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N A T I O N A L C O O P E R A T I V E H I G H W A Y R E S E A R C H P R O G R A M NCHRP REPORT 769 A Guide for Public Transportation Pandemic Planning and Response Kim Fletcher Loch haven Partners Edgewater, MD Shanika Amarakoon Jacqueline Haskell abt associates Bethesda, MD Paul Penn Megan Wilmoth environmentaL security internationaL/enmagine, inc. Diamond Springs, CA Deborah Matherly Neeli Langdon Louis berger grouP Washington, DC Subscriber Categories Public Transportation â¢ Security and Emergencies TRANSPORTAT ION RESEARCH BOARD WASHINGTON, D.C. 2014 www.TRB.org Research sponsored by the American Association of State Highway and Transportation Officials in cooperation with the Federal Highway Administration
NATIONAL COOPERATIVE HIGHWAY RESEARCH PROGRAM Systematic, well-designed research provides the most effective approach to the solution of many problems facing highway administrators and engineers. Often, highway problems are of local interest and can best be studied by highway departments individually or in cooperation with their state universities and others. However, the accelerating growth of highway transportation develops increasingly complex problems of wide interest to highway authorities. These problems are best studied through a coordinated program of cooperative research. In recognition of these needs, the highway administrators of the American Association of State Highway and Transportation Officials initiated in 1962 an objective national highway research program employing modern scientific techniques. This program is supported on a continuing basis by funds from participating member states of the Association and it receives the full cooperation and support of the Federal Highway Administration, United States Department of Transportation. The Transportation Research Board of the National Academies was requested by the Association to administer the research program because of the Boardâs recognized objectivity and understanding of modern research practices. The Board is uniquely suited for this purpose as it maintains an extensive committee structure from which authorities on any highway transportation subject may be drawn; it possesses avenues of communications and cooperation with federal, state and local governmental agencies, universities, and industry; its relationship to the National Research Council is an insurance of objectivity; it maintains a full-time research correlation staff of specialists in highway transportation matters to bring the findings of research directly to those who are in a position to use them. The program is developed on the basis of research needs identified by chief administrators of the highway and transportation departments and by committees of AASHTO. Each year, specific areas of research needs to be included in the program are proposed to the National Research Council and the Board by the American Association of State Highway and Transportation Officials. Research projects to fulfill these needs are defined by the Board, and qualified research agencies are selected from those that have submitted proposals. Administration and surveillance of research contracts are the responsibilities of the National Research Council and the Transportation Research Board. The needs for highway research are many, and the National Cooperative Highway Research Program can make significant contributions to the solution of highway transportation problems of mutual concern to many responsible groups. The program, however, is intended to complement rather than to substitute for or duplicate other highway research programs. Published reports of the NATIONAL COOPERATIVE HIGHWAY RESEARCH PROGRAM are available from: Transportation Research Board Business Office 500 Fifth Street, NW Washington, DC 20001 and can be ordered through the Internet at: http://www.national-academies.org/trb/bookstore Printed in the United States of America NCHRP REPORT 769 Project 20-59(44) ISSN 0077-5614 ISBN 978-0-309-28398-4 Library of Congress Control Number 2014936701 Â© 2014 National Academy of Sciences. All rights reserved. COPYRIGHT INFORMATION Authors herein are responsible for the authenticity of their materials and for obtaining written permissions from publishers or persons who own the copyright to any previously published or copyrighted material used herein. Cooperative Research Programs (CRP) grants permission to reproduce material in this publication for classroom and not-for-profit purposes. Permission is given with the understanding that none of the material will be used to imply TRB, AASHTO, FAA, FHWA, FMCSA, FTA, or Transit Development Corporation endorsement of a particular product, method, or practice. It is expected that those reproducing the material in this document for educational and not-for-profit uses will give appropriate acknowledgment of the source of any reprinted or reproduced material. For other uses of the material, request permission from CRP. NOTICE The project that is the subject of this report was a part of the National Cooperative Highway Research Program, conducted by the Transportation Research Board with the approval of the Governing Board of the National Research Council. The members of the technical panel selected to monitor this project and to review this report were chosen for their special competencies and with regard for appropriate balance. The report was reviewed by the technical panel and accepted for publication according to procedures established and overseen by the Transportation Research Board and approved by the Governing Board of the National Research Council. The opinions and conclusions expressed or implied in this report are those of the researchers who performed the research and are not necessarily those of the Transportation Research Board, the National Research Council, or the program sponsors. The Transportation Research Board of the National Academies, the National Research Council, and the sponsors of the National Cooperative Highway Research Program do not endorse products or manufacturers. Trade or manufacturersâ names appear herein solely because they are considered essential to the object of the report.
