectious/Communicable Diseases 0 Coordinate shelter resource needs to include shelter Operations/(SHS/NHS Liaisons) management personnel (DPH Nurses) with American Red Cross 0 Participate in unified command at State EOC; Send DPH Rep. IC Staff 0 Coordinate with DSHS and DEMA on potential Public Health/ Legal/Safety healthcare issues that should be addressed in the State of Emergency declaration such as: 0 Standards of Care Regulation/Laws 0 Public Health Safety/Hazards 0 Volunteer Healthcare Provider Liability Protection 0 Monitor status of area evacuation, evacuation routes and Operations DEOP, SHOC road closures through DEMA, Del DOT, DSP. 0 Coordinate patient movement through Healthcare System; Operations/Logistics send FRED alert and assist in the coordination of patient movement. 0 Contact/coordinate with state EOC/State/locals to monitor Operations evacuation routes to assist in opening shelters; and review state evacuation shortfalls for potential public health mobilization in support of evacuation plans. 0 Monitor special populations needs: Operations ISS 0 Evacuation/Transportation 0 Food 0 Medications/Equipment 0 Review/Update safety issues for SHOC personnel and Safety Officer ensure widest dissemination. 0 Emphasize safety procedures to all personnel. Safety Officer/PIO 0 Develop and maintain roster and organization charts for Finance & Administration deployed personnel (if deployed). 0 Coordinate strategic water and food plans for DPH Logistics facilities (ACC, SHOC). 0 Ensure all activated personnel, teams, and equipment have Planning arrived at their designated forward operating and/or staging facilities. 0 Assist in the identification and sourcing potential of sites Logistics for use as Base Camps for Federal Responders based on storm path. (On going through TS-24) 0 Ensure evacuation decisions of DPH personnel/facilities are Operations/Logistics DEOP completed prior to arrival of gale force winds (34knots/ 39 mph). Should be accomplished during daylight hours if possible. 0 Implement crisis-counseling plan (DSAMH). SHOC/Operations 0 Maintain 800 MHz radio communications with state and local Operations/Logistics/IT partners: 0 DPH 0 DEMA 0 Hospitals 0 Evaluate evacuation of DPH Facilities/Staff based on IC Staff/Planning/ Operations/LTCF Managers possibility of a change of direction in hurricane. 0 Update/distribute SITREP. Planning SHOC Pre-Incident Phase Through Landfall +1 Implement when a tropical storm or hurricane has formed and has the potential to threaten Delaware within 2 days (48 hours). TS pattern may be unpredictable. Actions should be used as a guide only. ACTION REQUIRED SHOC RESPONSIBILITES PLAN REFERENCE 0 Evaluate SHOC activation level to ensure coordination IC Staff SHOC assessments and preparatory actions are advancing. 0 Monitor National Hurricane Center and NWS information. Planning, PHPS 0 Review Hurricane Preparedness Guidelines and emergency plans. All SHOC 0 Review and consider actions provided in the previous phases All and complete those actions not performed as appropriate. 0 Continue to monitor status of area evacuation, evacuation Operations DEOP, HS 10 routes, and road closures through DEMA, Del DOT, DSP. 0 Review FEMA Hurricane CONOPS. IC Staff DHS/FEMA Region III 2007 Hurricane Season CONOPS 0 Continue monitoring National Hurricane Center and Planning NWS information. 0 Update IAP. Planning SHOC 0 Continue participation in FEMA-initiated IC Staff Region/State conference calls. 0 Participate in DEMA / NWS weather bridge calls Operations (as scheduled). 0 Ensure information is distributed to state and local partners. 0 Issue DHAN and FRED alerts as appropriate. Public Affairs / Logistics / IT 0 DHSS 0 DPH 0 Hospitals 0 Clinics 0 Ensure State EOC ESF-8 Liaison Reports to DEMA State EOC Operations SHOC, ESF 8 if activated. 0 Participate in conference calls with the SHOC and State EOC Operations and potentially affected states (as required). 0 Review/Update safety issues for SHOC personnel and ensure Safety Officer widest dissemination. 0 Emphasize safety procedures to all personnel. Safety Officer/PIO 0 Adjust SHOC staffing (as required). IC Staff SHOC 0 Develop and maintain roster and organization charts for Finance & Administration deployed personnel (if deployed). 0 Inventory SHOC essential supplies and re-stock for continued Logistics support of 24-hour operations for extended period / post- disaster activation: 0 Water 0 Food 0 Cots 0 Blankets 0 Medical Supplies 0 Continue evacuation and shelter coordination with Operations appropriate agencies. 0 ESF 1 0 ESF 6 0 DNG 0 Establish a statewide active daily surveillance system for Planning IRT evacuation shelters, Hospital EDs, MNS, NEHCs, and ACCs for: 0 Chronic Medical Conditions 0 Injuries 0 Mental Health Issues 0 Infectious/Communicable Diseases 0 Conduct human needs assessment: Planning NEHC 0 Vaccines 0 Healthcare 0 Potable Water 0 Determine needs for special populations: Operations/Logistics 0 Evacuation/Transportation 0 Food 0 Medications/Equipment 0 Coordinate shelter resource needs to include shelter Operations/(SHS/NHS Liaisons) management personnel (DPH Nurses) with American Red Cross. 0 Confirm availability of all Staff (Primary/Alternates/Shifts) Crisis & Risk Communication Health Communication Standard Operating Guideline () for activation and minimum of 72 hours of operation. Consider that first shift may need to stay beyond standard 12-hour shift. 0 Conduct DENS Notification 0 DHSS Disaster Coordinators 0 Medical Reserve Corps 0 Family Preparedness Operations/Logistics/IT 0 Assess and continue implementing State Evacuation support All actions (as required) from affected area(s) [Tropical Storm winds will impact]. 0 Continue to provide resource(s) status at alternate care Logistics sites as they become operational (ongoing throughout Pre- Incident and Response). 0 Initiate developing contingency plan for long-term Operations/ESF 6 Liaison sheltering/temporary housing if the storm is projected to be category 3 or higher at landfall. 