Before the interview Battalion Chief Hansen (of San Marcos, CA) prefaced our meeting by stating, “With CERT, there is not a lot of black and white right now as far as a pandemic goes and what role we all play in that so some of this is yet to be defined.” However, I could tell there had been a lot of thought put into what the city of San Marcos will do and how they use their CERT teams.
Note: This is a long interview with 5 questions marked in red, and some areas I summarized in blue...

QUESTION: Considering normal non-CERT citizens in the community, what can communities expect during a large-scale pandemic?

Chief Hansen led me to a basic understanding of what the role of the city and what type of planning is put into place. The city services are what are seen by the public and obviously during a pandemic these services would be reduced and perhaps severely and the main reason is reduced workforce. Nevertheless, the chief explained how cities, counties and the states plan for a pandemic event.

“The city [of San Marcos] has in place and every city should have in place as well as the county and state a plan; it’s called a COOP (Continuity Of Operations Plan) and in that one of the things we address is a reduced work force. Because what we look at with pandemic is up to 30% of our work force not being at work. Part of that is moving essential services to the employees that can do it at home so we may try social distancing. Instead of bringing all the critical employees in one place, let us keep them working from home because many people can telecommute, get a lot of the work done from home, and keep many of the essential services functioning. You know when we talk about essential city services obviously the first tier are health, law and fire [protection]… There are a lot of other essential city services that have to keep chugging around and that also goes for the utility company… If we are at 70% of work force, how do we continue offering essential city services? That is the Continuity Of Operations Plan. We do have one in San Marcos and that is [where] some of our focus is - how we maintain some of our essential city services. There are businesses that have a COOP.”

With an understanding of city services and how they dealt with them during an epidemic, I listened to Chief Hansen continue to explain what communities are likely to expect during a large-scale pandemic.

“Well I think just as we’re seeing right now. I don’t know if you saw the press last night or this morning but Mission Hill’s high school is going to be closed for 2 weeks starting Monday because they do have a suspected but not confirmed, but 97% sure case at Mission Hills High School… One thing with the pandemic a lot of direction comes from the international level, the World Health Organization then at the national level the Center for Disease Control (CDC) and then from there it comes from the State and then down at the county. “

“Local agencies that control the CERT teams don’t have so much [control]… We, we really follow the guidance of CDC, of County Health and State Department of Health. We aren’t so much making those decisions as we are following their guidance and support of those decisions, basically. They don’t come to us and [discuss with] the city of san Marcos “Hey we want to close Mission Hills High School,” that’s a school district [decision], they do talk to the school district about [possible actions] …, [These are] CDC recommendation that the school district enacts. Therefore, what someone can expect is what we have seen going on right now, Mission Hills High School is closed.”

“Possibly through the COOP plan with the city, one of the things [planned] is social distancing where we reduce city services where we don’t have walk in service to the counter. [Non-essential city services would be phased out.]”

He explained how contingency planning would happen on two different levels: creating actions and response to a possible pandemic, and staffing up our extra fire engines and ambulances to deal with increased patients-

“If our work force is significantly impacted we may not be able to staff that extra equipment so if we get a flood of 911 calls for flu like symptoms… our response times might get longer. When we get to the hospital what we call our off load times may get longer. We may have to sit with the patient for hours. Right now on a normal any given week night occasionally [we] run into an hour plus offload delay where our ambulance arrives at the hospital with a non-critical patient and they sit with that patient for an hour before there’s any space available for them-that is in the perfect world today.”

With that information in mind, he gave me an example of an increase of 300 people who need hospitalization over a given amount of days it became easy to see how the system could get stretched to the breaking point very quickly.

Chief Hansen continued, “So our ability to quickly respond to those 911 calls might degrade a lot; what we talk about through our CERT training is normal response time is 3 to 5 minutes. It might double or triple during that time. I think there would be reduction in public safety. The same thing in law enforcement, there might be a reduction in law enforcement’s ability just due to their employees being sick. They may not be able to staff as many positions or due to increased call demand depending on how the public is reacting during the pandemic.”

“…The bird influenza which you have a much more mortality-morbidity rate we’re expecting than what we are seeing with the current event [H1N1 Swine Flu] so you might run into a social upheaval type thing that might tax law enforcement so there’s all sorts of parts to it. … The short answer, would be is, yeah is that you’d see non-critical functions close down, you’d see schools close down which is an impact to families and day-care issues; people being able to go to work with their kids now home…”

“If it’s a very bad pandemic and we have a lot of very sick people we will quickly run out of hospital beds. During Golden Guardian we practiced setting up a field hospital at Cal State San Marcos, I think they had 5 ventilator equipped beds… They were able treat other things, but if what people need is respiratory assistance there will be a point where ventilators are short.”

QUESTION: During a pandemic, the community would probably listen what the CDC says on the news, but do you have any good advice for what people should do?

“Yeah, and guidance to the community [right now] it seems in what we are seeing with this is your basic hygiene type practices and what we call social distancing. Just isolating yourself from crowds of people where you could possibly become infected, frequent hand washing, and frequent cleaning. [For example] I share this office with two other people so, you know, if, if it’s your home, your office and you’re not bringing anything in it’s a little different, you know, I don’t know if my coworker is sneezing on this keyboard this morning right before I come In – now I’m clicking on the mouse and I rub my nose or rub my eye and I’ve contaminated myself. Social distancing and basic hygiene really, and I think non-essential things will be shut down.”

“There are some events going on, I know there’s a walk for life, a cancer walk at Cal State San Marcos and I know that is a congregation of people, I know tomorrow is the street fair in Carlsbad which typically 30 to 40 thousand are expected. [What we’ll experience is] kind of like what’s going on in Mexico, shutting down.”