The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. On the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences. The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. C. D. Mote, Jr., is president of the National Academy of Engineering. The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, on its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine. The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academyâs purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. C. D. Mote, Jr., are chair and vice chair, respectively, of the National Research Council. The Transportation Research Board is one of six major divisions of the National Research Council. The mission of the Transporta- tion Research Board is to provide leadership in transportation innovation and progress through research and information exchange, conducted within a setting that is objective, interdisciplinary, and multimodal. The Boardâs varied activities annually engage about 7,000 engineers, scientists, and other transportation researchers and practitioners from the public and private sectors and academia, all of whom contribute their expertise in the public interest. The program is supported by state transportation departments, federal agencies including the component administrations of the U.S. Department of Transportation, and other organizations and individu- als interested in the development of transportation. www.TRB.org www.national-academies.org
C O O P E R A T I V E R E S E A R C H P R O G R A M S AUTHOR ACKNOWLEDGMENTS The research reported herein was performed under NCHRP Project 20-59(44) by Abt Associates Inc. as the prime contractor. Kim Loch Fletcher (Loch Haven Partners) is the principal investigator and Shanika Amarakoon (Abt Associates) is the project director. Other members of the research team are: Jacqueline Haskell (Abt Associates); Deborah Matherly and Neeli Langdon (Louis Berger Group, Inc.); Paul Penn and Megan Wilmoth (Environmental Security International/EnMagine, Inc.); and Kim Stephens (now with Readiness Consulting Services). Also from Abt Associates: Tom Rich (provided quality review); Ray Glazier (provided strategic insights); and Charlie Koch and Kelly Peak (supported the teamâs work). Capt. Lynn A. Slepski, PhD, RN (Department of Transportation) provided support on current federal doctrine and terminology. CRP STAFF FOR NCHRP REPORT 769 Christopher W. Jenks, Director, Cooperative Research Programs Christopher J. Hedges, Manager, National Cooperative Highway Research Program Stephan A. Parker, Senior Program Officer Danna Powell, Senior Program Assistant Eileen P. Delaney, Director of Publications Margaret B. Hagood, Editor NCHRP PROJECT 20-59(44) PANEL Field of Special Projects Terecia W. Wilson, Institute for Global Road Safety and Security, Prosperity, SC (Chair) Joseph C. Bober, Homeland Defense Solutions, Inc., Old Bridge, NJ Van Chesnut, Advance Transit, Inc., Wilder, VT Peter J. Haas, Mineta Transportation Institute, San Jose, CA Robert E. Lenehan, Jr., MBTA Transit Police Department, Boston, MA John A. Sorrell, Wiregrass Transit Authority, Dothan, AL Jeffrey L. Western, Western Management and Consulting, LLC, Madison, WI Laurel J. Radow, FHWA Liaison Ben E. Dinsmore, U.S. Department of Agriculture, Food Safety and Inspection Service Liaison Georgia M. âGiaâ Harrigan, DHS Science and Technology Directorate Liaison Lynn A. Slepski, U.S. Department of Transportation Liaison Michael âMikeâ Smith, APTA Liaison Christopher Zeilinger, CTAA Liaison Jennifer L. Weeks, TRB Liaison
NCHRP Report 769: A Guide for Public Transportation Pandemic Planning and Response provides support to transportation organizations as they prepare for pandemics and other infectious diseases such as seasonal flu. While primarily intended for small urban and rural transit organizations, this guide can be used by all types and sizes of transportation agencies and organizations with different levels of preparedness for pandemics. A pandemic can be described as a global disease outbreak. Depending on the character- istics of the disease, it may spread easily, there is little or no immunity to the disease, no vaccine is available, and there is a high rate of people getting sick and/or dying. Pandem- ics cause significant absenteeism, change patterns of commerce, have limited immediate medical solutions, and interrupt supply chains. Addressing decision-making