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Risk Communications/Emergency Public Information and Warning
Topic Collection
August 8, 2022

Topic Collection: Risk Communications/Emergency Public Information and Warning

Disasters can have significant health impacts on communities and their residents. Effective communication is a key component to properly managing and responding to incidents of all sizes. Communication includes providing the public with information through verbal, written, or symbolic means. As the world watched the 2014 Ebola outbreak spread through West Africa and land on American soil, medical professionals trained in risk communications sprang into action to release timely and effective messages providing public awareness, and other important information such as symptoms to look for. Clear, concise messages provided by trusted leaders before, during, and after an incident can help residents feel more in control and persuade them to make important health-related decisions to help ensure their safety. Resources in this Topic Collection include lessons learned; education and training modules; results from studies conducted on the effectiveness of risk communications; and plans, tools, and templates that can be tailored to meet the specific threats and needs of healthcare and medical professionals.

Each resource in this Topic Collection is placed into one or more of the following categories (click on the category name to be taken directly to that set of resources). Resources marked with an asterisk (*) appear in more than one category.

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Centers for Disease Control and Prevention. (2015). Crisis and Emergency Risk Communication (CERC) and Ebola.
This factsheet shares Ebola-specific risk communication information and emphasizes that the disease can be accompanied by public fear and misinformation, making clear communication even more important. The site includes information about transmission, stigma (and countering stigmatization), and provides quick tips for communicators (e.g., be empathetic, provide positive action steps).
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Centers for Disease Control and Prevention. (2021). The CDC Clear Communication Index.
This evidence-based tool can help healthcare emergency communications staff create and assess communication products on a variety of topics for diverse audiences. Users are prompted to provide information about seven key communications areas (e.g., main message, behavioral recommendations) and the Index provides an overall score. Links to message development resources are also provided on this webpage.
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Drexel University. (n.d.). National Resource Center on Advancing Emergency Preparedness for Culturally Diverse Communities. (Accessed 12/9/2022.)
This website provides links to resources geared towards disaster preparedness in culturally diverse communities. Materials are grouped into six main categories: Community, Type of Emergency, Resource Type, Language, U.S. Region, and those that fall under Multiple Categories.
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Emory University Interfaith Program. (2014). Public Health and Faith Community Partnerships: Model Practices to Increase Influenza Prevention Among Hard-to-Reach Populations. Association of State and Territorial Health Officials.
The guidance in this document can help healthcare coalition members work with faith- and other community-based organizations to develop influenza-specific messages that reach traditionally difficult to reach audiences.
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Federal Emergency Management Agency. (2021). Improving Public Messaging for Evacuation and Shelter-in-Place: Findings and Recommendations for Emergency Managers from Peer-Reviewed Research.
The authors conducted a literature review of 127 articles and focused on five research questions specific to the effect of select variables on evacuation and shelter-in-place decisions. The conclusion includes key recommendations and suggestions for additional research.
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Health Canada. (2011). Communicating the Health Risks of Extreme Heat Events.
This toolkit can help health communicators tasked with developing or updating heat-related health communication strategies. It features strategies for reaching specific audiences.
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Li-Vollmer, M. (2013). Emergency Risk Communication. University of Washington, Northwest Center for Public Health Practice.
This 2.5 hour, interactive course teaches health communicators about the following topics: reactions the public might have during a public health emergency, effective communication strategies, how to communicate with the media, how to work with the community, and the importance of developing communication plans before an incident occurs.
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Public Health – Seattle & King County and Northwest Center for Public Health. (n.d.). Texting for Public Health: Emergency Communication, Health Promotion, and Beyond. (Accessed 12/5/2022.)
This easy-to-use, online toolkit helps public health and healthcare entities plan for and implement text messaging programs for use in emergencies and for more general health promotion. It covers topics such as why text messaging is effective, how to get people to subscribe, legal issues, and technological options.
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Substance Abuse and Mental Health Services Administration. (2019). Communicating in a Crisis: Risk Communication Guidelines for Public Health Officials. U.S. Department of Health and Human Services.
This guide can help health officials (and others responsible for communicating to the public before, during, and after a crisis) prepare their messaging to ensure it is actionable and received effectively by the public.
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U.S. Department of Health and Human Services, Assistant Secretary for Preparedness and Response. (2012). Disaster Response for Homeless Individuals and Families: A Trauma-Informed Approach.
This webpage emphasizes the fact that learning more about the effects of past traumatic events on people experiencing homelessness can help emergency responders communicate more effectively with this population during a disaster and encourage them to comply with public health directives.
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At-Risk Populations

