Ten years ago, a team of representatives from King and Pierce counties, cities of Seattle and Bellevue, Joint Base Lewis McChord, and Pacific Northwest National Laboratory set forth on developing the Regional Recovery Framework for a Biological Attack in the Seattle Urban Area. A collaboration of the Seattle Urban Area Security Initiative (UASI) partners and military and federal agencies, the framework was specific to a hypothetical catastrophic, wide‐area biological attack using weaponized anthrax in the Seattle urban area but was designed to be flexible and scalable to serve as the recovery framework for other chemical or biological incidents. The team revisited the framework again in 2012 to create the Denver UASI All-Hazards Regional Recovery Framework. Such frameworks have been revisited again for use during the COVID pandemic.
The team’s approach was designed to assist policymakers and emergency managers in shortening the timeline for recovery and minimizing the economic and public health impacts of a catastrophic chemical, biological, or other attack – but from a local perspective. Together, the team outlined long-term recovery gaps in terms of economic redevelopment, waste management, fatality management, and prioritization of cleanup, which are highlighted in the DomPrep Journal’s October 2012 edition, entitled “Medical Emergencies.”
Welcome to 2020
In 2020, at the onset of a worldwide pandemic, Washington state was one of the first states in the nation tasked to respond to the COVID-19 outbreak. Now – in part due to its framework and more importantly its regional partnerships – Washington is positioned to be at the forefront of shaping recovery.
Although still in the throes of the pandemic, emergency managers know the time to plan for recovery is now (though yesterday would have been better). Since the start of the pandemic when frameworks were revisited, emergency managers have seen some events unfold as expected, some key elements being missed, and other things that were never imagined.
This Was Done Right
Considering pre-established frameworks, the following common recovery needs were accurately identified as applicable to the COVID-19 pandemic:
- Leadership – There is a persistent need for clarity about who are in key leadership positions today and in the long-term. This includes who has jurisdiction over what part of response versus recovery, and when the transfer of leadership occurs.
- Information sharing – Technology has come a long way since 2010. However, the core need for consistent, well-informed communications transcends technology. The front lines need accurate information, regardless of their Wi-Fi strength or mobile device. (And yes, in some cases, paper still works just fine.)
- Forward planning – The need for forward-planning of personal protective equipment (PPE), storage space, equipment, facilities, etc. became apparent. This year, PPE became the word of all people, not just the language of first responders and constructions sites. Furthermore, there is a need to know those in the supply chain – not only vendors but also backup vendors, perhaps two to three levels deep.
- Regional approach – As the pandemic permeates all boundaries, a regional approach is essential for situational awareness and a comprehensive response.
This Was Missed
Recovery planning is like trying to tell the future: some hazards and impacts can be anticipated, with drills conducted based on realistic scenarios designed around assumptions regarding the future of communities, technology, etc., but real life always brings the element of surprise. In the case of COVID-19, the surprise is still live. Learning the science of the virus and building solutions must occur simultaneously.
To that end, frameworks were not the ultimate crystal ball. A pandemic is admittedly different from the anthrax and weapons of mass destruction attacks that UASI addressed. As such, the following were not accounted for:
- Global impacts – This is a disaster with global impacts, whereas most disasters are localized or finite.
- Behavioral changes – Because humans carry the virus – not just facilities or materials – recovery will take more than decontamination and rebuilding. It will require behavior changes.
- Limited options – Not having an available or proven vaccine, drug, or therapeutic limits options.
- Implementation procedures – Communities at every level seem to be in conflict on proper actions to take. Recovery is hindered when response efforts are not implemented properly.
- Decision factors – The virus is still unknown. Without knowing enough to have plans rooted in science, plans can only be based on the last similar disaster. In this case, it is severe acute respiratory syndrome (SARS).
This Was Not Expected
The pandemic has brought with it some unique 21st century response challenges and impacts, which will ultimately transform communities’ recovery approach:
- The human element (psychological impacts) – Individuals and societies are forever changed by disasters. That is not new. In the face of this virus, however, the onus is on the people. Each individual bears the responsibility to limit exposure/transmission, as do employers and communities who want to do the right thing. Yet, with COVID-19, the “right thing” keeps changing. Mask recommendations, isolation, and quarantine restrictions drove people inside, where the psychological impacts of this disaster are felt in homes, alone, and online. For many people, support systems have become virtual: working, communicating, grocery shopping, and ingesting news and safety guidance online. Even educating (or at least attempting to educate) children online.
