SPH leads the way in emergency preparedness training
In the aftermath of the COVID-19 pandemic, Illinois leaders recognized the need for emergency preparedness and response training. UIC’s School of Public Health is delivering just that
Intro
As the COVID-19 pandemic faded further into the background, the State of Illinois performed a selfautopsy to assess its handling of a public health emergency that contributed to an estimated 41,000 deaths in the state, rattled daily lives and shook confidence in institutions. In May 2024, the state released a 13-page after-action report and a 33-page playbook designed to inform preparations for and responses to future public health emergencies.
“Following a once-in-a-century event like the COVID-19 pandemic, it is critical that we take the time to thoroughly study how our state responded to the emergency and seek to learn lessons that will put us in a stronger position the next time such an all-of-government response is required,” Illinois Governor JB Pritzker said.
While the after-action report identified strengths in the state’s response, such as employing a data-driven approach and prioritizing underserved communities in allocating resources among them, it also noted flaws. The state’s reflection acknowledged limited planning for a major infectious disease emergency requiring vast governmental response and weaknesses in health and operational data infrastructure and capabilities. The playbook, meanwhile, detailed lessons that could be gleaned from the pandemic alongside recommendations to tackle future public health emergencies. In particular, the state noted insufficient, fragmented or absent training for staff at the Illinois Department of Public Health (IDPH) and local health departments, which impeded their collective ability to respond rapidly and capably to the emergency. To improve preparedness, the state’s report suggested introducing a whole-of-government training cadence to address the next public health emergency.
Enter the UIC School of Public Health and emergency preparedness and response experts representing both the Division of Health Policy Administration and the Division of Epidemiology and Biostatistics (Epi-Bio). Informed by lessons and insights from the COVID-19 pandemic, the SPH team is currently creating standardized, high-quality online training modules to increase understanding of key preparedness functions and issues. The training is designed to enhance the state’s preparedness and response capabilities, driving positive health and human services outcomes amid future public health emergencies.
“In the case of infectious disease emergencies, it’s not a question of whether another infectious disease crisis will emerge, but when, and the idea is that this training will allow various workforces to ‘hit the ground running’ when the next crisis emerges,” said Ronald Hershow, associate professor and director of SPH’s Epi-Bio Division. Hershow is spearheading the project with Paul Sambanis, MS ’12, PhD ’16, an adjunct assistant professor and director of the Emergency Management and Resilience Planning (EMRP) Program at SPH.
Leveraging expertise
Over recent decades, SPH has solidified its status as an emergency preparedness and response leader, delivering research, education and service to help public health practitioners attend to emergency situations. Epi-Bio, for instance, boasts deep faculty expertise in the areas of prevention, management and control of a wide range of infectious diseases, while the interdisciplinary EMRP program – housed within the Health Policy and Administration Division – prepares professionals to guide organizations through a multitude of emergency response and preparedness requirements with its certificate program and implementation science projects. In the earliest stages of the COVID-19 pandemic, SPH displayed its ability to handle a public health emergency with swiftness and skill. Under Hershow’s direction, SPH created a robust campus contact tracing program staffed by student workers. The effort gained widespread notoriety in public health circles and became a model for similar programs at college campuses across the U.S. It also pushed open the door for additional emergency preparedness projects, including an IDPH-contracted effort to develop workforce training modules for employees of the state’s long-term care facilities.
When the state released its post-COVID autopsy and improvement recommendations last May, SPH Dean Wayne Giles listened to IDPH leaders explain their need for stronger emergency preparedness and response training. The agency wanted training modules introducing individuals from diverse professional fields to the National Incident Management System (NIMS) Emergency Operations Center (EOC) as well as education on the essential principles of infection prevention, management and control of pathogens. In discussions with Giles about IDPH’s needs, Hershow expressed his comfort providing training around infection prevention, management and control – areas neatly aligned with the bulk of his work since arriving at UIC in 1987. For the former part, however, Giles suggested a collaboration with Sambanis and EMRP, which possessed the subject matter expertise, cooperative mindset and immediate personnel to attack the IDPH project with a Hershow-led group.
Over recent months, Hershow and Sambanis have led teams to fulfill IDPH’s stated needs for interactive asynchronous training around handling a public health emergency with confidence and competency. Together, the SPH group, which includes faculty, research staff and graduate students, is developing 12 online modules related to health care preparedness, creating both the educational content and a program impact assessment to fuel the training’s relevancy and reach.
Part 1: Emergency preparedness overview
Sambanis and his team are developing the first six modules, which offer a sweeping overview of emergency preparedness and response. The modules include:
- Introduction to Public Health Preparedness and Response, a summary of national structures, programs and frameworks used for emergency management across the country, and how they apply to public health preparedness and response in Illinois.
- Introduction to the Public Health Emergency Operations Center (PHEOC), which describes the nation’s guiding framework for response management utilized in an emergency operation center environment and policies and procedures applicable to IDPH PHEOC.
- Expectations of PHEOC Members, an overview of expectations for PHEOC staff members in terms of availability, training and technology/resource access.