Osorio, L., Castaneda, X., and Vostrejs, M. (2011). Improving Outreach to At-Risk Latino Populations for Pandemic Influenza and Public Health Emergency Preparedness. University of California, Berkeley, School of Public Health, Health Initiative of the Americas.
The guidance in this document includes promising practices for health authorities and providers to work with community-based organizations in order to reach Latino populations in the event of a pandemic or a public health emergency.
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* Rowel, R., Sheikhattari, P., Barber, T., and Evans-Holland, M. (2009). A Guide to Enhance Grassroots Risk Communication Among Low-Income Populations. Maryland Department of Health and Mental Hygiene.
Many health and emergency management practitioners plan and implement emergency and disaster preparedness activities that entail working with grassroots organizations serving low-income populations. This guide contains strategies that can help stakeholders more successfully deliver health-specific messages to those populations.
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  • Aaron Gettinger broken link :-(
    5/28/2019 4:50:02 PM
Tell Me. (n.d.). New Communication Strategies for Working with Different Sub-populations / Target Groups. (Accessed 12/5/2022.) British Medical Journal Publishing Group.
The guidance in this document is geared towards helping healthcare agencies increase the number of members of at-risk groups who get vaccinated against flu. The authors identify the at-risk groups, summarize traditional communication issues, and provide strategies for developing immunization messages. The emphasis is on communications for an influenza pandemic, although the principles can be adapted to other contexts.
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U.S. Department of Health and Human Services, Assistant Secretary for Preparedness and Response. (2012). Disaster Response for Homeless Individuals and Families: A Trauma-Informed Approach.
This webpage emphasizes the fact that learning more about the effects of past traumatic events on people experiencing homelessness can help emergency responders communicate more effectively with this population during a disaster and encourage them to comply with public health directives.
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* University at Albany School of Public Health. (2013). Latinos During Emergencies: Cultural Considerations Impacting Disaster Preparedness.
The speakers in this webinar emphasize the importance of engaging the Latino community in preparedness and the need for disaster responder cultural awareness.
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Education and Training

Centers for Disease Control and Prevention. (2018). Crisis and Emergency Risk Communication.
This introductory course can help participants learn about emergency risk communication principles and tools.
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  • Audrey Mazurek Thank you Melanie for your feedback. Though we include the CDC CERC site in this collection, we do not specifically mention the 2014 edition of this publication. It is available through our Resource Library and we will be sure to include it in our next iteration of this collection.
    10/6/2015 5:36:23 PM
  • Melanie Motiska The CDC has a 2014 version of the CERC publication: http://emergency.cdc.gov/cerc/resources/pdf/cerc_2014edition.pdf
    10/6/2015 12:17:20 PM
Centers for Disease Control and Prevention. (2019). Crisis and Emergency Risk Communication (CERC).
This website hosts the Centers for Disease Control and Prevention's updated crisis and emergency risk communication training modules, resources, shared learning materials (e.g., case studies), and social media links.
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Li-Vollmer, M. (2013). Emergency Risk Communication. University of Washington, Northwest Center for Public Health Practice.
This 2.5 hour, interactive course teaches health communicators about the following topics: reactions the public might have during a public health emergency, effective communication strategies, how to communicate with the media, how to work with the community, and the importance of developing communication plans before an incident occurs.
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Prepare Iowa. (2017). Don't Panic: Principles of Crisis and Risk Communication Scenario. Upper Midwest Preparedness and Emergency Response Learning Center.
Prepare Iowa created this interactive course to help health practitioners increase their ability to effectively communicate with the public, other practitioners, the response community, and the media during a public health emergency.
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* University at Albany School of Public Health. (2013). Latinos During Emergencies: Cultural Considerations Impacting Disaster Preparedness.
The speakers in this webinar emphasize the importance of engaging the Latino community in preparedness and the need for disaster responder cultural awareness.
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Evaluation

