Reflections on the Orlando shooting

Since Sunday morning, our team, along with much of America, has been consumed with the news and updates coming out of Orlando. Like many other health preparedness folks, I spent time thinking about the role of public health in this horrible tragedy. A few things jumped out:

• The value of our emergency responders – The first responders who arrived – from the police, health responders, mortuary teams and behavioral health experts – are such a valuable part of our emergency management framework. If we ever question the role of public health and ESF-8 in events like this, we should look no further than to the critical role that these experts played. The immediate actions of those on the scene demonstrated that we have incorporated some lessons from previous events, including the shooting in Aurora, CO. Fortunately, there was also a trauma care center nearby, which undoubtedly saved many lives that would not have survived a lengthy transport. In addition, the incorporation of behavioral health services in emergency response is important to address the trauma associated with such an event. UnitedHealthcare’s offering of free mental health services to anyone – insured or not – was especially powerful. From the long lines to donate blood, to removing barriers to mental health services, the groundswell of support was powerful reminder/demonstration of community.
• Informing the public – Efficient crisis communication to the public, especially in the immediate aftermath of an event, helps to manage the fear associated with such an event. We commend the public servants who shared pertinent information freely, and promptly. This is especially important because when a hospital is being overwhelmed with cases, or there is a need for the public to contribute in some way to expedite the response (in this case, blood donations). This is a lesson that we should continue to carry into other events. 
• Understanding HIPAA and professional judgment of physicians – There were many mixed messages about the need for a HIPAA waiver (this article summarizes the steps that would be necessary in order to obtain one) in order to inform family and loved ones about the status of their relatives. This confusion demonstrated the need to explain such laws to our executive leadership, so that they are clear on the need for waivers. This confusion is very reasonable (the “professional judgment” of a physician and the amount of information that can be shared are complicated issues), but it is the job of healthcare providers to ensure that these questions are clarified to avoid lags in response and communication with families affected by the event.

Ultimately, there have been many subsequent actions to prevent events like this from happening again. And many in emergency management will continue to monitor the event to glean lessons and develop new preparedness strategies for such events. As a public health professional, I am heartened by the calls to lift the ban which prevents the CDC to research gun violence as a public health issue. Both APHA and AMA have really stepped up and made the case for creating a scientific research stream to understand, and ultimately prevent, gun violence. While this isn’t the typical event that Healthcare Ready responds to, we are prepared to provide support and activate in response to all-hazards, including terrorism. 

Our thoughts will remain with those in Orlando and others affected by the epidemic of gun violence. We have much more work to do.