TY - JOUR AU - Harvey,, Stephen AB - Abstract Disaster response planning for laboratory animal facilities is a time- and personnel-intensive undertaking. This article outlines numerous considerations in formulating a plan for disaster response in a high containment animal unit. The planning process is discussed around a set of elements: planning team formation, situational understanding, goal and objective determination, plan development, preparation, and rehearsal or implementation. The importance of an appropriate planning team and personnel development is explored in relationship to exemplary disaster scenarios such as natural disaster and terrorism. Specific risks such as hazardous agent and animal species type serve to delineate goal-setting methods. These goals provide the framework for an institutional disaster plan. The review further uses elements of the planning process to explore the difficulties of euthanasia of animals treated with hazardous agents. Ultimately, the pitfalls of handling media relations following disaster are examined. Proactive measures for preparing to speak to the media and mitigate negative perceptions of research are presented. disaster response, containment unit, laboratory animal facility, animal, review Introduction Disaster response planning for laboratory animal facilities is a time- and personnel-intensive undertaking. Recent disasters such as Superstorm Sandy and Hurricane Katrina have led to a surge in recommendations and guidance for disaster preparedness. As we have learned, disaster planning is not as easy as putting a plan to paper or hiring a company and putting each animal on a truck cage by cage. Development of personnel at all levels is critical to a successful disaster response, especially when contending with animals in a containment unit. This review focuses predominantly on hypothetical worst-case scenarios in animal biocontainment units. Understanding potential risks associated with biological, chemical, or radiation hazards could prevent chaotic responses. Awareness of the dynamics of emergency response and preparedness can strengthen skills for decision-makers and build a work culture based on risk evaluation. There are many resources available for developing a plan and preparing facility personnel for disaster response. There are only a few published commentaries directly addressing the intricacies of handling animals in high containment facilities during a disaster, such as the review by Swearengen et al., 2010.1 The current review expands high containment units to include United States Biosafety Levels BSL-3, BSL-4, and BSL-3Ag and certain chemical or radiation hazards.2 Containment unit disaster response planning is often a small component of the larger facility plan. It requires the same dedication and thought in planning a response for a conventional animal unit. However, complexities are greater with the additional regulations, safety considerations, personnel training, and public perception associated with containment level research. This review examines appropriate disaster response planning, including specific risk considerations, plan and personnel development, humane euthanasia challenges, and handling media relations. Discussions of real-time response and recovery are not included within this article. Advanced Considerations In Resilience Planning Disaster planning must be tailored to the individual institution. The planning process for disaster has been outlined in numerous articles, generally focusing around a common set of elements: planning team formation, situational understanding, goal and objective determination, plan development, preparation, and rehearsal or implementation.3 Planning Team Formation: Stakeholders The leadership of institutions with containment facilities must fully appreciate the intricacies that accompany this work, especially as it pertains to the care and development of personnel running a containment unit, expectations of safety, and euthanasia. Institutional leadership may view comprehensive disaster preparedness as extraneous time and effort, leading to increased costs.4 The most difficult hurdles in disaster planning are the infrequency of disasters and the belief “it won’t happen to us” or “we are ready for it.”5,6 The risk of a high-profile disaster in a containment unit often encourages the active support of leadership. Still, the vision for a disaster response for containment animal facilities usually comes from the animal facility team. This vision must earn the backing of institutional leadership, or the plan is unlikely to succeed.7 Establishing a guiding coalition to achieve this vision requires careful consideration of members. Greater numbers of participants are required for containment level planning. All groups who may be affected by a containment unit disaster must be included. At any institution or company (either private or government), multiple departments will play important roles in a large-scale emergency situation. Not all entities’ planning teams will comprise the same positions or expertise. Planners include subject matter experts (e.g., biological safety officer, veterinarian, principal investigators), first responders (e.g., police, fire department, emergency medical), government (e.g., local, state, federal), institutional administrators (e.g., senior leadership, facility managers, security, media relations), the institutional animal care and use committee, and day-to-day operators (husbandry and veterinary technicians).8 Teams may further vary depending on a number of factors such as infrastructure, geographical location, biosafety levels, etc. For example, an agricultural institution utilizing biological select agents or toxins (BSATs) and livestock would likely have additional internal and external stakeholders, such as local farmers (Table 1). Facilities in dense, urban areas may face vocal community scrutiny, necessitating additional media relation expertise.9,10 Table 1. Examples of Internal and External Stakeholders Involved in Risk Management Internal Stakeholders External Stakeholder Administration First responders Biosafety officer or EHS department Government (federal, state, local) Facility managers External media Principal investigators Community members Public safety/security Internal media relations Internal Stakeholders External Stakeholder Administration First responders Biosafety officer or EHS department Government (federal, state, local) Facility managers External media Principal