Helping Health Departments Manage Concurrent Disasters

Water flooding into the street over cement and fence with dark clouds in the background.

“For the general public, this means communities will have a larger toolbox of resources to better protect themselves and their families during concurrent disasters.”


Mollie Mahany, MPH, ATSDR Emergency Management Natural Hazards team lead

In 2021, ATSDR Emergency Management (EM) responded to multiple environmental disasters, oversaw environmental health issues related to the COVID-19 pandemic, and partnered with the National Environmental Health Association (NEHA) and the Council of State and Territorial Epidemiologists (CSTE) to identify gaps and develop resources for local environmental and public health agencies responding to concurrent disasters.

ATSDR’s Emergency Management serves as a central coordination point for CDC’s National Center for Environmental Health (NCEH) and ATSDR-led emergency responses and manages environmental health issues during CDC Emergency Operations Center-led emergency responses.

In 2021, despite the COVID-19 pandemic, it was critical that NCEH/ATSDR maintain the ability to prepare for and respond to non-COVID-19 related emergencies and disasters. Multiple staff deployments, expanded roles related to the pandemic, staff shortages, worker safety precautions, and new staff resiliency and operational planning needs required the business model of emergency management preparedness and response to adapt — especially for the 2021 Atlantic hurricane season, the third most active in history.

Managing any environmental disaster requires swift coordination and a clear, detail-oriented focus. Now imagine working at a health department and having to manage a disaster during a global pandemic. ATSDR’s EM Natural Hazards team lead Mollie Mahany, MPH, explains there’s now a project to support this complex work, the Concurrent Disasters Project.

“This project came about because we were having conversations with health departments and heard there were challenges in their ability to respond to disasters during the pandemic, so modifications were needed,” said Mahany.

For this project, “concurrent disasters” refers to natural disasters such as hurricanes, wildfires, and earthquakes that occur at the same time as an infectious respiratory disease pandemic. However, the term can also apply to other sets of hybrid disasters that occur at the same time, or because of one another. “The COVID-19 pandemic added a layer of complexity we hadn’t previously experienced on this scale,” said Mahany.

To address this challenge, ATSDR is partnering with the National Environmental Health Association (NEHA) and the Council of State and Territorial Epidemiologists (CSTE) to

  • Conduct a needs assessment to identify gaps and challenges faced by state, tribal, local, and territorial (STLT) environmental and public health agencies when responding to concurrent disasters.
  • Identify resources to address these challenges.
  • Develop tabletop exercises and other technical resources to support concurrent disaster planning, preparedness, and response activities in the future.

Resources identified so far range from peer-reviewed journal articles to factsheets, separated by audience and topic areas. Because this is an ongoing process, more resources will be added over time. The goal is to create a resource hub for state, tribal, local, and territorial (STLT) jurisdictions to enhance their preparedness, response, and recovery for concurrent disasters.

“We are committed to supporting STLTs in the difficult work of responding to concurrent disasters,” said Mahany. “We want to develop tools and resources to strengthen response and recovery capabilities, reduce risk to people living in settings that put them at higher risk of exposure, and strengthen community resilience.”

While this work affects how the federal government and STLT partners respond to concurrent disasters, it also has implications at the individual level. Researchers are still analyzing resources, but initial findings and future pilot implementations are promising. “We plan to hold tabletop exercises with six jurisdictions from July to September 2022,” said Mahany. “We plan to do these in two sets of three jurisdictions, to evaluate, revise, and make the final learnings into a tool.”

ATSDR, NEHA, and CSTE look forward to sharing their findings to broad networks and through partners such as the National Association of County and City Health Officials (NACCHO) and the Association of State and Territorial Health Officials (ASTHO).

ATSDR, NEHA, and CSTE also hope this work will highlight the need for better coordination across all public health sectors and foster opportunities for sharing information across practitioners and professionals. In the years to come, EM looks forward to developing customizable tools for STLT jurisdictions, bringing new professions to the table to increase health equity in emergency management, and sharing strategies from this resource hub to create safer communities for all.