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Discussion: Determining Which Agency Should Command an ICS Post

Emergency Medical Services (EMS) personnel are routinely called to treat and transport patients with infectious disease. This may include a patient with pulmonary tuberculosis or the flu. It also includes victims of a bioterrorist attack. In a biological WMD release, EMS personnel may respond to the initial 9-1-1 call(s) for a patient with a fever and rash illness long before the cause of the illness is known.
In the event of an announced release of anthrax or smallpox into a building ventilation system, exposed people may take anywhere from a couple of days (anthrax) to 7-17 days (smallpox) to become ill. These people may not need transport to a medical facility, but will need to be identified for public health information purposes so they can receive antibiotics or vaccine at a later time.
EMS may be the primary health care provider at these scenes initially and must assure that an accurate accounting of all patient contacts is made and then provide such to public health officials.
1. In such cases should the ICS be commanded by a public health official/EMS Chief/MD rather than the police and fire units?
2. To what extent should non-medical personnel/managers make medical decisions during a bioterrorist incident?
3. Required Reading
4. Disaster-specific memorandum of understanding (2017). FEMA. Retrieved from https://www.fema.gov/media-library-data/1416583062704-86cb8bebe23906b594ce14860d86f8af/Disaster-Specific_MOU_updated_weblinks.pdf
5. Emergency Support Function #9: Search and Rescue Annex (2016), FEMA. Retrieved from https://www.fema.gov/pdf/emergency/nrf/nrf-esf-09.pdf
6. Law enforcement preparedness for public health emergencies: An executive summary of the resources series (2010). BJA-US Department of Justice. Retrieved from http://www.policeforum.org/assets/docs/Free_Online_Documents/Public_Health/law%20enforcement%20preparedness%20for%20public%20health%20emergencies%20-%20an%20executive%20summary%20of%20the%20resources%20series%202010.pdf Read pp. 1-8.
7. Memorandum of understanding between the City of Mercer Island and the American Red Cross Chapter serving King and Kitsap Counties concerning the placement, maintenance and care of disaster relief supplies (2007). Retrieved from http://www.mercergov.org/files/Am%20Red%20Cross%20-%20Disaster%20Relief%20Supplies.pdf Review this sample MOU.
8. Overview of MSCC, emergency management and the incident command system. Health and Human Services (2012). Retrieved from: http://www.phe.gov/preparedness/planning/mscc/handbook/chapter1/pages/default.aspx
9. RECP law enforcement and coroner/medical examiner subsidiary plan: San Francisco Bay Area regional emergency coordination plan (2008). Retrieved from: http://www.sfdem.org/ftp/uploadedfiles/DEM/PlansReports/LawEnforcementAnnex.pdf Read the Introduction
10. Weine, S. (2017). How local law enforcement uses community policing to combat terrorism. Lawfare. Retrieved from https://www.lawfareblog.com/how-local-law-enforcement-uses-community-policing-combat-terrorism

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