investigators Community members Public safety/security Internal media relations Open in new tab Table 1. Examples of Internal and External Stakeholders Involved in Risk Management Internal Stakeholders External Stakeholder Administration First responders Biosafety officer or EHS department Government (federal, state, local) Facility managers External media Principal investigators Community members Public safety/security Internal media relations Internal Stakeholders External Stakeholder Administration First responders Biosafety officer or EHS department Government (federal, state, local) Facility managers External media Principal investigators Community members Public safety/security Internal media relations Open in new tab More participants increase the potential for conflicts arising from differing objectives or viewpoints. Position in institutional hierarchy may also drive committee dynamics. The hands-on knowledge of personnel involved in day-to-day operations is instrumental in exploring and revealing points of weakness in the disaster response. Their opinions should not be diminished in the planning process due to fear and/or anxiety barriers of perceived judgment by persons above them in a workplace hierarchy.11 For this group to work smoothly, leadership should consider educating members in techniques such as organizational communication12 to ensure planning receives input from all groups. This technique facilitates open conversation and listening among all team members, rather than dominance by more senior managers.12 Employees with a voice in the process are more likely to engage during plan development and implementation, leading to a successful response and recovery. Situational Understanding Unfortunately, there can never be full mitigation of risk, especially in a containment facility. Facilities must undertake risk control to bring risk to the lowest tolerable or acceptable level.13 Situational understanding is recognized by the Federal Emergency Management Association’s National Incident Support Manual as a key component in disaster response.14 It is the ability to identify risks, assess these risks, and further prioritize them regarding potential danger to human health or research in the context of historic catastrophic events, future possibilities, and understanding the capabilities of the organization. Response goals are then based on these situational considerations.15 Risk Assessment One of the first steps in situational understanding is commonly referred to as risk assessment. This assessment establishes a baseline for an institution by identifying and evaluating the potential for risk. Proper procedures must be in place to influence the outcome of a potential, critical situation and protect the health and safety of the personnel working at a given institution or installation. Risk assessment is an ongoing process. As new events unfold, protective measures are reassessed and the proper recourse established.16 Organizations are encouraged to apply this process to research protocols or emergency response procedures, like chemical spills. Having subject matter experts and institutional committees involved with the risk evaluation and decision-making process at any phase is critical. They are responsible for determining the existing threats and vulnerabilities, thus keeping the institution a safer workplace. Specific Considerations for Situational Awareness Situational awareness takes a great deal of creativity to consider all threats and an astute mind to recognize them. Organized methodologies for creative analysis are available, the use of which can facilitate development of containment unit responses. One such example of creative problem solving is the Osborn-Parnes Creative Problem Solving process.17 Structured problem-solving enables decision-making teams to not miss any risks or ignore subsequent response goals and objectives. These analytic tools can further planning-team cohesiveness and efficacy by giving equal voice to all ideas. The following are examples of risks which may profoundly impact a containment unit in disaster. Human Risk The most common of risks, human error, cannot be overlooked.18,19 Human error could lead to release of a pathogen or data. Human error can also worsen the situation during a disaster response. This error may have significantly greater impact on human and animal life if it occurs in a containment unit. Of the many risks to a containment facility, managing this one is likely the most rewarding and will be discussed in detail below in the plan development and review section. Situational understanding may identify another human risk inherent in many plans. Nearly all disaster plans incorporate outside agencies as part of the response. In reality, a major disaster will likely require these responders to address human injury first and may delay or prevent actions benefitting the animal facility. When available, outside responders may not even enter a containment area either by design or because of fear of the hazards. Animal facility on-site personnel may have to respond first to disaster in a containment facility while awaiting outside agencies. This may require decisions and actions the animal facility staff consider the responsibility of others, such as fire quenching or medical emergencies. This possibility should serve as a core issue during planning. Humans may also pose risk due to malicious intent. Information technology poses great opportunity and threat for containment facilities. Technology has greatly increased capabilities in data collection and processing as well as facility operations. Cybercrime may compromise security and safety systems or release classified information. Cyberattacks could potentially confound identification of animals, administered agents, or biosafety elements through malicious data alteration. This could expose personnel to hazards unknowingly. Illegal entry or override of security measures may occur, allowing release of animals in an act of domestic terrorism. Classified information may be hacked, misconstrued, and released with wicked intent. This could incite public fears against the work done in research facilities and lead to public relation disasters or threats upon the facility and/or personnel. Public perception of high containment research is an inherent risk. Much of this perception focuses on worst-case scenarios such as accidental release of pandemic influenza or Ebola. Others focus on the potential for weaponization of