On March 12, a major city I’ve worked with on emergency planning and counterterrorism issues over the past two decades asked me to review their response plan around COVID-19.  Here is what I told them:

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You guys have done the easy part.

Luckily, you have a population with no known cases but I promise you it is lingering behind the scenes.  (note: since the 12th they’ve identified over half a dozen) The WHO pandemic declaration and national response gives you room to act preemptively.  You need to start the social distancing aspect now. Get the schools closed, etc.

You need capacity counts on all hospitals and surge capacity identified.  Other resources nearby that can be made available?  If hit hard, the primary need is around respiratory support.  What is your current capacity.  What is the contingency if you get a surge from XXX, etc.

Non-essential surgeries requiring hospitalization post-op need to be wiped from the calendar once hospitals reach a certain capacity.  I don’t know what that is, but worth talking with them now.

Don’t burn your emergency staff too hot from the start.  They are going to get stressed to the max and large percentages will get infected. Their inclination is going to be to get all hands on deck, but you need steady shifts respectful of the social distancing until things start to gain momentum.

Identify recently retired medical folks that might be brought back in if needed.

Have a closed meeting discussion with your core planners around triage criteria and implementation.  Hopefully this isn’t necessary, but easier to discuss plan now than when it is needed and emotions are running wild.

Police services are going to be important depending on disposition of citizens and potential for unrest.  Same as with medical staff, you need a phased approach.  Key deployments now are going to be in high risk areas of the city and points of social stress/panic (Costco, etc).

I’m not as concerned with supply lines at this point, but good to have them as part of your planning process. We need to watch closely over the next two weeks.

We might be ahead of this still, and maybe none of this comes into the play, but worth going through the planning process.  In Italy, medical capacity issues are driving the mortality rate up.  We don’t want to be Italy, which is why I’m glad we are taking this seriously.

Also, as you know, there are worse bugs out there.  This is a great real-world exercise to work out the kinks on future response.  Make sure you are capturing lesson’s learned, etc along the way.  What were the key inflection points, etc.  All worth rolling forward for the next one.

For you personally (and your team), stay healthy.  Get sleep (grab some melatonin if you need to).  Keep the family safe.

Call me anytime.  Number has been the same for 20 years.