Test, Test: NLE 2018 Tests Hurricane Preparedness

May 16, 2018 | ASTHO Staff

On April 30 through May 11, the Federal Emergency Management Agency (FEMA) conducted its National Level Exercise (NLE) 2018. This event, conducted every two years, brings together state, local, tribal, territorial, private sector, and non-profit partners for a training exercise to test preparedness and response activities in the event of a major disaster. In an effort to incorporate lessons from the 2017 storm season—which proved the costliest year on record—and better prepare for the upcoming 2018 hurricane season, NLE 2018 simulated a Category 4 hurricane making landfall in the Mid-Atlantic region near Hampton Roads, Virginia, moving inland and impacting several HHS Region 3 states, as well as causing mandatory evacuations in Virginia, Maryland, and Washington, D.C.

In addition to major threats such as high winds and heavy rainfall, areas of concern for public health and healthcare entities when a hurricane makes landfall include: facility status (particularly dialysis centers), manufacturing, maintaining cold supply chain, as well as access and other functional needs (i.e., vulnerable populations). NLE 2018 offered communities, families, businesses, and other entities the opportunity to better understand these and other risks, develop preparedness plans, test response capabilities, improve existing plans, update insurance, and revisit other preparedness policies and procedures.

During this time, ASTHO also participated in NLE 2018, engaging in a two-pronged response challenge. The first challenge involved assessing ASTHO’s ability to support state and territorial health departments and staff who live and work in impacted areas, with the conclusion being that a real incident on this scale would tax ASTHO’s incident coordination process, most likely requiring the establishment of a virtual emergency operations center. In addition, other ASTHO response efforts included participating in federal agency information sharing conference calls, and testing text alert systems and other communication with Region 3 public health preparedness directors.

Over the past two weeks, ASTHO also heard back from states participating in NLE 2018. In West Virginia, the Center for Threat Preparedness (CTP) activated the health department’s Health Command to support public health and emergency medical missions. In addition, West Virginia CTP tested its SMARTT system to gather information on bed availability for displaced patients, noted its capacity to assess impacts on healthcare facilities and local health departments, and simulated shelter needs and requests monitoring. 

In Virginia, participants used NLE 2018 to meet state requirements for an annual hurricane preparedness and response exercise, and leveraged an opportunity to test local and state health continuity plans. Regional healthcare coalitions (with role-player patients) tested facility evacuation plans and conducted federally-mandated surge tests. Simulation activities also included participation from local health departments, local health incident management teams, and health department operation centers, as well as tests and updates to plans implemented by the Virginia Department of Health and local health departments following last year’s hurricane season.

One thing is certain: as this year’s hurricane season approaches, we must be prepared. By engaging in exercises such as NLE 2018, ASTHO and states continue to improve their ability to prepare for, respond to, and recover from catastrophic hurricane scenarios. For more information, visit the NLE 2018 website, which outlines steps to better prepare yourself and your community for hurricane season, including a FEMA app for alerts and warnings about weather conditions, a family communications plan, information on flood insurance, and much more. If you have questions, contact FEMA’s Intergovernmental Affairs Division at (202) 646-3444 or FEMA-IGA@fema.dhs.gov.