There Is No National Coordination System - There Are 12

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There Is No Single National Coordination System For Disaster Response

NO, there is no single US system to help everyone in every state and in every hospital get the critical pandemic/disaster response supplies, resources, staff, and equipment that they need here in the largest catastrophe the US has faced in a century.  A video on this same subject is here.

There is no national coordination system for the prioritization, allocation, and distribution of limited critical national resources in a catastrophe or pandemic.

There isn't.

It doesn't exist.

There ARE several multiscale and overlapping coordination systems that compete for limited critical resources against each other in every disaster and catastrophe.

These systems DO normally compete with each other for critical response resources, supplies, staff, and equipment.

Every. Single. Disaster.

There is no single national system to prioritize such resources between entitites requesting them. There is no process to prioritize the needs of the entities themselves; or to prioritize the processing of certain resources over others as they are mobilized. There is no single national system for mobilizing, re-mobilizing, or demobilizing such resources. There is no single national system for funding of these kinds of resources, for reimbursement of them, for cost apportionment, or other financial considerations.

There is no single national coordination system. 

There are about 12.

Why We Need A National Coordination System

"The federal government - FEMA - should have been the purchasing agent. Buy everything, and then allocate it by need to the states... Did you really have to learn that 50 states shouldn't compete against 50 states? And then FEMA shouldn't come in late, and then compete with 50 states? You know it's not that you had to go to the Harvard Kennedy School to learn this, right?" - NY Governor Andrew Cuomo, today.

Yeah. Yeah, we did have to learn that. And, we haven't learned it. 

Obviously.  Now.

After 9/11, we said (generally) that we were going to create a system for doing this more efficiently.

We didn't.

This Is Not Written Up Elsewhere

This is one of the wicked problems of catastrophes that nobody ever wants to take on, or even talk about.

I have been one of very, very few inside government trying to get attention on this. Very few people get it. It's overwhelming. It's systems thinking. It's actually about very complex systems that most people don't ever touch all at once.

Now we're living it.

In every single large disaster - and certainly in the big catastrophes - issues come up because of these 12 loosely defined multi-scale and overlapping systems. Every single time. They come up in large-scale exercises. They come up in government policy meetings. 

The whole thing is a huge mess. Fixing it needs to be done with a combination of executive and legislative branch action. However, no one ever thinks (or didn't, anyway) that the worst-case scenario will affect them. No one thinks the biggest catastrophes are going to happen on their watch, or in their lifetime. I have pursued action on this internally at FEMA - with our office's whole team - and watched FEMA work around the issues rather than take them on head-on and try to resolve them. Again and again.

Yet here are.  Living it in the middle of a pandemic that was not unexpected.

12 (Or So) Multi-Scale & Overlapping Coordination Systems

Here are the 12 or so somewhat loosely-defined multi-scale and overlapping systems, or resource response systems, competing for limited critical response resources right now in this pandemic. 

It's 12 "or so" because none of these are specifically designated anywhere as coordination systems in the way I am describing them here. Hyperlinks on each are not included for the most part, in part because there is significant nuance within each, and in part because there is a massive amount of information about each within each of the "systems."

One:

All 50 states (plus DC + insular areas) are obviously competing with each other for limited critical resources. Normally, states move resources through state-to-state mutual aid (EMAC, under NEMA; authorized by each state's legislature). In this case, there is some mutual aid, but there is also competition between states through plain old attempts to purchase supplies and equipment... anywhere.

Two:

There is intrastate (inside each state) mutual aid, too.

Three:

There is a National Response Framework (NRF), administered by FEMA, under the Stafford Act, divided into Emergency Support Functions (ESFs), and mobilized via mission taskings (all of this is the main key to federal response that should be happening now). There are Federal Interagency Operational Plans (FIOPs) too, and annexes, such as the pandemic response plan (annex). That pandemic annex should, in theory, be driving the whole respnose within the framework of those plans (FIOPs) and frameworks. However, it is written inside the paradigm of the frameworks and FIOPs - not these 12 multi-scale and overlapping coordination systems. (NOTE:  This plan is not likely the same plan as the pandemic plan at the National Security Council (NSC) that the media has a laser-focus on.  This annex is actually the executive branch's operational pandemic plan. Why doesn't the media ever talk about that?  More importantly - is the Trump Administration even using it?)

Four:

There is a critical infrastructure framework, with 16 critical infrastructure sectors and their sub-sectors. In this pandemic, we have both public and private hospitals in the mix (health & medical sector); obviously they are the main show here. But we have other critical infrastructure sectors needing personnel, supplies, and equipment too. Especially including first responders (Emergency Services Sector), grocery grocery store and other critical services employees (Commercial Facilities Sector, and others such as Energy), and other
critical infrastructure owners of all kinds.