research items like an infectious disease.20 The public’s perception of a potential breach from a hazardous containment suite is a significant risk to the facility’s reputation. As discussed in the section on media relations, facilities should understand public perception of the work and proactively mitigate a negative perception of danger. If a risk to the public from containment animals does arise from a disaster, this must also be clearly and appropriately explained before it is misconstrued, intentionally or otherwise. Species Risks The species type in a containment facility impacts risk. Nonhuman primates and agricultural animals can be among the most difficult species to handle during or following a disaster. Both categories complicate disaster preparations. Nonhuman primates generally will remain in a cage during or following disaster. The most likely risk will be injury to the animal itself and the need to treat it in nonstandard conditions like power outage, flooding, or room damage. Animals at agriculture-specific biosafety level BSL-3Ag are unique. The facility itself serves as the primary biocontainment tool for loose-housed agricultural animals.16 Agricultural animals may become frightened during a disaster such as a tornado or earthquake and may be behaviorally unpredictable. During or following a disaster, animals may not be contained in pens or stalls. Free-roaming animals increase risks to personnel because of the animals’ often large size. Frightened animals are far more likely to injure themselves and may require on-site treatment (if the building is intact), sedation, or euthanasia to contain the biological agents they may harbor. Facilities should prepare personnel to handle these situations. Consequently, considerable emergency preparation is necessary to ensure the safety of personnel, the welfare of the animals, and the biosecurity of infected animals. One of the major risks to animals in a containment facility is the inability to rapidly move them to safety. Following Super Storm Sandy, animals were transported from the New York University Langone Medical Center to another local facility for housing until permanent housing was repaired or rebuilt. This capability is unlikely for containment level animals, especially larger animals. Suitable containment facilities at alternate locations, or even the ability to safely transport hazard-exposed animals, will likely be limited. Shelter-in-place is also probably not realistic for containment level animals if there is a structural breach or even the risk of one. Facility directors should still have conversations and agreements (even if only verbal) with nearby facilities to understand the capabilities each may have in aiding others during time of disaster. As will be discussed in the humane considerations section, this movement limitation leads to difficult decisions regarding euthanasia in disaster preparation or response. Another potential sequela of certain disasters may be the escape of containment level animals. No matter the cause, facilities should have some method for locating, trapping, and potentially euthanizing these animals. For example, following an earthquake it might be impossible to determine how many mice are unaccounted for if cages fall off a rack. Accurate mouse census numbers may be unavailable if animals are tracked by cage rather than individual. Transponders might be one method for location. For larger animals, consideration may be given to pre-event communication with a nearby zoo. These facilities regularly practice animal escape drills and often have established response plans with local authorities, such as local law enforcement.21 These facilities have organized recapture teams with expertise in setting traps and darting or shooting animals to allow for humane live or lethal capture of larger animals such as nonhuman primates or equine species.21 Zoos may be involved in their own disaster response efforts during an actual emergency. Therefore, consideration should be given to meeting with these organizations prior to a disaster. Disaster Type Considerations As part of disaster planning, facilities should consider the most likely disaster(s) to strike their containment facility. When considering environmental catastrophes, institutes should engage local and federal response agencies who have calculated these risks.22 Infrastructural needs will vary depending on location, age of building, zoning, or other requirements. Planning groups must prioritize environmental risks and solutions.23 Facilities in an area prone to tornado strikes need to decide on structural ratings compatible with the highest predictable local wind speeds or consider placement of facilities within underground locations.22,24 Conversely, flood zone areas should consider above-ground facility placement to reduce risk of animal drowning or agent release in effluent following flood. Even if buildings are built to withstand structural damage from earthquakes, other repercussions must be considered.25 As seen in a major earthquake in Japan in 2011, the buildings withstood the earthquake, but vibrations sent cages cascading from racks.26 Future events like this could result in hundreds or thousands of mice or other rodent species running through the containment unit, requiring capture and euthanasia. Large animal cages or stocks in BSL-3Ag could conceivably open and release animals into larger holding areas or beyond. Agent Considerations Many facilities house animals that harbor naturally occurring zoonotic diseases, such as Macacine herpesvirus (B-virus). With an increase in microbiota research, rodents may be obtained with unclear adventitious agent status (e.g., feral or pet store rodents). These animals carry risks for zoonotic disease such as lymphocytic choriomeningitis, Hantavirus, or enteric pathogens. Individual risks associated with these animals may not be identified due to disease-shedding dynamics or facility biosecurity testing regimes. Disaster may lead to release of these animals or human exposure. Dependent on species and funding, as with conventional animals, losses may or must be reported to the USDA and OLAW respectively postdisaster.27,28 Animals infected with biological select agents and toxins, such as many in BSL-3Ag environments, are treated as an “agent”-containing vessel. Previous reviews provide guidance on the increased identification and accounting requirements for select agent- inoculated animals euthanized, found dead, or lost after