0 Identify potential post hurricane recovery Public Planning Health issues. Develop incident action plans: 0 Safe Drinking Water – Disinfecting Water (Boil) 0 Water Test Kits 0 Food Safety 0 Power Outages 0 Sanitation 0 Special Populations 0 Mental Health Counseling 0 Medical/LTC Facility Evacuation 0 Immunizations 0 Tetanus 0 Hepatitis A 0 Typhoid 0 CDC Recommendations 0 PPE Recommendations 0 Biological Building Contaminants 0 Mildew 0 Mold 0 Fungi 0 Asbestos 0 Mortuary Services 0 Vector/Mosquito Control 0 Other 0 Assess all identified vulnerabilities to health and medical Planning systems including requesting results from an overlay of surge model and critical facilities from DEMA. (GIS mapping) 0 Confirm all pre-landfall (TS 120 to TS 72 hours) IC Staff preparatory actions are complete. 0 Update/distribute SITREP. Planning SHOC Watch Phase Implement when a hurricane threatens Delaware with the effects of gale force winds within 36 hours and/or no later than when the hurricane is 300 miles or greater from Delaware. TS pattern may be unpredictable. Actions should be used as a guide only. ACTION REQUIRED SHOC RESPONSIBILITES PLAN REFERENCE 0 Evaluate SHOC activation level to ensure coordination IC Staff SHOC assessments and preparatory actions are advancing. Adjust staffing (as required). 0 Review Hurricane Preparedness Guidelines and emergency plans. All SHOC 0 Review and consider actions provided in the previous phases All and complete those actions not performed as appropriate. 0 Monitor National Hurricane Center and NWS information. Planning, PHPS 0 Review FEMA Hurricane CONOPS. IC Staff 0 Continue participation in FEMA-initiated Region/State IC Staff conference calls. 0 Update IAP. Planning 0 Participate in DEMA / NWS weather bridge calls Operations (as scheduled). 0 Ensure information is distributed to state and local partners. 0 Issue DHAN and FRED alerts as appropriate. Public Affairs / Logistics / IT 0 DHSS 0 DPH 0 Hospitals 0 Clinics 0 Ensure State EOC ESF-8 Liaison Reports to DEMA State EOC Operations SHOC, ESF 8 if activated. 0 Review/Update safety issues for SHOC personnel and Safety Officer ensure widest dissemination. 0 Emphasize safety procedures to all personnel. Safety Officer/PIO 0 Develop and maintain roster and organization charts for Finance & Administration deployed personnel (if deployed). 0 Coordinate shelter resource needs to include shelter Operations/(SHS/NHS Liaisons) management personnel (DPH Nurses) with American Red Cross. 0 Issue Shelter-In-Place recommendation. Public Affairs 0 Maintain 800 MHz radio communications with state and Operations/Logistics/IT local partners: 0 DPH 0 DEMA 0 Hospitals 0 Monitor status of area evacuation, evacuation routes and Operations DEOP, SHOC road closures through DEMA, Del DOT, DSP 0 Update/distribute SITREP. Planning SHOC Warning Phase Implement when a hurricane threatens Delaware with the effects of gale force winds within 24 hours and/or no later than when the hurricane is approximately 200 miles or greater from Delaware. TS pattern may be unpredictable. Actions should be used as a guide only. ACTION REQUIRED SHOC RESPONSIBILITES PLAN REFERENCE 0 Evaluate SHOC activation level to ensure coordination IC Staff SHOC assessments and preparatory actions are advancing. Adjust staffing (as required). 0 Review Hurricane Preparedness Guidelines and emergency plans. All SHOC 0 Review and consider actions provided in the previous phases All and complete those actions not performed as appropriate. 0 Review FEMA Hurricane CONOPS. IC Staff 0 Monitor National Hurricane Center and NWS information. Planning, PHPS 0 Pre-position equipment / vehicles (as necessary). Logistics 0 Update IAP. Planning SHOC 0 Continue participation in FEMA-initiated Region/State IC Staff conference calls (as scheduled). 0 Participate in DEMA / NWS weather bridge calls Operations (as scheduled). 0 Review/Update e-mail distribution groups (as necessary). 0 Ensure information is distributed to state and local partners. 0 Issue DHAN and FRED alerts as appropriate. Public Affairs / Logistics / IT 0 DHSS 0 DPH 0 Hospitals 0 Clinics 0 Determine if alternate SHOC location will be necessary based IC Staff SHOC on possibility of change of direction in hurricane. 0 Ensure State EOC ESF-8 Liaison Reports to DEMA State Operations SHOC, ESF 8 EOC if activated. 0 Review/Update safety issues for SHOC personnel and Safety Officer ensure widest dissemination. 0 Develop and maintain roster and organization charts for Finance & Administration deployed personnel (if deployed). 0 Re-evaluate evacuation of DPH Facilities/Staff based on Planning possibility of change of direction in hurricane. 0 Emphasize safety procedures to all personnel. Safety Officer/PIO 0 Coordinate shelter resource needs to include shelter Operations/(SHS/NHS Liaisons) management personnel (DPH Nurses) with American Red Cross. 0 Ensure evacuation decisions are based upon completion prior IC Staff to arrival of gale force winds (34 knots/39 mph). Should be accomplished during daylight hours if possible. 0 Maintain 800 MHz radio communications with state authorities Logistics and local partners: 0 DPH 0 DEMA 0 Hospitals 0 Update situational awareness of hospital and healthcare Operations infrastructure facilities (including power, water, and debris). Report to ESF 8 at EOC. 0 Assess all identified vulnerabilities to health and medical Planning systems including requesting results from an overlay of surge model and critical facilities from DEMA (GIS mapping). 0 Coordinate additional equipment at medical treatment Operations/Logistics facilities and shelters and ensure necessary logistics actions are initiated. 0 Update/distribute SITREP. Planning SHOC Landfall Phase (Day 1) Actions to consider after the arrival of gale force winds and all pre-event actions are terminated TS pattern may be unpredictable. Actions should be used as a guide only. ACTION REQUIRED SHOC RESPONSIBILITES PLAN REFERENCE 0 Continue to monitor local weather conditions to determine Planning when it is safe to proceed outside. 0 Continue participation in FEMA-initiated Region/State IC Staff conference calls. 0 Issue updates via DHAN and FRED (as required). Public Affairs/Operations/ Logistics/IT Crisis & Risk Communication 0 Adjust SHOC staffing (as required). All SHOC 0 Maintain 800 MHz radio communications with state and Operations local partners: 0 DPH 0 DEMA 0 Hospitals 0 Finalize human needs assessment: Planning NEHC 0 Vaccines 0 Healthcare 0 Potable Water 0 Identify and prepare staff to participate in: Planning/Operations DEOP 0 Damage Assessment (DA) Teams 0 Individual Assessment (IA) Teams 0 Disaster Recovery Centers 0 Distribution of: 0 Educational Material 0 Water Test Kits 0 Investigative Response Teams (IRT) 0 Other 0 Develop plan of action for damage assessment of Planning DEOP DPH facilities. 