Fallout Shelter Management Course for MMRS Medical Facilities

Fallout Shelter Management Course for MMRS Medical Facilities August 2006 1

Fallout Shelter Management Course Disclaimer/Waiver of Liability The use of or adaptation of any materials or any presentation techniques by any entity and/or individual signifies that the user and/or adaptor understands the inherent risks involved and further assumes any and all liability that may result. The City of _________, the _____ County Commission, and the _____ Emergency Management Agency express that reasonable care and good faith were exercised in development of the materials and presentation techniques; nevertheless, use of these materials or presentation techniques is at the sole risk and liability of the user. The City of _________, the _____ County Commission, the _____ County Emergency Management Agency, and the federal government specifically disclaim any and all responsibility or liability for any damages to person or property resulting from the use of these materials or presentations. Materials and presentation techniques include any materials and/or presentations, outline instructions and actions which are generally accepted as typical for recovery from the detonation of a nuclear weapon or dispersal of radiological isotopes. However, the conditions created by such events cannot be foreseen, thus, any entity and/or individual implementing the instruction materials may suffer property damages as well as serious injury up to and including death.

Housekeeping -Parking & building access -Classroom -Refreshments -Restrooms -Schedule: breaks and session lengths -Smoking -Outlines/course materials -Student manuals -Test -Graduation & certificate

Course Plan Introduction 1. 0 hour Module 1, Public vs. Medical Fallout Shelters 3. 0 hours Module 2, Organizing for Survival 3. 0 hours Module 3, Managing Critical Resources 3. 0 hours Module 4, Review and exercise 1. 5 hours Test & Evaluation TOTAL . 5 hours 12. 0 hours 4

CEUs for Nurses The SPH Nursing Division has been approved by the _____ State Nurses Association (_SNA) and the _____ Board of Nursing (_BN) to provide: 7. 2 CEUs for nurses for completion on August 30 7. 2 CEUs for nurses for completion on August 31 (14. 4 CEUs total) Physicians, Administrators and others will receive a Certificate of Attendance 5

Pre-course Survey Yes ____ ____ No ____ ____ ____ 1 week 1 month 1 year forever ____ 9. How long will it take to regain our present standard of living? 10. ____ 11. ____ 1 week ____ 1 month 10. What portion of our population will be alive 1 -year after an attack? 75 -100% 50 -75% 25 -50% 1. 2. 3. 4. 5. 6. 7. 8. I want to survive a nuclear attack. Survival from a nuclear attack is possible. The Government has made all necessary preparations to protect me. Protection against nuclear weapon effects is possible. In a nuclear war, the earth will be destroyed. In a Fallout Shelter, purposeful leadership is as important as protection from radiation or food and water. Combining my skills and resources with those of others will enable us to survive. How long will lethal radiation last? 1 year never ____ 6

Fallout Shelter Management in the 21 st Century This is not refighting the “Cold War” but adapting to the threat of global terrorism and the spread of nuclear weapons to nations who will use them if they get them. The Department of Homeland Security (DHS), under the Metropolitan Medical Response System (MMRS) established a three-phased program against attack with Biological and Chemical agents and Nuclear/Radiological attack. MMRS requires _____ County to be capable to respond to an attack, postulating a small-yield (10 KT) weapon, and/or a Radiological Dispersion Device (RDD; incorrectly called “Dirty Bomb”) that produces: - 7, 500 immediate deaths - 25, 000 contaminated victims (10, 000 acute & 15, 000 moderate) - 100, 000 displaced persons Having and using Fallout Shelters would minimize these casualties. 7

Course Objectives Upon completion of the course, you will be able to: 1. Know what a Fallout Shelter is and how it protects people. 2. List the three principles of radiation protection and how they are embodied in a Fallout Shelter. 3. Know the Duties of a Fallout Shelter Manager and how the Shelter would operate within the _______ County Shelter System. 4. Know how to create a shelter staff and organize the shelter population. 5. Integrate Fallout Shelter & staff operations with medical facility operations. 6. Operate a Fallout Shelter during the three phases of shelter life. 7. Know the importance of an orderly preparation for life in the post- attack recovery period. 8. Describe the emergency, expedient plans for stocking, equipping and upgrading the protection of Fallout Shelters. 8

Duties of the Fallout Shelter Manager 1. Fill the shelter rapidly and orderly to capacity. 2. Protect the shelter against weapons effects. 3. Satisfy basic human needs: Air; Water; Sanitation & Hygiene; Sleep; Food; Psychological and Medical support. 4. Establish a Shelter Organization and Schedule to carry out all activities. 5. Maintain order and uphold the highest social standard of society. 6. Train the shelter population for post-attack living. 7. Keep morale high. 8. Prepare for in-shelter emergencies. 9. Prepare for both temporary and permanent shelter exit. 10. Work with hospital management to continue medical operations. 9

Nuclear Attack in the 21 st Century A nuclear attack may: • be on all major urban, industrial, economic, transport, communications & military targets. • be only on selected targets such as military bases with offensive weapons. • be a single up to a few dozen detonations on specific or random targets. • be on armed forces outside the United States, e. g. the far East; the Mid East; Europe; the Balkans; naval forces at sea or air battles. • be an act by a non-state, i. e. a terrorist group such as Al Qadea. • be threatened to bring about a military or political result or to bend the will of the people. • involve a detonation (fission/fusion) or release via an RDD • involve nations or armed forces other than the United States. • occur all in one attack – or recur over weeks, months, even years. 10

Protective Options Evacuation • • Feasible if completed before fallout/contamination arrives. Area would have to be small and time adequate. Detonation effects (blast/thermal/EMP) may impede evacuation. Evacuees may be exposed and/or contaminated. Shelter In Place • • Critical facilities that can not evacuate, e. g. , hospitals, must continue to operate. Necessary if fallout/contamination will arrive before evacuation complete Fallout Shelters needed to protect against high level radiation/detonation. Shelter-in-place (not necessarily Fallout Shelter) near RDD/very low level. Shelter stay would range from a few days to 2 weeks. Authorities outside affected area can organize rescue/evacuation effort. Shelterees may be exposed and/or contaminated. 11

Protective Options: Critical Facilities Evacuation • Feasible only if all staff and patients/clients can evacuate before fallout/contamination arrives and operations transferred to an alternate facility. Shelter In Place • • • Necessary if operations can not be transferred or if staff & clients can not evacuate. Necessary if needed to support operations of other response agencies. Must have Radiological Monitoring & Exposure Control capabilities Critical Facilities may be used to shelter families of the staff. Critical Facilities will not be used to shelter the general public. 12

Fallout Shelter Management Course Module 1 Public vs. Medical Fallout Shelters 13

Fallout Shelter Management Course The Fallout Shelter is the core of the _____ County Population Protection Program. The mission of the Fallout Shelter Manager: Protect the lives of as many people as possible and assist them to enter the post-attack world well enough in mind and body to begin reconstruction of society. In MMRS Medical Facilities with Fallout Shelter space, enable medical operations during high level radiation conditions. Within the Fallout Shelter, the Shelter Manager works as an extension of city or county government. 14

