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In 2009 the Institute of Medicine (IOM) began to assess the need
for better-defined medical and public health crisis standards of
care (CSC) for catastrophic disasters and public health
emergencies. Over the next 10 years, the IOM defined templates for
those stakeholders responsible for integrated CSC planning and
implementation; created a tool kit with guidance on indicators and
triggers; provided a discussion kit for stakeholders to use with
their own communities to establish appropriate indicators and
triggers to guide their planning; disseminated the messages and key
concepts of CSC; and built on the initial efforts to refine certain
elements and address remaining gaps. This current Proceedings of a
Workshop captures the discussions from a 2019 workshop reviewing
the successes and gaps over the last 10 years of CSC work, in order
to inform the next phases of planning and implementation. Table of
Contents Front Matter 1 Introduction 2 Informing the Next Stage of
Crisis Standards of Care 3 Ethical and Legal Considerations 4
Crisis Standards of Care Application Across Sectors 5 Implementing
Crisis Standards of Care Across Sectors References Appendix A:
Workshop Agenda Appendix B: Speaker Biographies
Consequences of natural disasters and the COVID-19 pandemic have
taken a cumulative toll on the health and well-being of people in
the Gulf of Mexico region. Long-standing societal challenges
related to racism, poverty, education, housing, and underemployment
are compounding the trauma, leading to chronic stress for many Gulf
residents. The Committee on Progress Toward Human Health and
Community Resilience in the Gulf of Mexico Region new report,
Advancing Health and Community Resilience in the Gulf of Mexico
Region: A Roadmap for Progress, explores key challenges and
priorities in Gulf states, including Alabama, Florida, Louisiana,
Mississippi, and Texas and evaluates recent progress. The report
also makes recommendations for closing critical gaps and
implementing transformative approaches that focus on the diverse
needs and experiences of people who live and work in the Gulf
region. Table of Contents Front Matter Summary 1 Introduction 2
Understanding Systems of Health and Community Resilience 3
Addressing Critical Data Gaps in Human Health and Community
Resilience in the Gulf Region 4 Strengthening the Foundation:
Pillars for Progress Toward Health and Community Resilience in the
Gulf Region 5 A Road Map for Advancing Progress Towards Health and
Community Resilience in the Gulf Region Appendix A: References
Appendix B: Public Session Agendas Appendix C: Commissioned Paper:
Current State of Health, Community Resilience, and Cohesion in the
Gulf of Mexico Region Appendix D: Committee Members and Staff
Biographical Sketches
Crisis Standards of Care (CSC) inform decisions on medical care
during a large-scale crisis such as a pandemic or natural disaster,
eliminating the need to make these decisions at the bedside without
protections or guidance. Numerous points throughout the COVID-19
pandemic have demonstrated the necessity of this type of crisis
planning. The National Academies of Sciences, Engineering, and
Medicine Forum on Medical and Public Health Preparedness for
Disasters and Emergencies convened a series of public workshops to
examine the experiences of healthcare providers during the COVID-19
pandemic and identify lessons that can inform current and future
CSC planning and implementation. The workshops examined staffing
and workforce needs, planning and implementation of CSC plans, and
legal, ethical, and equity considerations of CSC planning. Topics
of discussion included improving coordination between the bedside
and boardroom, increasing buy-in from elected officials, expanding
provider engagement, and addressing health equity issues. This
publication summarizes the presentation and discussion of the
workshops. Table of Contents Front Matter 1 Introduction 2
Reflections, Inflections, and the Future 3 Considerations for
Staffing, Effects on the Workforce, and Future Trends 4 Crisis
Standards of Care: From Plans to Reality 5 Legal, Ethical, and
Equity Considerations for Crisis Standards of Care 6 Looking
Forward References Appendix A: Workshop Agendas Appendix B: Speaker
Biosketches
To explore issues related to the effects of disasters on children
and youth and lessons learned from experiences during previous
disasters, the virtual workshop From Hurricane Katrina to Paradise
Wildfires, Exploring Themes in Disaster Human Services was convened
on July 22 and 23, 2020, by the National Academies of Sciences,
Engineering, and Medicine. The workshop was designed to focus on
families engaged with federal, state or local supportive programs
prior to disasters. Additional areas of focus were the coordination
of disaster response efforts and the transition to reestablishing
routine service delivery programs post-disaster by human services,
social services, and public health agencies at the state, local,
tribal, and territorial levels. The workshop was also intended to
provide a platform for highlighting promising practices, ongoing
challenges, and potential opportunities for coordinated delivery
and restoration of social and human services programs. This
publication summarizes the presentations and discussion of the
workshop. Table of Contents Front Matter 1 Introduction 2 Exposure
Outliers: Children Coming of Age in an Age of Environmental
Extremes 3 Effect of Disasters on Critical Child Infrastructure 4
Exploring the Gaps in Evidence 5 Case Studies: Effect of Disasters
on Specific Populations 6 Workshop Reflections References Appendix