0 Establish plan of action for re-entry and recovery procedures. Planning SHOC, ESF 8 0 Review and consider actions provided in the previous phases All SHOC and complete those actions not performed as appropriate. 0 Update IAP. Planning 0 Emphasize safety procedures to all personnel. Safety Officer/PIO 0 Update/distribute SITREP. Planning SHOC Landfall +1 Day Implement when the winds have subsided below gale force, after storm passage. ACTIVITY / ACTION REQUIRED SHOC RESPONSIBILITES PLAN REFERENCE 0 Participate in Disaster Recovery Center and Damage Assessment IC Staff DEOP Teams as directed by State EOC. 0 Re-establish communications with all public health and Logistics/Communications hospital channels. 0 Assess damage to healthcare facilities and systems. IC Staff DEOP 0 Activate additional MMES Sections as determined essential. Operations NEHC/SHOC/ACC/ESF8 (NEHC, ACC) 0 Restore response equipment and facilities to “ready” status. Logistics SHOC/NEHC/ACC/DEOP 0 Issue DHAN and FRED (as required). Operations Crisis & Risk Communication 0 Coordinate recovery actions with State EOC ESF-8 liaison. Operations DEOP/SHOC 0 Provide updated information regarding safe drinking water, Public Affairs Officer / JIC Officer Crisis & Risk Communication food spoilage, sanitation, and contamination, etc. 0 Coordinate recovery actions with Regional III HHS / Federal Partners. (CDC) 0 Determine need to request: Operations SNS/ISS/SHOC 0 ISS 0 SNS 0 Determine need to request personnel through Disaster Operations Coordinators. 0 Deploy Response Task Force (IRT) (as required). Planning IRT 0 Monitor statewide active daily surveillance system in Planning IRT evacuation shelters, Hospital EDs, MNS, NEHCs, and ACCs for: 0 Chronic Medical Conditions 0 Injuries 0 Mental Health Issues 0 Infectious/Communicable Diseases 0 Forward all incident-related documentation to the Planning All SHOC/ESF 8/DEOP Section for organization and preparation for reimbursement and archiving. 0 Forward personnel documentation/expenses to Finance & All Administrations Section. 0 Collect and provide documentation for After Action Report All and reimbursement if federally declared disaster. 0 Monitor DPH staff for stress disorders and activate mental All health response teams or EAP (as necessary). 0 Update IAP. Planning 0 Update/distribute SITREP. Planning SHOC 5.0 Weather Bridge Call Procedures Order of Events Responsible Person Task Completed or Agency 1. DEMA Collaborate with the National Weather Service of Mt. Holly, New • Jersey, to initiate a Weather Bridge Call when it is determined that a significant storm may affect Delaware. 2. DEMA Issue a message via e-mail and fax regarding the exact time that • the Weather Bridge Call will occur. 3. DPH/PHPS Representative Research http://www.nhc.noaa.gov/ and http://www.noaa.gov/ to gather • information about the impending storm. 4. DPH/PHPS Representative Begin drafting the Weather Bridge Call e-mail based on the following: • - Subject - Date - Conference Call Time - Weather Conditions - Advisories, Watches and Warnings - Other Agency Activities - Follow-up Conference Call Time 5. DPH/PHPS Representative Call DEMA at the appropriate time to connect to the weather bridge call. • 6. DPH/PHPS Representative Upon completion of the Weather Bridge Call, complete the Weather Bridge • Call e-mail and send it to DHSS management and hospitals throughout the state. See B1 for an example of a Weather Bridge Call e-mail and B2 for an example of advisories, Watches and Warnings. Figure 1 – Weather Bridge Call E-mail (Example) Hi Everyone, Below is a summary of the conference call held on Wednesday, March 7, 2007, at 0900 hours (9 a.m.) concerning the approaching snow conditions and information from the National Weather Service. Conference Calls * Conference Call A conference call was conduct at 0900 hours on March 7, 2007, concerning the weather conditions that could be caused by approaching snow. * Follow Up Conference Call Another conference call will be scheduled on an as needed basis. Weather National Weather Service * There is a weak low pressure system over the Mississippi Valley. The snow is expected to be off coast by tonight. Light snow is expected to come into area with the possibility of heavier snow forming occurring the late morning to mid afternoon. * The snow will be over by 1600 hours (4 P.M.). A bulk of the snow will fall in three to four period, 1100 hors (11 A.M.) to 1500 hours (3 P.M.). The expected snowfalls are 1 inch to 2 inches over New Castle County and 2 inches to 4 inches over Kent County and Sussex County. * Temperatures should be in the mid to high 20’s in the northern part of the state and in the low 30’s in the southern part of the state. Some indirect sunshine might help to warm roads. Temperatures on Thursday should be in the mid to high 30’s, and it should be mostly sunny. * Not much wind is expected to occur today. With tomorrow’s surge of cold air out of northwest, winds of 25 mph to-30 mph could occur. Snow may blow as a result of these winds. Advisories, Watches, and Warning Other Agencies Delaware State Police (DSP)—In New Castle County, there has been 63 crashes, mostly on I-95. This has caused alternate routes to be clogged. In Kent County and Sussex County, there have been no weather related incidents. DELDOT—Roads were treated with brine yesterday. Staff is standing by in all the counties. Tab A Glossary of Terms A ACC - Acute Care Center AARs - After Action Reports ARC - American Red Cross B Blizzard - A blizzard means that the following conditions are expected to prevail for a period of three hours or longer. a. Sustained wind or frequent gusts to 35 miles an hour or greater; and b. Considerable falling and/or blowing snow (i.e., reducing visibility frequently to less than 1/4 mile). Blizzard Warning - These warnings are issued when sustained wind speed of at least 35 miles per hour are accompanied by considerable falling and/or blowing snow. Visibility is dangerously restricted. C Community Shelter – An evacuation shelter for the general population, pets and individuals with non-typical functional needs. Children in State Care – Children who are temporarily or permanently separated from their parents, custodians, or legal guardians and reside at a state operated facility. D DEMA - Delaware Emergency Management Agency DENS - Delaware Emergency Notification System DHAN - Delaware Health Alert Network DMRC - Delaware Medical Reserve Corps DRC – Disaster Recovery Center DSP - Delaware State Police DSCYF - Department of Services for Children, Youth and their Families Disaster – A situation that creates an actual or imminent serious threat to the health and safety of persons, or a situation that has resulted in or is likely to result in catastrophic loss to property or the environment, and for which traditional sources of relief and assistance within the affected area are unable to repair or prevent the injury or loss. DMAT – Disaster Medical Assistance Team A DMAT is a volunteer group of medical and non-medical individuals, usually from the same State or region of a State, who have formed a response team under the guidance of the National Disaster Medical System, or under similar State or local auspices. TYPE I = fully operational; Type II = operational; Type III = augmentation/local team; Type IV = developmental. Personnel include a mix of physicians, nurses (RN), nurse practitioners (NP), physicians' assistants (PA), pharmacists (RPh), emergency medical technicians (EMT), other allied health professionals, and support staff. DMORT – Disaster Mortuary Operational Response Team A DMORT is a volunteer group of medical and forensic personnel, usually from the same geographic region, who have formed a response team under the guidance of the National Disaster Medical System (or State or local auspices), and whose personnel have specific training/skills in victim identification, mortuary services, and forensic pathology and anthropology methods. DMORTs usually includes a mix of medical examiners, coroners, pathologists, forensic anthropologists, medical records technicians, fingerprint technicians, forensic odentologists, dental assistants, radiologists, funeral directors, mental health professionals, and support personnel. DMORTs are mission tailored on an ad hoc basis, and usually deploy only with personnel and equipment specifically required for current mission. There are currently two Portable Morgue Units within National Disaster Medical System. DCSE - Division of Child Support Enforcement DDDS - Division of Developmental Disabilities Services DLTCRP - Division of Long Term Care Residents Protection DMS - Division of Management Services DMMA - Division of Medicaid & Medical Assistance DPH - Division of Public Health DSAAPD - Division of Services for Aging and Adults with Physical Disabilities DSS - Division of Social Services DSSC - Division of State Service Centers DSAMH - Division of Substance Abuse and Mental Health DVI - Division for the Visually Impaired Drought – A prolonged period of dry weather during which there is an inadequate supply of water to meet demands. It may occur at any time of the year, though summer droughts have more of an impact due to the higher demand for water during the hot months. Drought Advisory Guidelines – The following guideline may be declared by the Governor pursuant to 20 Del. C. § 3116(a)(5): Drought Watch: The potential for drought suggests that voluntary water demand reductions, be requested. E Earthquake – A sudden motion or trembling in the earth caused by the abrupt release of slowly accumulated strain along subterranean ground faults. Emergency – A sudden crisis requiring urgent attention. Emergency Operations Center – The physical location at which the coordination of information and resources to support incident management activities normally takes place. An EOC may be a temporary facility or may be located in a more central or permanently established facility, perhaps at a higher level of organization within a jurisdiction. EOCs may be organized by major functional disciplines (e.g., fire, law enforcement, and medical services), by jurisdiction (e.g., Federal, State, regional, county, city, tribal), or by some combination thereof. ESF - Emergency Support Function, as defined in the National Response Plan refers to a group of capabilities of Federal departments and agencies to provide the support, resources, program implementation, and services that are most likely to be needed to save lives, protect property, restore essential services and critical infrastructure, and help victims return to normal following an incident. EMAC - The Emergency Management Assistance Compact is a congressionally ratified organization that provides form and structure to interstate mutual aid. Through EMAC, a disaster impacted state can request and receive assistance from other member states quickly and efficiently, resolving two key issues upfront: liability and reimbursement. F FRED - Facility Resource Emergency Database FEMA - Federal Emergency Management Agency Flash Flood – The NWS definition of a flash flood implies the swiftness with which it can occur. Occurs in any season of the year, but most take place in the spring and summer months in connection with sudden intense thunderstorms. Flash Flood Statement – Follow-up information regarding a flash flood/flood event. Flash Flood Warning – Flash flooding or flooding has been reported or is imminent – take necessary precautions at once. Flash Flood Watch – Flash flooding or flooding is possible within the designated WATCH area – be alert. G H HVA – A Hazard Vulnerability Analysis is a systematic approach to identifying all hazards that may affect an organization, assessing the risk (probability of hazard occurrence and the consequences for the organization) associated with each hazard and analyzing findings to create a prioritization comparison of hazard vulnerabilities. HSPS - Health System Protection Section Heavy Snow - This generally means: a. Snowfall accumulating to four inches or more in depth in 12 hours or less; or b. Snowfall accumulating to six inches or more in depth in 24 hours or less. Heavy Snow Warning - This generally indicates that snowfalls of at least four inches in 12 hours or six inches in 24 hours are expected. I Ice Storm - An ice storm is used to describe occasions when damaging accumulations of ice are expected during freezing rain situations. Incident Action Plan – An oral or written plan containing general objectives reflecting the overall strategy for managing an incident. It may include the identification of operational resources and assignments. It may also include attachments that provide direction and important information for management of the incident during one or more operational periods. IRT - Investigative Response Task Force I J K L M Major Disaster – Any natural catastrophe (including any hurricane, tornado, storm, flooding, earthquake, snowstorm, or drought) or regardless of cause, any fire, flood, or explosion which causes damage of sufficient severity and magnitude to warrant major disaster assistance to supplement the efforts and available resources of the State, local governments, and/or disaster relief organizations in alleviating the damage, loss, hardship, or suffering caused thereby. MNS - Medical Needs Shelter Medical Surge Capacity – Medical surge capacity refers to the ability to evaluate and care for a markedly increased volume of patients – one that challenges or exceeds normal operating capacity. The surge requirements may extend beyond direct patient care to include such tasks as extensive laboratory studies or epidemiological investigations. MMES - Modular Medical expansion System Mutual Aid Agreement – Written agreement between agencies, organizations, and/or jurisdictions that they will assist one another on request by furnishing personnel, equipment, and/or expertise in a specified manner. N NDMS – National Disaster Medical System NWS - National Weather Service NEHC - Neighborhood Emergency Help Center Non-Typical Functional Needs – Individuals with non-typical functional needs are individuals who have medical conditions or needs that prevent them from performing normal physical and/or emotional functions. O ODW - Office of Drinking Water OCME - Office of the Chief Medical Examiner Out-of-Home Care – A child is considered living in out-of-home care when the child is not living with a parent, custodian or legal guardian and the Department of Services for Children,Youth and Their Families has a legal responsibility to plan for the child through custody awarded by Family Court. P Preparedness – Preparedness encompasses actions designed to build organizational resiliency and/or organizational capacity and capabilities for response to and recovery from hazard impacts. Preparedness includes activities that establish, exercise, refine, and maintain systems used for emergency response and recovery. PHPS - Public Health Preparedness Section Q R Resource Typing – Resource typing is the categorization and description of resources that are commonly exchanged in disasters via mutual aid, by capacity and/or capability. S Saffir/Simpson Scale - The Saffir-Simpson Hurricane Scale is a 1-5 rating based on the hurricane's present intensity. This is used to give an estimate of the potential property damage and flooding expected along the coast from a hurricane landfall. Wind speed is the determining factor in the scale, as storm surge values are highly dependent on the slope of the continental shelf and the shape of the coastline, in the landfall region. Note that all winds are using the U.S. 1-minute average. SART - State Animal Response Team SHOC - State Health Operations Center SNS - Strategic National Stockpile T Tornado – A violently rotating column of air extending from a thunderstorm to the ground. In the winter and early spring, tornadoes are often associated with strong, frontal systems that form in the central states and move east. The most violent tornadoes are capable of tremendous destruction with wind speeds of 300 miles per hour or more. They are rated according to the Fujita Scale, commonly referred to as the F Scale. Damage paths can be in excess of one mile wide and 50 miles long. Tornadoes may accompany tropical storms and hurricanes and are most common to the right and ahead of the path of the storm center as it comes onshore. Tornadoes occur anywhere and take many shapes and sizes. Generally, they are categorized into three groups. Weak Tornadoes: last one to ten minutes; winds less than 110 mph; 69% of all tornadoes; less than five percent of all tornado deaths. Strong Tornadoes: may last 20 minutes or longer; winds 110-205 mph; 29% of all tornadoes; nearly 25% of all tornado deaths. Violent Tornadoes: may exceed one hour; winds greater than 205 mph; only two percent of all tornadoes; approximately 70% of all tornado deaths. Warnings are issued to alert the public of an approaching tornado. The NWS will issue a: Tornado Watch: when weather conditions are favorable and tornadoes are possible. Tornado Warning: when a tornado has been sighted or is indicated by Doppler weather radar. U Unattended Children – Children who have become temporarily separated from their parents, custodians or legal guardians during emergencies and for whom the Department of Services for Children, Youth and Their Families is providing assessment, crisis intervention, case management, emergency shelter, and family reunification services. V Volunteer – Any individual accepted to perform services by an agency that has authority to accept volunteer services when the individual performs services without promise, expectation, or receipt of compensation for services performed. W Water Supply Drought – Impacts population centers. Fountains, displays, car washing, lawn watering and other activities using water may need to be curtailed, delayed, or postponed until normal or adequate water supplies are available. Water use restrictions may require residents to curtail or halt any unnecessary use of water. Winter Storm Advisory/Warning: Issued when a hazardous winter weather condition is occurring, is imminent, or has a very high probability of occurring. A warning is used for conditions posing a threat to life or property. Advisories are for less serious conditions that could cause significant inconvenience and, if caution is not exercised, could lead to situations that may threaten life and/or property. Winter Storm Emergency Statement: Issued at frequent intervals to amplify watches, warnings, and advisories by reinforcing the message, indicating what is expected, and outlining appropriate suggested response actions. Winter Storm Outlook: Issued when winter storm conditions are forecast for the state within the next 12 hours. Winter Storm Watch: Issued when the possibility of a hazardous winter weather event has increased significantly, but its occurrence, location, and/or timing is uncertain. It is intended to provide lead-time to set emergency plans into motion. X Y Z Tab B Natural Disaster SHOC Quick Reference Guide There are many procedures that should be accomplished by SHOC that are applicable to most natural disasters