As we close out another year, we extend our thanks to those of you who serve this nation’s communities so selflessly. We know our ASPR TRACIE stakeholders dedicate themselves to our safety and health, and we are honored to help share your resources and experiences. We also know that flu season may be affecting many of your communities, and we invite you to review these related resources:

• Healthcare Coalition Influenza Pandemic Checklist
• Considerations for the Use of Temporary Care Surge Sites for Managing Seasonal Patient Surge
• Influenza Epidemic/Pandemic Topic Collection

As always, please reach out to us if you need technical assistance or have an article or experience to share.

In this issue of The Express, we highlight an upcoming webinar, new and updated resources, and news from our three domains.

Recent incidents in the U.S. and abroad have highlighted the need to plan for accidents involving chemicals and emerging chemical threats (e.g., fourth generation agents). Issue 9 of The Exchange focused on planning, response, and lessons learned specific to chemical incidents. Due to the growing interest in this topic area, ASPR TRACIE is pleased to host a webinar to further expand on those articles. Panelists will discuss the potential effects of a chemical incident and share recent guidance and lessons learned in assessing, triaging, and treating patients, including considerations for novel nerve agent treatment. The webinar will take place Tuesday, January 14, from 1:30 PM-3:00 PM ET. Register today!

We encourage you to be on the lookout for messages from ASPR TRACIE on additional upcoming webinars in early 2020. One webinar will cover the development of the healthcare coalition (HCC) Pediatric Surge Annex and we will also host a joint webinar with the National Ebola Training and Education Center on new highly pathogenic infectious disease training and exercise resources.

This document provides a summary of the EPAP data collected and analyzed for the following natural disasters that occurred in 2018:

• Hurricanes Irma and Maria, U.S. Virgin Islands (January-August 2018)
• Hurricane Michael, Florida (November-December 2018)
• Typhoons Mangkhut and Yutu, Mariana Islands (November 2018-January 2019)
• California Wildfires (December 2018-January 2019)

ASPR TRACIE developed the HCC Surge Estimator Tool for nationwide use, after first piloting it with six regions across the country in the fall of 2018. Since its release in July 2019, we have received several questions about the restrictions that were placed on the data for Average Daily Occupancy on the hospital data collection form. Upon review, we have altered the tool to remove those limits and also to ensure you must enter a number for Average Daily Occupancy. This change allows high occupancy/high acuity hospitals to accurately enter their average daily census data while also permitting small hospitals (especially critical access hospitals) to accurately calculate their coalition surge capacity—an important contributor during a pandemic or regional patient redistribution situation. 

Updated versions of the HCC Surge Capacity Estimator Tool: Hospital Data Collection Form and Aggregator Tool are now available. Adjusting this variable on the hospital data collection form necessitated an update to the aggregator tool; we updated and re-released both tools. All coalitions need to use the updated versions. If you have not started yet, please download the updated tools. If you have already completed the data collection using the old tools, please reach out to the ASPR TRACIE Assistance Center for help converting your existing tools into the new format. We believe these changes will make the surge estimates as accurate and meaningful as possible to coalitions.