Are You Prepared for a Disaster?

Are You Prepared for a Disaster?

Are You Prepared for a Disaster? | Johns Hopkins Medicine

Linkedin Pinterest Preparing for an Emergency First Aid and Safety Everyday Safety Potential Emergency Situations and Conditions

When Superstorm Sandy knocked out power in Baltimore, Thomas Kirsch, M.D.,was unfazed.

The emergency physician at The Johns Hopkins Hospital anddirector of the Johns Hopkins Bloomberg School of Public Health’s Centerfor Refugee and Disaster Response had studied many natural disasters,including the devastation left behind by Hurricane Katrina.

So as Sandymade its way up the East Coast, he already had everything on hand that hecould ever need to ride out the coming power outage.

He and his family ended up spending four days without power, camping in theliving room and cooking food on a propane camping stove. In the evenings,they illuminated the room with battery-powered headlights.

“Being prepared is huge, because it minimizes the impact of a disaster foryou and loved ones you can help with planning,” Kirsch says. It can alsocontribute to resiliency and mental health after the disaster passes. TakeHurricane Katrina survivors, for example.

Research showed that people whodid not feel relatively safe for a long time—meaning they had moredifficulty finding refuge and taking care of their basic needs—tended tohave a higher risk of developing post-traumatic stress disorder versus those who were more prepared and able to respond quickly.

What to Prepare

There are three basic steps to being prepared: Have a plan, have a kit andbe informed. Kirsch suggests you consider what types of disasters arecommon in your area. In the central United States, it’s often tornadoes.

InCalifornia, it may be wildfires and earthquakes. On the East Coast,sometimes hurricanes threaten.

Consider the same for any loved ones whowould benefit from help with planning—those who live alone are often at thegreatest risk at these times.

Then consider what happens during those disasters. Will you lose power? Howabout Internet and phone? What do you rely on for your day-to-day needsthat probably won’t be available after a disaster? What happens if you haveto evacuate? Consider the impact a disaster might have on your life or aloved one’s, beginning with asking yourself questions in these crucialareas.


If you have to evacuate, always take your medicines with you. And how willyou refill prescriptions if needed? “When people evacuate or flee from adisaster, half of them leave their medications at home,” says Kirsch.“During a disaster, you can’t just call your physician and ask for a newprescription—and going without some medicines, even for a short length oftime, can be devastating.”


How will you manage financially if your place of employment is shut downfor days or even weeks? If your home or car is destroyed? What kind ofinsurance do you carry, and does it cover the type of devastation mostly to happen in your area?

Friends, neighbors and family

How will you stay connected if phone service or power is out? Who willthink to check up on you to make sure you are OK? Do those people have keysto your home in case you are injured and can’t let them in?

State of mind

How will you deal with the boredom of being sidelined from your regularactivities for many days without power? Who will be there to help you andprovide support?

Making a Disaster Plan

Overall, consider how you will minimize the impact of a disaster. Then comeup with and practice a plan for your household and for loved ones who needsupport in the event of a disaster, Kirsch suggests. Some questions toanswer:

  • How will you find one another?
  • Where will you meet?
  • What’s your evacuation plan? What route will you take? What mode of transport? Where will you go?
  • What will you do if you lose power? Will you travel somewhere—perhaps to a relative’s house outside of the disaster zone? Go to a shelter? Or shelter in your living room?
  • What important records will you be unable to access without power that you might back up and store in a fireproof safe or somewhere far away?

Also, create a disaster kit complete with:

  • Water
  • Nonperishable food
  • A flashlight or headlight
  • An emergency radio and batteries
  • First-aid supplies
  • A seven-day supply of medicines
  • Personal hygiene items
  • Hand sanitizer
  • Extra cash
  • Area maps

Depending on your health, you might also include spare hearing aids,glasses, contact lenses and other health supplies.

If you do all of that, you’ll be ready. “The more you prepare in advance,the more resilient you’ll be when a disaster hits, and the faster you’llrecover,” says Kirsch.

What the Experts Do

During Superstorm Sandy, Kirsch might not have had power, but his phone andcomputer never went dead. That’s because he owned adapters that allowed himto charge both in his car.