Elledge, B., Brand, M., Regens, J., and Boatright, D. (2008). Implications of Public Understanding of Avian Influenza for Fostering Effective Risk Communication. Health Promotion Practices. 9(4 Suppl):54S-59S.
The authors of this study conducted 12 focus groups in Tulsa, OK to help the local public health department understand the community's level of awareness and develop effective messages about avian influenza.
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Federal Emergency Management Agency. (2021). Improving Public Messaging for Evacuation and Shelter-in-Place: Findings and Recommendations for Emergency Managers from Peer-Reviewed Research.
The authors conducted a literature review of 127 articles and focused on five research questions specific to the effect of select variables on evacuation and shelter-in-place decisions. The conclusion includes key recommendations and suggestions for additional research.
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Meredith, L., Eisenman, D., Rhodes, H., et al. (2007). Trust Influences Response to Public Health Messages During a Bioterrorist Event. (Abstract only.) Journal of Health Communications 12(3): 217-32.
The authors of this study examined qualitative data from focus groups held with 75 African American adults living in Los Angeles County to better understand their traditionally lower levels of trust in public health messaging regarding terrorism preparedness. They found that perceived honesty and consistency of information most frequently determined trust/distrust.
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Meredith, L., Shugarman, L., Chandra, A., et al. (2008). Analysis of Risk Communication Strategies and Approaches with At-Risk Populations to Enhance Emergency Preparedness, Response, and Recovery. RAND Health.
This assessment is intended to inform planning for risk communication regarding public health emergency preparedness, response, and recovery for individuals with access and functional needs.
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Wood, M. M., Mileti, D. S., Kano, M., et al. (2011). Communicating Actionable Risk for Terrorism and Other Hazards. (Abstract only.) Risk Analysis. 32(4):601-15.
The authors propose a different approach when communicating to people when the objective is to motivate household disaster preparedness actions. Based on their study, they recommend emphasizing what to do about risk rather than sharing information about the actual risk.
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General Resources

American Psychological Association (2014). As Ebola Concerns Mount, Psychology Offers Guidance on Health-Risks Communication.
This webpage (created during the 2014 Ebola outbreak) is geared towards medical risk communicators and emphasizes that fear and other emotions can interfere with community members' judgment and behavior, particularly during an Ebola outbreak. This makes it extremely important to evaluate and test messages before releasing them to the public, and tailor messages to various audiences (e.g., young people, limited or non-English speakers, the elderly).
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Centers for Disease Control and Prevention. (2015). Crisis and Emergency Risk Communication (CERC) and Ebola.
This factsheet shares Ebola-specific risk communication information and emphasizes that the disease can be accompanied by public fear and misinformation, making clear communication even more important. The site includes information about transmission, stigma (and countering stigmatization), and provides quick tips for communicators (e.g., be empathetic, provide positive action steps).
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Substance Abuse and Mental Health Services Administration. (2019). Communicating in a Crisis: Risk Communication Guidelines for Public Health Officials. U.S. Department of Health and Human Services.
This guide can help health officials (and others responsible for communicating to the public before, during, and after a crisis) prepare their messaging to ensure it is actionable and received effectively by the public.
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Tell Me. (n.d.). New Communication Strategies for Health Agencies and Healthcare Professionals. (Accessed 1/17/2023.) British Medical Journal Publishing Group.
The guidance in this document is geared towards helping healthcare agencies increase the number of healthcare professionals who get vaccinated against flu. The authors summarize research, identify existing gaps, describe different segments in the healthcare profession, and suggest strategies for communicating with healthcare providers and patients.
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The National Academies Press. (2013). Public Response to Alerts and Warnings Using Social Media: Report of a Workshop on Current Knowledge and Research Gaps. The National Academies Press.
This report summarizes presentations made at a 2012 workshop organized by the Committee on Public Response to Alerts and Warnings Using Social Media. Chapters cover the fundamentals of alerts, warnings, and social media, how social media has been used in emergencies by local agencies, the dynamics of social media, message credibility, privacy and legal issues, and research gaps and other challenges.
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Plans, Tools and Templates: Ebola and Flu