Fallout Shelter Profile • _____ Co. has more than 150 federally surveyed and approved Public Fallout Shelters. Total capacity is 000, 000+ persons. • MMRS medical facilities - _____have a combined capacity of 00, 000 spaces reserved for medical operations and sheltering of staff, patients and their families, not for public sheltering. • _____ has reserved a few federally surveyed and approved Fallout Shelters for use in Direction and Control, Medical and Recovery operations. Some of these are privately owned. • Hundreds of privately owned Tornado/Fallout shelters exist. • A number of unsurveyed but potential shelters exist that could augment existing federally surveyed and approved Fallout Shelters. 15

Fallout Shelter Program Overview, Cont’d • Fallout Shelters protect against radiation based on the size, mass and location or site of the building and its surroundings. • Fallout Shelters are not intended to protect against other (blast, heat) effects of a nuclear detonation, explosions or Chemical & Biological Agents. Such a capability may exist in a building due to its size, mass & location. • Fallout Shelters are not intended for use after use of a RDD (but may be). • Contamination from a RDD can be expected to cover a few up to a few hundred acres with low-level radioactive material; • A nuclear detonation may affect large areas (10 -100 sq. miles) damaged by direct effects and 100 s to 1, 000 s of sq. miles with radioactive fallout. 16

Principles of Leadership The Shelter Manager must: • • • Assume command rapidly Act with authority Delegate authority Organize people into task teams to meet needs Refrain from personal over involvement with shelterees. Establish priorities Set a schedule Be an example of model shelteree behavior Recognize the changing needs of the shelterees Keep people informed Motivate people • In critical and medical facilities, integrate operations with COO. 17

The Three Phases of Shelter Stay • Entry The time from opening until a routine is established. • Routine A daily living pattern exists along with training & preparation for post-shelter living; medical operations resume. • Emergence The period from when preparations are complete and it is safe to exit to begin work of reconstruction until people can leave shelter permanently. Medical operations expand. 18

Fallout Shelter Areas in MMRS Medical Facilities – 19

Shelter Emergencies The Shelter Manager may be faced with life-threatening emergencies and must plan to cope with them. Examples are: • • Structural damage to the shelter from a nearby detonation. Fire in the shelter. Dangerously high radiation levels. Severely high temperatures and humidity. Oxygen and Carbon Dioxide imbalance in the shelter. Depletion of essential supplies. Disease and injury among staff, patients & families. Unrest, anxiety, crime or defiance of order or authority. 20

The Shelter Manger’s Responsibilities in Radiological Protection 1. Have the Radiological Monitor locate, by use of monitoring instruments, the best protected areas in the shelter. 2. Keep the people in the shelter until outside radiation rates are low enough to leave safely. 3. Keep the shelter, people and supplies from being contaminated. 21

Nuclear Vs. Conventional Weapons Conventional explosives produce - Heat - Blast/Shock and are measured in tons of explosive force. Radiation Dispersion Device, RDD or “Dirty Bomb” - May use conventional explosive to spread radioisotope - Radioisotopes may be placed or spread without any explosion! - No fission involved – just exposure/contamination. Nuclear explosions produce - Heat - Blast/Shock - Initial Nuclear Radiation - Electromagnetic Pulse (EMP) and - Residual Nuclear Radiation or Fallout and are measures in Kilotons (1, 000 s of tons) or Megatons (1, 000 s of tons) of explosive force. 22

Weapon Effects Nuclear Weapons produce effects in a time sequence. In order of occurrence and duration, they are: • • • Initial Nuclear Radiation Electromagnetic Pulse (EMP) Heat Blast/Shock Residual Nuclear Radiation or FALLOUT - less than 1 second - first few seconds - few to 90 seconds - up to 60 seconds - diminishes very rapidly at first, then slowly over. . . hours, days, weeks, years. . . 23

Weapons Effects video 24

Weapon Effects, Cont’d 25

Where does the Energy Go? 26

The Electromagnetic Spectrum 27

Effects Across the Electromagnetic Spectrum 28

Understanding Radiation & Radioactivity • Elements are substances that can not be broken down into simpler substances by chemical means. • There are 116 identified elements; each has unique properties. • An atom is the simplest unit an element can be divided into and still keeps its unique properties. • Atoms which emit ionizing radiation are said to be radioactive. • Ionizing radiation produces charged particles, ions, in anything it strikes. It damages molecules in both living cells and inanimater. • Radiation refers to all sources of energy emissions, such as visible light, radio and sound waves as well as ionizing radiation. 29

Nuclear or Ionizing Radiation 30

Types of Radiation Alpha Particles - Largest, heaviest and most highly charged type of radiation - Least penetrating; stopped by 1 sheet of paper or single layer of clothing. - Range 3 -7 inches in air - Normally, only an Internal Contamination Hazard Beta Particles - Smaller, lighter, faster & less charge than Alpha (equivalent to an electron) - Moderate penetration; about 0. 05” in flesh, about 0. 10” of Aluminum - Range 10 feet in air - Internal more than an External Contamination Hazard 31

Types of Radiation, Cont’d Gamma rays - Least charged - Most penetrating; stopped by dense, thick shielding (e. g. , 8” of lead) - Range 1 mile in air - Both an Internal and External Contamination hazard Neutrons - Ejected from the nuclei of atoms - Very penetrating - Range 3000’ in air - ONLY radiation type that makes other matter radioactive! 32

Biological Injury Caused by Radiation Gamma X Rays 1 “unit” of damage Beta Particles 1 x Neutrons 2 -10 x Alpha Particles 20 x 33

Biological Effects of Ionizing Radiation Level of Biological Organization Important Radiation Effects Molecular Damage to enzymes, DNA, RNA, etc. and interference to biological pathways Cellular Damage to cell membranes, nucleus, chromosomes, etc. Inhibition of cell division, cell death; transformed to malignant state. Tissues & Organs Damage and disruption to intestinal tract, bone marrow, capillaries, thyroid, central nervous system, etc. Cancers induced. Whole Body Radiation ‘Lifeshortening’ & death. Populations Changes in the genetic characteristics of individuals. 34

Radiation Measurement Terms/Units Four measurements used to describe radiation, radiation exposure and the damage it can do to living beings. • Activity (quantity) • Exposure & Exposure Rate (energy) • Absorbed Dose & Absorbed Dose Rate (absorbed energy) • Dose Equivalency & Dose Equivalency Rate 35

Radiation Measurement Terms/Units Activity (quantity) Term: Curie, Ci Measures decay activity and is expressed as disintegrations per second, DPS or counts per minute, CPM. Alpha & beta radiation rates are typically expressed in CPM 1 Ci = 3. 7 billion DPS System International (SI) Term: Becquerel, Bq 1 Bq = 1 DPS (3. 7 g. Bg = 1 Ci) 36

Radiation Measurement Terms/Units Exposure & Exposure Rate (energy) Term: Roentgen, R, R/hr Measures energy of gamma and X-radiation in air. Does not apply to beta or alpha radiation SI Term: Coulomb/Kg, C/Kg/hr 37

Radiation Measurement Terms/Units Absorbed Dose & Absorbed Dose Rate (absorbed energy) Term: RAD, RAD/hr (Radiation Absorbed Dose) Measures energy of any radiation in any mater. SI Term: Gray, Gy/hr 1 Gy = 100 RAD 38

Radiation Measurement Terms/Units Dose Equivalency & Dose Equivalency Rate Term: REM, REM/hr (Roentgen Equivalent Man) Measures energy of any radiation in people. SI Term: Sievert, Sv/hr 1 Sv = 100 REM 39