In case that failed, he had a backup plan tocharge them at work, as many hospitals—including Johns Hopkins—have asource of backup power and are usually the first places power is restoredafter an outage.

Make sure your car has gas in it before an event;afterward, the stations might be closed.

Post-traumatic stress disorder (PTSD): A disorder in which your“fight or flight,” or stress, response stays switched on, even whenyou have nothing to flee or battle.

The disorder usually developsafter an emotional or physical trauma, such as a mugging, physicalabuse or a natural disaster.

Symptoms include nightmares, insomnia,angry outbursts, emotional numbness, and physical and emotionaltension.


Tools and Resources

Are You Prepared for a Disaster? | Johns Hopkins Medicine

Data Safety and Monitoring/ Data Safety Monitoring Boards

What is a DSMP or DSMB? A Data Safety Monitoring Plan (DSMP) establishes the process for overseeing the progress of a human subjects research project or clinical trial.  At JHU, all studies must provide a description of the DSMP.  The JHM IRB will review the plan for appropriateness related to the design, risk profile, and study population for each study.

A DSMP’s purpose is to maximize research participant safety and welfare and data accuracy by periodically

  • evaluating a study’s adherence to the IRB approved research plan, by affirming all study procedures are being followed;
  • assuring compliance with applicable institutional policies and regulatory requirements, by ascertaining, for example, that informed consent is being effectively obtained and documented, or that all changes in research received IRB approval before initiation of any changes;
  • confirming adverse events are properly identified, documented, reported, and resolved (if necessary);
  • verifying the maintenance of accountability of the investigational product (i.e., drugs or devices); and
  • examining data (and appropriate source documentation) for quality, validity, and consistency.

A DSMP designates who is responsible for the monitoring activity, while outlining when monitoring will occur (per established intervals), and what study documents and data will be reviewed.

  A critical component to the DSMP is that all detected deficiencies (i.e.

, “deviations”) are communicated to the Principal Investigator (PI) and study team for reconciliation, and for implementation of appropriate corrective action plans.

A Data Safety Monitoring Board (DSMB) is convened when an investigation’s design, risk profile, and/or study population warrants an independent review by a group of experts (e.g., a multicenter randomized trial of a high-risk new drug, or pursuant to NIH requirements).  Per procedures outlined in the DSMP operational plan (i.e.

, “DSMB Charter”), the DSMB reviews data and safety information provided by an investigator. The DSMB assesses study progress via statistical analysis of interim study outcomes and safety signals, and then renders a decision that the study may proceed, be amended, or should cease enrollment.

DSMBs will compile a summary report that, per JHM IRB requirements, are to be reported to the IRB.

JHM IRB Policy:

FDA Guidance:

SKCCC CRO Guidance:

Guidance for Data and Safety Monitoring Plans (ICTR DDRS):
DSMP/DSMB Consultation is provided by the JHU Office of Human Subjects Research Compliance Monitoring Program. Contact Fed Ludthardt at for additional information.

Please email our Research Navigators at to access any of these templates.

FDA Guidance Document

Cancer Center’s DSMP provides helpful guidance on risk assessment, auditing and monitoring, and DSMBs

Guidance for Data and Safety Monitoring Plans (ICTR DDRS)
Please email our Research Navigators to access any of these templates.


Preparing for an Appointment

Are You Prepared for a Disaster? | Johns Hopkins Medicine

COVID-19 Appointment Information and Procedure Updates
Get the latest updates for all appointments and procedures at Johns Hopkins.

COVID-19 Appointment Information from the Division of Rheumatology

For New Patients

In order for your care to be matched to an appointment with an expert in the field of your diagnosis, it is necessary to have your records available to our physician reviewers prior to scheduling an appointment. Therefore, we ask that you have your referral and medical records faxed to 443-267-0090.

It is important to include the following: a referral from your current physician, any clinical notes, imaging reports (including x-rays and MRIs), lab results, other tests results as applicable (such as pulmonary function tests echocardiograms, pathology reports, EMG/NCS results), New Patient Demographics Form.

Once the review process has been completed, you will be contacted by one of our intake coordinators to assist with scheduling your appointment. You may also call the scheduling office at 443-997-1552 at any time to inquire as to the status of your record review.

