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Five Phases of Emergency Preparedness

In 2017, the centers for Medicare and Medicaid established emergency preparedness requirements for:

  • Hospitals

  • Nursing facilities

  • Home health providers

  • Federally qualified health centers

These programs were established for providers to prepare for natural, physical, or biological disasters. In addition, they required regularly-held emergency preparedness drills and exercises.

The coronavirus pandemic exposed the fact that many facilities that care for the elderly and impoverished were not prepared for emergencies.

The Preparedness Cycle is comprised of five phases and include:

  1. Preparedness

  2. Prevention

  3. Response

  4. Recovery

  5. Mitigation

These phases suggest a continuous cycle of planning, training, organizing, equipping, exercising, and evaluating emergency preparedness activities. They allow organizations to increase their scope and flexibility to experience and recover from any disaster.

By implementing The Preparedness Cycle, organizations should have specific strategies to prepare for any disaster. Although it is impossible to prevent disasters, it can be an effective mechanism to plan and reduce the loss of life and property.


The focus of prevention is creating plans, training, and exercises well ahead of a disaster to prepare your organization. This emergency planning and activities allow organizations to reduce loss of life, develop organizational-specific plans, standardize tools and set emergency management protocols.


This part of the cycle requires continuous emergency planning, staff training, exercising, assessment, and remedial actions. Both preparedness and readiness are necessary for organizations and communities to prepare for a disaster.


As organizations respond to disaster, they must use all emergency preparedness tools to respond to any disaster including how to deal with supply chain interruptions, changes in service delivery, and day-to-day staffing.


This part of the cycle focuses on restoring critical business functions to maintain day services and increase capacity to serve all people in the community or organization.


This action allows organizations to reduce loss of life and physical assets, including supplies and buildings. It lessens the overall effect of the disaster on an organization and the whole community.

There was a breakdown of the Preparation Cycle before and during the pandemic throughout the medical system. According to AARP, 95 percent of Americans killed by COVID 19 were 50 or older. These are grim and alarming statistics taken from demographic data available from the Centers for Disease Control and Prevention (CDC). It was truly devastating.

New York seemed to be the center of the breakdown. Medication, masks, and morale were running low at the Brooklyn Hospital Center. The vast majority of those that went to the hospital were older adults.

Then COVID-19 became rampant in nursing homes. Long-term care facilities shouldered an even more significant burden. According to data from the Centers for Medicare and Medicaid Services, more than 61,000 home residents died from COVID-19 in the United States.. Adding in staff and residents, and the Kaiser Family Foundation reported 84,000 deaths.

One reason the virus was especially lethal in older adults was the prevalence of chronic diseases. Eighty percent of these older adults had at least one chronic health condition, from obesity to cancer. The immune function also played into the disaster, making older adults less capable of fighting off Corona. They did not have the layers of resiliency that younger people possessed.

Residents in long-term facilities did not have access to medical-grade masks, gowns, gloves, and other forms of personal protective equipment meant to block the transmission of the virus. There were also staff shortages.

Older Americans are now demanding that elected officials take the pandemic seriously. The situation was difficult for hospitals generally, but long-term facilities shouldered a more significant burden.

The Perfect Storm

Chronic disease, along with aging immune systems, created the perfect storm for disaster. People living and working together in confined, indoor spaces created an environment ripe for the rapid spread of the virus.

A growing number of coronavirus survivors report lingering symptoms of the illness. The concern is learning the best way to provide for those still suffering weeks and months after they contracted the virus. Hopefully, there are many lessons learned from COVID-19. A geriatrician, Paula Lester, suggests that older adults stay on top of the medications their doctor prescribed, eat healthy, manage stress, and get plenty of exercise. No one was prepared for the toll on mental health that many older adults face. They feel isolated, depressed, anxious, and overwhelmed and need to contact with family, friends, and volunteers. AARP remains committed to helping the 50-plus population.

Even though the pandemic is nearly contained, it is crucial to remain vigilant.

According to the CDC, those that are at an increased risk for severe illness from COVID-19 include:

  • Substance use disorders (alcohol, opioid, or cocaine use)

  • Stroke or cerebrovascular disease

  • Organ or blood stem cell transplant

  • Smoking, current or former

  • Sickle cell disease

  • Pregnancy

  • Overweight and obesity (body mass index of 25 or greater)

  • Liver disease

  • Immunocompromised state (weakened immune system)

  • HIV infection

  • Heart conditions (heart failure, coronary artery disease, cardiomyopathies, or hypertension)

  • Down Syndrome

  • Diabetes (type 1 or type 2)

  • Dementia or other neurological conditions

  • Chronic lung disease, including COPD, asthma, interstitial lung disease, cystic fibrosis, and pulmonary hypertension

  • Chronic kidney disease

  • Cancer

No one knows when the next big disaster will occur, but by following the guidelines set out by Medicare and Medicaid, fewer people will be affected. It would be wise for each family to utilize each phase in The Preparedness Cycle:

  • Preparedness

  • Prevention

  • Response

  • Recovery

  • Mitigation

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