disaster.1,29,30 Besides biologic agents, radioactive and chemical agents are also administered to animals to further biomedical aims. Practically speaking, most chemical agents given to animals will not pose serious risk to first responders or facility personnel once administered to the animal. Volumes will vary based on size of animal and may increase risk especially if excreted in feces or urine and pose an aerosol risk. Certain chemicals such as 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine may pose a human risk, even after administration to animals. Volatile radioactive agents such as Iodine-131 used at therapeutic doses in animals pose small risk to responders or staff. Ventilation failure is a significant contingency as a volatile radioactive material may concentrate to high levels in a closed room. Responders entering an area with a highly-radioactive airborne agent could be exposed to radiation doses in excess of regulatory limits. Simple precautions, such as ensuring that radioactivity detectors are maintained in multiple locations to increase accessibility during or following a disaster, can greatly reduce exposure risk. Environmental Hazards Although most facilities consider hazards contained within animals in their containment unit disaster response, additional hazards common to many, if not all, facilities need also be considered. Chemical sanitization and disinfection agents are frequently found in large quantities in animal facilities, often in proximity to a containment suite where they are used. Chemicals such as 12.5% sodium hypochlorite (bleach) or chlorine dioxide are capable of skin or respiratory toxicity. Persons rushing into animal containment areas without consideration of the presence of these chemicals or others like isoflurane may be unnecessarily exposed if spills or leaks occurred, especially if ventilation is compromised. Similarly, facilities may have separate gas supply areas for containment units. Displaced gas cylinders can take on torpedo-like properties if manifolds fail. They are also explosion risks in times of fire. High containment areas are generally separated from conventional housing areas geographically and/or by structural safeguards such as airlocks and increased security measures. Facilities should ensure storage of required materials: specialized personal protective equipment (PPE), caging, food and bedding, flashlights, communication equipment like walkie-talkies or satellite phones in alternate locations beyond animal holding areas. During Super Storm Sandy, the storm rendered inoperable the door to one storage area containing PPE. Fortunately, this was not the only central storage location. If a containment area is breached, it may be necessary to don appropriate PPE in a location other than the usual gowning station to reduce risk at time of entry. Regulatory Considerations For all the numerous contingencies encountered during disaster response, laws, regulations, or guidelines set by external agencies such as the USDA, CDC, and US Nuclear Regulatory Commission provide objective guidance in planning. This can be a comprehensive list, especially if select agents, hazardous chemical agents, or radioactive materials are used. The facility must ensure that it is in compliance with all regulations and should maintain as high a standard as feasible in accordance with guidance documents. As there are numerous documents available on these topics, this review will not focus on them. Determining Goals and Objectives Appropriate situational awareness underlies the goals and objectives needed to eliminate risk. Each goal aims to reduce a specific risk by completing objectives.15 A goal of having appropriately trained personnel will likely be one of the most commonly proposed by facilities. An objective to achieve would be to develop personnel’s soft or nontechnical skills necessary for disaster response. These include communication capabilities, stress prevention, leadership skills, and situational awareness.31,32 Nontechnical skills are of particular importance for a containment unit where deliberate actions are required. For example, a containment unit may actually not be harmed during a disaster. If personnel have not developed appropriate nontechnical skills along with plan knowledge, panic may ensue because of uncertainty.31 A panicked employee may leave the containment unit without appropriate decontamination. An injured employee or one tending to an injured employee may also head straight for the emergency room, turning a contained environment into a potential community exposure.33 Even if human error occurs, calm decision-making will prevent compound worsening of this error. Panicked decisions will only worsen the situation.34 Many decisions during or after a disaster will likely come from an Incident Command System (ICS). An ICS provides a formal hierarchical command structure, often lead by the head of institutional safety.35 All other institutional departments will fall into roles beneath this lead. Transitioning the guiding coalition into the ICS provides a management structure resulting in better decisions and more effective use of available resources. Having worked closely together to formulate a plan using concepts such as organizational communication, members know the capabilities and strengths of one another. This leads to trust. Many ICS delineate clear roles and responsibilities for participants. If a person within the ICS hierarchy is not available at time of response, another leader can step up to guide the response calmly and appropriately. Another goal should include appropriate understanding and delineation of the roles first responders may play. The presence of first responders may make a situation worse due to unfamiliarity with site and hazards. Many containment units do not anticipate entry of first responders into the facility in time of disaster or crisis. Instead, plans may prescribe that trained facility staff respond to situations such as personnel injury, active flooding, or initial area evaluation after earthquake. Prepared facilities should ensure that their employees receive training from responders such as firefighters and paramedics. Part of this training ensures appropriate decontamination of injured personnel or communication to first responders that decontamination was not possible due to injuries. First responders must also understand situational risks if they enter or approach an animal containment area. For example, large agricultural