For International patients, please contact Johns Hopkins International for initial and return patient appointments.

Unfortunately, our physicians cannot speak with or give medical advice to patients that are not currently under our care.

On the day of your scheduled appointment, it is important to:

  • Arrive at least 30 minutes before your appointment to allow time for registration
  • Bring your insurance card
  • Bring a photo I.D.
  • Bring your co-payment
  • Bring a copy of name and address of all persons/doctors who would to get copies of your visit materials
  • Bring the following medical records if not already sent:
  • All medical records relevant to your diagnosis (including rheumatology records, discharge summaries)
  • List of all current medications (include all over-the-counter medications)
  • Recent laboratory results
  • Any imaging results (i.e., x-rays, ultrasounds, etc.)
  • Pulmonary function tests (bring all test results)
  • Echocardiogram (bring all test results)
  • High resolution CT scan of lung (bring written report and copy of actual scan on CD-ROM disc)

To be evaluated at the Myositis Center, you often do not need specialized testing. However, if already done, please provide:

  • Recent laboratory results – especially results from blood tests for CPK and/or aldolase
  • Any MRI films of your muscle (please bring original films and report).
  • The original pathology slides and report from a muscle biopsy. It is particularly important that we have the actual muscle biopsy slides as this may be crucial for making the correct diagnosis.

Once you receive your appoint confirmation, plan to arrive 30 minutes ahead of time for registration and vital signs. Remember to bring a copy of your insurance card(s) to the appointment. New patients should plan on spending the entire day at the Center.

For Returning Patients

  • Return appointments for the Myositis Center can be made by calling (410) 550-6962.
  • Please arrive 15 minutes before your appointment.
  • You may also be asked to complete some additional forms to allow us to bill your insurance, to review your health, and help us know how you have been doing since your last visit.
  • Bring a copy of your insurance cards.

Rescheduling Appointments and Cancellations

We schedule our appointments weeks in advance and are usually unable to reschedule on short notice. If you must reschedule, call us at 410-550-6962 as soon as possible. This will allow us to schedule another patient who is waiting to be seen.

Late, Canceled and No Show Appointments

Late: The appointment time scheduled for you is time specifically allotted for your visit. If you are running late for an appointment, please call our scheduling office. Please note if you are more than 15 minutes late for your scheduled appointment time, we may not be able to accommodate your visit.

Canceled / No Show: If you are unable to keep your appointment we require a minimum of 24 hours’ notice. If you repeatedly do not provide our office with 24 hours’ notice, you may be subject to be discharged from our practice.

Rescheduling Appointments

Our clinic is very busy and unfortunately patients often have to wait several months for an appointment. If you need to reschedule your appointment, please call us at 443-997-1552 as soon as possible. This will allow us to schedule another patient who is waiting to be seen.

Office Hours

Our normal clinic hours are Monday – Friday 7:30am-5:00pm. Our normal phone hours are Monday – Friday 9:00 AM -4:00 PM.

Our Office is closed for the following Holidays:

  • New Year’s Eve
  • New Year’s Day
  • Martin Luther King, Jr. Day
  • Memorial Day
  • Independence Day (July 4th when it falls on a regular business day, the Friday before when it falls on Saturday, or the Monday after when it falls on Sunday)
  • Labor Day
  • Thanksgiving Day
  • Day after Thanksgiving
  • Christmas Eve
  • Christmas Day (December 25th when it falls on a regular business day, the Friday before when it falls on Saturday, or the Monday after when it falls on Sunday)

There may be other posted days that are closed due to divisional activities and/or professional development. That information will be provided on all divisional voicemails.

After-Hours, Weekends and Holidays Calls

  • If you are experiencing a medical emergency after-hours, please call 911 or go to your nearest urgent care facility or emergency department.
  • If your need is a medical management question that cannot wait until our next business day, we offer an On-Call Provider to help you. Our On-Call Provider may be paged by calling our answering service at 410-955-6070.

