Recovery / Resilience after Radiation Emergencies

• Definitions and Time Period
• Response During Late Phase
• Useful Guidance about Recovery and Resilience

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Definitions and Time Period

• Recovery phase planning begins during intermediate phase of a response and extends post event until remediation is completed
• Resilience
  • Concept officially introduced in Presidential Policy Directive / PPD-8: National Preparedness (March 2011)
    • Focuses on strengthening the security and resilience of the Nation through systematic preparation for the full range of 21st century hazards that threaten the security of the Nation, including acts of terrorism, cyber attacks, pandemics, and catastrophic natural disasters
  • New component of the National Health Security Strategy (NHSS)
    • NHSS is built on a foundation of community resilience - healthy individuals, families, and communities with access to health care and with the knowledge and resources to know what to do to care for themselves and others in both routine and emergency situations.
  • Based on the "whole community" approach
    • Recognizes that DHS/FEMA is only a part of the team, and not the entire emergency management team.
    • Includes
      • FEMA and partners at the federal level
      • State, local, tribal and territorial governmental partners
      • Non-governmental organizations (NGOs) like faith-based, volunteer and non-profit groups
      • The private sector and industry
      • Most importantly, individuals, families, and communities
• Requires planning in advance.
• Addressed in many of the most recent planning documents
• Timelines
  • Phases of a response
  • Diagram showing the Recovery Continuum timelines and tasks and considerable overlap among recovery tasks during the short term, intermediate term and long term phases of an incident. National Disaster Recovery Framework (DHS/FEMA)
  • The EPA PAG Manual 2017 has a radiation specific update to the recovery framework in Table 4-2, page 50 "Reentry Matrix: Quick Reference to Operational Guides".

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Response During Late Phase

• Actions no longer represent a response to "emergency situation"
• Action objectives include cleanup and site recovery, work of reducing environmental radiation levels to acceptable levels
• Phase ends when all remediation actions have been completed
• Monitoring and treatment for late medical effects will also occur during the Recovery phase

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Useful Guidance about Recovery and Resilience

General

• A Guide to Infrastructure Security and Resilience (DHS/CISA, November 2019)
  • About the Cybersecurity and Infrastructure Security Agency (DHS/CISA)
• Presidential Policy Directive / PPD-8: National Preparedness (March 2011)
• National Health Security Strategy (NHSS)
• National Disaster Recovery Framework (DHS/FEMA)
• National Protection Framework (PDF - 616 KB) (DHS, June 2016)
  • Describes how the whole community safeguards against acts of terrorism, natural disasters, and other threats or hazards.
  • Describes core capabilities, roles and responsibilities, and network of coordinating structures that facilitate the protection of individuals, communities, and the Nation.
  • Describes partnerships at all levels of government, and with the private and nonprofit sectors coordinate the development and delivery of 11 national core capabilities for Protection.
  • Guided by the principles of resilience and scalability, risk-informed culture, and shared responsibility.
• Regional Resiliency Assessment Program (DHS/RRAP)
  • RRAP is a cooperative assessment of specific critical infrastructure within a designated geographic area and a regional analysis of the surrounding infrastructure.
  • RRAP is led by the Department of Homeland Security and addresses a range of hazards that could have regionally and nationally significant consequences.
  • Each year, the Department selects these voluntary and non-regulatory RRAP projects with input and guidance from federal and state partners.
• Community Resilience (HHS)
• Acosta JD, Burgette L, Chandra A, Eisenman DP, Gonzalez I, Varda D, Xenakis L. How Community and Public Health Partnerships Contribute to Disaster Recovery and Resilience. Disaster Med Public Health Prep. 2018 Oct;12(5):635-643. [PubMed Citation]
• Zamboni LM. Theory and Metrics of Community Resilience: A Systematic Literature Review Based on Public Health Guidelines. Disaster Med Public Health Prep. 2017 Dec;11(6):756-763. [PubMed Citation]
• National Biodefense Science Board Community Health Resilience Report (HHS/ASPR, April 23, 2014)
• Building and Measuring Community Resilience, Actions for Communities and the Gulf Research Program (NASEM, 2019)
• Medical and Public Health Preparedness, Response and Recovery Considerations for Children and Families. (Institute of Medicine of the National Academies, June 10, 2013)
• Improving International Resilience and Response to Chemical, Biological, Radiological, and Nuclear Events: Proceedings of a Workshop in Brief (NASEM, 2019)
• Post-Incident Recovery Considerations of the Health Care Service Delivery Infrastructure (Institute of Medicine of the National Academies, July 31, 2012)
• Building Community Disaster Resilience through Private-Public Collaboration, National Academies Press: Summary of findings (2010); Purchase full report (2011)