i.e., hurricane, flooding, winter storm/hail, severe thunderstorm tornado and a major earthquake (however, excluding drought due to its limited impact). The information in this document outlines basic procedures that should be considered prior to, during and/or after a natural disaster. This document should be used as a quick reference only. It should not replace sound judgment or other more comprehensive guides, i.e. the Natural Disaster Standard Operating Guideline (SOG) and the Hurricane Preparedness SOG. Type of Disaster Action Required Recommendation Group Responsible Hurricane, Flooding, Consider/Confirm site selection and protective Prior to Natural Disaster Operations/ Logistics Winter Storm/Hail pre-positioning of the following: Alternate SHOC site, MMES components, Equipment Trailers and Vehicles. Hurricane Inventory the following essential supplies and stock to Prior to Natural Disaster Logistics support NEHC, MNS and Emergency Response Teams: Safe Drinking Water, Food, Medical Supplies, and Medications. Hurricane, Winter Storm/Hail Ensure all vehicles and back-up generators have sufficient Prior to Natural Disaster Logistics fuel levels (ensure a minimum of 72 hours of fuel for generators). Hurricane, Flooding, Determine the following needs for individuals with non- Prior to Natural Disaster Operations/ Logistics Winter Storm/Hail typical functional needs: Evacuation/Transportation, Food, and Medications/Equipment. Hurricane, Flooding, Prepare MMES equipment for deployment. Prior to Natural Disaster Operations/ Logistics Winter Storm/Hail Hurricane, Flooding Confirm transportation (acquisition of transportation Prior to Natural Disaster Logistics, ESFs 1, 5 and 6 resources and timeline) requirements for possible patient evacuation. Hurricane, Flooding, Secure/safeguard the following equipment from potential Prior to Natural Disaster Logistics Winter Storm/Hail weather related hazards: vehicles and equipment trailers. Hurricane, Flooding, Winter Evaluate SHOC activation level to ensure coordination Prior to, During and After Natural Disaster IC Staff Storm/Hail, Tornado*, assessments and preparatory actions are advancing. Adjust Earthquake** staffing (as required). Hurricane, Flooding, Winter Monitor National Hurricane Center and/or National Weather Prior to, During and After Natural Disaster PHPS, Planning Storm/Hail, Tornado* Service (NWS) information. Hurricane, Flooding, Winter Prepare/Update/Distribute Situation Report (SITREP). Prior to, During and After Natural Disaster Operations Storm/Hail, Tornado*, Earthquake** Hurricane, Flooding, Winter Prepare/Update Incident Action Plan (IAP). Prior to, During and After Natural Disaster Planning Storm/Hail, Tornado*, Earthquake** Hurricane, Flooding, Winter Test and maintain emergency communication systems with . Prior to, During and After Natural Disaster Logistics Storm/Hail, Tornado*, state and other partners Earthquake** Hurricane, Flooding, Winter Review/Update safety issues for SHOC personnel and Prior to, During and After Natural Disaster Safety Officer Storm/Hail, Tornado*, ensure widest dissemination. Earthquake** Hurricane, Flooding, Tornado*, Coordinate shelter resource needs to include shelter Prior to, During and After Natural Disaster Operations, SHS/NHS Liaisons Earthquake** management personnel (DPH Nurses) with American Red Cross. Hurricane, Tornado*, Develop and maintain roster and organization charts for Prior to, During and After Natural Disaster Finance & Administration Earthquake** deployed personnel (if deployed). Hurricane, Tornado*, Implement statewide active daily surveillance system for Prior to, During and After Natural Disaster Planning Earthquake** evacuation shelters, Hospital EDs and MMES components for the following: Chronic Medical Conditions, Injuries, Mental Health Issues, and Infectious/Communicable Diseases. Hurricane, Flooding, Monitor status of area evacuation, evacuation routes and road Prior to, During and After Natural Disaster Operations Tornado*, Earthquake** closures through DEMA, DelDOT and DSP. Hurricane, Flooding, Winter Emphasize safety procedures to all personnel. Prior to, During and After Natural Disaster Safety Officer, PIO Storm/Hail, Tornado*, Earthquake** Hurricane, Flooding, Prepare human needs assessment for vaccines, healthcare and Prior to, During and After Natural Disaster Planning Tornado*, Earthquake** potable water. Hurricane, Flooding, Develop plan of action for damage assessment of DPH facilities. Prior to, During and After Natural Disaster Planning Tornado*, Earthquake** Hurricane, Flooding Establish plan of action for re-entry and recovery procedures. After Natural Disaster Planning Hurricane, Flooding, Winter Coordinate and conduct teleconferences for the purpose of Prior to During and After Natural Disaster IC Staff Storm/Hail, Tornado*, identifying potential Federal resource deployment requests Earthquake** (as needed). Contact CDC, FEMA, NDMS. Hurricane, Flooding, Winter Coordinate and conduct teleconferences for the purpose of Prior to and After Natural Disaster All SHOC Positions Storm/Hail, Tornado*, identifying potential resource shortfalls or issues for the Earthquake** following: Delaware Hospitals, LTC facilities, other medical facilities. Hurricane, Flooding, Monitor evacuation and shelter coordination with appropriate Prior to and After Natural Disaster Operations Tornado*, Earthquake** agencies. Hurricane, Tornado*, Coordinate Emergency Pharmaceutical Assistance Program. Prior to and After Natural Disaster Planning Earthquake** Hurricane, Flooding, Coordinate patient movement through Healthcare System; send Prior to and After Natural Disaster Operations, Logistics Tornado*, Earthquake** FRED alert and assist in coordination of patient movement. Hurricane, Flooding, Coordinate strategic water and food plans for DPH facilities Prior to and After Natural Disaster Logistics Tornado*, Earthquake** (SHOC, MNS, and other response facilities). Hurricane, Flooding, Continue to monitor local weather conditions to determine During and After Natural Disaster Planning Tornado* when it is safe to proceed outside. Hurricane, Flooding, Identify and prepare staff to participate in the following: During and After Natural Disaster Planning, Operations Tornado*, Earthquake** Damage Assessment Teams, Individual Assessment Teams, Disaster Recovery Centers, Distribution of Educational Material, Water-Test Kits, and