Just in Case: Emergency Preparedness and the Role of the Health Department as First Responder

Sara Gardner, MPH

Executive Director


When it comes to disasters there is one indisputable fact: they happen whether we are ready or not. New York City is no stranger to natural or man-made disasters. In the last two decades we experienced Hurricane Sandy, which was the second largest storm to make landfall in US history, and the September 11 terrorist attack on the World Trade Center.

Despite the inevitability of hurricanes and other catastrophes, most individual citizens probably don’t spend a lot of time thinking about the next disaster much less preparing for it. I have lived in New York City for over thirty years and for the past 23 I have been married to a New York City firefighter. My husband’s three brothers are NYC police officers so you might say I have had a fairly up close and personal view of the life of a first responder. If any family should have an emergency plan we should. To be completely honest, we don’t.

So it is good to know that behind the scenes at the federal, state, and local levels there is a network and system for emergency response and preparedness at work around the clock. They work in tandem to anticipate and prepare for a multitude of different scenarios, natural and man-made, that are unlikely to cross our conscience except in our darkest nightmares.

The Federal Emergency Management Agency (FEMA) takes the lead nationally. FEMA’s mission is to support both citizens and first responders to build, sustain, and improve our capacity to prepare for, protect against, respond to, recover from, and mitigate all hazards. It is a huge job and one that continues to grow in importance as we manage more and more weather events, disease outbreaks, and terrorist threats. It’s why the proposed 900 million cut to FEMA that Congress was considering for the 2018 federal budget must be reconsidered!

To do its work, FEMA collaborates with both elected officials and state and local agencies like NYC Emergency Management (NYCEM). In planning for and responding to city-wide emergency events, NYCEM is responsible for organizing and coordinating with all other New York City agencies, some like Police and Fire that one might expect to be on the front lines of a wide-scale emergency but others that you may not consider like Department of Buildings, Department of Citywide Administrative Services, Department of Parks and Recreation and the Department of Health and Mental Hygiene.

The NYC Health Department, which most of us associate with birth certificates, smoking restrictions, restaurant grades, and other local health-related issues, will take on the role of first responder in the event of a major emergency such as a coastal storm, a biological attack, or a disease outbreak. Like Police and Fire, the Health Department is constantly preparing and training behind the scenes for any number of emergency scenarios. And in New York City, with its 8.4 million residents, this is a tall and expensive undertaking. It’s also a critical one that must be built and sustained with adequate Federal funding.

When Hurricane Sandy caused the East River to flood the generators that kept the Neonatal Intensive Care Unit of NYU Langone Medical Center running, an established protocol and trained staff made sure that all patients were safely transferred to other hospitals.

In the instance of a biological attack like anthrax, taking certain medications after exposure before the disease develops can keep people from getting sick. To prepare, the Health Department has identified 165 Points of Dispensing (PODs), temporary sites that can be activated within hours to provide life-saving medications city-wide. Rapid, city-wide mobilization requires practice and continued support for complex exercises to continually test and improve plans.

When the first Ebola patient was admitted into a city hospital, the Health Department’s Public Health Laboratory was able to confirm the diagnosis in less than three hours. The Health Department lab is an essential part of controlling potential outbreaks as highly trained and practiced technicians are constantly at the ready to test and detect a variety of infectious diseases and minimize the spread.

In 2004 when FEMA marked September as National Preparedness Month (NPM), it did so to coincide with the onset of hurricane season and to elevate the importance of emergency preparedness. This September, as we bear witness to the damage of hurricanes Harvey and Irma and mark the 16th anniversary of the 9/11 attacks, it is essential that we realize that our country’s and city’s readiness is the result of foresight, planning, and coordinated training which requires sustained attention and funding over time.

Often times, and thankfully, many major emergencies never come to fruition, but we must prepare nonetheless. It is critical that our federal government maintain the investments necessary so that we can continue to plan and respond in ways that save lives and protects the health and wellbeing of all of us.