Forum on Medical and Public Health Preparedness for Disasters and Emergencies

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When disaster strikes, critical infrastructure failures can follow - from loss of power and water to failures of information technology infrastructure and systems. Threats to the nation's healthcare and public health (HPH) critical infrastructure are highly complex and rapidly evolving, creating potentially new or increased national health security risks and disruptions, challenging assumptions about the current and future resilience of HPH critical infrastructure design and operations, and altering the implications for interdependent sectors and workforce. In December 2024, the National Academies Forum on Medical and Public Health Preparedness for Disasters and Emergencies hosted a public workshop to consider strategies, policies, and innovative actions to improve the resilience of HPH critical infrastructure concerning impacts from disasters and other emergencies.

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15 pages · 8.5 x 11 ·
ISBN Ebook: 0-309-73573-4
DOI: https://doi.org/10.17226/29081

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National Academies of Sciences, Engineering, and Medicine. 2025. Enhancing the Resilience of Health Care and Public Health Critical Infrastructure: Proceedings of a Workshop—in Brief. Washington, DC: The National Academies Press.

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The Forum on Medical and Public Health Preparedness for Disasters and Emergencies convenes public- and private-sector leaders to improve the nation's preparedness for, response to, and recovery from disasters, public health emergencies, and emerging threats. The forum fosters in-depth policy discussion and collaboration to identify barriers and explore solutions to ensure and sustain national security, promote recovery, and enhance resilience. This publication describes the activities of the forum during 2024.

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20 pages · 8.5 x 11 ·
ISBN Ebook: 0-309-09906-4
DOI: https://doi.org/10.17226/29090

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National Academies of Sciences, Engineering, and Medicine. 2025. Forum on Medical and Public Health Preparedness for Disasters and Emergencies: 2024 Annual Report. Washington, DC: The National Academies Press.

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Indigenous American and tribal nations and communities represent an important component of the U.S. medical and public health emergency preparedness and response system. As public health threats grow, Indigenous knowledge and practices are and will be critical to improving preparedness and response systems. The National Academies Forum on Medical and Public Health Preparedness for Disasters and Emergencies hosted a public workshop in July 2024 to explore opportunities to support the capacity of Indigenous American and tribal communities and nations to prepare for, respond to, and recover from disasters and public health emergencies.

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11 pages · 8.5 x 11 ·
ISBN Ebook: 0-309-73012-0
DOI: https://doi.org/10.17226/28284

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National Academies of Sciences, Engineering, and Medicine. 2024. Strengthening Indigenous America: Building Resilience Through Disaster Preparedness, Response, and Recovery: Proceedings of a Workshop—in Brief. Washington, DC: The National Academies Press.

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The Forum on Medical and Public Health Preparedness for Disasters and Emergencies convenes public- and private-sector leaders to improve the nation's preparedness for, response to, and recovery from disasters, public health emergencies, and emerging threats. The forum fosters in-depth policy discussion and collaboration to identify barriers and explore solutions to ensure and sustain national security, promote recovery, and enhance resilience. This publication describes the activities of the forum during 2023.

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20 pages · 8.5 x 11 ·
ISBN Ebook: 0-309-72170-9
DOI: https://doi.org/10.17226/27826

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National Academies of Sciences, Engineering, and Medicine. 2024. Forum on Medical and Public Health Preparedness for Disasters and Emergencies: 2023 Annual Report. Washington, DC: The National Academies Press.

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The National Academies Forum on Medical and Public Health Preparedness for Disasters and Emergencies hosted a 5-part virtual public workshop series to build on lessons learned from responses to past public health emergencies and discuss future opportunities for public-private partnerships to facilitate the distribution, dispensing, administration, acceptance, and uptake of medical countermeasures during a public health emergency.

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12 pages · 8.5 x 11 ·
ISBN Ebook: 0-309-71684-5
DOI: https://doi.org/10.17226/27594

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National Academies of Sciences, Engineering, and Medicine. 2024. Expanding Delivery and Increasing Uptake of Medical Countermeasures Through Public–Private Partnerships: Proceedings of a Workshop—in Brief. Washington, DC: The National Academies Press.

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The COVID-19 pandemic catalyzed unparalleled speed and cross-sector collaboration in the innovation of tools and technologies to address an emerging infectious disease outbreak. Continued innovation and collaboration in rapid development and implementation of new vaccines, therapeutics, and diagnostics is central to future outbreak preparedness. The National Academies Forum on Microbial Threats; Forum on Drug Discovery, Development, and Translation; and the Forum on Medical and Public Health Preparedness for Emergencies and Disasters held a workshop in December 2022 to explore how innovative approaches in research can enhance health systems preparedness and responses to emerging infectious diseases and dangerous pathogens. Workshop participants reflected on critical scientific infrastructure for stakeholder coordination and innovations that can facilitate rapid and effective preparedness and response to emerging infectious disease threats. This Proceedings of a Workshop summarizes the discussions held during the workshop.