participation on IRTs. Hurricane, Flooding, Finalize human needs assessment for vaccines, healthcare After Natural Disaster Planning Tornado*, Earthquake** and potable water. Hurricane, Flooding, Update situational awareness of hospital and healthcare After Natural Disaster Operations Tornado*, Earthquake** infrastructure facilities (including power, water and debris). Report to ESF 8 at EOC. Hurricane, Flooding, Winter Forward all incident-related documentation to the Planning After Natural Disaster All Storm/Hail, Tornado*, Section for organization and preparation for reimbursement Earthquake** and archiving. Hurricane, Flooding, Winter Forward personnel documentation/expenses to Finance & After Natural Disaster All Storm/Hail, Tornado*, Administrations Section. Earthquake** Hurricane, Flooding, Collect and provide documentation for After Action After Natural Disaster All Tornado*, Earthquake** Report and reimbursement if federally declared disaster. Hurricane, Flooding, Monitor DPH staff for stress disorders and activate mental After Natural Disaster All Tornado*, Earthquake** health response teams or EAP (as necessary). Hurricane, Flooding, Winter Participate in DEMA/NWS weather bridge calls (as scheduled) As Necessary Operations Storm/Hail, Tornado* Distribute information to state and local partners. Hurricane, Flooding, Winter Issue Delaware Health Alert Network (DHAN) and Facility As Necessary Public Affairs, Logistics, IT Storm/Hail, Tornado*, Resource Emergency Database (FRED) alerts as appropriate. Earthquake** Hurricane, Flooding, Winter Ensure that State EOC ESF-8 Liaison Reports to DEMA As Necessary Operations Storm/Hail, Tornado*, State EOC (if activated). Earthquake** Hurricane, Flooding, Winter Develop a timeline for receipt of Federal assets/ As Necessary IC Staff Storm/Hail, Tornado*, resources (if federal assets have been requested or Earthquake** deployed). Hurricane, Flooding, Prepare the following necessary documentation and provide to As Necessary IC Staff, Legal, Safety Tornado*, Earthquake** DEMA for the Governor to declare a State of Emergency addressing Public Health actions: Standard of Care Regulations/Laws, Public Health Safety/Hazards, and Volunteer Healthcare Provider Liability Protection. Hurricane, Flooding, Confirm with DEMA the arrival of the ERT-A Teams in As Necessary Operations Tornado*, Earthquake** Delaware (if deployed). Hurricane, Flooding, Activate additional MMES. As Necessary Operations Tornado*, Earthquake** Hurricane, Flooding, Deploy IRTs. As Necessary Planning Tornado*, Earthquake** * Tornados and Tornadic conditions can be unpredictable and therefore hard to plan for. The Natural Disasters SOG has included Tornados in most planning stages (See “Action Required”). These actions may or may not be achievable during the recommended timeframe; however, they should be considered if weather conditions are favorable for tornado. ** Earthquakes are unpredictable and therefore very hard to plan for. Additionally, a Hazard Vulnerability Analysis on Delaware has concluded that the likelihood of a major earthquake impacting Delaware is low. The Natural Disasters SOG has included Earthquake in most planning stages. Due to the fact that earthquakes are unpredictable, all recommended actions should be considered after a major earthquake has impacted the state. Tab C Weather Measurement Scales Scale 1 - Saffir/Simpson Scale for Hurricane Scale 2 - Fujita Tornado Scale (F Scale) Scale 3 – North East Snowfall Impact Scale (NESIS) Scale 4 - Modified Mercalli/Richter Intensity Scales for Earthquake Scale 5 – Heat Index Scale 1 - Saffir/Simpson Scale for Hurricane Hurricanes are a classification of tropical cyclones which are defined by the National Weather Service as non-frontal, low pressure, large scale systems that develop over tropical or subtropical waters and have a definite organized circulation. Hurricanes are classified using the Saffir/Simpson scale, which categorizes hurricanes based upon their intensity, and relates this intensity to damage potential. * Tropical Storm o Winds 39-73 mph * Category 1 Hurricane — winds 74-95 mph o No real damage to buildings. Damage to unanchored mobile homes. Some damage to poorly constructed signs. Also, some coastal flooding and minor pier damage. * Category 2 Hurricane — winds 96-110 mph o Some damage to building roofs, doors and windows. Considerable damage to mobile homes. Flooding damages piers and small craft in unprotected moorings may break their moorings. Some trees blown down. * Category 3 Hurricane — winds 111-130 mph o Some structural damage to small residences and utility buildings. Large trees blown down. Mobile homes and poorly built signs destroyed. Flooding near the coast destroys smaller structures with larger structures damaged by floating debris. Terrain may be flooded well inland. * Category 4 Hurricane — winds 131-155 mph o More extensive curtainwall failures with some complete roof structure failure on small residences. Major erosion of beach areas. Terrain may be flooded well inland. * Category 5 Hurricane — winds 156 mph and up o Complete roof failure on many residences and industrial buildings. Some complete building failures with small utility buildings blown over or away. Flooding causes major damage to lower floors of all structures near the shoreline. Massive evacuation of residential areas may be required. Scale 2 - Fujita Tornado Scale (F Scale) (F0) Gale Tornado (40-72 mph) Light Damage Some damage to chimneys; breaks branches off trees; pushes over shallow- rooted trees; damages sign boards. (F1) Moderate Tornado (73-112 mph) Moderate Damage Peels surface off roofs; mobile homes are pushed off foundations or overturned; moving autos are pushed off the roads. (F2) Significant Tornado (113-157 mph) Considerable Damage Roofs are torn off frame houses; mobile homes demolished; boxcars pushed over; large trees snapped or uprooted; light-object missiles generated. (F3) Severe Tornado (158-206 mph) Severe Damage Roofs and some walls torn off well-constructed houses; trains overturned; most trees in forest uprooted; heavy cars lifted off ground and thrown. (F4) Devastating Tornado (207-260 mph) Devastating Damage Well-constructed houses leveled; structures with weak foundation blown off some distance; cars thrown and large missiles generated. (F5) Incredible Tornado (261-318 mph) Incredible Damage Strong frame houses lifted off