Inclement Weather and Unexpected Closings

  • It is the policy of Johns Hopkins Medicine to reasonably maintain outpatient clinical operations; however, due to weather or other unexpected closings, such as an area-wide power outage or water main break, there may be times when it is necessary to close our office.
  • Our closing notices will be provided for you via our voicemail recording and our staff will contact you if we are not able to keep your appointment, let you know what we are experiencing, and when we may be looking to reschedule your visit.

Insurance / Billing Information

We are participating with the following insurance payors:

  • Aetna Health Plan
  • Beech Street PPO
  • Blue Cross Blue Shield
  • CareFirst BlueChoice HMO
  • Coventry Healthcare
  • EHP
  • First Health
  • Great West/One Health PPO
  • Humana Choicecare
  • InforMed/CHP
  • Kaiser
  • Maryland Medical Assistance
  • Medicare Part B*
  • Multiplan PPO
  • NCAS
  • One Net PPO
  • Optimum Choice HMO
  • Priority Partners MCO
  • Private Healthcare Systems (PHCS)
  • Tricare Reserve Select
  • Tricare Standard
  • United Healthcare
  • US Family Health Plan

*We do not participate with out-of-state Medicaid or Medicare Advantage/Replacement plans.


It is a good idea to check with your insurance to make sure you are covered for your visit and services with us. Please be prepared to pay your copay and any balance due at the time of your visit. We accept VISA, MASTERCARD, DISCOVER, AMERICAN EXPRESS, and CHECKS.

Non participating insurance/self-pay:

We realize that insurance may not always cover care at Johns Hopkins.

With the exception of Medicare Advantage and Medicaid plans, patients may have the ability to pay out-of-pocket for non-covered services.

Patients scheduled for new patient appointments are required to pay a $600 deposit at the time of service. Patients scheduled for return visits are required to pay a $289 deposit at the time of service.

Prescription Policies and Prescription Refills

In order for our office to provide you with timely refills, please request your medication refills at least one week in advance. Refill requests may be made via a myChart message to your provider, calling our office, or by receiving a fax from your pharmacy.

Forms Completion

The only documentation regarding your health or illness required by law (and included in the office visit charge) is an office visit note.

Completing paperwork for schools, camps, Family Medical Leave Act (FMLA) claims, long-term care, life insurance, the Department of Veterans’ Affairs, and other disability claims go beyond routine medical care and may require an update of your medical information or a special examination.

In order to make this determination, please forward your form(s) to our office prior to your scheduled visit. For those forms that can be completed outside of a clinical visit, please allow a minimum of 5 business days for your completed form to be returned to you.


JHU to Hold Fourth Annual Emergency Preparedness Fair

Are You Prepared for a Disaster? | Johns Hopkins Medicine

Last summer was considered a catastrophic hurricane season, with Harvey, Irma and Maria battering Texas, Florida and Puerto Rico.

Would you be prepared if a hurricane or other disaster struck our community?

In an effort to ensure the community is safe in the event of an emergency, Johns Hopkins University, the National Cancer Institute, and other local, state and federal agencies are working together to bring the fourth annual Emergency Preparedness Fair to the JHU Montgomery County Campus. The Emergency Preparedness Fair is scheduled for 11 a.m. – 2 p.m. Wednesday, Sept. 5, in the JHU parking lot at the corner of Key West Avenue and Broschart Road. (The rain date is Sept. 12). The event coincides with the Shady Grove Farmers Market, also held on campus.

The fair is being held during National Preparedness Month, which is sponsored by the Federal Emergency Management Agency’s Ready campaign. It is a nationwide effort to encourage families, businesses and communities to work together to prepare for emergencies at home, work, businesses, schools and places of worship.

This year’s theme is “Disasters Happen. Prepare Now. Learn How.” Attendees will be reminded that everyone should prepare themselves and their families now — and throughout the year — for emergencies.

Each week of National Preparedness Month has a different focus: Make and Practice Your Plan; Learn Life Saving Skills; Check Your Insurance Coverage; and Save for an Emergency.