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172 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-70784-6
ISBN Ebook: 0-309-70785-4
DOI: https://doi.org/10.17226/27194

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National Academies of Sciences, Engineering, and Medicine. 2023. Applying Lessons Learned from COVID-19 Research and Development to Future Epidemics: Proceedings of a Workshop. Washington, DC: The National Academies Press.

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The Forum on Medical and Public Health Preparedness for Disasters and Emergencies convenes public- and private-sector leaders to improve the nation's preparedness for, response to, and recovery from disasters, public health emergencies, and emerging threats. The forum fosters in-depth policy discussion and collaboration to identify barriers and explore solutions to ensure and sustain national security, promote recovery, and enhance resilience. This publication describes the activities of the forum during 2022.

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17 pages · 8.5 x 11 ·
ISBN Ebook: 0-309-71283-1
DOI: https://doi.org/10.17226/27374

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National Academies of Sciences, Engineering, and Medicine. 2023. Forum on Medical and Public Health Preparedness for Disasters and Emergencies: 2022 Annual Report. Washington, DC: The National Academies Press.

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The use and misuse of antibiotics contributes to the rise in drug-resistant bacteria - a serious and worsening threat to human health. The development and use of rapid point-of-care diagnostics in the healthcare setting plays an important role in avoiding unnecessary use of antimicrobials by providing clinicians with the right information at the right time to help them make decisions about appropriate drug treatment for patients. Diagnostics also have the capacity to support early detection and diagnosis of drug-resistant bacterial infections, enable disease surveillance, and help prevent disease spread.

The National Academies Forum on Drug Discovery, Development, and Translation; Forum on Medical and Public Health Preparedness for Disasters and Emergencies; and Forum on Microbial Threats hosted an October 2022 workshop exploring the current landscape of rapid diagnostics to address antibiotic resistance, challenges and opportunities for spurring innovation, and practical next steps for accelerating the development of new diagnostic tools.

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150 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-70240-2
ISBN Ebook: 0-309-70241-0
DOI: https://doi.org/10.17226/27008

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National Academies of Sciences, Engineering, and Medicine. 2023. Accelerating the Development and Uptake of Rapid Diagnostics to Address Antibiotic Resistance: Proceedings of a Workshop. Washington, DC: The National Academies Press.

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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.

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138 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-69682-8
ISBN Ebook: 0-309-69683-6
DOI: https://doi.org/10.17226/26805

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National Academies of Sciences, Engineering, and Medicine. 2023. Future Planning for the Public Health Emergency Preparedness Enterprise: Lessons Learned from the COVID-19 Pandemic: Proceedings of a Workshop. Washington, DC: The National Academies Press.

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The National Academies Forum on Medical and Public Health Preparedness for Disasters and Emergencies and Forum on Microbial Threats cohosted a two-day public workshop in March 2023 to explore U.S. laboratory and testing responses to past, present, and potential health emergencies (e.g., COVID-19, monkey pox, chemical, radiological or nuclear threats). Speakers addressed the future of laboratory capabilities, capacities, and coordination for national health emergencies response across public and private entities. The workshop culminated with a discussion envisioning the ideal structure, characteristics, components, capabilities, and functions of what could be considered a coordinated national laboratory system, a coordinated system of public and private laboratories, manufacturers, pharmacies, and other entities, that is prepared to respond to future public health threats and emergencies. This Proceedings of a Workshop-in Brief summarizes the discussions held during the workshop.

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14 pages · 8.5 x 11 ·
ISBN Ebook: 0-309-70636-X
DOI: https://doi.org/10.17226/27147

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National Academies of Sciences, Engineering, and Medicine. 2023. Future of the Nation's Laboratory Systems for Health Emergency Response: Proceedings of a Workshop—in Brief. Washington, DC: The National Academies Press.

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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.

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114 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-68879-5
ISBN Ebook: 0-309-68880-9
DOI: https://doi.org/10.17226/26573

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National Academies of Sciences, Engineering, and Medicine. 2022. Evolving Crisis Standards of Care and Ongoing Lessons from COVID-19: Proceedings of a Workshop Series. Washington, DC: The National Academies Press.