Specific for radiation incidents

• The EPA PAG Manual 2017 has a radiation specific update to the recovery framework in Table 4-2, page 50 "Reentry Matrix: Quick Reference to Operational Guides".
• Response and Recovery Knowledge Product: Key Planning Factors for Recovery from a Radiological Terrorism Incident (PDF - 7.48 MB) (DHS/FEMA, September 2012)
• Radiological Recovery Logistics Tool (DHS/NUSTL, FEMA, EPA)
  • Can be used during the response and recovery from a radiological or nuclear incident to effectively allocate appropriate commercial and public works equipment to mitigate, remove, and contain radiological contamination.
  • See excellent downloadable poster detailing the platform and implementation
• Arrangements for the Termination of a Nuclear or Radiological Emergency: General Safety Guide No GSG-11 (PDF - 3.6 MB) (IAEA and international partners, 2018)
• Coleman CN, Sullivan JM, Bader JL, Murrain-Hill P, Koerner JF, Garrett AL, Weinstock DM, Case C Jr, Hrdina C, Adams SA, Whitcomb RC, Graeden E, Shankman R, Lant T, Maidment BW, Hatchett RC. Public health and medical preparedness for a nuclear detonation: the nuclear incident medical enterprise. Health Phys. 2015 Feb;108(2):149-60. [PubMed Citation]
• Decision Making for Late-Phase Recovery from Major Nuclear or Radiological Incidents, (NCRP Report No. 175), National Council on Radiation Protection and Measurements, Bethesda, MD, 2014.
  • Chen SY. Decision making for late-phase recovery from nuclear or radiological incidents. Health Phys. 2015 Feb;108(2):161-9. [PubMed Citation]
  • Nisbet AF, Chen SY. Decision making for late-phase recovery from nuclear or radiological incidents: new guidance from NCRP. Ann ICRP. 2015 Jun;44(1 Suppl):162-71. [PubMed Citation]
• Coleman CN, Blumenthal DJ, Casto CA, Alfant M, Simon SL, Remick AL, Gepford HJ, Bowman T, Telfer JL, Blumenthal PM, Noska MA, Recovery and Resilience After a Nuclear Power Plant Disaster: A Medical Decision Model for Managing an Effective, Timely, and Balanced Response, Dis Med Pub Health Prep 2013;7(2),2013. [PubMed Citation]
• UK recovery handbook for radiation incidents (and associated publications). (Public Health England, May 2013) Note: These 6 documents cover food production, inhabited areas, drinking water, among other topics.
• Rad Resilient City: a Local Planning Tool to Save Lives Following a Nuclear Detonation (UPMC Center for Health Security)
• Application of the Commission's Recommendations to the Protection of People Living in Long-term Contaminated Areas after a Nuclear Accident or a Radiation Emergency, ICRP Publication 111, Ann ICRP 39 (3), 2009.
• Planning Guidance for Response to a Nuclear Detonation (PDF - 2.62 MB) Second Edition, 6/2010, National Security Staff
• Preparing to Save Lives and Recover after a Nuclear Detonation: Implications for US Policy, Univ of Pittsburgh Center for Biosecurity, June 2010
• Eraker E, Clean up after a radiological attack, The Nonproliferation Review, Fall/Winter, 2004
• Disposal of Waste as Clean Up of Large Areas Contaminated as a Result of a Nuclear Accident, IAEA Technical Report Series No. 330.
• Resilience Resources for Emergency Response (OSHA)
• Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA), 1980 (Wikipedia)

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