Real Life Radiation Measurement For our purposes, 1 R = 1 RAD = 1 REM 1 R/hr = 1 RAD/hr = 1 REM/hr Available radiation measuring instruments are calibrated in CPM and R/hr. SI units not used. 40

Naturally Occurring, Long-lived Radionuclides in the Human Body Isotope: 238 U, Uranium 226 Ra, Radium 228 Ra, Radium 210 Pb, Lead 210 Po, Polonium 40 K, Potassium 14 C, Carbon 3 H, Tritium 87 Rb, Rubidium 90 Sr, Strontium Activity, p. Ci (Pico curies) 26 120 50 600 200 130, 000 87, 000 27, 700 29, 000 2, 886 The total radioactivity in the body is 277, 582 p. Ci. - 10, 270 DPS - 887, 374, 138 disintegrations per day Each radioactive decay produces a radiation effect. Sources: Radiation Protection (pages 56, 370), Shapiro, 1990, Harvard Press. 41

Natural Radioactivity in a Bananas are a good source of potassium, a very important nutrient. Natural potassium contains 0. 0117% potassium-40 (40 K) a radioactive isotope. A medium size banana contains about 451 mg of potassium. The amount of 40 K in it is 0. 0528 mg. This is equivalent to 14 DPS or 0. 00037 u. Ci. The dose equivalent from eating a banana is about 0. 01 m. REM, sometimes, this is called the “banana equivalent dose. ” Sources: Food Values of Portion Commonly Used, 16 th edition, Bosen and Church. Chart of Nuclide, F. William Walker et al. 42

Medical effects of radiation video 43

Types of Nuclear Detonations High Altitude Burst Air Burst Surface Burst Subsurface Burst 44

Types of Nuclear Detonations High Altitude Air Burst Surface Burst Subsurface Burst (100, 000’+) fireball does not touch Surface fireball touches surface fireball does not break surface of ground or water. moderate maximized nil maximized minimal Not to scale Heat Blast Shock EMP INR Fallout minimal nil maximized none nil maximized nil moderate nil minimal 45

EMP from a High Altitude Burst 46

EMP from High Altitude Bursts 47

The Reach of 500 KT, 1 MT & 5 MT Weapons Weapon Yield *500 KT 1 MT 5 MT Ground Burst 4 miles 5 miles 8 miles Doubling yield does not double the reach. Air Burst 7 miles 8 miles 13 miles * Average size Russian weapon. 48

Weather Patterns 49

Fallout Pattern -Time/Wind effects 50

Fallout Decay 51

7/10 Rule for Fallout Decay The 7/10 rule approximates decay for a single detonation during any period in its history. For every 7 -fold increase in Time, Fallout intensity decreases 10 -fold. Rate/Time 2800 R/Hr at H+1 280 R/Hr at H+8 28 R/Hr at H+49 2. 8 R/Hr at H+343 Time (0; time starts at H+1) 7 7 x 7 x 7 % Remaining 100% 1%. 10% 52

Expected Effects of Short Term Gamma Radiation Doses Dose, in Roentgens Effect 0 - 50 80 – 170 180 – 220 270 – 330 400 – 500 550 – 750 No obvious effect; lab exam necessary to determine. Vomiting & nausea for about 1 day in 25% of people; no deaths expected. Vomiting & nausea; 50% of people sick; no deaths expected. 100% of people sick; up to 20% deaths. Survivors convalesce 3 months. 50% deaths; survivors convalescent about 6 months. Up to 100% deaths; few survivors convalescent 6+ mos. Radiation Sickness is NOT contagious ~ Victims are NOT radioactive! 53

Principles of Protection Time Fallout radiation intensity decays rapidly; 90% in just the first 7 hours. The less time you spend in a radiation field, the less dose received. Distance The farther you are from a source, the less dose you receive. Shielding Denser (heavier, massive) materials absorb more radiation. Greater thickness of any given material absorbs more radiation. 54

Selecting Fallout Shelter Space 55

Fallout Shelter Space 56

Fallout Protection Factor, FPF = Ratio between the radiation rate OUTSIDE to that INSIDE the shelter. Outside 50 R/hr or 12. 5 R/hr = 4 FPF Inside A FPF of 100 means the inside rate is 1/100 th the outside rate. Example: The nominal FPF of a shelter is 40. What are the inside rates if the outside rates are: Time 1000 1100 1200 1300 1400 2400 Rate Outside the Shelter 1 R/hr 100 R/hr 500 R/hr 440 R/hr 50 R/hr 40 R/hr 57

Fallout Protection Factor, FPF = Ratio between the radiation rate OUTSIDE to that INSIDE the shelter. Outside 50 R/hr or 12. 5 R/hr = 4 FPF Inside A FPF of 100 means the inside rate is 1/100 th the outside rate. Example: The nominal FPF of a shelter is 40. What are the inside rates if the outside rates are: Time 1000 1100 1200 1300 1400 2400 Rate Outside 1 R/hr 100 R/hr 500 R/hr 440 R/hr 50 R/hr 40 R/hr Rate Inside the Shelter 0. 025 R/hr 2. 5 11 1. 25 1 58

Protection Factors & Mass of Materials How Much Protection? PF 2 4 8 16 32 64 128 1000 2000 Lead. 3". 5" 1. 0" 1. 2" 1. 5" 2. 0" 2. 1" 3. 0" 3. 3" Steel. 7" 1. 5" 2. 0" 3. 0" 4. 2" 5. 0" 7. 7" Concrete Earth 2. 0" 3. 3" 5. 0" 7. 0" 6. 5" 10. 0" 9. 0" 14. 0" 1 ft 15. 0" 13. 2" 19. 8" 15. 0" 2 ft 22. 0" 33. 0" 2 ft 3 ft Water 5" 10" 15" 20" 2 ft 2. 5 ft 3 ft 4. 5 ft Wood 9" 15" 27" 3 ft 4. 5 ft - Radiation is reduced on an increasing scale. For example, 1 ft of concrete reduces 800 R/hr 32 -fold to 50 R/hr; 2’ reduces it 2, 000 -fold to. 4 R/hr. (Much better than if proportional & reduction of 64 -fold ensued. ) 59

Possible FPFs in Example Buildings 60

Applying the 7/10 Rule For every 7 -fold increase in Time, Fallout intensity decreases 10 -fold. Examples: It takes fallout 4 hours (H+5) to reach you and maximum reading in the shelter with a PF of 55 at H+5 is 35 R/Hr. • What will the inside and outside rates be in 7 hours (Start Time of H+5 x 1 Factor 7; 5 x 7 or H+35)? • In 10 days, 5 hours (Start Time of H+5 x 2 Factor 7 s; 5 x 7 x 7 or H+245)? • If time of detonation is unknown, plot readings for several hours, then extrapolate forward. 61

Applying the 7/10 Rule For every 7 -fold increase in Time, Fallout intensity decreases 10 -fold. Examples: It takes fallout 4 hours (H+5) to reach you and maximum reading in the shelter with a PF of 55 at H+5 is 35 R/Hr. • What will the inside and outside rates be in 7 hours? • In 10 days, 5 hours (H+245 or 5 x 7 x 7)? • If time of detonation is unknown, plot readings for several hours, then extrapolate forward. 62