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The Forum on Medical and Public Health Preparedness for Disasters and Emergencies convenes public and private sector leaders to improve the nation's preparedness for, response to, and recovery from disasters, public health emergencies, and emerging threats. The Forum fosters in-depth policy discussion and collaboration to identify barriers and explore solutions to ensure and sustain national security, promote recovery, and enhance resilience. This publication describes the activities of the forum during 2021.

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20 pages · 8.5 x 11 ·
ISBN Ebook: 0-309-69357-8
DOI: https://doi.org/10.17226/26709

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National Academies of Sciences, Engineering, and Medicine. 2022. Forum on Medical and Public Health Preparedness for Disasters and Emergencies: 2021 Annual Report. Washington, DC: The National Academies Press.

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20 pages · 8 x 8 ·
ISBN Ebook: 0-309-09411-9
DOI: https://doi.org/10.17226/26327

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National Academies of Sciences, Engineering, and Medicine. 2021. Forum on Medical and Public Health Preparedness for Disasters and Emergencies: 2020 Annual Report. Washington, DC: The National Academies Press.

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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.

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80 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-67625-8
ISBN Ebook: 0-309-67626-6
DOI: https://doi.org/10.17226/25767

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National Academies of Sciences, Engineering, and Medicine. 2021. Crisis Standards of Care: Ten Years of Successes and Challenges: Proceedings of a Workshop. Washington, DC: The National Academies Press.

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California and other wildfire-prone western states have experienced a substantial increase in the number and intensity of wildfires in recent years. Wildlands and climate experts expect these trends to continue and quite likely to worsen in coming years. Wildfires and other disasters can be particularly devastating for vulnerable communities. Members of these communities tend to experience worse health outcomes from disasters, have fewer resources for responding and rebuilding, and receive less assistance from state, local, and federal agencies. Because burning wood releases particulate matter and other toxicants, the health effects of wildfires extend well beyond burns. In addition, deposition of toxicants in soil and water can result in chronic as well as acute exposures.

On June 4-5, 2019, four different entities within the National Academies of Sciences, Engineering, and Medicine held a workshop titled Implications of the California Wildfires for Health, Communities, and Preparedness at the Betty Irene Moore School of Nursing at the University of California, Davis. The workshop explored the population health, environmental health, emergency preparedness, and health equity consequences of increasingly strong and numerous wildfires, particularly in California. This publication is a summary of the presentations and discussion of the workshop.

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160 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-49987-9
ISBN Ebook: 0-309-49988-7
DOI: https://doi.org/10.17226/25622

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National Academies of Sciences, Engineering, and Medicine. 2020. Implications of the California Wildfires for Health, Communities, and Preparedness: Proceedings of a Workshop. Washington, DC: The National Academies Press.

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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.

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210 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-48914-8
ISBN Ebook: 0-309-48915-6
DOI: https://doi.org/10.17226/25372

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National Academies of Sciences, Engineering, and Medicine. 2019. Exploring Medical and Public Health Preparedness for a Nuclear Incident: Proceedings of a Workshop. Washington, DC: The National Academies Press.

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Disasters tend to cross political, jurisdictional, functional, and geographic boundaries. As a result, disasters often require responses from multiple levels of government and multiple organizations in the public and private sectors. This means that public and private organizations that normally operate independently must work together to mount an effective disaster response. To identify and understand approaches to aligning health care system incentives with the American public's need for a health care system that is prepared to manage acutely ill and injured patients during a disaster, public health emergency, or other mass casualty event, the National Academies of Sciences, Engineering, and Medicine hosted a 2-day public workshop on March 20 and 21, 2018. This publication summarizes the presentations and discussions from the workshop.

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154 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-48212-7
ISBN Ebook: 0-309-48213-5
DOI: https://doi.org/10.17226/25203

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National Academies of Sciences, Engineering, and Medicine. 2018. Engaging the Private-Sector Health Care System in Building Capacity to Respond to Threats to the Public's Health and National Security: Proceedings of a Workshop. Washington, DC: The National Academies Press.

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As the United States continues to adapt to a more digital, mobile, and interconnected world, health care and public health professionals have sought to better prepare for and respond to long-standing and emerging threats to the nation's health security. Health security is the collective effort to prevent, protect against, mitigate, respond to, and recover from the health consequences of natural, man-made, and technological disasters. Although substantial progress has been made in the past 15 years toward improving health care and public health systems and capacities for health security threats, many complex challenges persist, and often the nation's preparedness efforts are not sufficient.

On March 8-9, 2017, the National Academies of Sciences, Engineering, and Medicine's Forum on Medical and Public Health Preparedness for Disasters and Emergencies hosted a two-day public workshop to acknowledge these persistent issues; to evaluate past, and perhaps inadequate, approaches to addressing them; and to discuss intentional and innovative new solutions. This publication summarizes the presentations and discussions from the workshop.