Expected participants at the fair include:

  • American Red Cross
  • Disaster Aid USA
  • Federal Protective Service
  • Gaithersburg Police
  • Johns Hopkins University
  • Maryland Emergency Management Agency
  • Maryland Insurance Administration
  • Maryland Responds Medical Reserve Corps
  • Montgomery Amateur Radio Club
  • Montgomery County Auxiliary Communications Services
  • Montgomery County Community Emergency Response Team
  • Montgomery County Commuter Services
  • Montgomery County Fire and Rescue Service
  • Montgomery County Office of Emergency Management and Homeland Security
  • Montgomery County Police Department
  • National Cancer Institute Emergency Management and Physical Security Branch
  • National Cancer Institute Emergency Response Team
  • National Institutes of Health Civil Program
  • National Institutes of Health Division of Emergency Management
  • National Institutes of Health Division of Police
  • National Institutes of Health Radio Amateur Club
  • National Library of Medicine Disaster Information Management Research Center
  • Suburban Hospital
  • Washington Gas

At the fair, the National Cancer Institute will discuss its volunteer emergency response team. The NCI also will bring disaster bags, kits, handouts and displays to teach attendees how to prepare emergency bags for schools, homes, cars and public transportation.

JHU and other organizations will hand out supplies that could be helpful in preparing an emergency kit. Washington Gas will provide information about the benefits of natural gas; resources on how to get the most your energy services; and safety and emergency tips.

Suburban Hospital, a member of Johns Hopkins Medicine, will highlight the Stop the Bleed campaign, a nationwide initiative to teach people how to use tourniquets and provide other live-saving measures before first responders arrive at an emergency scene.

The emergency preparedness fair is free and open to the public.


Around Johns Hopkins: Preparing for the Unexpected

Are You Prepared for a Disaster? | Johns Hopkins Medicine

See more in:

Robert “Bob” Maloney (center), senior director for the Johns Hopkins Medicine Office of Emergency Management, leads the “Operation Unplugged” exercise in April 2018. Also pictured are Stephanie Reel, chief information officer for the Johns Hopkins University and Health System, and Andrew Frake, senior director of

health information technology.

In a time of crisis, a hospital’s emergency management team oversees the response. Outside a crisis, the emergency management team is preparing for events through exercises and training.

In this issue of Hopkins on Alert, CEPAR spotlights the emergency management team for the Johns Hopkins Heath System and the Johns Hopkins University School of Medicine. Robert “Bob” Maloney, senior director, Johns Hopkins Medicine Office of Emergency Management, oversees the team responsible for disaster prevention, mitigation, preparedness, response and recovery.

Prior to joining Johns Hopkins in 2017, Maloney was the emergency manager for the city of Baltimore for more than a decade, responsible for citywide emergency preparedness and homeland security funding and coordination.

He was also deputy mayor of emergency management and public safety, coordinating public safety, emergency management and related operational agencies. Maloney also served in the U.S.

Naval Reserve, deploying for a year to Fallujah, Iraq.

He recently spoke with CEPAR about his and his team’s efforts at Johns Hopkins.

Q: What is your role in emergency management?

A:  I am part of a remarkable team that is responsible for building resiliency to hazard and crises that may interrupt the mission of Johns Hopkins Medicine, including an efficient and effective response when events occur. 

Q: How did you become interested in emergency management?

A: In 1994, I decided I wanted to join the Baltimore City Fire Department. Around that time, fire service across the country was going through a transition from primarily firefighting to a fire-based emergency medical services (EMS) system, because the majority of 911 calls were EMS-related.

To prepare myself for the fire department, I earned my EMT-Basic certification, and I also volunteered at a local hospital. The first night I volunteered, I watched paramedics bring in and care for a gunshot victim. In that moment, I knew what I wanted to do for the rest of my life.

I wanted to be in a profession where I helped people. 

The field of emergency management really began to grow after the 9/11 attacks and Hurricane Katrina.

When I became the fire department’s chief of staff, I handled day-to-day emergency management tasks for the fire chief, who was the acting emergency manager.

During this time, I gained a tremendous amount of experience organizing a team to work in a unified system when responding to crises. So, after the fire chief retired, I was honored to be appointed by Mayor Sheila Dixon as the city’s emergency manager.

Q: What are some of the unique emergency preparedness challenges The Johns Hopkins Health System and school of medicine face? How are you working to overcome these challenges?  