animals may complicate on-site injury reporting during extraction efforts. Personnel exiting the facility could be injured from the cause of the disaster, from a frightened animal, or from potential biological agent exposure. Pre-disaster communication of goals and role delineation is paramount. Plan Development and Review Many of the areas of weakness that containment units may identify will involve significant strategic challenges such as ensuring buildings are disaster-proofed or IT configurations are fortified against hackers. Facilities would do well to take the areas for improvement identified and categorize them into strata such as that provided by FEMA. FEMA breaks planning down into 3 levels: strategic, operation, and tactical.36 Strategic planning examines the larger picture in response, including allocation of resources—financial and other—to ensure appropriate capabilities and capacities for withstanding and rebuilding after disaster.36 Even careful strategic planning may not mitigate all risk, leaving the possibility for disastrous consequences. As illustrated in the comprehensive examination of the National Bio- and Agro-Defense Facility in Manhattan, Kansas, even one of the most studied and planned animal high containment units may have potential, unpredictable weaknesses in the face of natural disaster.34 History has shown that proposed upper tolerance limits for anticipated weather or other natural disasters may not be sufficient in events such as Super Storm Sandy and Tropical Storm Allison.35,37 While strategic planning looks to attenuate risks through integral capabilities, further operational and tactical planning serve to complete contingency responses. Operational plans aim to identify the roles and responsibilities of people identified in situational awareness and goal setting. These are the paper plans including business continuity, emergency operations, and risk management.15 Tactical planning focuses on the personnel and auxiliary resources required in the actual response.15 Ultimately, tactical planning may be the most critical for success in a disaster response. The development of personnel involved in daily care of animals, and thus most likely to be involved in a response, is paramount. As previously discussed, facilities must develop both the plan and personnel. Without appropriate, disaster-prepared personnel, no paper plan will succeed. Creative evaluation and implementation of plans should follow development. Rehearsing for the Plan and Learning to Improvise There are 2 types of rehearsal exercises used: discussion and operation based. Discussion-based exercises include seminars, workshops, tabletop exercises, and games, whereas operation-based exercises include drills as well as functional and full-scale exercises. Discussion-based exercises can be used to familiarize players with or develop new, plans, policies, agreements, and procedures; they focus on strategic, policy-oriented issues.38 Operation-based exercises are used to validate plans, policies, agreements, and procedures; clarify roles and responsibilities; and identify resource gaps. Furthermore, they rehearse activities such as initiating communications or mobilizing personnel and resources.38 An effective way to reduce the impact of an incident is to share practical knowledge through exercises. Institutions utilizing BSATs must follow regulatory requirements dictating the need to execute training or exercises on an annual basis. These include examples such as response to the previous scenario of injury of personnel in high containment areas. Facility personnel should rehearse performing cardiopulmonary resuscitation when unable to access a person’s airway due to PPE and ensuring that a responder can safely move injured personnel out of a containment facility without further injury or contamination of others. All personnel who may work in biocontainment areas should have annual training. A key component is a live, scenario-driven exercise to ensure that those who work in this environment can extract both themselves and a colleague if an emergency arises. Institutions that do not work with BSATs, but with pathogens still considered high risk, may not be obligated to conduct training or exercises but nonetheless may benefit from following best practices. No matter the type of training or drills employed, they should be commensurate with the target audience, whether it be the ICS, cleaning personnel, or external stakeholders. The training should reinforce the roles, responsibilities, and procedures required in the event of an emergency. The implementation of exercises should be continuous, as it is a practical tool for simulating new ideas and concepts and further developing communication methods among all players. The practice of proposed scenarios should not be done only in controlled, scheduled trainings. Stress induces a significant change in personnel thought processes.19 Simple actions in a controlled environment become difficult with pressure. The threat of a hazardous agent is such pressure. The authors recommend using development techniques that place employees in challenging situations. Training like this increases participant comfort in handling the pressures of disaster.31 Examples include discussion-based forums like tactical decision games31,39 or operation-based ones such as working in a power outage. Many overlooked difficulties are elucidated in these trainings such as trying to find flashlights or realizing that head lamps are better to keep hands free. Without appropriately developed personnel, no amount of planning will lead to a successful disaster response. Development of both technical and nontechnical skills requires time investment. Beyond the aforementioned nontechnical skill training, containment unit staff need specific technical skills. More than one person should have the appropriate technical skills to handle animals in a biocontainment unit. All essential personnel may not be available depending on the nature of the disaster. Training should include investigative staff that run high containment Animal Biosafety Levels (ABSL) satellites. These personnel and animal facility personnel must be comfortable with responding to disaster or another crisis. Laboratory personnel working in a high containment facility should undergo the same disaster response education as that of the primary animal handling staff. For containment facilities that are managed by laboratory personnel, there should be a backup