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124 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-46375-0
ISBN Ebook: 0-309-46376-9
DOI: https://doi.org/10.17226/24856

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National Academies of Sciences, Engineering, and Medicine. 2018. Examining Challenges and Possible Strategies to Strengthen U.S. Health Security: Proceedings of a Workshop. Washington, DC: The National Academies Press.

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On April 26, 2017, the Forum on Medical and Public Health Preparedness for Disasters and Emergencies convened a workshop during a 4-hour session of the 2017 Preparedness Summit. Participants discussed potential characteristics of society in the year 2042 and the key resources, tools, and opportunities necessary to support the development of a robust, scalable, and regularly engaged disaster health volunteer workforce prepared for such a future. This publication summarizes the presentations and discussions from the workshop.

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9 pages · 8.5 x 11 ·
ISBN Ebook: 0-309-46393-9
DOI: https://doi.org/10.17226/24859

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National Academies of Sciences, Engineering, and Medicine. 2017. Preparing for the Future of Disaster Health Volunteerism: Proceedings of a Workshop—in Brief. Washington, DC: The National Academies Press.

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Countering violent extremism consists of various prevention and intervention approaches to increase the resilience of communities and individuals to radicalization toward violent extremism, to provide nonviolent avenues for expressing grievances, and to educate communities about the threat of recruitment and radicalization to violence. To explore the application of health approaches in community-level strategies to countering violent extremism and radicalization, the National Academies of Sciences, Engineering, and Medicine held a public workshop in September 2016. Participants explored the evolving threat of violent extremism and radicalization within communities across America, traditional versus health-centered approaches to countering violent extremism and radicalization, and opportunities for cross-sector and interdisciplinary collaboration and learning among domestic and international stakeholders and organizations. This publication summarizes the presentations and discussions from the workshop.

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146 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-45365-8
ISBN Ebook: 0-309-45366-6
DOI: https://doi.org/10.17226/24638

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National Academies of Sciences, Engineering, and Medicine. 2017. Countering Violent Extremism Through Public Health Practice: Proceedings of a Workshop. Washington, DC: The National Academies Press.

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When disaster strikes, it rarely impacts just one jurisdiction. Many catastrophic disaster plans include support from neighboring jurisdictions that likely will not be available in a regional disaster. Bringing multiple stakeholders together from sectors that do not routinely work with each other can augment a response to a disaster, but can also be extremely difficult because of the multi-disciplinary communication and coordination needed to ensure effective medical and public health response. As many communities within a region will have similar vulnerabilities, a logical step in planning is to establish responsibilities and capacities, and be able to work toward common goals to address all-hazards when the entire region is affected. To explore these considerations, the Institute of Medicine's Forum on Medical and Public Health Preparedness for Catastrophic Events organized a series of three regional workshops in 2014 to explore opportunities to strengthen the regional coordination required in response to a large scale multijurisdictional disaster. The purpose of each regional workshop was to discuss ways to strengthen coordination among multiple jurisdictions in various regions to ensure fair and equitable treatment of communities from all impacted areas. Regional Disaster Response Coordination to Support Health Outcomes summarizes the presentation and discussion of these workshops.

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118 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-37149-X
ISBN Ebook: 0-309-37150-3
DOI: https://doi.org/10.17226/21713

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Institute of Medicine. 2015. Regional Disaster Response Coordination to Support Health Outcomes: Summary of a Workshop Series. Washington, DC: The National Academies Press.

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Over the past decade, preparedness and response capacities of government agencies, hospitals and clinics, public health agencies, and academic researchers in the United States and abroad have been challenged by a succession of public health emergencies, ranging from radiological threats to pandemics to earthquakes. Through After Action Reports, each of these emergencies has yielded important information and lessons learned that can inform future disaster response and recovery efforts. However, important information that needs to be collected during and immediately following these emergencies is often missed because of barriers and obstacles to gathering such data, such as varying institutional review board restrictions in different states, no sustainable funding network for this type of work, uncertainty on who should be involved in research response, and a lack of knowledge around how best to integrate research into response and recovery frameworks.

Taking action to enable medical and public health research during disasters was the focus of a workshop held on June 12 and 13, 2014, coordinated and supported jointly by the Institute of Medicine Forum on Medical and Public Health Preparedness for Catastrophic Events, National Institute of Environmental Health Sciences, the National Library of Medicine, the U.S. Department of Health and Human Services' Office of the Assistant Secretary for Preparedness and Response, and the Centers for Disease Control and Prevention. Invited speakers and participants from federal, state, and local government, academia, and community and worker organizations came together to discuss how to integrate research into existing response structures; identify critical research needs and priorities; identify obstacles and barriers to research; discuss structures and strategies needed for deployment of a research study; share ideas, innovations, and technologies to support research; and explore data collection tools and data-sharing mechanisms for both rapid and longitudinal research. Enabling Rapid and Sustainable Public Health Research During Disasters summarizes the presentations and discussion of the workshop.