A:  Baltimore City government, with the exception of essential services, can close. At Johns Hopkins Medicine, however, we must maintain our mission of patient care, teaching and research every day. Our patients and many other people count on us to deliver.

By maintaining our mission, whether it’s for the person who needs a lifesaving surgery, the person who ran medication, the student learning to be a doctor, or the critical research needed to make key decisions, we must deliver. We are the best health system in the world, and so our emergency management program needs to be equal to that.

And the onus is on all the individuals who work in preparedness to do everything we can to enable the caregivers, researchers and teachers to do their job — without interruption.

The breadth, diversity and locations of Johns Hopkins Medicine offer unique challenges. For example, Johns Hopkins All Children’s Hospital is in a hurricane zone and, therefore, more susceptible to major storms, while The Johns Hopkins Hospital is fortunate to have most of its entities on the East Baltimore campus, and Johns Hopkins Community Physicians has locations throughout the region.

Q: How do you determine the subject of emergency preparedness drills? 

A: We have a hazard vulnerability analysis that we collectively develop each year. We determine what hazards are most ly to happen, and the magnitude of those hazards on the enterprise. These determine what we drill and exercise.

During the last year, we’ve put a tremendous amount of focus on information technology and building resiliency in that area. We also recently completed a mass decontamination drill, which we did outside the Johns Hopkins Hospital emergency department.

Unfortunately, the events in the country also demonstrate an increasing need to be ready for incidences of mass trauma/surge of patients. We have increased our ability to respond to such events.

Q: Why are preparedness exercises important?

A: It’s an opportunity to test our plans, identify preparedness gaps and make changes, thus building resiliency. First and foremost, during all exercises, we test the command structure to make certain we can coordinate and maintain control. Second, we test our response capabilities, depending upon the crisis. Take, for example, a cyberattack.

We want to test our ability to stop the spread of the attack. Or, if it’s a mass decontamination event, we want to avoid further contamination, so we take the necessary steps to protect patients before entering the hospital. Whatever the emergency, it’s our opportunity to simulate practicing our response to things we may not experience day to day.

What is a hospital incident command system, and what does it take to set up this structure?

It’s an organizational structure that facilitates integration to effectively solve problems and delegate responsibilities. A hospital incident command system relies on a team of people, working in unison, who are trained to respond to incidents such as an influx of patients or a weather emergency. The structure is expandable. So if necessary, we can include all essential stakeholders.

We now have a team of more than 50 people who have been trained to come to a central location, or command center, and perform the specific functions of the staffing positions necessary to set up a hospital incident command system.

When those individuals are notified, they immediately come to the hospital to receive the situational assessment, determine an incident action plan moving forward, provide notification and information to the public, staff and visitors, inform senior leadership and seek advice when necessary.

The team ensures an exchange of timely and accurate information so the best response policy and direction can be implemented.

During an event, the incident command will remain open until the situation is resolved. There are policies and procedures that dictate when we open up the command at The Johns Hopkins Hospital. That is always done in consultation with hospital leadership.

When was the last time you set up the hospital incident command center during an actual incident?

The last time we set up our command center due to a real incident was during last flu season. The Johns Hopkins Hospital was full, and the emergency department was seeing an influx of patients who needed to be admitted. So we set up the hospital incident command center to alleviate stress on the emergency department.

During this activation, patient care in the emergency department was disrupted by a water-related issue that happened at the same time as the surge. Setting up the command center during this event, without a doubt, helped us maintain the mission continuity of the hospital.

In addition, there have been several times that entities throughout the enterprise have set up incident command centers, and my team was integrated into the command structure to assist.

What are some of the projects that you have worked on or are working on at Johns Hopkins of which you are most proud?

There have been many projects. My team worked on the standardization of color codes on ID badges at The Johns Hopkins Hospital.

We’ve collaborated with departments to place stop the bleed supplies throughout all Johns Hopkins Health System hospitals to equip bystanders with bleeding control tools in the event of mass casualty events.

We also led “Operation Unplugged,” the largest exercise ever done at Johns Hopkins Medicine.

But I’m most proud that during crises, as a team, we have been able to come together to build a system that’s not dependent on one person to minimize crisis impact and maintain our continuity of operations.