Answers: Applying the 7/10 Rule For every 7 -fold increase in Time, Fallout intensity decreases 10 -fold. Examples: It takes fallout 4 hours (H+5) to reach you and maximum reading in the shelter with a PF of 55 at H+5 is 35 R/Hr. • What will the inside and outside rates be in 7 hours? Inside is 35 R/hr÷ 10 = 3. 5 R/hr. Outside; 35 R/hr x 55 = 1925 R/hr • In 10 days, 5 hours (H+245 or 5 x 7 x 7)? Inside is 35 R/hr÷ 10 = 0. 35 R/hr. Outside; 0. 35 R/hr x 55 = 19. 25 R/hr • If time of detonation is unknown, plot readings for several hours, then extrapolate forward. 63

Accumulated Exposures The following readings are taken outside: Time R/hr 0400 0415 0430 0445 0500 0600 0700 0800 0900 1000 1100 1200 Accum. 1 25 100 300 400 168 106 80 68 58 46 40 64

Questions: Accumulated Exposures The following readings are taken outside: • What dose will a person who is outside the shelter until 0500 accumulate? Time R/hr 0400 0415 0430 0445 0500 0600 0700 0800 0900 1000 1100 1200 Accum. 1 25 100 300 400 168 106 80 68 58 46 40 65

Questions: Accumulated Exposures The following readings are taken outside: • • What dose will a person who is outside the shelter until 0500 accumulate? If PF is 40? Time R/hr 0400 0415 0430 0445 0500 0600 0700 0800 0900 1000 1100 1200 Accum. 1 25 100 300 400 168 106 80 68 58 46 40 66

Questions: Accumulated Exposures The following readings are taken outside: • What dose would a person accumulate in the shelter until noon if the FPF is 10? Time R/hr 0400 0415 0430 0445 0500 0600 0700 0800 0900 1000 1100 1200 Accum. 1 25 100 300 400 168 106 80 68 58 46 40 67

Answers: Accumulated Exposures The following readings are taken outside: • • What dose will a person who is outside the shelter until 0500 accumulate? If PF is 40? What dose would a person accumulate in the shelter until noon if the FPF is 10? Time R/hr Accum. 0400 0415 0430 0445 0500 0600 0700 0800 0900 1000 1100 1200 1 25 100 300 400 168 106 80 68 58 46 40 6. 5 R 22 72 160 444 581 674 748 811 863 906 68

Federal Fallout Shelter Standards To meet federal standards, a public Fallout Shelter must have: • • 10 sq. ft. /person with a 3 cfm/person ventilation rate, or 500 cu. ft. / person if unventilated. A Fallout Protection Factor, FPF, of 10 or more and A capacity of 50 persons or more. Other, “best available” (but still federally approved) shelters must offer: • • The same area/volume & FPF characteristics, A capacity of less than 50 persons. 69

_____ County Fallout Shelter Summary _____ County, has ~150 public Fallout Shelters with a total nominal capacity of ~000, 000 persons available for the public. Shelters are divided geographically into 9 groups for administration and mutual support. MMRS medical facilities have XX, 000+ additional places: • MMRS medical facilities are reserved for staff, patients and their families and will not be used as public shelters. 70

Fallout Shelters in MMRS Facilities 71

The Radiological Monitor’s Job The Radiological Monitor, RM, surveys the shelter and reports his findings to the Shelter Manager, SM, to: • Locate the best protected areas of the shelter (highest FPF) • Record the total accumulated dose of the shelter population. • Advise the SM how to rotate shelterees between different areas to equalize exposure to radiation and accumulated doses. • Set time limits for those working outside the shelter (Exposure Control. ) 72

Radiation Levels and Shelter Exit 73

Decontamination, Entering and Leaving the Shelter • After fallout arrives, decontaminate people and supplies by: • • • Brushing Shaking Washing Sweeping particles from shelter entrances Filtering water • Coordinate trips outside the shelter with EMA or your RM. • Set Exposure Limits: Plan the destination, the route, time allowed outside and who can go. 74

Activation of Fallout Shelters • Fallout Shelters may be activated: • • • As a result of escalating international tensions (Increased Readiness) Upon the Attack Warning from the federal government Upon a detonation with no warning • Public instructed to bring water, food, medicine, bedding, etc. with them. • If time allows, the shelters would be staffed and efforts made to stock them with water, first aid kits, sanitation/hygiene supplies and food. • The public enters public shelters only upon the Attack Warning; MMRS Facilities secured, operated as a shelter. 75

Command & Support of Fallout Shelters Emergency Operations Center Executive Group ________ Mayor/ Chairman, _____ County Commission EMA SCH 1 SCH 2 SCH 3 SCH 4 SCH 5 SCH 6 SCH 7 SCH 8 SCH 9 16 Shelters 15 Shelters 22 Shelters 11 Shelters 14 Shelters 24 Shelters 15 Shelters SCH = Shelter Complex Headquarters Number of shelters grouped in each SCH Critical Facilities Medical Law Enf. Fire Rescue Engineering Utilities 76

Upgrading Fallout Protection Increase shielding by: First: Second: Third: Forth: Last: Plan & improvise vents, ventilation & at least 2 entrances. Add wooden supports on each story. Add a maximum of 12” dirt on upper floors/roof. Cover windows & openings with plywood sheets. Pile dirt to ceiling height along outside walls & windows. 77

Upgrading Fallout Protection Increase shielding by: First: Second: Third: Forth: Last: Plan & improvise vents, ventilation & at least 2 entrances. Add wooden supports on each story. Add a maximum of 12” dirt on upper floors/roof. Cover windows & openings with plywood sheets. Pile dirt to ceiling height along outside walls & windows. A shelter to be upgraded is a single story high and 200’ x 200’ in size. It has a 6’ wide double door in front and a 3’ wide single door in back. It is decided to pile dirt 12” high on the roof & 6’ high; 6’ wide at base sloping evenly up to the 6’ mark - around the exterior except at the doors. How much dirt is needed? 78

Upgrading Fallout Protection How much dirt is needed? Is it practical? A shelter to be upgraded is a single story high and 200’ x 200’ in size. It has a 6’ wide double door in front and a 3’ wide single door in back. Dirt is to be piled 12” high on the roof & 6’ high; 6’ wide at base sloping evenly up to the 6’ mark around the exterior except at the doors. • Roof : calculate volume as 200’ x 1’ = 4, 000 cu ft of dirt • Sides: calculate volume using area of triangle x liner feet • 6’ x. 5 = 18 cu ft per linear foot • 200’ + 200’+ 200’ – 9’ = 791 linear feet. • 18’ x 791’ = 14, 238 cu ft • Total volume needed = 18, 238 cu ft or 676 cu yds (56 dump trucks @ 12 cu yd) • Other materials needed: plywood to cover 22 windows & 225 support posts. 79

Fallout Shelter Readiness Operational Readiness means your shelter is ready for use. To do this: 1. Determine what shielding capabilities the structure has. Upgrade the shielding if practical. 2. Integrate Medical Operations & Shelter Operations with Chief Ops Officer. 3. Select, train and assign Shelter Managers and Radiological Monitors. 4. As available, stock shelters with water, sanitation/hygiene & first aid supplies & food plus radiological monitoring instruments provided by EMA. 5. SM fills all shelter staff positions and begin Shelter Team training/functions. 6. Coordinate Shelter Readiness activities with EMA. 80

