In a prior post, I made reference to a study completed by the IBM Centre for the Business of Government, Adapting the Incident Command Model for Knowledge-Based Crises. That report drew on lessons learned during prior pandemic responses, including the 2002 outbreak of West Nile Virus and the 2003 outbreak of Severe Acute Respiratory Syndrome (SARS).
The 2003 outbreak of SARS saw the U.S. Center for Disease Control and Prevention (CDCP) rely on a team-based approach composed of subject matter experts in nine areas, with additional teams added on an ad hoc basis. Notably, this structure did not incorporate the ICS principle of “span of control” (the number of personnel to be supervised by a manager), and the scope of the leadership team increased to 15 teams, plus several ad hoc groups. In essence, “the CDCP viewed its emergency operations staff as filling an advisory role rather than a leadership role during the [2003 SARS outbreak] crisis.” (Ansell and Keller, 2014).
During the SARS response, the average staffing level (span of control) was 18. Learning from the challenges experienced as a result of the scale of the outbreak led the CDCP to incorporate ICS during its response to Hurricane Katrina in 2005. However, the lack of training throughout all parts of the CDCP led to organizational confusion. My colleague Timothy Riecker has written extensively on how the current ICS training curriculum can be improved, with a focus on application as opposed to rote theory-based learning.
Fast forward to the 2009 H1N1 pandemic response. In the second phase of the 2009 H1N1 pandemic response, the CDCP incorporated a number of key changes to the traditional ICS model:
- The role of the Incident Commander has been relegated to a supporting role to the CDCP Director, a position appointed by the U.S. President.
- Two roles, the Chief of Staff and the Deputy Incident Manager were created – reporting to the Incident Manager.
- The operations, planning, logistics and finance/administration functions reported to a Chief of Staff rather than to the Incident Manager (IM).
- The technical specialty unit, (traditionally a part of the planning section), formed the core of the incident management structure, reporting to the IM. These five “task forces” were Epidemiology/Lab, Community mitigation, Medical care and countermeasures, Vaccine and State coordination.
- A plans decision unit was created, under the direction of a Deputy Incident Manager in order to “vet” incoming information. A “B” team was also added to provide a second set of eyes in vetting CDCP decisions.
- A joint information center was elevated. Managed by the Deputy IM, the role of information center was expanded.
- The policy unit was created
As I have written previously, in my view ICS does not require adaptation, and can scale to any scenario. Having said that, I believe it is worth examining alternate approaches to continually refine and perfect our field.
While I have a number of critiques of the changes incorporated by the CDCP, I am particularly interested to hear your thoughts. What changes would you keep (if any?)
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