Covello, V. and Hyer, R. (2014). Top Questions On Ebola: Simple Answers Developed by the Association of State and Territorial Health Officials.
The authors worked with risk communication consultants and state health officials to develop messaging written at a 6th to 8th grade reading level. Questions are divided into the following categories: basic, preparedness, medicines and vaccines, healthcare response, quarantine and isolation, monitoring and contact tracing, mental health, travel and transport, and media.
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* North Shore-LIJ Health System. (2014). Ebola Virus Disease (EVD) Preparedness Manual.
Section VI of this manual focuses on external and internal communications and can be tailored by emergency communications planners to other hazards.
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Oregon Health Authority, Public Health Division Health Security, Preparedness, and Response Program. (2016). Risk Communication Toolkit for Seasonal Influenza.
This toolkit can help local health authorities develop public messaging before and during the influenza season. It includes background information, links to key resources, talking points, sample press releases, printable materials, and sample social media messages for Twitter and Facebook.
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Pan American Health Organization, World Health Organization. (2014). Communicating About Ebola: A Guide for Leaders.
This document can help health communication staff learn about the key concepts of risk communication, how to share information about the first case of imported Ebola, and communications goals. It also includes templates that can be downloaded and customized.
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Pan American Health Organization, World Health Organization. (2014). Risk Communication Checklist for Ebola.
The guidance in this document can help health risk communicators create and activate a national Ebola risk communication plan. The steps can also be customized for more local initiatives.
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Pan American Health Organization, World Health Organization (2014). Risk Communication Plan for the First Case of Ebola.
This document can help health communication staff design public announcements of a potential first case of Ebola in their country. The information can also be customized to suit local initiatives.
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Plans, Tools and Templates: General

