In their daily routines, a firefighter and a nurse are unlikely to sit side by side and develop an emergency response plan. Yet this collaboration is essential to emergency preparedness and is an example of the unlikely synergies that keep Michelle Shoresman motivated in her role as emergency preparedness program manager at the San Luis Obispo County Health Agency on California’s Central Coast. Shoresman works with a wide array of partners to synchronize emergency response plans and ensure that the health of those in her community is protected at all times. One of the primary partners in safety is the local nuclear energy facility, PG&E’s Diablo Canyon.
Q: How have you seen the emergency preparedness program evolve during your time at San Luis Obispo County Health Agency?
Shoresman: When I started in this position five years ago, most people did not think of the public health department as a first responder organization. They thought of fire, EMS, or law enforcement organizations first, but since 9/11, there has been more development in emergency planning in the health sector. Since I joined the emergency preparedness program, we have had more and more exposure to local governments and agencies that plan for emergencies, and now when one of those entities plans to run a drill or respond to a real life event, there is no question as to whether or not we will be involved. They think about the health implications of that event and know they can call us to help.
Q: To what extent do you work with the Diablo Canyon nuclear energy facility to prepare for an emergency at the facility?
Shoresman: We participate in regular joint drills that test activation of PG&E’s Diablo Canyon Emergency Operation Facility (EOF) and our county’s Emergency Operations Center (EOC), which are located in the same building. The EOF, which is a central command center for nuclear emergency preparedness, provides information to the county so they can make decisions about emergency worker safety, decontamination, congregate care shelters, school and park closures, etc.
Public health plays a big role in managing decontamination centers in an emergency or drill scenario. Public health nurses are trained to use dosimeters, which read radiation levels, treat and decontaminate people. To prepare, we have our staff run the centers exactly as we would if there were a radiological event at a nuclear energy facility. We have volunteers pretend to be patients and we take them through each and every procedure—from checking them in and out, to moving them through testing and showers.
Q: How do you share information about changes in your emergency response plan with the local nuclear energy facility and partners?
Shoresman: There is a lot of coordination between the partners involved in nuclear emergency preparedness. Public health works with PG&E, the county Office of Emergency Services (OES) and first responder entities to make sure that all the plans and procedures that we’re writing are aligned. Once our plans are in place, we run drills, exercise the plans, evaluate our performance and then troubleshoot procedural issues and revise the plans as needed.
All of our nuclear emergency preparedness procedures and plans have to be approved by the Federal Emergency Management Agency (FEMA). In San Luis Obispo, OES oversees the county’s nuclear emergency response activities and compiles feedback from each partner agency before revising and submitting these plans to FEMA.
For non-nuclear health events—pandemic influenza, for example—the county public health officer is the incident commander and the public health department is the lead agency. We have a pandemic incident response plan, but every section was taken to a multi-agency planning group for their review and approval. OES follows similar processes to ensure that everyone is on board with the nuclear energy facility response plan, and, above all, that they understand their roles and responsibilities.
Q: What is the role of a public health official in a community?
Shoresman: Public health officials provide the public with information they need to respond to all kinds of health-related emergencies, and to answer any questions members of the community might have about real and perceived health risks.
For example, following the accident at Fukushima, there was a lot of concern about radiation levels in local milk. Diablo Canyon’s Radiological Environmental Monitoring Program had found that while radiation levels were slightly higher than normal, they were still 5,000 times below levels of concern set by the FDA and would not have any effect on human health. Our public health officer held a press conference with OES to address concerns, explain the facts and reassure the public that there was no cause for alarm.
We also work with partner agencies and Diablo Canyon to push health-related information out of the Joint Information Center (JIC), a centralized communications hub that automatically opens when the EOC is activated to provide the public with real-time updates about a situation at a nuclear energy facility.
Q: Are there lessons or emergency response procedures that you’ve learned from your experience with the local nuclear energy facility and applied to other situations?
Shoresman: One of the things we’ve learned at the public health department from emergency planning with Diablo Canyon is how to activate a smaller version of a JIC in other health-related emergencies. We set up our own mini JIC with partner agencies that were involved in fighting the swine flu pandemic. These included some of the same players that would be involved in a nuclear emergency preparedness drill, including the county fire department and EMS providers, but also schools and healthcare providers since swine flu posed the biggest risk to children and those with compromised immune systems or other health issues.
We also borrowed the phone assistance center concept outlined in our nuclear emergency response plan, which would allow concerned citizens to call in to receive information or advice on what actions they should take if something happened at Diablo Canyon. During the swine flu event, public health workers staffed a phone bank and answered questions about the pandemic.