- The business element (economic impacts) – Owners of many companies essentially closed and walked away from their businesses. Structures are intact with no physical damage, yet the economic toll may be what destroys them. Compared to natural disasters, after which a business may relocate, business owners cannot open anywhere else due to widespread lockdowns. Or worse, the owner may have died without making arrangements for the business. Cities will now need to manage the impact of numerous businesses that closed and protect abandoned property in the midst of furloughs and stressed budgets. Given increased unemployment and the inability of people to pay rent and bills and buy food, social programs that manage these needs are overwhelmed. If major businesses abandon leases, relocate staff, and/or transition to fully remote operations, this may transform business models, and business communities, indefinitely – some good (flexibility, sick leave) and some bad (impacts to investments in mass transit, public safety, smart cities, etc.).
- The information element (communication impacts) – Although effective information sharing is a challenge, 2020 may be the year of the “overshare.” As they retreated to their homes, many people looked to smart devices and social media to monitor the situation and stay connected. Unfortunately, the same online environment that so many rely on is also becoming a place of dissention – an “infodemic.” The void is now full – speculation and misinformation abound as people fall back on collegiate skills to determine trustworthy information sources. In recovery, this challenges the dissemination of accurate and consistent safety communications. Addressing concerns raised in social media that influence response and recovery is an almost daily task, and it is exhausting. This goes beyond guidance for PPE and social distancing. Businesses, managers and employees, teachers and students, even family members will need the communications skills to have open, frank, and tough conversations about safety, while likely unpacking the conflicting information, beliefs, and/or doom data ingested during quarantine.
After closures around the world, now, county by county, state by state, even country by country, re-entry has begun. Safety – at the individual, community, and business levels – is at the forefront. In a phased approach, there are new definitions of essential and acceptable personnel and new requirements for PPE, social distancing, and cleanup in various spaces.
Comparing previously developed frameworks with the COVID response has shown expected events, missed opportunities, and things never imagined.
However, re-entry does not equal recovery. Wearing masks and going back into businesses do not fix the damage caused by lost loved ones, lost incomes, and the myriad (if not unknown) other repercussions of a global pandemic. So much of this pandemic response has been about social distancing to take care of individuals, but recovery requires taking care of individuals together.
What previous frameworks proposed, and is reiterated here, is the need for a concerted focus on long-term recovery. As the pandemic peak remains a moving target, with additional waves rumored on the horizon – this is the time to revisit and fit frameworks to the latest crisis. Now is the time to sketch out what long-term recovery means by asking the right questions in the following categories:
- Sustainability: What elements of the new normal will need to be sustained long-term? What elements could be sustained indefinitely, like workplace flexibility?
- Economic development: How will recovery be planned and conducted if the end of the pandemic is unknown? What happens until and when it is safe to leave home? How and/or will businesses resume normal operations?
- Health management: Hospitals stopped elective procedures, people discontinued preventative/wellness appointments, and in some cases other treatments were paused. Despite increased need for physicians to treat COVID patients, hospitals faced detrimental losses of income. How will the capacity for both COVID care and general health management be sustained?
- Fatality management: With hundreds of thousands of deaths in the U.S. alone, what resources are needed to address the long-term impacts from the projected fatalities?
- Waste management: How clean is clean? How will businesses sustain safety practices long-term?
- Prioritization: Tax revenues are expected to decline sharply and stay down for the near term. With limited time and funds, what are the priorities for recovery? What is the decision-making process? What happens with vulnerable populations?
- Operations: Based on what is known about pandemics, is the National Disaster Recovery Framework suitable or is a rewrite needed? How can lessons learned about the virus inform future occupational health guidelines?
- Mental health: What are the psychological effects from prolonged isolation, quarantine, and other public health measures carried out on national scale over what could be years? How will children react?
- Preparedness: What has been learned? What was done right or wrong, and how should existing frameworks and plans change – not only for biological incidents, but all hazards? How can emergency action plans better reflect challenges like family care, finances, etc.?
- Communications: How can community leaders counter misinformation, restore trust, and build the consensus that is needed for recovery to be effective? What is the most effective communication with audiences prone to vastly, generationally different media consumption (i.e., millennials vs. boomers)?
- Trust: How will trust be rebuilt – within public health institutions, within communities, within each person?
Emergency management professionals know recovery occurs while response is still under way and may last for years. Recovery is replacing what was lost, often before it is known what all has been lost or how long the disaster will last. Predictions about economic impacts are grim. However, with so little experience to draw upon, those predictions could be wildly off the mark. Previous frameworks lay a strong foundation for long-term recovery – that is where to start on COVID-19.