A mass casualty incident of infectious diseases at the port of Hamburg: an analysis of organizational structures and emergency concepts

Abstract

BACKGROUND The project “ARMIHN” (Adaptive Resiliency Management in Port) focuses on strengthening the capability to act in a mass casualty incident (MCI) due to an outbreak of infectious diseases (MCI-ID). In addition to the current threat from the COVID-19 pandemic and associated outbreaks on cruise ships, an MCI-ID can also be caused by pathogens such as Influenzavirus or Norovirus. The first step was, to get an overview of processes and resources using the example of the Port of Hamburg, and to show the relating interaction of involved parties. This will serve as a basis for developing an operational strategy and offers the opportunity to optimize current work processes. METHODS A selective literature research using specified key words was performed and existing MCI concepts were received from local authorities. Identified structures and processes were analyzed in a multiple step process and also brought together through discussions in workshops with involved organizations and other experts. Additionally, the distances between the nearest rescue stations and selected hospitals from the Port of Hamburg were analyzed. RESULTS The current available concepts are proven, but an adaptation to an MCI-ID shows opportunities for a further cross-organizational development. The organizational structure of an MCI-ID in the Port of Hamburg was described, including a large number of involved organizations (n = 18). There are 17 involved fire and rescue stations and the port can be reached from these locations within 6 to 35 minutes. Based on their specialist expertise, 14 of the 31 listed clinics were selected. CONCLUSION Based on identified existing structures and the determination of medical resources, an operational concept for an MCI-ID in the port can be adapted and can contribute to enhanced coping with this situation. Subsequently, the derived operational concept will be tested for practical suitability in several exercises within the present project.