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190 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-31330-9
ISBN Ebook: 0-309-31331-7
DOI: https://doi.org/10.17226/18967

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Institute of Medicine. 2015. Enabling Rapid and Sustainable Public Health Research During Disasters: Summary of a Joint Workshop by the Institute of Medicine and the U.S. Department of Health and Human Services. Washington, DC: The National Academies Press.

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When a disaster strikes, it rarely impacts just one jurisdiction. It is important for jurisdictions to consider how they will respond to a scenario in which the entire region is impacted. To explore these considerations, the Institute of Medicine's Forum on Medical and Public Health Preparedness for Catastrophic Events organized three regional workshops in 2014 to explore opportunities to strengthen the regional coordination required to ensure effective medical and public health response to a large-scale multijurisdictional disaster. Each of the three workshops covers different topics that may strengthen regional disaster response. The third and final workshop in this series, which this document summarizes, was held in New Orleans and considered how community engagement and information sharing can impact issues of surge management across the public health and health care spectrum.

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9 pages · 8.5 x 11 ·
ISBN Ebook: 0-309-36873-1
DOI: https://doi.org/10.17226/21696

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Institute of Medicine. 2015. Regional Disaster Response Coordination to Support Health Outcomes: Surge Management: Workshop in Brief. Washington, DC: The National Academies Press.

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The 2014 epidemic of Ebola Virus Disease (EVD), caused by a filovirus, has affected multiple countries in West Africa (Guinea, Liberia, Sierra Leone, Nigeria, and Senegal), along with Spain and the United States, becoming the worst EVD outbreak since its discovery in 1976. Until 2014, previous outbreaks have been confined to smaller geographic areas and often only affected a few hundred people. Confirmed and suspected cases of EVD have now occurred in the United States through human-to-human transmission, requiring the U.S. medical and public health systems to prepare for and respond to domestic cases of EVD. The heightened awareness and attention to the disease in the United States has also led to questions from affected communities on specific characteristics of the virus, how the virus behaves, and personal protective equipment and personal protective behaviors that can be used to prevent its spread and reduce exposure.

At the request of the Office of the Assistant Secretary for Preparedness and Response, the National Institutes of Health, and the Centers for Disease Control and Prevention, the Institute of Medicine , in collaboration with the National Research Council, convened a workshop on November 3, 2014, with key stakeholders and experts to discuss the research priorities that could guide medical and public health practice. Discussions included the degree of transmission and biopersistence of the virus under a range of conditions and on a variety of materials, as well as issues of handling potentially infected materials, decontamination, and the training and personal protective equipment usage of traditional and nontraditional workers involved in the full spectrum of this response. Research Priorities to Inform Public Health and Medical Practice for Ebola Virus Disease summarizes the presentations and discussion of the workshop.

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10 pages · 8.5 x 11 ·
ISBN Ebook: 0-309-31671-5
DOI: https://doi.org/10.17226/19004

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Institute of Medicine and National Research Council. 2014. Research Priorities to Inform Public Health and Medical Practice for Ebola Virus Disease: Workshop in Brief. Washington, DC: The National Academies Press.

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When a disaster strikes, it rarely impacts just one jurisdiction. It is important for jurisdictions to consider how they will respond to a scenario in which the entire region is impacted. To explore these considerations, the Institute of Medicine's Forum on Medical and Public Health Preparedness for Catastrophic Events organized a workshop in 2014 to examine how information and incident management can augment response efforts in a complex, regional emergency. This brief summary highlights the presentation and discussion of the workshop.

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9 pages · 8.5 x 11 ·
ISBN Ebook: 0-309-36797-2
DOI: https://doi.org/10.17226/21669

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Institute of Medicine. 2014. Regional Disaster Response Coordination to Support Health Outcomes: Information Sharing and Incident Management: Workshop in Brief. Washington, DC: The National Academies Press.

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At the April 2014 Preparedness Summit in Atlanta, Georgia, the Institute of Medicine's Forum on Medical and Public Health Preparedness for Catastrophic Events hosted a session to further the work on Crisis Standards of Care and the fair and ethical allocation of scarce resources during a medical or public health emergency. The purpose of this learning session was to share lessons and examples from communities who have been working on developing their plans and to provide a venue allowing participants to discuss challenges they experienced or are anticipating as they begin this type of planning in their own communities. After hearing lessons from various perspectives including state health, local health, health care coalitions, and emergency medical services, participants had discussions on specific challenges and opportunities for advancement within different disciplines. The discussions highlighted the critical role key stakeholders and facilitators play in developing crisis standards of care frameworks within each discipline, and how integrating medical surge plans into the emergency management system could improve disaster preparedness.

