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Photos from AMC’s The Walking Dead

Once Again, UC San Diego Health System Takes a Bite out of the Zombie Apocalypse

In May the CDC issued guidelines for The Zombie Apocalypse. We interviewed Jay Doucet, MD Associate Professor of Clinical Surgery & Director, Surgical Intensive Care Unit for UC San Diego Health System to assess our readiness for such an event. We know what people at home should do: “Get a kit. Make a plan.” But is our Health System ready to deal with this kind of disaster?

Dr. Doucet says yes, we are.

Question:  How would we get information that a deadly disease is infecting people?

Answer: If a new infectious disease were to appear, reports from hospitals and physicians to County Public Health officers would be the first step in identifying whether there was an occurrence of disease greater than would otherwise be expected at a particular time and place – typically called an “outbreak.” Epidemiologists and Infectious Disease specialists in government and universities would look at clinical data, samples, time and geography, to determine the source of the infections. Typically these are either “common source” – where all victims acquire the infection from the same source, such as contaminated food or water – or is “propagated” — where transmission occurs from person to person.
In many of the movies about Zombies, although the origin of the infection is unclear, bites from affected individuals seem to spread the condition. Often there is portrayal of an asymptomatic period, and then disease obviously affects the brain, and is highly lethal, which resembles the real disease rabies in some ways. This would make clinicians and scientists suspect a viral cause, probably a blood borne virus.

While finding a cure for Zombieism would be a focus for national laboratories in agencies such as the CDC, the military and universities, the most important initial control measures would focus on preventing spread. This could include quarantine or isolation of infected individuals and protective measures for the population such as school or work closures. Since Zombies are usually violent and likely non-complaint patients, such measures may be involuntary, and there are laws which permit such measures to be enforced.

The severity of the outbreak may require the declaration of a state of emergency by responsible elected officials, which allows emergency resources to be deployed.
Information about the outbreak would come from several sources. Hospitals and Health Care providers receive alerts from County and State Public Health officials via electronic alerts about potential outbreaks. The public would be informed media briefings from public officials and by agencies such as County Public Health and the CDC. Websites such as http://ready.gov, http://www.bt.cdc.gov and http://www.sdcountyemergency.com are good sources of current information too.

Q:   How will we deal with the walking well vs. the walking dead?

A: Hospitals are required by regulatory agencies such as the Joint Commission to have an “All-Hazards” disaster plan – a plan that can deal with any future known or unknown hazard. UC San Diego has three full-time staff dedicated to Emergency Preparedness and Responses.

One of the early priorities is control of access to the facility. Hospitals may be overwhelmed during disasters by worried-well persons, family members looking for loved ones, new volunteer providers, media and even public officials, all demanding access.

Control of access to the facility is an important component of emergency plans and exercises. Extra security will be seen at entrances and some entrances may be closed. Patients who are acutely ill or injured may be first seen outside the facility by providers in a “triage area” before entering the facility. Patients who are not ill or injured, but are simply worried about exposure to an infectious agent, such as Zombie saliva, may be observed in an area or building outside the hospital where infectious disease precautions may be used. Large numbers of worried well may be told to wait at home in voluntary quarantine and return if they suspect the onset of symptoms.

Non-compliant or violent individuals are actually part of All-Hazards plans and exercises. Since Zombies are popularly portrayed as a health threat and a security threat, both health organizations and law enforcement agencies would cooperate in protecting health facilities. Such cooperative schemes were actually practiced during recent “Golden Guardian” and “Golden Phoenix” exercises in California and at UC San Diego.

Q: What about barricades?

A: During exercises or events, patients and families may actually see barriers or checkpoints around their hospital. However, there will always be someone who will greet them at the facility. The first hospital personnel they meet may be accompanied by a security officer or law-enforcement officer, who may be armed. In a large scale event, the military may assist civil authorities in protecting key infrastructure, including hospitals. Patients seeking attention will still be seen, but hospital personnel may be wearing a mask and protective clothing until the visitors or patients can be asked about infectious exposures and symptoms.

Q: What general tips do you have for preparedness?

A: Emergency preparedness requires all of us to think and take action. Every person who is able should take action. The key things to do at home are to:

Make a plan for events with your family.

Prepare a disaster kit.

Stay informed.

Workplaces and schools should have preparedness plans too.

Q:  And finally, Dr. Doucet: are you ready for the Zombie apocalypse?

A: Absolutely! UC San Diego Health System is prepared!