Pediatric Long-term Care Disaster and Pandemic Planning

Background: Children are frequently victims of disasters, however significant gaps remain in pediatric disaster preparedness planning. There is a significant gap in resources for disaster planning for pediatric residents in long-term care facilities. The New York City (NYC) Pediatric Disaster Coalition (PDC) is funded by the New York City (NYC) Department of Health and Mental Hygiene (DOHMH) to improve NYC’s pediatric disaster preparedness and response. After creating resources for disaster planning in pediatric hospital departments, pediatric and neonatal intensive care units, obstetric/newborn services within NYC hospitals and outpatient and urgent care centers, the NYC PDC partnered with leaders and experts in pediatric disaster management and the care of pediatric residents in long-term care facilities and created the Pediatric Long-Term Care Planning Committee (PLTCPC).

Methods: The PLTCPC included physicians, nurses, administrators and emergency planning experts who have had experience working in long-term care settings. The PLTCPC’s goal was to create guidelines and templates for use in disaster planning for pediatric residents at long term care facilities. The committee met bi-weekly over 3 months and shared facility plans to create tools that meet the specific pediatric challenges presented by this population.

Results: Utilizing an iterative process that included a literature review, participant presentations and discussions, review and improvement of the working documents, the final guidelines and templates for surge and evacuation of pediatric residents in long-term care facilities were created. Due to the onset of the COVID-19 pandemic the NYC PDC reconvened the PLTCPC to focus on surge planning for pandemics at pediatric long-term care facilities. Two pediatric infectious disease clinicians were added to the committee to contribute their subject matter expertise (SME). Utilizing the same process delineated above, a detailed pandemic specific annex was created to the existing plans based on clinical pediatric experience gained throughout the COVID-19 pandemic.

Conclusion: To our knowledge these are the first pediatric specific resources for long term care disaster planning. They address the importance of matching available resources to the unique needs of PLTC facilities in regard to space, equipment, staffing and training. Pediatric long term care facilities present special needs during pandemics and this approach can be utilized as a model for other facilities nationwide.