plan in the event that they are not present or available in a disaster. Humane Considerations In or following a disaster, mass euthanasia techniques for containment animals should be considered. Personnel may have to euthanize animals if they cannot be appropriately treated or if their well-being is affected by worsening conditions. Considering the timing of euthanasia for these animals requires a great deal of thought and preparation. Guidelines for the order of euthanasia of animals should be developed such as that described in the Rockefeller University, NY disaster response plan.8 Euthanasia starts with containment level animals. Containment facilities require specialized and time-intensive care for the animals that may not be feasible during or after a disaster. Leadership of a containment facility must be prepared to activate or support the decision to depopulate animals in a high containment facility when the magnitude of disaster is uncertain such as for a predicted pandemic, storm, or other foreseeable potential catastrophe. Preemptive euthanasia may prevent animal suffering if sufficient staff cannot report to work due to disaster and care for animals or carry out euthanasia post-event.8 Events that occur without warning may also require euthanasia. When staff are present, euthanasia may be rapidly completed. If staff are delayed or unable to enter a facility, animal welfare may be significantly impacted. Euthanasia should be a focus area for plan development. Situational awareness, planning, and rehearsal of plan should include ensuring adequate, accessible supplies for euthanasia. For rodents and other small animals, planning must ensure that adequate CO2 is available and calculations of time required to euthanize all rodents in a containment facility. Rodent mass euthanasia can be a time-consuming endeavor in a standard facility.8 Large animals require sufficient euthanasia solution and a review of the time necessary to find and don appropriate PPE, enter the facility, draw up solution (performed with saline or appropriate substitute), and mock-administer it. Some animals may require sedation prior to administration of euthanasia, adding additional time to the process. In high containment facilities, it may take upwards of 30 to 40 minutes just to gown up to enter the facility.40 During or after an event people may rush to provide care for the animals. Mistakes may affect human life if staff rush or do not respond calmly. Employees must understand that their lives come first. In their dedication to the animals, this is something that animal facility personnel may not always immediately consider. When rapid euthanasia is required, facilities may need to look to alternate methods beyond conventional laboratory animal methodologies. The American Veterinary Medical Association is developing guidelines on depopulation of animals, including laboratory animals.41 Critical to this document is the distinction between depopulation and culling. Depopulation is done in response to a disaster or crisis situation and culling is done for pest or stray control or prophylactically to prevent disease spread.41 Depopulation will only be done in extraordinary circumstances in which leadership predicts that animals will eventually die as a result of the disaster. This death may be prolonged and potentially stressful or painful to the animals. The AVMA emphasizes that the choice of termination method should adhere to ethical standards and guidelines as well as state and federal laws.41 The guidelines reinforce the role of the attending veterinarian in deciding the best method of depopulation. The method required may not adhere to euthanasia guidelines in the time of emergency. For both ethical and humane reasons, disaster depopulation planning should not be the attending veterinarian’s alone. Rather, it should be a group effort to determine depopulation options. Various scenarios should be considered depending on time, resources, and personnel available. For example, in the face of a rising pandemic illness, cage-by-cage CO2 euthanasia of rodents may not be feasible. When a rapid response is required, placement of large numbers of mice in a large container prefilled with CO2 may be necessary. CO2 canisters may be limited or in inaccessible areas with more unlikely to arrive soon. Although these do not conform to the AVMA guidelines on euthanasia, in the event of disaster, routine, time-consuming methods of euthanasia may result in prolonged animal suffering. High containment facilities provide an opportunity for technologic advances, which may aid in emergency euthanasia. Current technology includes the capability to introduce CO2 into rodent microisolator racks in situ. High containment units for large animals could consider retrofit or new construction of areas to allow room-level euthanasia with CO2, argon, or nitrogen. These considerations could reduce the need for personnel to enter rooms in times of disaster and allow for rapid, humane killing of animals. Technology such as CO2 or nitrogen foam has been developed for mass depopulation of poultry farms.42 This technology may be adaptable to laboratory animal use in time of emergency. These techniques require numerous safeguards against human imperilment, loss of function in disasters, or accidental use. Remote euthanasia capabilities warrant further studies to reduce personnel exposure to toxic agents and emotional burdens. By reducing personnel time and effort through remote euthanasia, a greater number of noncontainment level animals may be saved or treated. Following mass euthanasia, carcasses must be disposed of properly. Redundant systems for disposal of high containment carcasses must exist in the forms of autoclaves, incinerators, or tissue digesters. Depending on the disaster type, these may not be functional during the recovery period. Alternate disposal methods appropriate to state and federal guidelines must be found. This may require contracting services with outside vendors capable of legally transporting these carcasses to a functional disposal system. If no transport available, carcasses may have to be placed in sealed bags and held until disposal possible. Housing rooms may serve as temporary morgues if they can be secured. Considerations for the people involved in the disaster response is needed. These are trying times and the loss of animal life can severely affect those who were their caretakers. Discussions and mental preparation for the possibility for mass