A: Workshop Statement of Task Appendix B: Workshop Agenda Appendix
C: Speaker Biographies
Large catastrophic events, or rare acute events, may cause
situations in which a local jurisdiction's medicines and medical
supplies are not sufficient to provide care to the population it
serves. In these cases of natural or engineered disasters, such as
a terrorist attack, influenza pandemic, or earthquake, state or
local authorities can request that the federal government provide
assets from the Strategic National Stockpile to augment the state
and local jurisdictions' resources. The Centers for Disease Control
and Prevention's (CDC's) Strategic National Stockpile (SNS) is the
nation's repository of antibiotics, chemical antidotes, antitoxins,
vaccines, antiviral drugs, and other medical materiel designed to
supplement and resupply state and local public health agencies in
the event of an emergency. The materiel is intended to support
national health security and is managed by the Office of Public
Health Preparedness and Response's (OPHPR's) Division of Strategic
National Stockpile (DSNS). The stated mission of the SNS is to
prepare and support partners and provide the right resources at the
right time to secure the nation's health. The National Academies of
Sciences, Engineering, and Medicine organized a two-day public
workshop to explore opportunities to improve the efficiency,
effectiveness, and sustainable methods used by the CDC's SNS to
distribute medical countermeasures and other supplies during
disasters and other public health emergencies, especially those
which result in disruption of physical infrastructure such as the
electrical grid, central roadways, bridges, and tunnels within the
impacted community. Participants explored relevant distribution
lessons learned from other federal agency stockpiles and the
private sector as well as opportunities to develop public-private
collaborations in the purchase, warehousing, management, and
distribution of medical countermeasures. This report summarizes the
presentations and discussions from the workshop. Table of Contents
Front Matter 1 Introduction, Background, and Context 2 The
Strategic National Stockpile: Origin, Policy Foundations, and
Federal Context 3 Studies and Reports Related to the Strategic
National Stockpile 4 Potential Opportunities for Restructuring
Strategic National Stockpile Scope, Governance, and Decision Making
5 Reaching the Last Mile: Potential Opportunities to Improve
Coordination and Communication Among Local, State, and Federal
Agencies 6 Potential Supply-Chain Opportunities and Lessons from
the Commercial Sector and Government Partners 7 Wrap-Up References
Appendix A: Workshop Agenda Appendix B: Workshop Speaker
Biographies
The National Academies of Sciences, Engineering, and Medicine held
a workshop on August 22?23, 2018, in Washington, DC, to explore
medical and public health preparedness for a nuclear incident. The
event brought together experts from government, nongovernmental
organizations, academia, and the private sector to explore current
assumptions behind the status of medical and public health
preparedness for a nuclear incident, examine potential changes in
these assumptions in light of increasing concerns about the use of
nuclear warfare, and discuss challenges and opportunities for
capacity building in the current threat environment. This
publication summarizes the presentations and discussions from the
workshop. Table of Contents Front Matter 1 Introduction 2 Federal
Planning for Nuclear Incidents 3 Current State of Nuclear
Preparedness 4 Updating Planning Assumptions of Nuclear
Preparedness 5 Implications of Communication, Education, and
Information Challenges 6 Challenges for Building Capacity Within
the Health Care System 7 Capability-Building Challenges and
Opportunities: Building Response Capability 8 Capability-Building
Challenges and Opportunities: Ensuring Workforce Readiness and
Response Capacity 9 Building Preparedness and Response Capability:
Looking to the Future 10 Reflections on the Workshop and
Opportunities for Moving Forward References Appendix A: Workshop
Agenda Appendix B: Workshop Speaker Biographies
COVID-19 has proven among the worst public health crises in a
generation. Public health emergencies (PHE) have always been
anticipated. Despite the growing field of PHE preparedness and
planning since the turn of the twenty-first century and the
preparedness plans and exercises developed, the U.S. experienced a
suboptimal national response to the emergence of COVID-19 in early
2020 compared to other countries. To explore the U.S. PHE
preparedness enterprise, the National Academies Forum on Medical
and Public Health Preparedness for Disasters and Emergencies
convened a workshop in May 2022. They invited participants from
government, NGO, and private sector organizations to consider key
components, success stories, and failure points in order to
identify opportunities for more effective catastrophic disaster,
pandemic, and other large scale PHEs planning at the federal,
state, local, tribal, and territorial levels. This Proceedings of a
Workshop summarizes the discussions held during the workshop. Table
of Contents Front Matter 1 Introduction 2 Public Health Emergency
Planning: Lessons from Past and Present for the Future 3
Coordinating Surveillance and Medical Countermeasure Response 4
Equity, Risk Communication, and Public Engagement 5 Coordination,
Government, and Leadership 6 Reflections References Appendix A:
Workshop Agenda Appendix B: Speaker and Planning Committee
Biosketches
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