Civil Unrest, Security, Mass Casualty Preparedness, and Law Enforcement Coordination Resources

June 3, 2020

With increasing protest activity and civil unrest stemming from the death of George Floyd in Minneapolis impacting cities and communities across the tri-state area, GNYHA is sharing a number of resources that may help facilities prepare for current and potential impacts. These include breaches of the hospital’s footprint impacting hospital security, staffing problems if employees are unable or unwilling to get to work, and the need to care for victims injured during protest activity and civil unrest, or from violent acts perpetrated by individuals taking advantage of this chaotic situation.

Information for New York City Facilities

For facilities located in New York City, Mayor de Blasio has extended the curfew through the evening of Sunday, June 7. The curfew is expected to be in effect from 8:00 p.m. each evening to 5:00 a.m. each morning. Essential workers, including health care workers, are exempt. Hospital staff who must travel during these hours should be instructed to carry hospital identification and identify themselves as essential personnel if stopped. GNYHA did conduct a brief Sit Stat 2.0 survey with New York City facilities earlier today to understand current operational impacts and proactive measures being taken. This information will inform GNYHA and agency actions.

Relevant GNYHA Resources

GNYHA’s Mass Casualty Incident (MCI) Response Toolkit is designed to help members develop and improve their mass casualty incident response plans. It includes suggested preparedness and response actions for the many clinical and non-clinical departments that would be involved in an MCI response.

GNYHA’s Hospital Coordination with Law Enforcement: Hospital Guidance Document was developed with the New York City Police Department (NYPD) and addresses coordination with law enforcement and investigative agencies in a number of scenarios. While this tool was developed with the NYPD, much of the information is applicable to other jurisdictions.

GNYHA’s Safety and Security Considerations for Hospitals synthesizes safety and security strategies compiled by a GNYHA-led workgroup of health care security directors and external law enforcement representatives. Considerations are organized into four sections—staff and vendor management, patient and visitor management, physical security, and emergency department security. A fifth section provides links to tools and resources.

Resources Recommended by ASPR TRACIE

GNYHA contacted HHS’s ASPR TRACIE for recommended resources related to civil unrest and is sharing several of these with members. Review of these articles may help hospitals prepare for the many facets of response.

This article addresses how hospitals can prepare for situations of civil unrest. It also describes the types of injuries that patients may present with at hospitals (e.g., eye and respiratory tract effects, bone injuries, and exposures to chemical agents). NOTE: This article is outdated but may provide useful pieces of information.

This article describes how staff at St. Paul’s Hospital in Vancouver, Canada prepared for possible mass casualties and responded to individuals injured during the riots that erupted after the 2011 Stanley Cup series.

This article addresses hospital preparedness and response during the riots that occurred in Baltimore in April 2015 after the death of Freddie Gray. Four major hospitals within Baltimore city limits worked to determine alternate routes to get their staff to work and prepared for increasing security during this time of civil unrest

The authors of this article provide a firsthand account of how their hospital prepared for and responded to the 2015 Baltimore riots after the death of Freddie Gray.

The authors of this article provide a list of 10 “musts” for nurses when planning for a crisis such as civil unrest. They provide examples of how hospitals responded in Ferguson, Missouri after the death of Michael Brown and in Baltimore after the death of Freddie Gray.

This document provides a checklist for hospitals when preparing for civil unrest. It also includes an organizational chart that identifies staff positions which should be activated when responding to such an incident.