euthanasia must be made in advance. Following a disaster, arrangements should be made to provide counseling to all persons involved in the response. Personal experience from the authors underscores the importance of this service. Media Response In the immediate and continued wake of a disaster to a containment facility, the public will want to know what happened to the animals and has anything dangerous escaped. Most animal facility personnel, leadership included, will state that they are not to speak to the press and that their institution’s public relations office will handle everything in the event of a disaster. The harsh reality, as experienced by the authors (GR and JP), is that it is unrealistic to expect PR staff members to know the animal facility and its operations in the level of detail often required of the press. To illustrate this point, try an experiment. Give your PR staff a briefing about everything you think they would ever need to know about the animal research facility. Then have a different person in the laboratory animal field ask them rapid fire questions, as a reporter would do. Even if senior PR staff have been given a presentation about animal research at the institution, they likely will not know the details of the disaster plan, precisely how animals are maintained, what hazardous agents are in use, etc. Given the 24-hour news cycle and prevalence of social media outlets, bad news travels faster than ever before and there simply is not enough time for multiple layers of leadership to ponder and prepare curated statements to the press. Animal facility leadership, who know their operation better than anyone, should be capable of presenting a statement to the press, likely with PR staff also present to provide a sense of security to the institution. While the PR office may control the institution’s social media accounts, animal facility leadership should be prepared to provide statements to the PR office for use on social media. Most of the fear of talking to the press comes from historical issues related to those who oppose animal research. While those individuals still exist, in the current political and socio-economic environment, the public as a whole is much more accepting of science and the need for biomedical research.43 The public does, however, have an understandable expectation of honesty, and the laboratory animal community needs to start being more open and transparent.44 If the public sees the people involved in animal research as the competent, caring individuals that we are, they are more likely to give us the benefit of the doubt and be a receptive audience in the event of a disaster. General Summary In this review, we focus on the challenges of developing a response plan for high containment animal research units. Many of these challenges reflect the need to adequately prepare personnel with skills beyond their everyday technical knowledge. This may not be a high priority for many facilities. Daily operations consume available time for development. Often only the bare minimum training is completed. This will not be sufficient when disaster strikes. Prior preparation can even reduce the stress of speaking to the media. Unclear communication with press may result in misspoken words or unclear responses. Theoretical written responses, such as plans for euthanasia, may not suffice. Close review and operational drills should be used to validate these. Institutes should work to incorporate stress in their training. This review emphasizes the importance of at least annual training and review for a high containment unit disaster plan. Acknowledgments The authors thank Katharine Hope, Colleen Thurman, Bruce Busby, and Nathaniel Powell for their insightful discussions and edits of this paper. References 1 Swearengen JR , Vargas KJ , Tate MK , Linde NS . Disaster preparedness in biocontainment animal research facilities: developing and implementing an incident response plan (IRP) . ILAR J . 2010 ; 51 ( 2 ): 120 – 126 . WorldCat 2 Choosewood LC , WIlson DE , eds. Biosafety in microbiological and biomedical laboratories . 5th ed . Washington, DC : U.S. Department of Health and Human Services ; 2009 . Google Preview WorldCat COPAC 3 Federal Emergency Management Agency . Developing and maintaining emergency operations plans. Comprehensive preparedness guide (CPG) 101 Version 2.0. https://www.fema.gov/media-library-data/20130726-1828-25045-0014/cpg_101_comprehensive_preparedness_guide_developing_and_maintaining_emergency_operations_plans_2010.pdf. Published November, 2010. Accessed February 1, 2018. 4 Mortell N , Nicholls S . Practical considerations for disaster preparedness and continuity management in research facilities . Lab Anim (NY) . 2013 ; 42 ( 10 ): F18 – F24 . WorldCat 5 Kapucu N . Collaborative emergency management: better community organising, better public preparedness and response . Disasters . 2008 ; 32 ( 2 ): 239 – 262 . WorldCat 6 Drabek TE . The human side of disaster . Boca Raton, FL : CRC Press ; 2013 . Google Preview WorldCat COPAC 7 Carnell M . Hold your ground . Qual Prog . 2017 ; 50 ( 6 ): 44 . WorldCat 8 Roble GS , Lingenhol NM , Baker B , Wilkerson A , Tolwani RJ . A comprehensive laboratory animal facility pandemic response plan . J Am Assoc Lab Anim Sci . 2010 ; 49 ( 5 ): 623 – 632 . WorldCat 9 Fell AH , Bailey PJ . Public response to infectious disease research: the UC Davis experience . ILAR J . 2005 ; 46 ( 1 ): 65 – 71 . WorldCat 10 Cantu M . NIH establishes groups to address concerns about Boston biolab . Biosecur Bioterror . 2008 ; 6 ( 2 ): 125 – 128 . WorldCat 11 Kelley T , Kelley D . Reclaim your creative confidence . Harv Bus Rev . 2012 ; 90 ( 12 ): 115 – 118 , 135. WorldCat 12 Groysberg B , Slind M . Leadership is a conversation . Harv Bus Rev . 2012 ; 90 ( 6 ): 76 – 84 , 144. WorldCat 13 Proag S-L , Proag V . A framework for risk assessment . Procedia Econ Financ . 2014 ; 18 : 206 – 213 . WorldCat 14 Federal Emergency Management Agency . National Incident Support Manual. FEMA. https://www.fema.gov/media-library-data/20130726-1821-25045-8641/fema_national_incident_support_manual_03_23_2011.pdf. Published February 2011 . Accessed January 15, 2018. 15 Benjamin GC , Brown L , Carlin E , eds. Strengthening the disaster resilience of the academic biomedical research community: protecting the nation’s investment . Washington, DC : National Academies Press ; 2017 . Google Preview WorldCat COPAC 16 Department of the Army . Risk Management. Headquarters, DOA. http://www.benning.army.mil/MCoE/MCoE-Safety/content/PDF/ATP%205-19%20Risk%20Management%202014.pdf. Published April 2014 . Accessed December 8, 2017. 