As we continue to build our capabilities — increase radios, supply caches, drills and exercises, and training — and refine our policies and procedures, the system will get more and more robust, and we will be even more ready.

Our job is to be ready. We always have to be prepared.

It’s also important to note that senior leadership has been supportive of emergency management and understanding of the importance of preparedness, resiliency and reducing risk. And that’s huge.

What should faculty and staff know about emergency preparedness?

Faculty and staff should remember to build resiliency at home, because they will ly have to work during an emergency, particularly during snow or severe weather.

If their home and family are inadequately prepared — not equipped with an emergency supply kit, a generator or food, or a family communications plan — they’re going to be at work worrying.

So it’s really taking the opportunity to think about how they could be better prepared.

All of this is easier said than done, especially considering our day-to-day responsibilities. But when we are prepared, loss of life and property damage or destruction will be reduced, and we will get back to normal operations sooner. That’s what you’re trying to do, trying to get back to normal during crises.

Finally, we want everyone on team Johns Hopkins to know how much we appreciate the support and efforts toward resiliency and preparedness. And please don’t hesitate to reach out to us for assistance in building resiliency. We can be reached at 410-502-6122, or visit our website.


The Global Health Security Index

Are You Prepared for a Disaster? | Johns Hopkins Medicine

1. Prevention: Prevention of the emergence orrelease of pathogens2. Detection and Reporting: Early detection and reporting for epidemics of potential international concern3. Rapid Response: Rapid response to and mitigation of the spread of an epidemic4.

Health System: Sufficient and robust health system to treat the sick and protect health workers5. Compliance with international norms: Commitments to improving national capacity, financing plans to address gaps, and adhering to global norms6. Risk Environment: Overall risk environment and country vulnerability to biological threats.

NOTE: All data are normalized to a scale of 0 to 100, where 100 = best health security conditions.

The average overall GHS Index score is 40.2 a possible 100. While high-income countries report an average score of 51.9, the Index shows that collectively, international preparedness for epidemics and pandemics remains very weak.


  1. Data Highlights:

    • 40.2: average overall Global Health Security Index score of a possible score of 100
    • 116: high- and middle-income countries not scoring above 50


    • National governments should commit to take action to address health security risks.
    • Health security capacity in every country should be transparent and regularly measured, and results should be published at least once every two years.
    • Leaders should improve coordination, especially linkages between security and public health authorities, in insecure environments.
    • New financing mechanisms should be established to fill preparedness gaps, such as a new multilateral global health security matching fund; and expansion of World Bank International Development Association (IDA) allocations to include preparedness.
    • The Office of the United Nations (UN) Secretary-General should designate a permanent facilitator or unit for high-consequence biological events.
    • Countries should test their health security capacities and publish after-action reviews, at least annually.
    • Governments and donors should take into account countries’ political and security risk factors when supporting health security capacity development.
    • The UN Secretary-General should call a heads-of-state-level summit by 2021 on biological threats including a focus on financing and emergency response.

    Read more on the Report & Model page.

  2. Data highlights:

    • 81% of countries score in the bottom tier for indicators related to deliberate risks (biosecurity)
    • 66% score in the bottom tier for indicators related to accidental risks (biosafety).
    • Fewer than 5% of countries provide oversight for dual-use research
      Zero: Number of countries that have legislation or regulations in place that require companies to screen DNA synthesis
    • 92% of countries do not show evidence of requiring security checks for personnel with access to dangerous biological materials or toxins


    • Governments and international organizations should develop the capabilities to address fast-moving pandemic threats.
    • Governments should include measurable biosecurity and biosafety benchmarks in national health security strategies and track progress on an annual basis.
    • A dedicated international normative body should be developed to promote the early identification and reduction of biological risks associated with advances in technology.
    • Public and private organizations should invest a percentage of their sustainable development and health security portfolios in the area of biosecurity.
    • Funders and researchers should provide incentives to identify and reduce biological risks associated with advances in technology and should invest in technical innovations that can improve biosecurity.
    • Leaders should prioritize the development of operational linkages between security and public health authorities for biological crises.
    • Countries and international organizations should prioritize the development of national biosurveillance capabilities and a global biosurveillance architecture.

