Lessons Learned From Implementing an Incident Command System During a Local Multiagency Response to a Legionnaires’ Disease Cluster in Sydney, NSW

Abstract

The incident command system (ICS) provides a common structure to control and coordinate an emergency response, regardless of scale or predicted impact. The lessons learned from the application of an ICS for large infectious disease outbreaks are documented. However, there is scant evidence on the application of an ICS to manage a local multiagency response to a disease cluster with environmental health risks. The Sydney Local Health District Public Health Unit (PHU) in New South Wales, Australia, was notified of 5 cases of Legionnaires' disease during 2 weeks in May 2016. This unusual incident triggered a multiagency investigation involving an ICS with staff from the PHU, 3 local councils, and the state health department to help prevent any further public health risk. The early and judicious use of ICS enabled a timely and effective response by supporting clear communication lines between the incident controller and field staff. The field team was key in preventing any ongoing public health risk through inspection, sampling, testing, and management of water systems identified to be at-risk for transmission of legionella. Good working relationships between partner agencies and trust in the technical proficiency of environmental health staff aided in the effective management of the response. (Disaster Med Public Health Preparedness. 2018;12:539-542).

From Uncoordinated Patchworks to a Coordinated System: MERS-CoV to COVID-19 in Korea

“…With the ICS, either a single incident commander or a unified command is designated to manage the emergency, depending on the disaster’s boundaries and the response needs (FEMA, 2017). For example, during a regional health epidemic, a state health department may be sufficient to serve as a single incident commander to coordinate multiagency response efforts at many local areas within the disaster region (Kirrage et al, 2007; Quinn et al, 2018). As a crisis expands to a larger scale, the demand for a more competent incident commander or even a unified command will also increase.…”

Factors affecting hospital response in biological disasters: A qualitative study

“…It also explains responsibilities clearly leading to appropriate response (90). The effectiveness of this system has been indicated in outbreaks of infectious diseases (91,92). If the response to biological emergencies will be designed as a systematic approach, it would lead to faster response by establishing coordination, speed of communication, recalling staff, etc.…”

“…This adaptation could include selection of specialized infectious and epidemiologic consultants, proper planning, operations based on infection control requirements, treatment and care, and other requirements for managing biological crises. In addition, matching these systems with biological emergencies can speed up the response by increasing external and intra-organizational coordination of multiagent organs (91).…”

Lessons Learnt From Exercise Celestial Navigation: The Application of a Geographic Information System to Inform Legionnaires’ Disease Control Activity

“…In May 2016, the Sydney Local Health District (SLHD) initiated a Legionnaires' disease cluster investigation, 5 and one of the key lessons from this investigation was the need to train staff and develop and implement standard processes for use of GIS in the control of infectious disease outbreaks. 6 SLHD PHU developed a desktop exercise to test the capability of NSW PHU staff in using GIS to inform an outbreak investigation (using the SLHD Legionella cluster as the example). Eleven staff members from 4 PHUs in metropolitan Sydney, NSW, participated in the exercise, held over 2 half-days on April 27 and 28, 2017.…”

“…Despite the growing use of GIS globally, 3 there is no common system, process, or guideline that Public Health Unit (PHU) staff in New South Wales (NSW), Australia, can use to inform Legionnaires’ disease control activity. In May 2016, the Sydney Local Health District (SLHD) initiated a Legionnaires’ disease cluster investigation, 5 and one of the key lessons from this investigation was the need to train staff and develop and implement standard processes for use of GIS in the control of infectious disease outbreaks 6 . SLHD PHU developed a desktop exercise to test the capability of NSW PHU staff in using GIS to inform an outbreak investigation (using the SLHD Legionella cluster as the example).…”