GNYHA and the NYC Department of Health and Mental Hygiene (DOHMH) recently hosted the 2025 Medical Response and Surge Exercise (MRSE). The two-part event is a required Department of Health and Human Services’ Administration for Strategic Preparedness and Response surge exercise for hospitals in the Hospital Preparedness Program. The Fire Department of New York, NYC Emergency Management (NYCEM), and NYC Office of the Chief Medical Examiner provided additional support for the exercise.
The exercise scenario involved four simultaneous explosions occurring on November 2, 2025, at the New York City Marathon near the marathon’s starting line and along the marathon route in Staten Island, Brooklyn, Queens, and the Bronx. All New York City hospitals participated in the event and exercised their disaster plans. The exercise focused on testing bed capacity, coordination, and transfers.
The first part of the MRSE featured a briefing and Emergency Support Function #8 Command Element Call facilitated by NYCEM, which provided a situational overview and set the stage for the rest of the exercise. The call highlighted the process used to coordinate health and medical agencies, including GNYHA, during a disaster. Hospitals and health systems were then tasked with obtaining a census that offered a snapshot of their facilities’ status that was used for the rest of the exercise.
Each hospital with an emergency department (ED) received a manifest that included profiles of patients with various injuries from the hypothetical explosions. The hospitals then considered rapid discharge abilities before triaging, treating, and dispositioning the surge of ED patients. The hospitals also evaluated their transfer needs and determined available excess capacity. Systems with multiple hospitals contemplated load-balancing between facilities.
Part two fast-forwarded the scenario six hours and centered on a hospital coordination call that involved hospital transfer centers, patient placement staff, clinical staff, and emergency managers. This part of the exercise consisted of active game players (hospital and health system representatives who were key to the exercise) and virtual observers (open to all hospitals) and included a live discussion followed by a “hotwash.” During the hospital coordination call, hospital leaders reconciled the transferring of patients and reviewed issues including specialty service placement (such as for pediatric critical care and burn care) and the availability of special medical treatment devices (e.g., hyperbaric chambers).
GNYHA and DOHMH will conduct an after-action review and develop action items to ensure the NYC region’s health care system remains prepared for real-life events.