challenges in pandemic response in the transportation context is a multi-dimensional task, involving not only transportation/transit organizations, but health organizations, emergency man- agement agencies, and communications outlets as well. This guide is designed to outline broad guidance on dealing with pandemic preparedness planning, not detailed procedures. It provides information, tools, tips, and guidance on where to find up-to-date recommen- dations from federal agencies and other resources, prior to and during a pandemic. Under NCHRP Project 20-59(44), Abt Associates was asked to develop a pandemic planning guide for use by all transit agencies with emphasis on (a) small urban and rural transit agencies; (b) human service transportation providers; and (c) the state DOTs that provide oversight for grant recipients in both categories. The project team undertook a multi-media, phased approach to gather information to develop the guide. First, they con- ducted a literature review of publications, websites, and other information posted by trans- portation, health, and other relevant agencies. Next, they developed and issued a survey to gather information on the extent to which pandemic planning is occurring; the level of interagency collaboration taking place for transportation pandemic planning; policies and procedures to continue transportation operations in a pandemic; and barriers to pandemic planning. The survey and initial interviews targeted relevant local, state, and regional agen- cies with emergency management and response responsibilities; transportation manag- ers; state transportation agency personnel; and other entities with a role in transportation planning and response in a pandemic. The survey and interviews were aimed at not only the rural and small urban transit systems but also larger organizations to assist in identify- ing key issues and current practices. The team used the information obtained through the literature review, survey, and initial interviews to develop a draft outline of the guide. Then, the team engaged key stakeholders based on the guideâs target audience: local, state, regional, tribal, and federal representa- F O R E W O R D By Stephan A. Parker Staff Officer Transportation Research Board
tives who have responsibility for integrated pandemic planning and response. Finally, the team received comments from the NCHRP Project 20-59(44) panel on key deliverables in each stage of the guide development. These comments were integral to shaping the initial research process, the structure and content of the guide, and the methodology for receiving stakeholder feedback. In addition to the guide, a methodology report and a PowerPoint presentation describ- ing the entire project are available on the TRB website at http://www.trb.org/Main/ Blurbs/170529.aspx.
1 Summary 4 Chapter 1 Introduction 4 How to Use this Document 6 What Is Important to Know About Pandemics? 8 Case Study: Pandemic Influenza 9 Why a Pandemic Plan is Needed 13 Chapter 2 How Prepared Is an Organization for a Pandemic? 15 Preparing for a Pandemic 15 Identifying Organizational Vulnerabilities During a Pandemic 18 Chapter 3 Decision Making and Partnerships 18 Decision Making 19 Working with Partners 20 Emergency Operations Center 21 Information Exchange 21 Role of Policy Makers 22 Chapter 4 Preventing the Spread of Disease 22 Non-Pharmaceutical Interventions 26 Cleaning and Disinfection of Transportation Assets 26 Medical Interventions 28 Chapter 5 Providing Services During a Pandemic 28 Identifying Essential Functions 30 Service Utilization Changes 30 Services for Ill Passengers 32 Chapter 6 Workforce 32 Staffing 32 Human Resources 33 Family Preparedness 35 Chapter 7 Crisis and Emergency Risk Communication 35 The Message 37 The Messenger 37 Delivery Methods 41 Assessment Tools and Checklists 42 Sample Pandemic Activation Matrix 43 Pandemic Vulnerability Assessment Tool 44 Decision Making and Partnership Planning Tool 46 Preventing the Spread of Disease Checklist 48 Providing Services During a Pandemic Checklist C O N T E N T S
50 Workforce Checklist 52 Public and Media Relations Checklist 53 Glossary of Terms 54 Bibliography 55 Index Note: Many of the photographs, figures, and tables in this report have been converted from color to grayscale for printing. The electronic version of the report (posted on the Web at www.trb.org) retains the color versions.