Five:

There is private sector mutual aid (contracts), like what happens when you have to restore power lines. This kind of mutual aid could be a factor in the pandemic if there are large infrastructure outages. Competition for limited critical resources to restart huge facilities (like huge generators) can become critical in that case. Right now, the private sector is also one of the competitors for critical national resources.

Six:

The National Guard, which can be activated and used by the states or the federal government. They have some resources cached, but will be in the mix competing for critical supplies and equipment as well.

Seven:

There is the US military, which is activated through the Pentagon. There are local bases that take local mutual aid action as well. The US military may well have the largest caches of everything, but it does not move quickly, and needs very specific authorities authorized to act.

Eight:

In this pandemic, the Veterans Administration (VA) and its hospital network will likely be both a contributor and a competitor for critical resources. It is critical infrastructure under "Health and Medical," but also military.

Nine, Ten:

There is also mutual aid and response action that happens in the legislative and judicial branches, at every level of government. In this case, most of that action will likely be tied to the prison and court systems. Legislators are a critical asset, under continuity-of-government and continuity of operations programs.

Eleven:

Volunteera and NGOs (non-governmental organizations) are usually a huge part of every response and include faith-based organizations and their own Networks.. There are established, huge bureaucracies for some NGOs, and others are ad-hoc organizations that may pop up on the fly, and evolve organically, or disappear. Local Disaster Response agencies usually have good Partnerships with ngos, but hyperactive volunteers can also be a challenge. It will be a particular and unique challenge in this kind of disaster because it is a pandemic, and volunteers will need protection, supplies, and equipment as well. On the other hand, volunteers are creating ad hoc organizations and movements, and making supplies and equipment that can help with the response. It's all very messy right now as it is coalescing very quickly, but it will iterate and evolve.

Twelve:

The interagency wildland fire world has the largest existing national coordination system for prioritizing, allocating, and mobilizing critical national resources, and does include caches of some supplies and equipment, although this will not be as relevant. This is yet another system that will need critical supplies and equipment as it typically supports other disasters (of all kinds), and also because wildfire season will occur (as will tornado and hurricane seasons).

Every single one of these systems competes for critical national resources with each of the other systems.

Other Major Factors

There are several other major factors are at play in this pandemic.  It's too complex to list them all, but here are a few highlights.  Or something.

• The Strategic National Stockpile (SNS) is a collection of strategically-placed pharmaceutical and medical supplies and equipment. Some of these items have already been distributed. Reporting indicates that distribution of these assets may have been problematic in many regards; other reporting indicates that some assets may have been turned over to the private sector for sale to requesting entities.
• The Defense Production Act could be used to federalize manufacturing capabilities in the United States to vastly increase the production of supplies and equipment necessary to help with this pandemic. The Trump Administration continues to hesitate on full activation of this capacity. Its use is allowed for wartime, for a pandemic, or for other national emergency use under the Stafford act, which has already been declared.
• Every person, business, and organization in the world, let alone in the US, may be seeking - and competing for - the same limited critical resources that each of these 12 systems are also competing for. Some of those organizations have significantly more resources available to secure critical resources when there is heavy competition. In other words, they're loaded. Money talks. That will be a factor.
• It's not clear how much the Stafford Act is being properly used and leveraged by the Trump Administration. The Stafford Act ties to the National Response Framework (NRF) as part of the five national preparedness system frameworks, and to the Federal Interagency Operational Plans (FIOPs) and annexes such as the pandemic response plan (annex). The NRF designates Emergency Support Functions (ESFs).  Under the Stafford Act, state/local/tribal governments request disaster declarations. There are mission tasking requests within ESFs for action from the federal interagency community (the federal executive branch) to support the whole array of federal, tribal, state, and local responses that are needed. However, there are questions about how well this critical, essential system is being utilized. Scattershot reporting indicates that there have been issues with getting mission taskings approved. Reporting and statements from the president himself indicate that there could be politicization of the system.
• There are reports that the Trump Administration has attempted to create its own systems parallel to all of the existing systems to mobilize resources.
• There are reports that the federal government has seized critical pandemic response supplies, equipment, and other assets at airports, in customs, and through other channels. In many cases these resources were paid for by hospitals or state and local government.
• Reporting indicates that the Trump Administration has not taken other actions that could help with resource availability, distribution, and access. These include but are not limited to price-fixing measures and export controls.

This Is (Some Of) The U.S. Disaster Response Landscape

These are the resource response systems. This is the landscape. It's messy, and it's piecemeal.  This post from 2016 gets into more detail; pre-pandemic.

It's not clear to most people that there is a massive problem with this landscape... until there's a huge catastrophe.

That is in part because we as humans have trouble understanding highly complex, interconnected, multi-scale and overlapping systems. 

It is also in part because the employees, managers, political appointees, elected officials, and legislators who have been running the federal and state/local/tribal interagency disaster response systems do not understand the complexity of all of these systems, have some denial about them, maybe don't have a reason to know about them in a steady-state world, or don't think it will affect them. 

