>> Robert Goff: It's when an evaluator stands up and says,
"I've been in nuclear power plants for 23 years,
and I've never seen a group work as well
as you did in this exercise."
The smiles and the high fives.
It's empowering, and it lets the community realize
that that's your local people doing that.
That's your health department people right there.
My name is Robert Goff, and I have served
as Emergency Response Coordinator
for the Southeast Region
of the Tennessee Department of Health since 2004.
Our team's focus began with smallpox and quickly spread
to include anthrax, and then to natural disasters.
And over that time we've built partner relationships,
because from a leadership standpoint there has been strong
encouragement that we communicate with each other
to make sure that we are prepared for our part
of the response, but also
so we can know what resources we can provide to others.
And that has helped us prepare for "human made" disasters
as well, like radiation emergencies,
and now our public health agency is invited
into the conversation right at the start
of the planning process.
I first interacted with CDC years ago at their exhibit table
at a Preparedness Summit.
I saw their boxed kit, and said, "What?!
They have radiation expertise?
This is awesome!"
At the table they had two different boxed kits
that contained several booklets, some DVDs,
and some other key resources.
And I remember having with me one of the videos from the kit.
It was the lady who was showing you how you use the
screening equipment.
I took that DVD, stuck it in my computer,
cut a clip from the video, and put it into my presentation
and thought, "This is awesome", because instead
of me just standing in front of a room presenting it,
it was a nice way to say
"There is an established way to do this."
There are products developed by the CDC that I'm able
to reference that speak our language.
From that, I became more encouraged personally
that we need to look at more than just our activities
with the FEMA Radiological Emergency Preparedness Program.
We needed to see what we've learned from FEMA,
and have that inform how we need to grow as a health department.
I knew that we had to focus on training.
We needed to focus on how the equipment works,
and then knowing what we do, how we do it, in what way,
in what order, everything.
At one point, I was at a training where they had person
after person after person go through the exercise,
and immediately I realized - "This is not what I'm used to.
I can't even think right now!"
It was overwhelming.
But it was at that moment I said,
"We've got to do this back home.
I want our people to feel what I just felt."
Over time we were able to create an opportunity to do
that for a Community Reception Center.
We met a director who said he was able to help.
He found us a place, saying, "You've got full reign of it.
It's yours.
Let's set it up how you want.
I'll rearrange anything, anywhere, anybody."
That gave us a chance and the ability to say, "Ok,
now I have to figure out the how and the who and the
when of setting up a CRC."
>> Lauren Finklea: It also gave CDC an opportunity
to collaborate with Robert and get better data
for our planning models.
One of the measurements we are interested
in is throughput times - how long it takes someone to get
through the stages of a CRC process.
Events like this are a great way to measure and build models
for predicting how a CRC should scale
to accommodate the large number of people we expect
in a radiation emergency.
>> Robert Goff: That event got a lot of interest,
and is something that has maintained our momentum to build
on those exercises, to challenge people to say,
"Not only do we need to know how this thing works,
but we need to make ourselves a little uncomfortable."
It also helped us to see whether the resources we are developing
are going to give us what we need in an emergency.
Building on those experiences and relationships,
in February we conducted a tabletop exercise for a CRC.
It was a great chance to continue to work together.
I provided a tabletop scenario and event details, our partners
at NACCHO helped to format and build the tabletop contents,
and Lauren moderated the execution of that event.
Working together, we helped to clarify the roles,
operational considerations,
and some of the public messaging needed
for a larger community event.
Then in April, we leveraged what we learned from the tabletop
and previous smaller exercises and stood
up a large-scale CRC exercise.
We did it again, but bigger and better, and it helped us
to improve our planning related to communication, safety,
technology, and resource management.
It was a great opportunity not just to get better ourselves
but to showcase some things that we hope can help other people
who want to do what we're doing.
CDC resources have had an impact along the way.
Early on, the CDC kit became very helpful for us.
I was able to pull some things out and use that information
in such a way that it helps me speak
to others in public health.
And moving forward, we've used a lot of the online tools
because there have been lots of times
when we just needed a good resource.
I specifically think back
to when we were developing KI materials, and looking at some
of the information on CDC's website
about why and when it's used.
We know all those things, but to be able
to have the information ready for us to look at
and nicely arranged and categorized,
it's kind of like the work's been done for us.
And then later we started using the CRC Drill Toolkit.
Never having done a CRC exercise,
it was nice to know there was something out there for me
to be able to sit down and look at.
Not just assume that a CRC would look like a POD
or EOC exercises, and think through some things
and have some planning guidance for something
as specific as a CRC exercise.
I really encourage any region, jurisdiction, county,
or health department preparing for a CRC to realize
that these exercises are not just as simple as opening
up the guidance and going, "I can do that."
It's a learning curve just like everything else.
Fortunately, we've had an opportunity to push ourselves,
and I hope we can take some of the things that we've learned
and share it with others so they can learn along with us.