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8 pages · 8.5 x 11 ·
ISBN Ebook: 0-309-36837-5
DOI: https://doi.org/10.17226/21676

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Institute of Medicine. 2014. Crisis Standards of Care: Lessons from Communities Building Their Plans: Workshop in Brief. Washington, DC: The National Academies Press.

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Many catastrophic disaster plans include provisions of support from neighboring jurisdictions that likely will not be available in a regional disaster. Bringing multiple groups and sectors together that don't routinely work with each other can augment a response to a disaster but can also be extremely difficult because of the multi-disciplinary communication and coordination needed to ensure effective medical and public health response.In March 2014, the Institute of Medicine Forum on Medical and Public Health Preparedness for Catastrophic Events convened a regional workshop bringing together key stakeholders to examine community planning and engagement when planning for health incidents in a large-scale response. This report highlights the presentations and discussion of that event.

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8 pages · 8.5 x 11 ·
ISBN Ebook: 0-309-36838-3
DOI: https://doi.org/10.17226/21677

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Institute of Medicine. 2014. Regional Disaster Response Coordination to Support Health Outcomes: Community Planning and Engagement: Workshop in Brief. Washington, DC: The National Academies Press.

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Our nation faces the distinct possibility of a catastrophic terrorist attack using an improvised nuclear device (IND), according to international and U.S. intelligence. Detonation of an IND in a major U.S. city would result in tens of thousands to hundreds of thousands of victims and would overwhelm public health, emergency response, and health care systems, not to mention creating unprecedented social and economic challenges. While preparing for an IND may seem futile at first glance, thousands of lives can be saved by informed planning and decision making prior to and following an attack.

In 2009, the Institute of Medicine published the proceedings of a workshop assessing the health and medical preparedness for responding to an IND detonation. Since that time, multiple federal and other publications have added layers of detail to this conceptual framework, resulting in a significant body of literature and guidance. However, there has been only limited planning effort at the local level as much of the federal guidance has not been translated into action for states, cities and counties. According to an informal survey of community preparedness by the National Association of City and County Health Officials (NACCHO), planning for a radiation incident ranked lowest in priority among other hazards by 2,800 local health departments.

The focus of Nationwide Response Issues After an Improvised Nuclear Device Attack: Medical and Public Health Considerations for Neighboring Jurisdictions: Workshop Summary is on key response requirements faced by public health and health care systems in response to an IND detonation, especially those planning needs of outlying state and local jurisdictions from the detonation site. The specific meeting objectives were as follows:

- Understand the differences between types of radiation incidents and implications of an IND attack on outlying communities.

-Highlight current planning efforts at the federal, state, and local level as well as challenges to the implementation of operational plans.

-Examine gaps in planning efforts and possible challenges and solutions.

-Identify considerations for public health reception centers: how public health and health care interface with functions and staffing and how radiological assessments and triage be handled.

-Discuss the possibilities and benefits of integration of disaster transport systems.

-Explore roles of regional health care coalitions in coordination of health care response.

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256 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-28601-8
ISBN Ebook: 0-309-28602-6
DOI: https://doi.org/10.17226/18347

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Institute of Medicine. 2014. Nationwide Response Issues After an Improvised Nuclear Device Attack: Medical and Public Health Considerations for Neighboring Jurisdictions: Workshop Summary. Washington, DC: The National Academies Press.

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Health systems and assets are a large part of the critical infrastructure of any community and are vital not only for the safety and well-being of its citizens, but also for the economic vitality, quality of life, and livelihood of the entire community. As part of its ongoing mission to foster dialogue among stakeholders and to confront the challenges inherent in ensuring the nation's health security, the Institute of Medicine (IOM) Forum on Medical and Public Health Preparedness for Catastrophic Events sponsored a town hall session at the 2012 Public Health Preparedness Summit. This event took place February 21-24 in Anaheim, California.

In this session sponsored by the IOM, the focus of discussion was sustaining health care delivery beyond the initial response to a disaster and facilitating the full long-term recovery of the local health care delivery systems. Many elements required for recovery are also fundamental to the day-to-day operations of these systems. Investing in improved health care delivery systems, both financially and through collaborative capacity building, can enhance economic development and growth before a disaster, and also prove instrumental in sustaining services and recovering after a disaster.

