Answering the Call: How the Northeast Central Ohio Regional Healthcare Coalition Prioritized Community Care and Coordination After the East Palestine Train Derailment
Answering the Call: How the Northeast Central Ohio Regional Healthcare Coalition Prioritized Community Care and Coordination After the East Palestine Train Derailment
East Palestine, Ohio
February 3, 2023
Quick Look
Background
On February 3, 2023, a train derailment and chemical spill in East Palestine, Ohio, threatened the health of the town’s nearly 5,000 residents.
Response
The Northeast Central Ohio (NECO) Regional Healthcare Coalition (HCC), supported by the Hospital Preparedness Program (HPP), worked with local, state, and regional partners to coordinate a multi-phased response effort. Previous trainings and exercises strengthened the response, leveraged existing community relationships, and provided access to situational awareness tools. The HCC coordinated hospital bed availability and patient transport with hospitals across the state, as well as established a local health clinic for injured residents.
Impact
The HCC’s community-centered response highlighted the importance of conducting preparedness exercises to strengthen regional collaboration and establish robust communication systems in advance of a disaster, all of which contributed to zero fatalities and minimal injuries throughout the region.
No one anticipated what the night would hold as evening fell over East Palestine, Ohio, on February 3, 2023. At 8:55 p.m., emergency responders received reports of a freight train derailment in Columbiana County, about a quarter mile west of the Ohio-Pennsylvania state line. It wasn't just the wreckage that caused alarm. The train was carrying hazardous materials. As chemicals began to seep into the air and critical water sources, the gravity of the situation became all too clear.
What unfolded in the days, weeks, and months that followed was nothing short of extraordinary—a testament to the power of planning, communication, and collaboration focused on meeting community needs.
The Response
As plumes of smoke billowed into the sky, responders quickly evacuated the small town’s nearly 5,000 residents as volunteer fire departments tried to control the blaze. First responders alerted the NECO HCC, prompting the coalition to spring into action and begin shaping a coordinated response effort.
NECO HCC is funded by ASPR’s HPP. As part of their cooperative agreement requirements, the NECO HCC conducts annual emergency preparedness and response exercises, working with its members to build and exercise community-specific plans for potential disasters. Beyond developing blueprints for response, these efforts build strong relationships and trust between NECO HCC members, including: hospitals, emergency medical services, emergency management agencies, public health, long-term care facilities, dialysis centers, and public safety partners.
In the days that followed, information sharing was paramount. The county’s biggest fear was injuries in East Palestine and the surrounding area. The county coordinated with their hospitals locally and across the region. The HCC used a state-wide patient tracking dashboard to monitor bed availability in all hospitals across Ohio. The HCC also coordinated frequent situational awareness updates with hospitals and emergency medical services in the state as they prepared to receive a potential influx of patients. Fortunately, the region avoided mass injuries by swiftly evacuating all affected residents as crews cleaned up the initial wreckage.
The NECO HCC's response readiness was put to the test and the results were remarkable. The region saw zero fatalities and minimal injuries, thanks to extensive planning, quick action, and effective communication.
“We've always done drills and coordinated activities, but this time it was real. We had rail cars on fire. We had potential for catastrophic explosions with chemicals all over our community in which thousands of people could have been impacted, including hundreds of first responders. Our big concern on Day One was ‘What's our surge capacity? What's our surge potential? What are we going to do when we have thousands of casualties? Can we handle it?’ That’s really where I had a lot of confidence in the HCC and in the region, knowing what our capabilities were.”
Columbiana County Health Commissioner
Transitioning to Recovery
Nearly two weeks later, the response transitioned to recovery, which included establishing a health assessment clinic. The NECO HCC coordinated the temporary clinic in a local Columbiana County church, providing hope and support for residents with ongoing respiratory and dermal injuries. The Ohio Department of Health played a critical role at the clinic, providing nursing support, technical assistance, and funding for a clinic physician. After operating for 28 days and serving 338 residents, the temporary clinic eventually evolved into a permanent health facility to meet the community’s need for ongoing post-exposure care.
“We were able to quickly adjust and adapt because of the strong foundations laid by HPP funding and years of collaboration,” she noted. “From supporting resources like the statewide hospital capacity tracking dashboard that helped maintain situational awareness and coordination, to building key relationships with HCC members through frequent meetings, interactions, drills, and exercises, HPP support positioned us for a successful response.”
NECO HCC’s Regional Healthcare Coordinator
As the dust settled and the smoke cleared, the community of Columbiana County emerged stronger and more united.
“We couldn't have done it without our partners. Everybody said, ‘How can I help?’ Nobody said, ‘It's not my job’. It didn’t matter who it was, or where they were coming from.”
Columbiana County Health Commissioner
Conclusion
The NECO HCC’s story stands as a powerful testament to preparedness, collaboration, and community resilience in the face of a man-made disaster. The successful response highlighted the value of having a community-centered coordinating entity, like an HCC. The HCC and its partners coordinated a lifesaving response that drew upon relationships, prioritized health equity, and minimized strain on area hospitals. The NECO HCC’s response shows that extraordinary things can be achieved when we come together in the face of crisis.
Since the school shooting in Uvalde, TX in May 2022, SETRAC has received multiple requests to conduct the mass casualty drill for hospitals, long-term care facilities, and other schools in the region. The training and its supplemental materials equip participants with the lifesaving practices and knowledge needed for a response during a mass casualty event. SETRAC's training efforts have also expanded from the regional level to provide training in nearby states. For example, the team instructed a session for the Health Center Association of Nebraska, expanding preparedness measures and establishing beneficial emergency response partnerships on an intrastate level.
The mass casualty response drill simulated a drive-by shooting with six injured students. SETRAC's team led students and staff through the proper response processes and supplemented the exercise with a school-specific manual they had created for response during an active attack. Participants in the drill learned firsthand how to identify critical patients and administer emergency wound care and first aid. SETRAC involved several health care and emergency response partners such as local emergency medical services (EMS), police officers, fire chiefs, as well as nearby hospital officials, to provide participants with additional awareness to key response stakeholders and their roles in an active response.