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Simulation Exercise 
The Next Two Days – Population and Environmental Impacts
May 1, 2021, at 8:30 AM, fire and law enforcement personnel responding to the incident scene are aware that an explosion has occurred that is not normal, and they have suspected that it is a nuclear explosion. They are detecting high levels of radiation, and it appears that some sort of nuclear explosion has occurred. There is a small mushroom cloud in the area.
The Incident Commander (IC) has asked for additional mutual aid resources. The IC is requesting the Oklahoma National Guard 63rd Civil Support Team (CST) be deployed immediately along with other neighboring response organizations.
By noon, the public, facilities, and hospitals receive notice to begin evacuating out of the Dangerous Fallout (DF) zone.
Many citizens have self-evacuated and are leaving Bobsville for a more secure environment.
May 1, 2021, at 9:00 AM, Bunnyville hospital initiated START triage as soon as victims began arriving at the hospital. Bunnyville hospital reports many citizens arriving at the emergency room without any physical impacts, but they demonstrate significant psychological effects. Bunnyville Hospital is already overwhelmed with victims who have presented with severe injuries. They have implemented START triage for all patients to include those with psychological or mental health issues. Bunnyville hospital is separating the physically injured and are placing the mental health patients in a holding area and are classifying them as green or delayed patients.
May 1, 2021, at 1:00 PM, Incident Command recommends the local college gymnasium be utilized as a temporary casualty collection point. This site offers sufficient space allocation, brick structure for shielding, accessibility, and amenities needed to support a casualty collection point.
May 1, 2021, 2:00 PM, a meeting is held with elected leaders, public health officials, hospital leadership, law enforcement, and community advocates/leaders.
The discussion is about high public anxiety over radiation and diminished understanding of the associated risks and protective actions implemented.
There is increased demand for messaging and information even at points distant from the incident.
Elevated behavioral health impacts already exist within the impacted population as public fear of radiation has resulted in many concerned, healthy citizens seeking medical assistance.  
If not mitigated radiological fear, and mental health issues will quickly add to the already overwhelmed limited medical facilities. Medical facilities impacted by the concerned yet healthy citizens will continue to affect capability and capacity to assist the sick and wounded.
By May 1, 2021, at 3:00 PM, patient fatalities have exceeded the capacity of the hospital morgue and the county medical examiner’s office.
Bobsville receives notice that a crude 1kt (kiloton) nuclear device appears to be the cause of the detonation. Currently, there is no information available as to who is responsible.
May 2, 2021, 8:00 AM, the Governor of the State of Oklahoma has prioritized the following response mission actions:
Lifesaving,
Life-sustaining,
Mental health,
Property protection,
Other measures intended to neutralize the immediate threat to life, environment, and property to achieve community stabilization.
The State of Oklahoma has also activated multiple units of the National Guard to respond to the impacted area of Bobsville.
Activated National Guard will provide mass care, critical transportation, and evacuation support resources to the community. Additionally, at the request of the Bobsville Incident Management Team Incident Commander, the Governor has requested any National Guard medical personnel with a background in mental health treatment or psychological first aid to be activated.
The National Guard is also assisting with scene security, and several additional Civil Support Teams (CST) have been requested and are en-route from other locations. The CST teams will support monitoring operations until other Federal agencies have arrived on the scene.
The State of Oklahoma has asked for assistance from the National Disaster Medical System with Disaster Mortuary Operation Response Teams (DMORT) to assist with identification, evidence collection and decontamination of deceased victims.
Mass Care of citizens, responders and domestics pets is a priority, and some agencies have already begun to arrive and have established mass care functions at Reception Care Centers (RCC).
Decontamination needs for mass care will place additional constraints on responder resources. In some cases, decontamination standards will need to be adjusted to allow entry and reentry into shelters or RCC’s.
Planning has begun for short and long-term domestic contamination migration issues due to unmonitored and uncontrolled movement of people, household pets and service animals, and transportation conveyances outward from the Bobsville, which could cause cascading challenges across multiple jurisdictions. GCPHD has begun to implement different surveillance methods to identify and track victims/patients/citizens that may have been exposed to radiation.
Additionally, GCPHD has implemented surveillance systems to track individuals who may be presenting with mental health issues.
Children continue to be sheltered-in-place at schools and have been anxious to be reunited with their parents and parents with their children.  Some parents have not yet been located, which has created some complexities. 
Some individuals did not receive the evacuation order. First responders have been attempting to locate all citizens still sheltering-in-place to be evacuated and relocated to [preidentified] Reception and Care Center (RCC) locations outside the hazard zone.
Environmental assessments and consequences have been evaluated and may include contamination of ground and water systems (natural and distributed).
Residual radioactivity in the environment (e.g., waterways, livestock, forests, agricultural land, and wildlife) may affect the food supply and drinking water.
Stormwater runoff may contaminate retention basins, stormwater management systems, and larger waterways, affecting drinking water.
Key Issues
During these 48 hours, hospital EDs and community health center clinics are above surge capacity.
A Casualty Collection Point is established at the college.
Residents, schools, and other locations have been sheltering-in-place but now have been instructed to begin evacuation procedures.
Civil Support Teams have arrived and are providing technical expertise to Incident Command.
Mental health issues and psychological first aid requirements for citizens are overwhelming the health care infrastructure.
Children are in the process of being reunited with located parents/guardians.
Bobsville and General County have begun to receive medical assets, food and evacuation assistance coordinated through the first responders, National Guard, the American Red Cross, state and local public health agencies.
Discussion Questions:
Based on the information provided, participate in the discussion concerning the issues raised in Week 6. Identify any additional requirements, critical issues, decisions, or questions.
What are the public health and medical agencies, short-term, intermediate, and long-term priorities?
What federal agencies should be requested or might automatically respond to this incident?
Post must be 400 words or more APA format with references.
References: 
https://training.fema.gov/emiweb/downloads/is3_is3all.pdf
https://www.nrc.gov/about-nrc/emerg-preparedness/in-radiological-emerg.html
https://www.nrc.gov/about-nrc/emerg-preparedness/about-emerg-preparedness/emerg-classification.html
https://www.nrc.gov/about-nrc/emerg-preparedness/prepare-for-radiological-emerg.html

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