Improvising Radiation Protection video 81

Attack Warning Signals - Methods • EAS, Emergency Alert System • TV • Radio • NOAA Weather Radio • Outdoor Warning Sirens • Cable & Satellite TV/Radio • Internet, Blackberry, etc. • Pager, PDA, etc 82

Attack Warning Signals Outdoor Warning Sirens • • Attack Warning Signal - a 3 to 5 minute wavering siren means that an actual attack or missile launch against the US has been detected; take protective action immediately. “This signal will be used for no other purpose and will have no other meaning. ” Alert Signal - is a 3 to 5 minute steady siren means “turn on your radio or television and listen for emergency information and instructions. ” This signal is typically used to during Tornado Warnings or other peacetime emergencies such as a Hazardous Material release. 83

Emergency Operations Center • The EOC serves as the seat of government during an emergency. An EOC must have: • Protection from fallout radiation (FPF of 100 recommended; new EOC is ~ 60) • Warning systems to notify the public. The EOC can activate the EAS and has outdoor warning siren coverage of ~80% county population. • Communications with local and state government agencies and with Fallout Shelters through the Shelter Complex Headquarters. (phones, radios & runners) • Trained staff from local government agencies & RACES • Equipment & supplies (if time allows, shelters stocked during Increased Readiness – otherwise everyone brings their own supplies!) 84

Fallout Shelter Management Course Module 2 Organizing for Survival 85

Shelter Organization The Shelter Manager is responsible for organizing shelterees into specialized teams capable of group survival. These teams are: • Leadership Teams • Management (Task) Teams • Groups of people (your families plus patients & their families) • 2. 2 A and 2. 2 A 1 86

Organization at Entry and After. . . At entry, the shelter organization need not be in its final, permanent form since it exists only to meet the requirements of the shelter Entry period. These requirements are: • Security & Traffic teams to screen people coming into the shelter (fill innermost areas first, working back to entrance) and take head count. • Traffic Assistants to aid the Leader & direct traffic. • Security, Medical, Communications, Safety and Sanitation Teams. • Other required team(s), depending on circumstances. 2. 2 B 1 87

Fallout Shelter Manager’s Kit A written plan on how to organize your shelter. 88

Shelter Groups The needs of everyone are met by organizing and exerting leadership through four groups: • Core Management Staff • Task Teams • Community Groups • Advisory Committee 2. 2 Cx 89

Tailoring: Meeting Your Needs The Form your shelter organization will take depends on: • The size of the shelter; • The shape of the shelter and contiguous shelter areas (e. g. separated building wings or floors, etc. ); • Capability of the shelter as limited by its structure (e. g. , an unventilated basement) and its supplies (e. g. , ample vs. scarce water); • Availability of trained people for team positions; • The shelterees themselves; how well they know each other, community spirit, etc. . . • For Critical Facilities – your mission. 2. 2 D 2 90

Shelter Organization Chart (ICS compliant) 91

Relationships Between Shelter Groups Community Groups • The Community Group head is responsible to see that shelterees participate in shelter activities. • In Critical Facilities, these can be workers arranged in their work units. • 2. E 3 -5 92

Task Teams plan and implement activities such as training, feeding, medical care, etc. The Task Team Chief is responsible to assign, train, schedule & supervise members of his team. He is responsible for members while they are on duty with the team. Considerations for team assignments: • • • Assign off-duty staff Reunite family or friends Rotate assignments or unpleasant tasks Give variety to the routine Gain better cooperation Give it a rest! • In Critical Facilities – to accomplish the mission. 93

Sample Daily Schedules 94

Registration is the best means for obtaining information to: • Identify & define skills & talents among the shelterees (in addition to job skills. ) • Provide data for assigning people to Task Teams & Community Groups. • Aid in reuniting families, return of personal property & taking the shelter census. • The Administrative Team keeps shelter records. At entry, get only the essential information; wait for a more appropriate time to complete Registration Forms. • In Critical Facilities, spouses, children, relatives & friends of employees must be expected, accommodated and organized! Put them to use! 2 F 95

_____ Department of Human Resources Form EWS-1 96

Shelter Staff Identification The Shelter Manager and his staff should be identified by some distinctive method. People will instinctively look to you for help & direction. • Such distinctive methods include labeled headgear, vests or armbands. Labels are included in the Shelter Kit. • Individual Shelterees should be identified by a name tag or improvised label. This helps break the ice and makes it easier for people to work together. • In Critical Facilities, the Shelter Manager may be the Director or the function may be delegated. 2 FB 97

Organizing Shelter Resources 1. Centralized supply management. 2. Decentralized Supply Management Functional Area 3. Combined Supply Management 2 G 98

Managing Shelter Supplies Sources of Supplies: • Supplies normally kept in the building • Supplies belonging to and brought in by shelterees • Supplies stocked during Increased Readiness • Improvised supplies • External sources, when safe 2. H 23 99

Managing Shelter Supplies, Cont’d Inventorying Supplies: • The Shelter Manager should inventory all supplies and materials as soon as possible after entry. • Prepare to ration supplies for a 14 day stay • Develop multiple uses for supplies & materials 2. H 23 100

Managing Shelter Supplies, Cont’d Distributing Shelter Supplies: 1. 2. 3. Fixed Point method Moving Point Method Combined method 2. H 23 101

Shelter Records - 1 A Shelter Log is kept by the Administrative Team to record: 1. 2. 3. 4. 5. Changes in vital statistics: census; births & deaths Medical events & treatments Serious violations of Shelter Rules Major management decisions Daily summary of shelter status & problems 2. I 4 -6 102

Shelter Records - 2 A Communications Log is Kept by the Communications Team 1. All messages are entered in the log. 2. Keep separate logs for Incoming and Outgoing messages. 103

Shelter Records - 3 Medical records are kept by the Medical Team 1. Record the names of those with medical problems, their symptoms, medication & treatment. 2. Deaths and circumstances are recorded 104

Shelter Records - 4 A Supply Status Summary is kept by the Supply Team: 1. Record the Inventory of all Shelter Supplies 2. Provide a running account (e. g. at end of each day) of all supplies. 105

Shelter Records - 5 A Radiation Monitoring Log is kept by the Radiological Monitor 1. Enter shelter survey dose rates, best protected area and FPF data. 2. Enter readings, by area on radiation levels & accumulated exposures. 3. Record the daily and accumulated dose for each shelteree. 106

Shelter Records - 5 A Survey Shelter Meter Reading Chart (add chart) Video - Using Radiological Instruments in a Fallout Shelter 107

Management of Private Property • Bulky items should be excluded to save space; store in non-shelter areas. • Pets should be excluded from the occupied shelter area for sanitation & safety reasons BUT may be put in surplus shelter areas or non-shelter areas. Alternate: leave pets in cars • Care & feeding by owners should be allowed & encouraged. • Encourage the donation of personal items if they help achieve the goal of group survival. • Drugs, alcohol and weapons can be viewed positively as survival supplies rather than as dangerous or personal possessions. 108

Private Property, Cont’d Personal items that may be useful include: Beverages Gloves Pens & pencils Utensils Cleaners Batteries Towels Notebooks Cell phones, Blackberries Knives Radios, DVDs, i. Pods Flashlights Laptops, PDAs Nails, nuts & bolts Shovels Axes Games Hammers Tools Diapers Bedding Clothing Medicine Rope, wire, string Books Toys Soap Food What’s in your car? 2. J 109