“Containment and mitigation – since this has already gone international it has already gone past containment and that is why border’s haven’t closed so now it’s time for mitigation which will slow the spread of the disease.”

QUESTION: What, if any role, would CERT team participation be in any pandemic?

“Well, I think is the first thing we talk about with CERT anytime is having yourself and your family prepared. So something as simple as having a family disaster plan in place or preparedness plan, emergency plan in place, um, so you and your family are taken care of. If things are bad, then we [recommend] social distancing. [As a CERT member] just having your preparedness taken care of at home where you have the food and the water and everything else you need, [allows you] to avoid going to the grocery store. That might be a very viable tactic. I mean, if we have something with a very high mortality rate – you are not going to want to go shopping at the grocery store every day!”

Sticking with the CERT training basics help members through all types of disasters and this is no different. It’s a great education as long as you take action to follow the basic steps. Chief Hansen pointed out that knowledge is your best weapon against a pandemic.

“You may have more knowledge than your neighbor has next door so you being able to educate yourself and educate your family uh and educate your neighbor you know that same principle that I always talk about in CERT, ‘take care of yourself, take care of your family [then] take care of your neighbors’ still definitely applies [during] a pandemic.”

“If things got to be very bad, and if we needed volunteers to maintain some critical city functions we would definitely look to CERT team as a pool of people that can help with that. As you know in our Emergency Operations Center (EOC) we have people serve in that as a CERT function and we would certainly call upon CERT to help in the EOC. Logistically, if we go to an EOC activation… we will always need logistical support. You know, CERT members are a great ‘go to’ for that.”

“Another key role that CERT plays with our point of distribution as far as mass medication goes for say an anthrax event we have the medication already pre-staged, pre-planned: we have the Point Of Distribution Plan and the Mass Medication Plan in place, and CERT plays a role in that and [CERT would] help to get that medication out … to critical staff[, CERT members and eventually] to the public…”

“If there’s a mass medication that is part of a pandemic response, be it a vaccinations or anti-virals or whatever it might be, we [might use] the CERT [as part of what] implementing the Point Of Distribution Plan… And that’s all going to be at the guidance of the agencies, like I said the CDC, State Health, County and on down…”

“… There’s definitely a role CERT plays. It’s support in nature… In the city we don’t have a big response role in the pandemic. Our responsibility is to maintain city services and that’s where CERT kind of helps do that. It’s what we envision as the CERT mission. [Another role would be] helpful is staffing our informational telephone lines [such as 211] CERT is good for that. Getting information to the public…”

“[Most importantly] having CERT members that know how to keep them[selves] and their family healthy, just like any emergency, will cut down on [emergency] calls… so if you are able to keep your family from being sick the best you can [then] you’re not dialing 911 and that’s going to help us immensely… If we can give you the tools so that you’re not dialing 911 [and not becoming a victim then] that’s half the battle. I think there are a lot of parallel to the normal CERT mission and the pandemic CERT response.”

QUESTION: What considerations do CERT team members need to think about when choosing to participate during an activation of the team for such a reason [as responding to a pandemic]?

“I think our priority at any time is the safety of our workers, and that’s our CERT team also. You know with our CERT team mantra is safety, safety, safety. We do not intend to put any of our people at risk unnecessarily. Personal safety has to be the #1 priority of the individual’s responsibility. As [for] the CERT program, [as] its manager [it is my] #1 responsibility for the safety of all CERT members…”

“Appropriate PP, personal protection, equipment either [that was] issued [already] or we get the appropriate gear to the CERT members and we train them how to use it at the appropriate level for whatever their task or assignment may be. The #1 thing for CERT is always that personal safety.]

“Another thing is that if a CERT member is sick we don’t want them to respond because that’s an isolation [issue]. It’s going to be a real problem if we have a sick CERT member- someone who has symptoms, and they come to the CERT activation; if we infect our CERT team that way [that would be a real problem], and whatever city functions we’re trying to maintain [by CERT would fail]. We give the same guidelines to all city employees, if you are sick then you have to let us know, and then we’ll use you when you are back to health. In the meantime, do not bring it with you [to work].”

QUESTION: What appropriate actions can CERT members do on their own that besides having a plan and keeping good cleanliness?

“Education is your best tool. The response must be preparedness and not panic… There is tons of information out there. Go to CDC [website] because that is where the information is starting... So knowing where to go for the right information is #1.”

“Raising your awareness to what the true risks are and following the guidance this is provided at the CDC is really important. I cannot stress enough and the CDC cannot stress enough is basic hand washing. [During our own] CERT training [Scott McClintock] takes the bottle of Cayenne Pepper and sprinkles it on someone’s hands and says, ‘Okay, now we’ll know when you wipe your nose or your eye.’ And something as simple as behavioral modification and knowing ‘if I touch this surface and then rub my eye, I will have introduced that into my body. “

“You know the very simple things that CERT members can educate their family members on that will go a long way into reducing the spread of that.”

“The big thing is not to panic as people in this country can do; this [Swine] flu has not been that bad…”

“Days, weeks or months, a pandemic is a long haul thing. There will be waves of it. It will return in the fall. [We] expect that it will return with the normal flu season when it’s easier to catch and transmit. It may be much worse and it can go through further mutations and changes. It’s mutated to this point, and it could… become resistant to anti-viral medications to where it could have a higher mortality rate than it does now. There are so many unknowns. Therefore the individual needs to prepare for this – it’s not just going to go away.”