Denial is another aspect.  Whenever I have explained this to people on that list - most have reacted with a sort of sheer terror about how bad it would be if we actually had a massive set of catastrophes - or a pandemic - within that "framework."

Now we're living it.

When you take this landscape - which is already messy and convoluted - and you add in a president who refuses (every day of this emergency) to effectively or fully use the pieces that are in place - we have an even bigger mess.

The response landscape we have is pieced together from US history, wars, pandemics, and prior disasters. It's not perfect. It needs a lot of work. But it works at least somewhat more effectively if you at least TRY use the parts as they're designed.

After any disaster, there are so many problems to fix... and people fix the stuff that's easy to fix. Time passes. The really overwhelming stuff slips to the side.

Next thing you know, this particular huge set of gigantic vulnerabilities and weakness hasn't gotten fixed yet.

And now we have a pandemic. It's a catastrophe of catastrophes. It's the mother of all of them.

Plus, we'll have more disasters in the middle.

Why It Matters To Know This

This may be one of the shortest posts ever written written about some of the systemic, fundamental, structural response and coordination issues going on behind the scenes that is creating the US pandemic landscape we see before us.

You won't see this kind of post from anyone else. I am one of very few people who has been inside of the different systems above, and working on these resource coordination issues at a fundamental level behind the scenes.

These are wicked problems. In other words, they are the kinds of problems that are hard to understand, and hard to navigate, and hard to find a way forward through.

There is a lot more to all of this than what is above. Each of the 12 systems highlighted above has thousands of pages of policy and process behind it, and thousands or hundreds of thousands of people behind it.

It's easy to think that it doesn't matter right now. Some snarky volunteer activist told me that she didn't need to know how all of this was broken; that it could just line the sewer for all the relevance it had to this moment.

Okay. But that's not really accurate.

It's helpful to understand a bit about the response landscape because...

• It's helpful to know how things work in the first place, if you want to help them work better.
• You want the systems that are already in place to work as well as they can. This pandemic is huge, and it's evolving at lightning speed. You need stuff in place that works. Even if it doesn't work well - it's better than no system. Helping what's in place work better matters.
• People who are trying to get things to work now need to work within existing systems. To a certain extent. You want to anchor to and leverage what's already in place.
• You can't reinvent all of the systems in the middle of the disaster. Although we're going to be doing a lot of that. Quite a lot. But some of the structures will remain. Some of the structures will get better. Some will merge. Some are already merging. For example, the state of New York is making all of the hospitals in the public and private sector in the state work together in one giant system - as of yesterday. We'll have more of that. Each state and each city will have to figure out what works for them.

Finding Our Way Through

Finally, I will say this. We will be better set up on the other side of this if we can keep as much of what we already have functioning well through the middle of it.

We need to protect and improve our institutions even as we use them to their maximum capacity. ALL of the institutions. Everywhere. Not just medical institutions. Government. Infrastructure. Media. Social institutions. Non-profits. Everything.

There IS an other side.

It is true that not everyone is going to get there. We know that. We're working hard now to get as many people there as we can - alive.

For those of us who do make it there... we're going to want a world that works. We're going to want government and systems that serve citizens, and that serve us well. We're going to want government that takes care of humanity.

We're going to want some updated morals and ethics to go along with everything. Obviously there are some serious deficiencies in those areas. However, we also have some pretty awesome humans just about everywhere doing pretty amazing stuff to help make this less bad. To protect their families and communities and fellow citizens. Many are risking their own lives every day already. More will.

We're going to be better positioned on the other side of this if we can take what we've got, make it work, make it work even better, transform some of it, and then work on evolving it when we get the chance down the road.

Some of the stuff is going to totally transform in the middle. It won't look like it does now. This is going to be a game of innovation and iteration. Fast. But that doesn't mean that you throw out the stuff that works... even a little. You need to anchor to it. Work out from there. We need to be doing more of that.

The fact that the federal government ISN'T doing more of that is an enormous problem. With any luck, we can pressure them to use some of the tremendous capability at their disposal.

Either way, we are going to need incredible strength at state, tribal, and local levels. That means we need to be able to leverage and use whatever IS out there as effectively as we can. And that does mean most everything in this post.

I heard someone call this "The Great Adaptation." Sounds about right.

There is a way through. Sitting back and hoping someone else will find it isn't going to get it done. We're all going to have to figure out different, unique little pieces to find our way forward. Everybody's on deck for this one.

Hopefully this kind of information helps you find your own way. We're all in this together.

Be well. Be safe. Take care of yourself, and take care of the people around you. It's what we're here for.

Good luck.

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UPDATE:  A video on this same subject is here.
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UPDATE ON POST:  To clarify, the various federal systems as part of the 12 different systems outlined here do have touchpoints in third system discussed - the National Response/Recovery Frameworks and corresponding FIOPs - but those touchpoints are not comprehensive and do not create an overarching national coordination system.
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