Social Control in a Shelter Hint: This Is the Most Important Concept in This Course! Every society has rules. Social Control is the way the group makes, communicates & enforces these rules. The Shelter Manager must develop a plan for shelter living containing a Schedule and set of Rules encompassing all shelter activities. This plan must be presented to and accepted by the shelterees! The Advisory Committee is the key to success. The Advisory Committee, made up of mature, grounded individuals selected from the Community Groups, can be a focus of feedback from the Community Groups - and a source of information to the groups. The Advisory Committee can exert calm, purpose, leadership, persuasion, morale building & moral authority, etc. to support the Manger. 110

The Importance of Social Control The Shelter Plan evokes confidence & a sense of security among shelterees by assuring them the highest standards of society will govern their stay. It also makes the future somewhat predictable by showing what they must do to increase their chances of survival. • 2. K. 111

Establishing Shelter Rules Every aspect of shelter living should be governed by rules, including: 1. Entering and leaving the shelter. 2. The use of all equipment and tools. 3. All daily activities: meals; recreation; sanitation, sleeping. . . 4. Potential troublesome behavior: fighting, quarreling, gambling; gang activity; alcohol or drug use; smoking, sexual behavior, etc. 2. L. 1 112

Developing Shelter Rules 1. Develop rules early, in advance of a problem. Proactive is much better than reactive. 2. Some rules may be elective, others prescribed. 3. Determine if a rule fulfills its intended purpose. 4. Coordinate rules so they don't conflict. 5. Make only necessary rules. If it ain’t broke. . . 2. L. 2 113

Maintaining Order in the Shelter • Identify and respond to potential problems before a rule is broken. • Evaluate the seriousness of a rule violation. • Corrective action should be in proportion to the offense. Reproof Physical Restraint Counsel . Arrest • Make clear you are concerned with group survival, not punishing one individual. • Violent responses or expulsion from the Shelter are not recommended. • If restraint is warranted, wrap person in sheets & bind with belts, rope, etc. and set a 24/7 watch on him/them in a isolated, secure area. 2. M 114

The Shelter Schedule The schedule should be developed by your core management staff as soon as possible after Entry. Guidelines: 1. Limit activities to an hour or less because of reduced attention span & fatigue. 2. Spread activities throughout the day for variety. 3. Schedule training when shelterees are most alert. 4. Allow daytime nap & rest periods. 5. Provide several snack breaks. 2. N. 1 -2 115

Shelter Schedule - 1 Shift 116

Shelter Schedule - 2 Shifts 117

Fallout Shelter Management Course Module 3 Managing Critical Resources 118

Atmosphere and Temperature Three goals of the Shelter Manager: 1. Maintain the temperature of the shelter within survival limits. 2. Control critical components in the atmosphere. 3. Control potentially lethal or noxious substances. 3. A 2 -3 119

Atmosphere and Temperature - 2 Air exchange is by means of: 1. Natural ventilation 2. Forced ventilation 120

Effective Temperature, ET ET is a measure of temperature, humidity and air movement combined. • People are much more comfortable at high temperature with low humidity and air movement than in high humidity or still air. • ET may greatly lower the shelter capacity - far, far below nominal capacity! 121

Managing Effective Temperature in a Shelter • One average size male produces 70, 000 calories/hour or 288 BTU/hr at rest. One hundred average-size males can produce 28, 800+ BTU/hr. • The output of the average home heating system is 30 -40, 000 BTU/hr. In a shelter, people are allotted space at the rate of 10 sq. ft/person; 100 people in 1, 000 sq. ft. Imagine the constant heat output of the average house in 1/2 its volume! -Where does the excess heat go? -How does it affect people? -How do you manage it? • Heat build up will be tremendous in areas with restricted airflow! Comfort↓ Fatigue↑ Irritability↑ Health↓ Heat stroke & death possible. 122

Zones of Equal Ventilation Rates in CFM per Person for 90% Reliability of Not Exceeding 82 o ET 123

Capacity Vs. Temperature & Ventilation • Federal Fallout Shelter Standards for ventilation = 3 cfm/person ventilation rate, or 500 cu. ft. / person if unventilated. • Higher than optimum Effective Temperature can lower shelter capacity to the number of shelterees that do not produce excess temperatures. • Lower than optimum ventilation can lower shelter capacity to the number of shelterees that don’t exceed O 2 or CO 2 imbalance. If you must reduce the number of people in your shelter, where will you send them? 124

Effective Temperature Ranges The range of comfort for Effective Temperature: 50 E ET Lower tolerance level if food & clothing available 67 -72 E ET Normally the most comfortable range 78 -85 E ET Tolerable, even for long periods 85 -90 E ET Heat stress progressively worsens >95 E ET Circulatory system collapse, death. 125

Temperature Control high temperatures by: • • • Avoiding heat producing activities Utilize the initial coolness of the shelter Ventilation Control low temperature with: • • Warm food & beverages Body coverings Physical activity Bundling 126

Ventilation Techniques 127

Kearny Fan 128

Oxygen/Carbon Dioxide Imbalance O 2 Content: 21% is normal. 14% is threshold of danger. 8% is fatal. CO 2 . 03% is normal. 2 -4% 10% 15 -30% N 2 H 2 O 78. 4% varies - typical example Symptoms: Nails & lips blue Vision Impaired Reflexes slow Giddy Unconsciousness Death Deep breathing Nausea Uncoordination Unconsciousness Diminished respiration Blood pressure falls Coma, Death - Inhale 21% Exhale 15. 3% . 03% 3. 5% 78. 4% 75% 0. 75% 6. 2% 3. A 12 -13 129

Noxious Substances Gas: Source: Symptoms: Carbon Monoxide Engine exhaust Tobacco smoke Open flames Flushed, ruddy skin Poor balance Faint Unconsciousness Death Methane , CH 4 (Explosive!) Decomposing human waste Combines with 02 to deplete 02 supply. Other gasses, fumes, vapors Cleaning agents Solvents Degreasers Batteries Fire Extinguishers, etc. Dangerous in a closed, poorly ventilated shelter 130 3. B 1 -2

Water Three goals of the shelter manager: 1. Control the use & distribution of water. 2. Secure & make drinkable alternate water sources 3. Control water consumption. • 1 Quart of water/day/person is the recommended ration. • This is below what people normally need but is acceptable as an austere ration when: • • Temperature and humidity are close to optimum, Physical activity is restricted, Salty or protein rich foods are eliminated, and Disease/injury that increase the need for water are absent. 3. B 1 -2 131

Water-2 Water is essential for life. When deprived of water, the physical damage to the body becomes irreversible; after 4 or 5 days without, water will not help a person recover. • Symptoms of water deprivation are: 1. 2. 3. Impaired mental function, Confusion, and Hallucination 3. B 1 -2 A 132

Water - an Essential Need Trips outside the shelter to get water before radiation levels are safe must be considered. Control of shelterees may be difficult if the water ration is very low or if they feel distribution is unfair or unwise. • Sources of Water: 1. 2. 3. 4. Containers issued during Increased Readiness. Water system of the shelter building. Juice in canned foods. Water mains, fire hydrants, wells, streams, ponds, etc. The water may have to be purified, filtered or decontaminated for biological organisms & hazardous chemicals. Fallout is nearly insoluble in water & is easily filtered out with, e. g. , a towel. 133

