Maintaining Focus On Evolving Disaster Needs

The mission of the National Center for Disaster Medicine and Public Health (NCDMPH) is to improve the U.S. disaster health readiness through education and science.

By Thomas D Kirsch, MD, MPH, FACHE, Professor and Executive Director, NCDMPH, Professor of Military and Emergency Medicine, USU,
and Craig Goolsby, MD, MEd, FACEP, Science Director at NCDMPH, Professor of Military & Emergency Medicine, USU

From S&B and CST/CBRNE, Winter/Spring 2020

The National Center for Disaster Medicine and Public Health, NCDMPH or “National Center”, was established in 2007 under the Homeland Security Presidential Directive 21 (HSPD 21) to be “…an academic center of excellence in disaster medicine and public health….” Led by Professor and Director Thomas D Kirsch, MD, and Science Director Craig Goolsby, MD, the Center plans and focuses on activities and projects which fall under its mandate set under HSPD 21. “NCDMPH endeavors to be the nation’s academic center of excellence leading domestic and international disaster health education and research efforts,” said Kirsch. “In collaboration with partners, we create and translate science and education to improve readiness.”

The overarching strategic theme of NCDMPH is medical and public health READINESS—preparing the Nation from disasters and catastrophic events. “Leveraging scholarships to advance the education and research agenda for disaster readiness in the United States are the missions; collaboration and leadership are the tools to achieve the preparedness mission,” noted Kirsch. “NCDMPH will accomplish this through a collaborative and coordinating approach, convening subject matter experts, developing position papers, conducting primary research on key questions, publishing evidence-based reviews, and developing and validating targeted educational tools informed by the evidence.  In collaboration with our federal partners the National Center will identify and conduct specific medical and public health preparedness projects that are consistent with their statutory authorities and funding availability,” Kirsch added.

The Center is a bridge between agencies and the academic and government spheres. This unique structure and position makes NCDMPH especially suited to meet our Nation’s critical disaster preparedness mission. In keeping with NCDMPH’s stated mission in HSPD 21, the 2017-18 strategic plan focuses on four key strategic themes: Readiness, Education, Research, Collaboration and Leadership.

Disaster Health Science

The National Center has undertaken a comprehensive assessment of the current state of disaster health science, as applied to research and education including research, reports, collaborations and symposia. These activities will help steer future disaster health science work at the National Center and across the field. The following studies were completed during FY18 and have been published in 2019:

U.S. governmental spending for disaster-related research, 2011-2016: This study characterizes federal funding for disaster-related research for five professional disciplines: medicine, public health, social science, engineering, and emergency management during a seven-year period.

Funding for the National public health preparedness capabilities, 2008-2017: This study describes the level of federal funding allocated for research related to national public health preparedness capabilities during a 10-year period.

Characterizing the current state of disaster research for 3 scientific disciplines: This study characterizes the current state of disaster science using qualitative indicators of developmental status as characterized by leaders of three scientific disciplines: medicine, public health and social science.

An analysis of After Action Reports from Texas Hurricanes in 2005 and 2017: The objective of this paper was to review and analyze After Action Reports (AARs) from jurisdictions following Hurricanes Katrina and Rita in 2005 and Hurricane Harvey in 2017 in order to assess the utility of AARs as a quality improvement measurement tool.

Stop the Bleed Initiative and Research

Trauma is the leading cause of death for people between ages of 1-40 years. Life-threatening bleeding from the arms or legs can be stopped by using a tourniquet. The National Center Stop the Bleed (STB) Initiative involves efforts to train, equip and empower laypersons to help during a bleeding emergency. A free Stop the Bleed App was launched in 2018. The app provides action steps to take during a bleeding emergency. There is also a Stop the Bleed video available on the NCDMPH website which has been watched by individuals from 150 countries, reports Goolsby.

Further STB initiatives include an education consortium which is a group of subject matter experts that collaborated to develop and publish the first national education standards for hemorrhage control training. Goolsby also reported that the consortium is working on a series of projects related to STB policy, assessment tools, research planning, as well as planning for future initiatives. Recent grants to the Center include:

Transforming Technology for the Warfighter (TTW) Grant

The National Center received a $2 million TTW grant to develop novel hemorrhage control technology. Research and development are being conducted in partnership with Harvard-Brigham and Women’s Hospital, Mayo Clinic, Linköping University/Region Östergötland in Sweden, and InnoVital Systems, Inc.

First Aid for Severe Trauma (FAST) Grant

In 2018, the National Center received a $3 million grant to develop a trauma training course geared toward high school students; we are in the midst of Phase 2 and expect Phase 3 to begin mid-2020. In partnership with the American Red Cross, the National Center is creating a curriculum focusing on applying pressure to stop bleeding, communication in emergencies, situational awareness, and body positioning.

Disaster Health Core Curriculum

The “Disaster Health Core Curriculum” was launched online in May 2018. It is a free eight-hour, online training course consisting of 11 lessons covering a variety of disaster health topics, such as personal or family preparedness, communication, and ethical and legal issues encountered in disasters. The foundation for the “Disaster Health Core Curriculum” is “Core Competencies for Disaster Medicine and Public Health.” Designed for a wide range of health professionals who may play a role in a disaster, it offers continuing medical education (CME) and continuing nursing education (CNE) credits.

Supporting Military Readiness

NCDMPH provides important readiness expertise to the Office of the Secretary of Defense for Policy (OSD-P), Office of the Assistant Secretary of Defense for Health Affairs, the Defense Health Agency, the Joint Chiefs of Staff, U.S. Combatant Commands and the National Guard Bureau. NCDMPH consults on DoD disaster preparedness exercises, provides opportunities to publish lessons learned and extends the military Tactical Combat Casualty Care principles into layperson training, facilitating the bridging of battlefield lessons to the American public. Additionally, NCDMPH consults on Humanitarian Assistance Disaster Response (HADR) activities and preparation with the federal government.

Civilian-Military Partnership

On September 17-18, 2019 NCDMPH partnered with the Civilian-Military Urban Outbreak tabletop exercise in collaboration with the Naval War College and the Johns Hopkins Applied Physics Laboratory. The goal was to identify and clarify issues related to an emerging infectious disease crisis in a large urban environment for civilian and military actors. Participants represented diverse fields (i.e. security, humanitarian action, health, infectious disease outbreaks, urban development), including:

• U.S. interagency (CDC, USAID, OFDA, DoD, DHHS)
• Non-governmental stakeholders (IFRC, NGOs [IMC, AmeriCares])
• Inter-governmental organizations (UN OCHA, WHO, UNHCR, IOM)
• Private sector
• Select partner nation militaries/agencies (UK, Germany, Australia, Argentina)
• Research community (select universities, NIH, UARCs)

Looking forward

“As we move into 2020, we continue to focus and plan activities and projects which fall under the National Center’s mandate set under HSPD 21,” emphasized Kirsch. “We very much look forward to further expanding our unique interagency and academic position to empower scientists and educators to protect our nation’s health from disasters.”