Post-Incident Recovery Considerations of the Health Care Service Delivery Infrastructure serves as a summary of the session and explains the value of regional capacity building; the importance of interagency, intergovernmental, and public-private collaboration; and the significant role that health care coalitions can play in ensuring resilient communities and national health security.

Publication information

40 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-26060-4
ISBN Ebook: 0-309-26061-2
DOI: https://doi.org/10.17226/13442

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Institute of Medicine. 2012. Post-Incident Recovery Considerations of the Health Care Service Delivery Infrastructure: Workshop Summary. Washington, DC: The National Academies Press.

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Influenza pandemics overwhelm health care systems with thousands or hundreds of thousands of sick patients, as well as those worried they may be sick. In order to ensure a successful response to the patient swell caused by a pandemic, robust planning is essential to prepare for challenges public health officials may face. This includes the need to quickly distribute and dispense antiviral medications that can reduce the severity and duration of disease to large numbers of people.

In response to a request from the Centers for Disease Control, the Institute of Medicine's Forum on Medical and Public Health Preparedness for Catastrophic Events held a series of workshops that explored the public's perception of how to facilitate access to antiviral medications and treatment during an influenza pandemic. To help inform potential strategies still in the development stages at the CDC, workshops were held in Fort Benton, Montana; Chattanooga, Tennessee; and Los Angeles, California during February and March 2012 to consider the usefulness of several alternative strategies of delivering antiviral medication to the public. Participants considered how the normal systems for prescribing and dispensing antiviral medications could be adjusted to ensure that the public has quick, safe, and equitable access to both potentially life-saving drugs and information about the pandemic and treatment options. This document summarizes the workshops.

Publication information

56 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-25694-1
ISBN Ebook: 0-309-25695-X
DOI: https://doi.org/10.17226/13404

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Institute of Medicine. 2012. Public Engagement on Facilitating Access to Antiviral Medications and Information in an Influenza Pandemic: Workshop Series Summary. Washington, DC: The National Academies Press.

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Whether or not the United States has safe and effective medical countermeasures—such as vaccines, drugs, and diagnostic tools—available for use during a disaster can mean the difference between life and death for many Americans. The Food and Drug Administration (FDA) and the scientific community at large could benefit from improved scientific tools and analytic techniques to undertake the complex scientific evaluation and decision making needed to make essential medical countermeasures available. At the request of FDA, the Institute of Medicine (IOM) held a workshop to examine methods to improve the development, evaluation, approval, and regulation of medical countermeasures.

During public health emergencies such as influenza or chemical, biological, radiological/nuclear (CBRN) attacks, safe and effective vaccines, treatments, and other medical countermeasures are essential to protecting national security and the well being of the public. Advancing Regulatory Science for Medical Countermeasure Development examines current medical countermeasures, and investigates the future of research and development in this area. Convened on March 29-30, 2011, this workshop identified regulatory science tools and methods that are available or under development, as well as major gaps in currently available regulatory science tools.

Advancing Regulatory Science for Medical Countermeasure Development is a valuable resource for federal agencies including the Food and Drug Administration (FDA), the Department of Health and Human Services (HHS), the Department of Defense (DoD), as well as health professionals, and public and private health organizations.

Publication information

150 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-21490-4
ISBN Ebook: 0-309-21491-2
DOI: https://doi.org/10.17226/13173

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Institute of Medicine. 2011. Advancing Regulatory Science for Medical Countermeasure Development: Workshop Summary. Washington, DC: The National Academies Press.

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Problems contacting emergency services and delayed assistance are not unusual when incidents occur in rural areas, and the consequences can be devastating, particularly with mass casualty incidents. The IOM's Forum on Medical and Public Health Preparedness for Catastrophic Events held a workshop to examine the current capabilities of emergency response systems and the future opportunities to improve mass casualty response in rural communities.

Publication information

144 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-17717-0
ISBN Ebook: 0-309-17718-9
DOI: https://doi.org/10.17226/13070

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Institute of Medicine. 2011. Preparedness and Response to a Rural Mass Casualty Incident: Workshop Summary. Washington, DC: The National Academies Press.

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The 2009 H1N1 vaccination campaign was one of the largest public health campaigns in U.S. history, vaccinating one-quarter of the population in the first three months. The Institute of Medicine held three workshops in Raleigh, NC; Austin, TX; and Seattle, WA to learn from participants' experiences during the campaign and improve future emergency vaccination programs.

Publication information

140 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-16021-9
ISBN Ebook: 0-309-16022-7
DOI: https://doi.org/10.17226/12992

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Institute of Medicine. 2010. The 2009 H1N1 Influenza Vaccination Campaign: Summary of a Workshop Series. Washington, DC: The National Academies Press.