Water Rationing "An Equal Amount For All” is generally the best rule. Exceptions: 1. Team members involved in strenuous physical activity. 2. Diabetics, burn victims, the injured, etc. 3. Infants, nursing mothers, etc. 3. B 8 -9 134

Water Rationing - 2 • Serve at regular intervals, up to 6 times a day. • If practical, keep a "water log" for each individual to allow more flexibility in rationing. • Issue each individual a drinking cup; mark it keep it in a safe place to use for the entire shelter stay. • Restrict the use of water for other purposes such as hygiene, sanitation, fire fighting or decontamination. 135

Safety Three goals of the shelter manager: 1. Be able to meet such environmental emergencies as: Fire, toxic fumes, smoke, & oxygen depletion Structural damage Panic among the shelterees 2. Organize a safety program. 3. Prepare shelterees to respond to emergencies. 3. C. 1 -3 136

Safety - Entry Phase At entry, inspect the building - both shelter & non-shelter parts - to eliminate fire hazards; to gather fire extinguishers, tools and others materials and to gain a knowledge of the building layout. 3. C. 1 -3 A 137

Safety - Routine Phase: Preparing Shelterees • Emphasize the importance of fire prevention. If necessary, restrict smoking and use of flammable materials. • Organize able bodied shelterees to upgrade the shelter. • Set up a 24 -hour fire watch. Inspect the shelter for: • Exposed wiring • Dangerous Machinery • Oxygen containers, first aid kits, foodstuffs & other usable items, etc. • Flammable, volatile substances and other hazards, etc. • Fire exits • Drill shelterees in evacuation procedures 3. C. 1 -3 B 138

Fire Extinguishers Preferred types: - Dry chemical - Sand - Water Oxygen Î Fuel Heat Types to avoid: - Carbon dioxide - Halon systems (Oxygen displacing) - Carbon tetrachloride (Halon 104; now illegal ) - Bromotriflouroumethane (Halon 1301) - Soda Acid (now illegal but may be in older buildings) 139

Food Three goals of the shelter manager: 1. Control and distribute food. 2. Keep food edible. 3. Meet the special needs of infants, the elderly, the sick and the injured. 140

Sources of Food • Food may be stocked during Increased Readiness from commercial suppliers. • Food may be brought by people entering the shelter. • Some food may already be in the shelter building. • Rationing may be required; a shelter census, an inventory and the estimated length of shelter stay are necessary. • Hold some food in reserve for the unexpected: spoilage, overcrowding or a longer than expected stay. 141

Food Rationing • “An equal portion for all” is again generally best. The same exceptions in water rationing may apply. • Meals should be served on a regular schedule, 5 or 6 times a day in conjunction with the water serving. • Be flexible: if possible, keep a food account for each individual. 142

Food Preparation Problems • Extra water needed for preparation & cleanup. • Procedures needed for cleanup, garbage disposal & spoilage prevention. • Some foods may need to be heated. • Individual utensils will be required. • Feeding may have to be done in shifts. 143

Sleep Three goals of the Shelter Manager: 1. Designate a sleep area, group & position the people. 2. Provide bedding and other equipment. 3. Control nighttime disturbances, etc. 144

Sleeping Arrangements • A single shift for sleep is best. • Have designated sleep period (s) and control other activities. • Partition or isolate the sleep area from the rest of the shelter. • Group sleepers on the basis of marital status, age and sex. • Position sleepers head-to-toe. 3. E 3 -7 145

Sleeping Arrangements 146

Sanitation Three goals of the Shelter Manager: 1. Provide an adequate number of toilets (& TP). 2. Maintain shelter cleanliness. 3. Allow those personal hygiene activities that can be permitted. 147

Sanitation Considerations. . . 1. Isolate the toilet area from all other areas and, if possible, near an exhaust vent to control odors & fumes. 2. Establish these guidelines to insure fire safety, good health, hygiene and high morale: • • Remove trash & garbage from the living areas ASAP. Hold regular cleanups, especially after each meal. Devise secondary uses for reusable items. Do not use water for cleaning or hygiene unless the supply is unlimited and humidity no problem. 3. F. 148

Medical Four goals of the Shelter Manager: 1. 2. 3. 4. Establish a medical capability. Integrate that capability into the facility. Detect sickness, injury & other medical problems. Treat those sicknesses and injuries. Set up a preventive medicine program. 3. GI 4 A 149

Medical Supplies • Hospitals/clinics have extensive array of medical supplies. • Some public shelters will have First Aid supplies already there. • Some supplies, such as bandages, can be improvised. • Some shelterees, such as diabetics, can be expected to bring their own medicines and may share them. • First Aid supplies may be distributed in Increased Readiness. 3. GI 4 B 150

Managing Medical Supplies • Medical supplies should be controlled and distributed by one specific member of the Medical Team. • Keep medicines under a 24 -hour watch; keep a running inventory. • Give only the immediate dosage. See that all medicines are taken on the spot, in the presence of the Medical Team. • Record each patient's medication in the Medical Log. 3. GI 4 C 151

Medical Staff Identify those with a medical background at Registration. Assign them based on qualifications. There is no plan to send doctors, nurses or EMTs to shelters. 3. GI 4 D 152

Medical Operations A separate "sickbay" should be created and isolated from the Medical Team examination, diagnosis & treatment area. This isolated sickbay: 1. Allows easier & better care. 2. Reduces the spread of contagious diseases. 3. Reduces the demoralizing effect of sickness on the rest of the shelterees. A system for detection & diagnosis should be instituted: 1. At entry; screen shelterees by trained medical staff as available. 2. After entry; “sick” persons report to the examination & treatment area. 3. Daily; at a scheduled “Sick Call. ” 4. Daily; with medical rounds throughout the shelter medical continued. 3. GI 4 E 153

Medical Priorities Treat all shelterees who have medical problems. But, if there are not supplies or medical staff to give everyone attention, then the Shelter Manager must establish a system of priorities. . . Such a system of priority treatment already exists and can be adapted to the fallout shelter. The system is called Triage (French "to Sort”). Triage categories, in order of treatment priority, are suggested: • Immediate treatment will save life. • Delayed Non-life threatening injury; treatment can wait. • Expectant Mortally wounded; treatment will not succeed. • Dead Set aside until burial/disposal can be arranged. 3. G 2 -13 A 154

Medical - Mortuary In event of death: • Record the death & the circumstances in the Shelter Log • Give personal effects to the family or store them • If the family requests, hold a simple religious ceremony • Attach durable identification to the body, wrap it securely and remove it from the shelter area. • Protect against vermin/scavengers • Consult with the EOC before burial. EOC will arrange collection when safe. 3. 6 155

Incidence of Illness in The Population Chronic Conditions Percent Afflicted Arthritis and Rheumatism Asthma and Hay Fever High Blood Pressure Heart Conditions Diabetes Chronic Bronchitis Peptic Ulcer Diabetes Pregnancy Epilepsy 25 -39 (of adults) 12 11 7 5 3 2 2 2 0. 5 Acute Illnesses in 3 -month Period Percent Afflicted Respiratory Ailments, Winter Respiratory Ailments, Summer Infective and Parasitic Diseases, Winter Infective and Parasitic Diseases, Summer Digestive Ailments Other 47 15 7 5 3 16 156

Light and Power Three goals of the Shelter Manager are: 1. Insure as many portable auxiliary lighting devices are brought into the shelter at entry as possible. 2. Control the use of emergency power should normal power fail. 3. Provide sufficient light in each different shelter area for each particular shelter task. 157