California Department of Public Health. (2011). Crisis and Emergency Risk Communications Toolkit.
This toolkit, adapted from the Centers for Disease Control and Prevention’s materials, can help healthcare emergency communications planners draft new plans or update and implement existing plans. It includes chapters on crisis communications planning, direct public outreach, the standardized emergency management system, state and federal medical countermeasures, and hazards (including public health threats). It also includes several templates for creating communications materials and plans.
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Centers for Disease Control and Prevention. (2011). Using HealthMap's Web-Based Risk Analysis Tools Before and During Public Health Emergencies.
The speakers in this webinar discuss the use of HealthMap (a mobile application and website that allows users to submit information related to local diseases or outbreaks) during the 2010 cholera outbreak in Haiti.
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Centers for Disease Control and Prevention. (2021). The CDC Clear Communication Index.
This evidence-based tool can help healthcare emergency communications staff create and assess communication products on a variety of topics for diverse audiences. Users are prompted to provide information about seven key communications areas (e.g., main message, behavioral recommendations) and the Index provides an overall score. Links to message development resources are also provided on this webpage.
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Group Health Research Institute. (2015). Program for Readability in Science and Medicine (PRISM).
This free toolkit and training can help medical communicators learn how to use plain language and improved the readability of their messages. These resources are useful for healthcare and public health staff who need to translate data and other technical information for general audiences.
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Kansas Department of Health and Environment. (2011). Public Information and Communications Standard Operating Guide.
Local health department communicators can customize this template before and in response to a variety of scenarios such as mass prophylaxis dispensing, disease outbreaks, and acts of terrorism.
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* North Shore-LIJ Health System. (2014). Ebola Virus Disease (EVD) Preparedness Manual.
Section VI of this manual focuses on external and internal communications and can be tailored by emergency communications planners to other hazards.
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Public Health – Seattle & King County and Northwest Center for Public Health. (n.d.). Texting for Public Health: Emergency Communication, Health Promotion, and Beyond. (Accessed 12/5/2022.)
This easy-to-use, online toolkit helps public health and healthcare entities plan for and implement text messaging programs for use in emergencies and for more general health promotion. It covers topics such as why text messaging is effective, how to get people to subscribe, legal issues, and technological options.
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* Rowel, R., Sheikhattari, P., Barber, T., and Evans-Holland, M. (2009). A Guide to Enhance Grassroots Risk Communication Among Low-Income Populations. Maryland Department of Health and Mental Hygiene.
Many health and emergency management practitioners plan and implement emergency and disaster preparedness activities that entail working with grassroots organizations serving low-income populations. This guide contains strategies that can help stakeholders more successfully deliver health-specific messages to those populations.
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  • Aaron Gettinger broken link :-(
    5/28/2019 4:50:02 PM
Washington State Department of Health. (n.d.). Emergency Preparedness Fact Sheets. (Accessed 12/5/2022.)
This website contains links to one-page fact sheets for the general public on infectious diseases, chemical and biological agents, radiation, severe weather, natural disasters, and emergency preparedness and response. Each resource is available in seven languages; some are available in large type.
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Health Canada. (2011). Communicating the Health Risks of Extreme Heat Events.
This toolkit can help health communicators tasked with developing or updating heat-related health communication strategies. It features strategies for reaching specific audiences.
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National Weather Service. (2020). Tsunami Message Subscriptions.
The National Weather Service provides links to sources that provide tsunami event messages.
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Oregon Health Authority, Public Health Division Health Security, Preparedness, and Response Program. (2017). Crisis and Emergency Risk Communication.
This toolkit can help local health authorities develop public messaging during a severe wildfire smoke event. It includes key messages, talking points, sample press releases, sample social media messages for Twitter and Facebook, and links to related information.
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Oregon Health Authority, Public Health Division Health Security, Preparedness, and Response Program. (2017). Risk Communication Toolkit for Flooding.
This toolkit can help local health authorities develop public messaging during a flood event. It includes information relevant to the actual event and the recovery period: key messages, talking points, sample press releases, factsheets, links to key resources, and sample social media messages for Twitter and Facebook.
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Oregon Health Authority, Public Health Division Health Security, Preparedness, and Response Program. (2017). Risk Communication Toolkit for Winter Weather.
This toolkit can help local health authorities develop public messaging during periods of extreme cold weather. It includes key messages, sample press releases, factsheets, links to key resources, and sample social media messages for Twitter and Facebook.
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Oregon Health Authority, Public Health Division Health Security, Preparedness, and Response Program. (2019). Crisis and Emergency Risk Communication Toolkit for Extreme Heat. Health Promotion Practice 9(4 Suppl):18S-25S.
This toolkit can help local health authorities develop public messaging during periods of extreme heat. It includes key messages, talking points, sample press releases, fact sheets, sample social media messages for Twitter and Facebook, and links to related information in English and Spanish.
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Rural/Frontier

Heideman, M. and Hawley, S. (2007). Preparedness for Allied Health Professionals: Risk Communication Training in a Rural State. (Abstract only.) Journal of Allied Health. 36(2): 72-6.
This article is a summary of a workshop on risk communication and message mapping in Kansas. The authors emphasize that in rural states, health workers should be able to communicate to the public from both a health and first responder perspective.
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Agencies and Organizations

Centers for Disease Control and Prevention. Crisis and Emergency Risk Communication (CERC).
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National Public Health Information Collection (NPHIC).
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Peter Sandman. The Peter M. Sandman Risk Communication Website.
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This ASPR TRACIE Topic Collection was comprehensively reviewed in May 2015 by the following subject matter experts (listed in alphabetical order):Molly Carbajal, Public Health Preparedness, Santa Clara Public Health Department,Meredith Li-Vollmer, Ph.D., Risk Communication Specialist, Public Health-Seattle & King County, and Jacquelyn Nash Gallego, MPA, Hospital Preparedness Program Coordinator, Santa Clara Public Health Preparedness.

Additional assistance provided by John Hick, MD, HHS ASPR and Hennepin County Medical Center, Alicia Livinski, Biomedical Librarian, HHS National Institutes of Health, and James Paturas, Director, Center for Emergency Preparedness and Disaster Response, Yale New Haven Health System.
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