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During public health emergencies such as terrorist attacks or influenza outbreaks, the public health system's ability to save lives could depend on dispensing medical countermeasures such as antibiotics, antiviral medications, and vaccines to a large number of people in a short amount of time. The IOM's Forum on Medical and Public Health Preparedness for Catastrophic Events held a workshop on November 18, 2009, to provide an overview of current threats, recent progress made in the public health system for distributing and dispensing countermeasures, and remaining vulnerabilities.

Publication information

94 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-15803-6
ISBN Ebook: 0-309-15804-4
DOI: https://doi.org/10.17226/12952

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Institute of Medicine. 2010. Medical Countermeasures Dispensing: Emergency Use Authorization and the Postal Model: Workshop Summary. Washington, DC: The National Academies Press.

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During public health emergencies such as pandemic influenza outbreaks or terrorist attacks, effective vaccines, drugs, diagnostics, and other medical countermeasures are essential to protecting national security and the public's well-being. The Public Health Emergency Medical Countermeasures Enterprise (PHEMCE)—a partnership among federal, state, and local governments; industry; and academia—is at the forefront of the effort to develop and manufacture these countermeasures. However, despite the PHEMCE's many successes, there are still serious challenges to overcome. Government-funded medical research is not always focused on countermeasures for the most serious potential threats, and it is difficult to engage pharmaceutical and biotechnology companies to develop and manufacture medical countermeasures that have a limited commercial market.

At the request of the Secretary of the U.S. Department of Health and Human Services and the Assistant Secretary for Preparedness and Response, the IOM held a workshop February 22-24, 2010, to address challenges facing the PHEMCE. Workshop participants discussed federal policies and procedures affecting the research, development, and approval of medical countermeasures and explored opportunities to improve the process and protect Americans' safety and health.

Publication information

194 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-15024-8
ISBN Ebook: 0-309-15025-6
DOI: https://doi.org/10.17226/12856

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Institute of Medicine. 2010. The Public Health Emergency Medical Countermeasures Enterprise: Innovative Strategies to Enhance Products from Discovery Through Approval: Workshop Summary. Washington, DC: The National Academies Press.

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During natural disasters, disease pandemics, terrorist attacks, and other public health emergencies, the health system must be prepared to accommodate a surge in the number of individuals seeking medical help. For the health community, a primary concern is how to provide care to individuals during such high demand, when the health system's resources are exhausted and there are more patients than the system can accommodate.

The IOM's Forum on Medical and Public Health Preparedness for Catastrophic Events held a workshop June 10-11, 2009, to assess the capability of and tools available to federal, state, and local governments to respond to a medical surge. In addition, participants discussed strategies for the public and private sectors to improve preparedness for such a surge. The workshop brought together leaders in the medical and public health preparedness fields, including policy makers from federal agencies and state and local public health departments; providers from the health care community; and health care and hospital administrators. This document summarizes the workshop.

Publication information

176 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-14674-7
ISBN Ebook: 0-309-14675-5
DOI: https://doi.org/10.17226/12798

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Institute of Medicine. 2010. Medical Surge Capacity: Workshop Summary. Washington, DC: The National Academies Press.

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During a wide-reaching catastrophic public health emergency or disaster, existing surge capacity plans may not be sufficient to enable health care providers to continue to adhere to normal treatment procedures and follow usual standards of care. This is a particular concern for emergencies that may severely strain resources across a large geographic area, such as a pandemic influenza or the detonation of a nuclear device. Under these circumstances, it may be impossible to provide care according to the standards of care used in non-disaster situations, and, under the most extreme circumstances, it may not even be possible to provide basic life sustaining interventions to all patients who need them.

Although recent efforts to address these concerns have accomplished a tremendous amount in just a few years, a great deal remains to be done in even the most advanced plan. This workshop summary highlights the extensive work that is already occurring across the nation. Specifically, the book draws attention to existing federal, state, and local policies and protocols for crisis standards of care; discusses current barriers to increased provider and community engagement; relays examples of existing interstate collaborations; and presents workshop participants' ideas, comments, concerns, and potential solutions to some of the most difficult challenges.

Publication information

174 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-12666-5
ISBN Ebook: 0-309-12667-3
DOI: https://doi.org/10.17226/12787

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Institute of Medicine. 2010. Crisis Standards of Care: Summary of a Workshop Series. Washington, DC: The National Academies Press.

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Forum on Medical and Public Health Preparedness for Disasters and Emergencies

Enhancing the Resilience of Health Care and Public Health Critical Infrastructure: Proceedings of a Workshop—in Brief

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