Sources of Emergency Lighting • • • Auxiliary generators. Battery powered lighting. Non-Electric lighting. If insufficient lighting exists, this means periods of planned darkness. 3. H 145 158

Communications The three goals of the Shelter Manager are: 1. Establish a capability for both in-shelter and external communications. 2. Have regular briefings with the shelter population 3. Allow shelterees to communicate with you 3. I 1 -6 A 159

In-shelter Communications • Megaphone • Written notices "broadsides" • PA system, intercom etc. • “Town Cryer” 3. I 1 -6 B 160

External Communications • Telephones/cell phones • Two-way radios • Messengers, once it Is safe 3. I 1 -6 C 161

Communications Coming Into the Shelter 1. Emergency Alert System (EAS) radio on AM & FM bands 2. NOAA Weather radio 3. Emergency Operations Center (EOC), or 3. Shelter Complex Headquarters (SCH), or 4. Other shelters. 5. Functioning cell phone, pager, wireless internet & other systems, etc. 162

The SM's Role in Evaluating Messages The Shelter Manager must evaluate all incoming messages & decide when and how to pass the information on to the shelterees. The Shelter Manger probably will not have a monopoly on all information coming into the shelter if cell phones or radio/TV service exists. Shelter Manager will get information from EOC to enable him to counter rumors & false reports. Information available to the Shelter Manager pertaining to shelter living, even if incomplete, should not be withheld. Only technical or other incidental data should not be relayed. 3. I 163

Communicating With the Shelter Population Entry: Tell people where to go in the shelter, what to do and reassure them about its protective capability. Traffic Assistants and/or early briefings can accomplish this. Routine: Hold regular briefings, at least once a day, to update shelterees. Relay at once emergency information or that requiring immediate action. Use a prearranged signal (e. g. whistle) to get attention. For routine messages, use the chain of command & group sessions. Emergence: Continue briefings: emphasize the importance of returning to the shelter to eat & sleep, etc. , until it is safe to leave permanently. 164 3. I 9

Training The Two goals of the Shelter Manager: 1. Establish a training program. 2. Motivate the shelterees to participate. The training should: • Provide shelterees with factual information about their current status and what is likely to occur in the future. • Teach person how to do his job on a Task Team and how to get along with other shelterees. • Prepare the people for survival in the post-attack world. 165

Guidelines for Training Course content should be meaningful and useful. • Keep a slow pace; use short, 30 -minute sessions, and plan to use the estimated length of shelter stay. • Encourage shelteree participation; vary training methods • Training priorities: 1. Core management and Task Teams 2. Shelterees, on rules & procedures 3. Shelterees, on post-attack living 4. Children with normal education. • Begin training sessions after the shelter is organized. the schedule is working and the Training Team selected and prepared. 3. JA 166

Psychological Support The two goals of the Shelter Manager: 1. Help alleviate mental anguish. 2. Prevent problems from becoming overwhelming. Psychological support makes positive use of the basic human instinct for self preservation. 3. KA 167

Sources of Psychological Support • Effective management builds confidence & trust. • Sympathetic & friendly interaction with others. • Goal oriented behavior. • Use of psychological first aid to treat maladaptive responses. 3. KB 168

Psychological First Aid • Psychological first aid is the immediate support given to persons in emotional trouble. • The basic technique is a relatively brief (10 minute) personal interview. • The purpose of the interview is to: • Permit problems to be expressed. • Provide reassurance. • Identify potentially dangerous persons. • Identify useful skills which the person can put to use after he is sufficiently recovered (i. e. , engage their mind & channel worry into purposeful work) 169

Specialized Psychological Support • Children - Tend to imitate the behavior of adults to reduce their own emotional stress. • Elderly - May be confused; difficult to accept reality of the attack; rigid in their views. 170

Service, Religious & Recreational Activities The goal of the Shelter Manager: Develop organized, voluntary efforts to: 1. 2. 3. 4. 5. Reduce fear, grief, & anxiety. Break down barriers to develop team spirit. Pass the time more quickly. Give comfort & strength through religious devotions. Make people feel they are giving a worthwhile contribution 3. L 171

Service Activities • Caring for children. • Caring for the elderly. • Caring for the sick and Injured. • Improving the safety or appearance of the shelter. • Improvising games, toys and other pastime materials. • Making bedding, dividers, furnishings, utensils, etc. • Making/sharing communications modes • Mac. Gyver, anyone? 3. LA 172

Religious Activities • Should be held only at the request of the shelterees. • Services may be denominational or nondenominational or individual prayer and meditation as determined by shelterees. • Space and time should be made available for these important activities. 3. LB 173

Recreational Activities These are limited only by space, Effective Temperature, food and water constraints. Examples are: • Physical fitness activities, aerobics, exercises, calisthenics, isometric exercises, etc. • Arts & crafts. • Group games, singing, story telling, skits, plays, talent shows, etc. 3. LC 174

Shelter Exit - the Temporary Phase 1. Shelter Related Work • • Removal of waste and garbage. Burial/removal of the dead. Relocation of the sick and injured to hospitals. Transfer of problem shelterees to authorities. 2. Shelter Supplies: Restock or Resupply • • • Water & food Sanitation & hygiene supplies Medicine, etc. 3. Recovery • • Damage surveys/repairs Radiation surveys around the shelter. Calculate projected safe exit time for general exit Restoration of essential community services. 3 M 175

Exit - Permanent Phase • Purpose of the shelter shifts from protection to housing and feeding. • Activities turn from shelter living to reconstruction & "normal" life. • Phase lasts until people can live at home or in some other permanent housing. • Expand living space to allow comfort & privacy. • Shelter Staff will reorganized: • • • Some Task Teams no longer needed; others expanded. Shelter Manager fills vacancies as turnover occurs. Shelter records must be accurately kept. 176

Exit - Permanent Phase, Cont’d 1. Shelter buildings: • The non-shelter part may be returned to its original use. • EOC will notify you when to close the shelter: • Relocate remaining shelterees to other facilities. • Dispose of remaining supplies. • Clean the area. 2. Return all records to the EOC. 3. Release the Shelter Staff. 3. N. 177

What Next? • Size up your building. Find the shelter areas. What is in them? Where, how, would you move the contents? • Sketch shelter areas and non-shelter areas on a floor plan. What nonshelter areas would be most useful? Where would the toilets go? • Decide what parts of your shelter you'd allocate for the community groups and which parts for the staff. • Plan how to ventilate areas with poor air flow. • Plan how the building should be upgraded. Mark areas where there is no shelter and where upgrading is not required. Calculate materials needed. • Recruit other interested persons to serve in management and task team positions. Explain the job to them. Call EMA for answers to their questions. 178

Fallout Shelter Management Course for MMRS Medical Facilities 179

Source References • Nuclear Files http: //www. nuclearfiles. org/ • Oregon Institute of Science and Medicine http: //www. oism. org/oism/s 32 p 25. htm • Federation of American Scientists Threat Analysis http: //www. fas. org/irp/threat/wmd. htm • Nuclear Threat Initiative http: //www. nti. org/ • The American Civil Defense Association http: //www. tacda. org/ • How Nuclear Bombs Work http: //www. howstuffworks. com/nuclear-bomb. htm • FEMA http: //www. fema. gov/hazard/terrorism/nuclear/index. shtm 180