foundations and carried considerable distances to disintegrate; automobile-size missiles fly through the air in excess of 100 meters; trees debarked; incredible phenomena will occur. Scale 3 – North East Snowfall Impact Scale (NESIS) The National Oceanic and Atmospheric Administration (NOAA) have developed a snowfall rating system for snowfalls that affect the North East United States. The rating system is called the North East Snowfall Impact Scale (NESIS) and is similar to the formats used in the Saffir/Simpson scale, which is used for hurricanes and the Fujita scale, which is used for tornados. The scale is not a forecast tool, but rather a means to alert the public to the significance and impact of a major snowfall event, after it occurs. The NESIS is based on a mathematical formula combined with an automated Geographical Information System (GIS) that takes into account the area affected by the snow storm, the depth of the snow, and the number of people living in the affected regions. Category 1 (Notable): Category 1 storms (NESIS Value 1-2.499) produce widespread areas of 4 inches of snow and small scale areas of 10 inches of snow. Category 2 (Significant): Category 2 storms (NESIS Value 2.5-3.99) produce widespread areas of 10 inches of snow with small scale areas of 20 inches of snow. Category 3 (Major): Category 3 storms (NESIS Value 4.0-5.99) produce widespread areas of 10 inches with large areas of the North East covered with 20 inches of snow. Category 4 (Crippling): Category 4 storms (NESIS Value 6.0-9.99) produce widespread areas of 10 inches with significant portions of the North East covered with at least 20 inches of snow. The impact to the national economy and transportation system is readily observable. Category 5 (Extreme): Category 5 storms (NESIS Value > 10) produce the largest areas of at least 10 inch snowfalls with significant areas of 20 and 30 inch snowfalls. Scale 4 - Modified Mercalli/Richter Intensity Scales for Earthquake Mercalli Intensity Richter Magnitude* Effects I – Instrumental 1.9 Not felt except by a very few under especially favorable conditions II – Feeble 2.5 Felt only by a few persons at rest, especially on upper floors of buildings. Delicately suspended objects may swing. III – Slight 3.1 Felt quite noticeably indoors, especially on upper floors of building but, many people do not recognize it as an earthquake. Standing motorcars may rock slightly. Vibration like passing of truck. Duration estimated. IV – Noticeable 3.7 During the day, felt indoors by many, outdoors by few. At night some wakened. Dishes, windows, doors disturbed; walls make creaking sound. Sensation like heavy truck striking building. Standing motorcars rocked noticeably. V – Moderate 4.3 Felt by nearly everyone, many awakened. Some dishes, windows, etc., broken: a few instances of cracked plaster, unstable objects overturned. Disturbances of trees, poles, and other tall objects sometimes noticed. Pendulum clocks may stop. VI – Rather Strong 4.9 Felt by all, many frightened and run outdoors. Some heavy furniture moved; a few instances of fallen plaster or damaged chimneys. Damage slight. VII – Strong 5.5 Everybody runs outdoors. Damage negligible in buildings of good design and construction; slight to moderate in well-built ordinary structures; considerable in poorly built or badly designed structures; some chimneys broken. Noticed by persons driving motorcars. VIII – Very Strong 6.1 Damage slight in specially designed structures; considerable in ordinary substantial buildings, with partial collapse; great in poorly built structures. Panel walls thrown out of frame structures. Fall of chimneys, factory stacks, columns, monuments, and walls. Heavy furniture overturned. Sand and mud ejected in small amounts. Changes in well water. Persons driving motorcars disturbed. IX – Destructive 6.7 Damage considerable in specially designed structures; well designed frame structures thrown out of plumb; great in substantial buildings, with partial collapse. Buildings shifted off foundations. Ground cracked conspicuously. Underground pipes broken. X – Disastrous 7.3 Some well-built wooden structures destroyed; most masonry and frame structures destroyed with foundation; ground badly cracked. Rails bent. Landslides considerable from riverbanks and steep slopes. Shifted sand and mud, water splashed (slopped) over banks. XI – Ruinous 7.9 Few, if any (masonry) structures remain standing. Bridges destroyed. Broad fissures in ground. Underground pipelines completely out of service. Earth slumps and land slips in soft ground. Rails bent greatly. XII - Catastrophic 8.5 Damage total. Waves seen on ground surfaces. Lines of sight and level distorted. Objects thrown upward into air. Wording is that of Wood and Neumann. (1931) Effects on cars, trucks, and buildings built according to modern standards may be different. * Although earthquakes of the same maximum (epicentral) intensity do not always have the same magnitudes, it is possible to estimate the magnitude with the formula; magnitude = 1.3 + (0.6 X maximum intensity). Values in the table were obtained using this formula. Reference: Wood, H.O., and Neumann, Frank, 1931, Modified Mercalli Scale of 1931: Seismological Society of America Bulletin, v.21, no.4, pp.277-283. Scale 5 – Heat Index The NWS has stepped up its efforts to provide an effective method of alerting the general public and appropriate authorities to the hazards of heat waves - those prolonged excessive heat/humidity episodes. The NWS has devised the “Heat Index” (HI), (sometimes referred to as the “apparent temperature”). The HI, given in degrees Fahrenheit, is an accurate measure of how hot it really feels when the relative humidity (RH) is combined with the actual air temperature. For example, if the air temperature is 950F and the RH is 55%, the HI is 1100F. Since HI values were devised for shady, light wind conditions, exposure to full sunshine can increase HI values by up to 150F. To find the HI, look at the following Heat Index chart. The shaded area above 1050F corresponds to a level of HI that may cause increasingly severe heat disorders with prolonged exposure and/or physical activity. The chart relates ranges of HI with specific disorders, particularly for people in higher risk groups. Natural Disasters Standard Operating Guideline Final, July 2008 Division of Public Health, State of Delaware Doc Control # 35-05-20/08/05/18B