17 Miller B , Vehar JR , Firestein RL , Thurber S , & Nielsen D . A look at Creativity. In: Creativity Unbound: An introduction to creative process . 5th ed . Evanston, IL : FourSight, LLC ; 2011 : 11 – 24 . Google Preview WorldCat COPAC 18 Petrillo A , De Felice F , Falcone D , Silvestri A , Zomparelli F . A hybrid probabilistic model for evaluating and simulating human error in industrial emergency conditions (HEIE) . J Fail Anal Prev . 2017 ; 17 ( 3 ): 462 – 476 . WorldCat 19 Brennan PA , Mitchell DA , Holmes S , Plint S , Parry D . Good people who try their best can have problems: recognition of human factors and how to minimise error . Br J Oral Maxillofac Surg . 2016 ; 54 ( 1 ): 3 – 7 . WorldCat 20 Zubay G . Terrorism and fear how to cope. In: Zubay G , ed. Agents of Bioterrorism . New York : Columbia University Press , 2005 , p. 1 – 4 . Google Preview WorldCat COPAC 21 Miller RE , Fowler ME . Fowler’s zoo and wild animal medicine: current therapy . Vol 7 . St. Louis, MO : Elsevier/Saunders ; 2011 . Google Preview WorldCat COPAC 22 National Institute of Standards and Technology . Community Resilience Planning Guide for Buildings and Infrastructure Systems Vol 1.U.S. Department of Commerce. https://nvlpubs.nist.gov/nistpubs/specialpublications/NIST.SP.1190v1.pdf. Published May 2016 . Accessed January 15, 2018. 23 Vogelweid CM , Hill JB , Shea RA , Truby SJ , Schantz LD . Using site assessment and risk analysis to plan and build disaster-resistant programs and facilities . Lab Anim (NY) . 2003 ; 32 ( 2 ): 40 – 44 . WorldCat 24 Federal Emergency Management Agency . Safe Rooms for Tornadoes and Hurricanes: Guidance for Community and Residential Safe Rooms 3rd ed. FEMA. https://www.fema.gov/media-library-data/1467990808182-0272256cba8a35a4e8c35eeff53dd547/fema_p361_July2016_508.pdf. Published March 2015 . Accessed January 15, 2018. 25 Vogelweid CM , Hill JB , Shea RA , Johnson DB . Earthquakes and building design: a primer for the laboratory animal professional . Lab Anim (NY) . 2005 ; 34 ( 7 ): 35 – 42 . WorldCat 26 Ikeda T . Crisis management and recovery from the damage to the laboratory animal production facility due to the Great East Japan Earthquake . Exp Anim . 2012 ; 61 ( 1 ): 1 – 11 . WorldCat 27 APHIS . Stakeholders Announcement, Inspection Procedures in Response to an Incident or Adverse Event in Regulated Facilities. USDA. https://www.aphis.usda.gov/publications/animal_welfare/2012/inspection_incident_response_sa.pdf. Published 2012 . Accessed January 15, 2018. 28 OLAW . Guidance on Prompt Reporting to OLAW under the PHS Policy on Humane Care and Use of Laboratory Animals. DHS. https://grants.nih.gov/grants/guide/notice-files/NOT-OD-05-034.html. Published February 24, 2005 . Accessed January 15, 2018. 29 Kastenmayer RJ , Moore RM , Bright AL , Torres-Cruz R , Elkins WR . Select agent and toxin regulations: beyond the eighth edition of the Guide for the Care and Use of Laboratory Animals . J Am Assoc Lab Anim Sci . 2012 ; 51 ( 3 ): 333 – 338 . WorldCat 30 Tate MK . Disaster planning for animal biocontainment facilities. In: Richmond JY , ed. Anthology of Biosafety No. XII. Managing Challenges for Safe Operations of BSL/ABSL-3 facilities . Mundelien, IL : American Biological Safety Association , 2011 . Google Preview WorldCat COPAC 31 Pullium JK , Roble GS , Raymond MA . Emergency planning: be prepared . Nature . 2014 ; 514 ( 7523 ): 430 . WorldCat 32 Crichton M , Flin R . Identifying and training non-technical skills of nuclear emergency response teams . Ann Nucl Energy . 2004 ; 31 ( 12 ): 1317 – 1330 . WorldCat 33 der Heide EA . The importance of evidence-based disaster planning . Ann Emerg Med 2006 ; 47 ( 1 ): 34 – 49 . WorldCat 34 National Research Council . Evaluation of the updated site-specific risk assessment for the national bio-and agro-defense facility in Manhattan, Kansas . Washington, DC: National Academies Press ; 2012 . Google Preview WorldCat COPAC 35 Mische S , Wilkerson A . Disaster and contingency planning for scientific shared resource cores . J Biomol Tech . 2016 ; 27 ( 1 ): 4 – 17 . WorldCat 36 Department of Homeland Security . National Planning System. FEMA. https://www.fema.gov/media-library-data/1454504745569-c5234d4556a00eb7b86342c869531ea0/National_Planning_System_20151029.pdf. Published February 2016 . Accessed January 15, 2018. 37 Sincell M . Houston flood. Research toll is heavy in time and money . Science . 2001 ; 293 ( 5530 ): 589 . WorldCat 38 Department of Homeland Security . Homeland Security Exercise and Evaluation Program (HSEEP). FEMA. https://www.fema.gov/media-library-data/20130726-1914-25045-8890/hseep_apr13_.pdf. Published April 1, 2013 . Accessed January 15, 2018. 39 Crichton MT . Improving team effectiveness using tactical decision games . Safety Sci . 2009 ; 47 ( 3 ): 330 – 336 . WorldCat 40 Copps J . Issues related to the use of animals in biocontainment research facilities . ILAR J . 2005 ; 46 ( 1 ): 34 – 43 . WorldCat 41 American Veterinary Medical Association . Draft for comment: The AVMA Guidelines for the Depopulation of Animals. AVMA. https://www.avma.org/KB/Policies/Documents/AVMA-Depopulation.pdf. Published 2017. Accessed January 15, 2018. 42 National Animal Health Emergency Management System . NAHEMS guidelines: mass depopulation and euthanasia. ISU. http://www.cfsph.iastate.edu/pdf/fad-prep-nahems-guidelines-mass-depopulation-and-euthanasia. Published August 2015 . Accessed January 15, 2018. 43 Kennedy B . Americans broadly favor government funding for medical and science research. Pew Research Center. http://www.pewresearch.org/fact-tank/2018/07/03/americans-broadly-favor-government-funding-for-medical-and-science-research/. Published July 3, 2018 . Accessed September 7, 2018. 44 Buckmaster CA . Either open up, or give up . Lab Anim (NY) . 2015 ; 44 ( 8 ): 325 . WorldCat © The Author(s) 2018. Published by Oxford University Press on behalf of the National Academy of Sciences. All rights reserved. For permissions, please email: journals.permissions@oup.com This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model) TI - Disaster Planning for Animals in Hazardous Agent Containment Units JF - ILAR Journal DO - 10.1093/ilar/ily022 DA - 2018-12-31 UR - https://www.deepdyve.com/lp/oxford-university-press/disaster-planning-for-animals-in-hazardous-agent-containment-units-X7a7boHyV5 SP - 195 VL - 59 IS - 2 DP - DeepDyve ER -