IceStorm 98 Study

We (family) prepared for a loss of power for the 8th, and I knew we had a real emergency the next day. I could not get out of my driveway (in the country) that morning and the phone was out for most of the day. It was clear that the storm had covered most of the area. I did not have a battery-powered radio.

By Friday morning Brockville was in a state of emergency and Dr. Allan was called into the command centre for a 10:00 meeting. "By then my drive way was cleared and I was able to attend that meeting."

Bryan Allan's (BA's) responsibility was to coordinate health response and to report on health issues. The emergency plan did not prove to be beneficial because some assumptions proved to be invalid. The plan assumed that at least one of the offices would be functioning, so the plan was useful but they had to be innovative -- and over the next couple of days they created a new one as they went along. "We'd had mock emergencies, but we had no idea what was going on outside of Brockville. But people just did what they were supposed to do" (this statement is repeated at least three times over the course of the interview).

A shelter was established in Gananoque and Kemptville, and staff were ready for Brockville's shelters with the assistance of public health officials when they opened on Friday.

The Ice Storm of four years ago provided a model for this event. Shelter workers knew how to register people, divide singles from families and so forth.

Authority under Act versus emergency plan: BA does not know what the nature of his authority was in the emergency. It's assumed that he does not, but acted as if he did have more authority

• i.e. Lack of guidelines for the shelters set up by the Legion
  • smoking, drinking, partying, etc., in the shelters
  • OPP wanted to ban drinking & smoking etc., (Warden agreed)
  • guidelines for the shelters were improvised

We were not sure we had the authority to act in the way we did, but we went ahead anyway assuming we had that authority. No one ever challenged my authority or called it into question. There was consensus that the scope of the emergency required an extraordinary response.

Money: "We didn't have to spend a lot because we were more involved with distribution rather than providing. The only issue concerned overtime. There were some heated discussions at the outset, with some of the nurses, who set up their own shifts and acted autonomously, but since I had not authorized them there was some question whether they had that right."

"We eventually decided not to fight over money -- at that point -- but to do what had to be done and sort out the money later."

We divided the roles up into north and south, Fay Brooks managed the north in Smiths Falls (613)283.2740 and then Henry Garcia managed the Leeds, Grenville.

Decision making: Met regularly with staff, at shelter base, until power restored 4 days later. Meeting once a day. Cell phone system (generator produced) in place by Saturday. Strategy sessions twice a day by Monday.

At the beginning BA treated it like a military exercise, laying down responsibilties, designating authority and deciding what their functions were because it was not clear what they were going to do.

After meeting with command centre BA had some idea of what was going on regionally. The crisis really took hold on Friday as the heat buildup that most people had in their homes began to deplete.

Friday: order evacuations of some seniors to shelters -- again without careful review of BA's authority to do so -- all available staff meet at school, authority delegated to various regions and report back to establish priorities.

Priority: for BA

1. coordinate health medical services as and where needed. - most agencies did their own reporting, with BA reporting for hospitals and ambulances to command centre.
2. provide nursing services to shelters divided geographically, establish health inspector and nurse teams to inspect shelters. - after a couple of days we devised a form to perform a full needs assessment of our 40 shelters. Organized time off for the people who had been working since Wednesday night.
3. disease control, outbreaks investigated and food safety, set up communication systems, coordination of Public Service Announcements and media liaison.
4. vulnerable groups (elderly and late term pregnancies) where they were and contact, identify areas.
5. coordination of all services.

House-to-House: One municipality identified a number of people with medical problems who were not being attended to and would not move. BA organized a medical team to do assessments House to House search and this required BA bring in extra staff.

By Saturday most phones were working again, though not at the Health Unit because those phones depended on power.

What worked well? Despite the absence or obsolescence of plans, something worked to the extent that everyone seemed to put their best effort into things and were determined to have things succeed. City of Brockville had a good plan and the plan worked, the mayor was "extremely" well organized and effective. Counties were hampered by the fact that they did not have wardens so there was no one to declare a state of emergency until later (day 5)

• despite that, things were working, police, fire, hospitals, everyone did what they were supposed to do.

What didn't work?

• shelters were understaffed and proliferated badly and took too much time to get organized.
• people running them had no idea what they were doing, lack of registration, no one knew where people were,
• parochialism between neighboring shelters (not a serious problem, more of an inconvenience)
• people were just coping, good thing crisis did not go on longer
• shelter jurisdictions and guidelines
• Roles of St. John's and Red Cross, coordinated from Ottawa, unaware of local needs, responding in an ad hoc manner, duplication and wastage.
• role of local hospitals, sick people went to shelters, because non-sick were going to hospitals
• use of generators for people who needed oxygen and dialysis in their home or shelter.
• allocation of powers, the timing of this problem was not identified.

Dr. Allan's Biggest Problem:

• Emergency plan assumes that BA will be able to coordinate from a central command centre. But each region set up their own as a consequence of the power -- too many -- so that there was a lot of traveling between command centres, and it was difficult to get a global view of situation from these dispersed centres of command
• BA spread too thin over region, lack of information,

e.g. one hospital was acting as a shelter which BA did not know until after the crisis -- it would have been better to have known that that space was available for people with medical problems.

• responders were also victims.

Next time:

• ensure communication system that works when power goes down, car radios went down because they too require a central base with power. More and better phones not dependent on a source of electricity.
• set up files on possible emergency situations so that press releases are ready for distribution,

What are you changing:

• preparing a file on hard copy (see above)
• communication issues
• prioritizing individual responders' needs between community and personal needs (OPP just ordered people into work, but this is not possible for civilian responders) -- this issue has to be resolved.
• establish 1.800 line, independent of power system at health unit.
• encourage other regions without plans to get them together, Lanark county in particular has resisted putting an emergency plan in place.
• emergency plans were not taken seriously, some were terribly out of date, not reflective of current reality of what can or cannot be done.

Emergency Training: not built in or required but most have attended the Arnprior course, in addition to mock disaster training, pushed by Dupont.

BA made no contact with provincial counterparts -- they were outside the boundaries of the world. Neighboring counties called to offer help. There was no need to call Toronto nor was there anything BA needed from them.

Federal: out of BA's jurisdiction. By the time the Feds showed up a lot of things were already in place and operating. Though if the emergency had lasted the Feds' mobile kitchens would have been useful.

Issues: closing of pharmacies-people could not get drugs and turned up at Hospital Emergency departments for refills, this is a serious health issue which needs to be addressed.

• banks, people run out of cash quickly

Media: no regular press briefings in Brockville, no common radio station or media outlet.

• system of press releases, which BA would prepare or edit
• BA called to local stations about to talk about hypothermia,
• on the whole it was set up so that every county had one media contact person

Stress: Not a concern, on a high, working 16 hour days, not eating or sleeping -- but BA seemed to be fine, has taken one day off since the event.

Most of staff were okay, one-half of older staff turned down post-traumatic stress counseling

The Event was a Boon to public health profile, raised visibility in a time of cutbacks, BA et al. were doing "pure public health." On the whole rather exciting, novel and challenging

Sexual activity: among teenagers in shelters, shelters were too much fun in some cases, noisy places, party central, security issues in shelters, violence

Fatuous complaints: water pressure in shelter showers

OPP: domestic violence complaints dropped to zero during the emergency

House to house searches, turned up one blind person, an older man, living in a house with farm animals defecating all over the place.

There was also an account of a dog chained and frozen to death -- there were a lot of sad animal stories

Post-Event Guilt from people who were not suffering, some people were ashamed to admit that they were going home to warm houses and so forth.