By Janelle Foskett
WASHINGTON, DC — FEMA Administrator Pete Gaynor shared a letter with emergency managers on Friday, requesting action on critical steps related to the COVID-19 pandemic.
Gaynor, who was emergency manager prior to his current appointment, thanked his fellow emergency managers for their tireless efforts under these unprecedented and very demanding circumstances, and urged them to work as a team to deliver locally executed, state-managed and federally supported solutions, adding, “We are emergency managers, and America needs us at our best.”
Urging decisive and immediate action to defeat the spread of COVID-19, Gaynor outlined seven critical steps for emergency managers:
1. Mitigation works. Ensure you preserve your "force" while maintaining the ability to respond in a COVID-19 degraded environment without access to the tools typically used in an emergency or disaster like mutual aid and EMAC. Ensure that your communities, small or large embrace mitigation efforts. Every American has a role to play in defeating COVID-19, including good hygiene and social distancing. Follow the President's 15 Days to Slow the Spread.
2. Integrate all emergency management and public health operations. Identify and integrate your leading health official into your Emergency Operations Center and Unified Command Group at every level of government. You must form a unified Emergency Management – Public Health Team. Ensure that the entire state political leadership team understand the emergency management process. All requests to the federal government must be formally communicated by the state's emergency manager to the FEMA regional administrator. This is the same process as natural disasters.
3. Collect public, private and government hospital bed capacity data, if you haven't already – total beds, acute care beds, normal occupancy, predicted surge occupancy. This data will assist you in crafting requests for high demand, low-density critical resources should the time come that you may need it. We must use all data wherever possible to allocate scarce resources, including consideration of population size, demographics, and vulnerability.
4. Actively plan to stand-up Alternate Care Sites. Be creative in identifying facilities that can support low-acuity patients and require a minimal amount of medical staff, already in short supply. Consider locations such as convention centers, hotels, shuttered hospitals, college or university dormitories or vacant open space in commercial buildings. Ask your FEMA regional administrator to brief you on the U.S. Army Corps of Engineers "Hotel to Healthcare" initiative. Here is a link to a plan.
5. Maintain situational awareness of ventilators that may be used across your area. Check hospitals, acute care sites, outpatient locations and any other location that may use these devices, especially those that may be a source for reallocation to an area of greater need. Like hospital bed capacity, this data will help you understand what you have and what you may need, informing your resource management strategy for these high-demand, low-density critical resources should the time come that you may need it. Just as we are moving resources nationally, you should also be moving resources within your state.
6. Identify all sources to surge medical professionals. Look for retirees, medical contract services, nurses, respiratory therapists, medical students and EMTs or local equivalents. You will need them to support the increased hospital surge and management of patients on ventilators and you should be cataloging and training them now, as appropriate.
7. Manage PPE carefully. We have stood-up the Supply Chain Stabilization Task Force within FEMA with the purpose of increasing the flow of critical medical supplies such as N95 masks, surgical masks, and ventilators. We are using four guiding principles: 1) preserve what we have; 2) locate medical stockpile around the globe; 3) distribute them to locations most in need; and 4) build capacity in America through partners with industry. While some of these strategies will yield near-term benefits, it must be your highest priority to carefully manage what you have available to you now.
To help with this step, Gaynor shared the CDC-produced Personal Protective Equipment (PPE) Burn Rate Calculator, which provides information for healthcare facilities to plan and optimize the use of PPB for response to COVID-19.
Gaynor explained that while FEMA will reimburse all eligible expenses for emergency protective measures, managers to not wait for the PPE from the federal government to show up: “Take aggressive action now to source your own,” he wrote. “Continue to be resourceful … review and utilize the guidance the Supply Chain Stabilization Task Force released regarding guidance for PPE.”
Gaynor also shared external communications related to best practices, rumor control and other ways to help during this national emergency.
Gaynor’s message concluded with optimism and a call to action: “As professional emergency mangers, we are built for this – this is what we do best: coordinate, problem-solve, and act. I ask all of you to lead, innovate and be resourceful. This is a whole of nation response, and I need every emergency manager to be an active participant.”