- Introduction of Roles and Responsibilities of Incident Command System (ICS) Staff, which details roles and responsibilities of ICS Command staff positions within the PHEOC during a public health emergency and promotes teamwork, coordination and effective communication across various units.
- Introduction of Roles and Responsibilities of ICS General Staff, a spotlight on the roles and responsibilities of ICS General Staff within the PHEOC and Subject Matter Experts during a public health emergency and how they interact with one another, which is vital for smooth operation of the center.
- Public Health Response Resources, a summary of resources and programs available to IDPH to aid state and local partners in a public health emergency.
Sambanis said the six modules his team is producing will deliver the “high-level, foundational material every worker in this process would need.” From specifying the command system and general structure to how things move from the local to the state to the federal level, the modules provide a “crash course” in emergency management, Sambanis said.
“The Illinois Department of Public Health needs these foundational courses so that when new employees come in, they can take this training at any time and get up to speed,” he added.
Far too often, there’s an assumption that individuals, even those from public health backgrounds, encounter an emergency situation and know what to do. Yet, COVID-19 demonstrated that’s not the reality, said Camila Bagley MPH ’23, a research specialist on Sambanis’s team. “A big part of preparedness, and specifically this project, is about having everybody know their role depending on what the emergency is and to create a system that’s flexible and scalable depending on the issue at hand,” said Bagley, who has been developing concise and engaging 20-minute scripts for the project’s first six modules. Even amid emergency situations, health care is critical infrastructure that needs to be working without delays.
While physical infrastructure is one part of the puzzle, such as flood walls around a hospital and backup generators, Sambanis called administrative and procedural elements the other, equally crucial part. “You need to have the right individuals in the room in the right roles and trained up with the right skill set,” Sambanis said. “Continuity is the idea. How can you scale back up?”
Part II: Tailored training
Hershow is leading the second part of the training project alongside Epi-Bio Division colleagues Mark Dworkin and Natalia Lopez-Yanez. The six remaining modules will feature introductory concepts of infection prevention and control tailored to six specific audience groups identified by IDPH:
- For the general workforce, a primer on basic infection prevention. The training includes a discussion of common infection risks, personal safety measures and workplace hygiene as well as guidance on handling illness and exposure in the workplace.
- For the general public, a module featuring basic infectious disease information applicable to the masses, such as respiratory etiquette, testing and staying home when sick and other relevant topics.
- For individuals working with children, such as those in school environments and other childcare settings, supplemental information on disinfection, vaccination requirements and illness policies in educational settings.
- For first responders, such as firefighters, police officers, EMTs and paramedics, a defined segment explaining personal protective equipment selection, supplemental environmental cleaning, bloodborne pathogen management, considerations for congregate living situations like firehouses and specific pathogen concerns, such as airborne diseases and rashes.
- For community health workers, a module offering guidance on explaining infection prevention basics to community members as well as considerations for home visits and public meeting safety. The community health worker training will also address chronic illness and increased risk factors as well as vaccine education and resources for community outreach.
- For individuals working in health care settings, a training module discussing infection prevention and control practices for health care workers in facilities monitored by IDPH, specifically long-term care facilities.
In addition, the Hershow-led team is compiling reference materials to IDPH, including auxiliary online educational opportunities as well as the latest guidelines from the Centers for Disease Control and Prevention regarding current infectious disease health issues. “One thing we learned during COVID-19 is that an effective emergency response is not driven by public health alone, but rather something accomplished in partnership with agencies and employment groups,” Hershow said. “We see this training as an academic-public partnership to improve public health by creating direct, relevant education that speaks to specific groups and combats misinformation with good information.”
Empowering swift, purposeful movement
The SPH team hopes to complete the training program for IDPH by early spring. The group then plans to spend the subsequent months assessing the impact of the training by reviewing data centered around the number of trainings completed, knowledge gained and survey results from participants.
“One of the key lessons from COVID-19 is that we weren’t as prepared as we thought we were and, as a result, we didn’t mount the most effective response,” Hershow said. “We want to learn from the COVID-19 example and apply those lessons to better planning because we can do better and need to do better.”
Preparedness, after all, enables people to perform in emergency situations when inaction increases the likelihood of negative consequences to individual wellbeing, property and quality of life. In an emergency, time is of the essence.
“This project is so important because well-trained people are able to execute their jobs better in emergency situations,” said Clare Beidelman, EMRP ’23, MPH ’24, a research assistant on Sambanis’ team who helped develop module content. “Training is an easy way to build resilience within the public health field and contribute to more optimal outcomes.”
To that point, Sambanis believes the SPH training modules provide a valuable foundation to deal with emergencies and an ever-evolving threat matrix, which can run from a pandemic to an active shooter situation to a natural disaster. “Unfortunately, these events do occur and it really takes a village to respond,” Sambanis said. “With our training, we’re trying to develop that foundational knowledge so people are prepared to move with purpose and efficiency whenever a public health emergency arises.”