Preparedness of the US Mass Fatality Infrastructure

Converging factors are creating a “perfect storm” worldwide- in terms of large scale disasters and resultant mass fatalities. In the last dozen years alone, a wide range of natural and anthropogenic disasters resulted in... [ view full abstract ]

Converging factors are creating a “perfect storm” worldwide- in terms of large scale disasters and resultant mass fatalities. In the last dozen years alone, a wide range of natural and anthropogenic disasters resulted in exceptionally high numbers of fatalities. Recent examples include the 2004 South Asian tsunami (~220,000-230,000 deaths), 2005 Kashmir earthquake (~75,000 deaths), 2008 Sichuan, China earthquake (~87,000), 2009-10 H1N1 pandemic (~20,000 deaths), the 2010 Haiti earthquake (~200,000 deaths), the 2011 Great East Japan mega-disaster (~22,000 deaths), 2014 West Africa Ebola virus disease epidemic (~11,000 deaths) and 2015 Nepal earthquake (~8,500 deaths).

The management of mass fatality incidents (MFI) is extremely challenging and complex, and requires the cooperation and collaboration of a large network of public and private agencies and organizations. In the United States, we refer to this network as the “mass fatality infrastructure.” To assure the readiness of this infrastructure, it is important to assess operational, organization, and resources sharing capabilities. A barrier to this has been the lack of appropriate metrics for each of the sectors comprising the infrastructure.

To address this gap, in 2014-2015, we developed and tested preparedness metrics for five major MFI sectors in the US: medical examiners/coroners; death care industry; departments of health; offices of emergency management; and faith-based organizations. Internet survey responses from 879 representatives of these sectors indicated highly variable levels of preparedness across sectors. Overall, the infrastructure as a whole had a composite score of 51%- only about half of the key capabilities for preparedness were in place. Particularly serious gaps in capabilities were noted for managing MFI that involved hazardous agents. Strategies for addressing these deficiencies were identified. This information may be of interest to other countries that are interested in assessing and improving their MFI capabilities.

Keywords: mass fatality infrastructure, disaster, preparedness