    Read more on the Report & Model page.

  3. Data highlights:

    • 85% show no evidence of having completed a biological threat–focused International Health Regulations (IHR) simulation exercise with the World Health Organization (WHO) in the past year
    • Fewer than 5% show a requirement to test their emergency operations center at least annually
    • 77% do not demonstrate a capability to collect ongoing or real-time laboratory data
    • 24% show evidence of a nationwide specimen transport system
    • 89% do not demonstrate a system for dispensing medical countermeasures during a public health emergency
    • 19% demonstrate at least one trained field epidemiologist per 200,000 people


    • Countries should test their health security capacities and publish after-action reviews, at least annually. By holding annual simulation exercises, countries will show commitment to a functioning system. By publishing after-action reviews, countries can transparently demonstrate that their response capabilities will function in a crisis and can identify areas for improvement.
    • Health security financing, evaluations, and planning should prioritize functional capability and regular exercises.

    Read more on the Report & Model page.

  4. Data Highlights:

    • 5% score in the top tier for financing
    • One country, Liberia, has published a description of specific funding from its national budget for gaps identified in existing assessments and/or national action plans
    • 10% show evidence of senior leaders’ commitment to improve local or global health security capacity


    • Health security preparedness financing should be tracked by a specific, globally recognized entity and briefed annually to heads of state.
    • Domestic financing for health security should be urgently increased, made transparent, and tied to benchmarks within national action plans.
    • Decision makers should create new health security preparedness financing mechanisms that incentivize measurable improvements, such as a such as a new multilateral global health security matching fund, and expansion of IDA allocations to include preparedness.
    • International leaders should examine the availability of financing to support rapid and complete outbreak response. The UN should track and publish outbreak-related costs and contributions.

    Read more on the Report & Model page.

  5. Data Highlights:

    • Higher overall score: Countries with effective governance and political systems
    • 55% score in the bottom and middle tiers for political and security risks indicators
    • 15% score in the highest tier for public confidence in government
    • 23% score in the top tier for political system and government effectiveness, representing approximately 14% of the global population


    • Plans should be developed to assist countries with challenging risk environments and to bolster preparedness in countries bordering those at increased risk.
    • National governments and donors should assess political and security risk factors when making resources available to support capacity development.
    • The UN Security Council should urgently convene a series of meetings aimed at the development of rapid response capabilities, strategies, workforce, and protections necessary for outbreaks that originate in or spread to countries with high political or security risks.

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  6. Data Highlights:

    • Lowest scoring category: for health systems, average score of 26.4; 131 countries in the bottom tier; weaknesses among even high-income countries
    • 27% demonstrate the existence of an updated health workforce strategy
    • 3% show a public commitment to prioritizing healthcare services for healthcare workers who become sick as a result of participating in a public health response
    • Low scores: physician and nurse/midwife density per 100,000 population
    • 11% show plans to dispense medical countermeasures during health emergencies


    • Decision makers should measure and take into account health system capabilities as an integral part of all health security planning, investments, and financing strategies.
    • Leaders should take steps to build and maintain robust healthcare and public health workforces that play a major role in biological crises.
    • National Action Plan for Health Security (NAPHS) should take into account specific benchmarks to improve and finance the overall health system and its workforce.

    Read more on the Report & Model page.

  7. Data Highlights:

    • 30% demonstrate existence of mechanisms for sharing data among relevant ministries for human, animal, and wildlife surveillance
    • 8% demonstrate a cross-ministerial unit dedicated to zoonotic disease
    • 51% offer field epidemiological training programs that explicitly include animal health professionals
    • 62% have not submitted a report to the World Organisation for Animal Health on the incidence of human cases of zoonotic diseases for the past calendar year


    • National public and animal health authorities should coordinate during the development of NAPHS and should incorporate a One Health approach as part of pandemic planning and national disaster preparedness and response efforts.
    • Countries should identify an agency and grant it authority to coordinate training and information sharing among human, animal, and environmental health professionals for outbreak preparedness and response.
    • Decision makers should consider infectious disease risks when developing policies and plans related to climate change, land use, and urban planning.

    Read more on the Report & Model page.

  8. Data Highlights: