ANNEX 6: MASS FATALITY

A mass fatality incident is any situation where the number of fatalities exceeds the ability of local resources to manage the bodies. The primary functions of a mass fatality response are body recovery, morgue operations, and assisting the decedents’ family members and loved ones. Although the morgue capacity within the Municipality is approximately 100 bodies, an incident with 25 fatalities would likely overwhelm local capabilities.

A mass fatality incident may be caused by natural or manmade disaster including airline crash, infectious disease outbreak, structural collapse, avalanche, warfare, and act of terrorism.

OPERATIONAL CONCEPTS

A.      As set forth by Alaska state law, responsibility for collection, identification, storage, and dispatch of bodies lies with the Alaska State Medical Examiner’s Office (SMEO). The Municipality will contact the SMEO as soon as practicable when a mass fatality incident has been identified and will provide resource support for the SMEO’s actions as requested and within its capabilities.

B.      In an incident where the SMEO is unable to respond, it may delegate certain duties to local law enforcement or other personnel.

C.      The Ted Stevens Anchorage International Airport will direct FAA mass fatality protocols during a mass fatality incident caused by aircraft crash.

D.     The Federal Bureau of Investigation may assume victim identification responsibilities in incidents involving interstate commercial carriers, hostage situations, acts of terrorism or other incidents that include a law enforcement component.

E.      The Municipality in coordination with SMEO will submit a request to the state for disaster mortuary capability immediately upon awareness that an incident may overload area local mortuary capabilities.

Recovery Activities

A.      Recovery activities should occur only after all known survivors of the incident are reasonably moved to safety.

B.      The Municipality will ensure that the welfare and mental health needs of staff working to respond to a mass fatality incident are attended to and will be balanced with social pressures to quickly complete mortuary procedures and repatriate victims.

C.      A mass fatality site occurring from any incident other than a natural disaster should be treated as a crime scene until the incident commander in consultation with the SMEO directs otherwise.

D.     The Municipality will establish a Joint Information Center (JIC) to ensure accurate and expedient dissemination of information. All agencies involved in incident response should coordinate public information activities through the JIC.

E.      Bodies will not be moved from the incident site without approval from the SMEO.

F.      In most situations, the presence of dead bodies is not considered a significant public health risk. However, because of the possibility of responder contact with bodily fluids a mass fatality site will be treated as a biohazard site until the incident commander directs otherwise. Responders having direct contact with bodies will take universal precautions to protect themselves from contact with bodily fluids.

G.     Bodies will not be stacked on top of one another in any storage situation, except in extreme situations when it is necessary to use refrigeration to preserve the bodies and space is limited or during transportation.

H.    Every attempt should be made to identify the bodies at the site where they are found regardless of the number of dead. Tags should be attached to the bodies that provide the name, if known, and the approximate age, sex, and location of the body.

I.        Examination of bodies will not be conducted at the incident site with the exception of checking pockets of victim’s clothing to look for identification documents when directed by the incident commander.

J.        If body bags are not available for the removal of remains, a durable impermeable substitute may be used.

K.      The Municipality will establish a resource staging area at or near the incident site to control the incident response resources.

L.      The Municipality will establish a body staging and transport area at or near the incident site where remains can be held temporarily and securely prior to transfer to a morgue.

Incident Morgue Operations

A.      If typical mortuary transport is not available, the Municipality will arrange for bodies to be transported from the incident site or hospitals in vans, trucks, or other enclosed vehicles. To the extent possible, the Municipality will cover any identifying markings on vehicles used to transport or hold bodies.

B.      When possible, bodies will be transported to the SMEO. When the number of victims exceeds the SMEO capacity, the Municipality may establish a temporary morgue in facilities with suitable cooling and security capabilities including ice rinks, aircraft hangars, warehouses, and empty public buildings.

C.      Temporary burials may be justified during a mass fatality incident to help slow decomposition until conditions allow for the transfer of the remains to their final destination. Temporary burials may also be authorized during infectious disease outbreak when public gatherings, such as funerals, should be limited. The use of documentation and markers of the temporary burial site should be followed in the same accordance as final burial in officially established cemeteries.

D.     To ensure positive identification of victims, the Municipality will employ established identification methods including forensic odontology, fingerprinting, x-rays, and DNA.

E.      The Municipality may establish a private viewing area within the morgue for decedents’ family members and loved ones. Mental health services will be established nearby to provide emotional assistance.

F.      Under no circumstances will the Municipality bury victims in mass graves or conduct mass cremations.

G.     The Municipality will make every effort to respect religious rites or cultural beliefs of families of the deceased with regard to recovery, identification, and burial. Where the religious or cultural beliefs of the deceased are unknown, the cultural norms of the community at large will be honored.

H.    Unidentified remains will be buried so that they can be exhumed when identification is possible and returned to their relatives for disposition. Prior to burial, the Municipality will ensure that appropriate samples are taken to proceed with future identification.

I.        The Municipality will request the governor authorize expedited certification of deaths from the disaster when body recovery is impossible because of the nature of the disaster.

J.        During an extended mass fatality incident, such as an infectious disease outbreak, the mayor may implement resource controls, including refrigeration fuels, to ensure continued capability for morgue operations.

K.      While direction and control of emergency medical functions at hospitals remain the responsibility of each facility's management and staff during a mass fatality incident, hospitals should coordinate external efforts including morgue operations through the Anchorage Emergency Operations Center.

L.      The Municipality will coordinate a locally based response to support a mass fatality incident in another Alaskan community.

Family Assistance

A.      With the exception of a mass fatality incident cause by infectious disease outbreak, a family assistance center will be established to provide regular briefings and respond to the questions of family members and loved ones of the missing and dead. Every effort will be made to protect families from the media and curiosity seekers.

B.      Translation services will be available at family assistance centers established by the Municipality.

C.      The Municipality will not authorize the release or confirmation of decedents’ names until the next of kin have been officially notified.

D.     The Municipality will make every effort to ensure that notification of death is done on an individual basis. 

E.      If a mass fatality incident is the result of an industry accident, the Municipality will support any appropriate family assistance activities of the affected industry.

F.      The Municipality will support SMEO’s efforts to establish a database of presumed victims to be cross-referenced with a separate database of the human remains undergoing examination.

RESPONSIBILITIES

Primary Agencies

Anchorage Office of Emergency Management / Emergency Operations Center

1. Coordinates overall strategic disaster response.
2. Secures additional resources through state and federal agencies as needed.
3. Coordinates with and supports requests from field agencies during disasters.
4. Disseminates critical emergency information to the public through a joint information center and deploys field public information officers to mass fatality sites and family assistance centers.
5. Designates temporary morgue sites and identifies available transportation resources in advance of a mass fatality incident.
6. Arranges for the delivery of refrigerated trucks, body bags, and other resources to local hospitals.
7. Facilitates identification of staging areas to support incident response.

Anchorage Fire Department

1. Provides aid to viable patients including rescue, triage, treatment, and transportation.
2. Provides assistance to support management of human remains.
3. Conducts onsite decontamination of survivors if necessary.

Anchorage Police Department

1. Provides perimeter control and scene security.
2. Assists SMEO in activities to document, reconstruct, and investigate the incident.
3. Supports search and recovery activities.
4. Provides assistance to support management of human remains.

Support Agencies

Area Hospitals

1. Provides medical care.
2. Provides support for decontamination as needed at their respective facilities.
3. Coordinates special resource requests through the Emergency Operations Center.
4. Hold decedents until the Municipality can arrange transportation to a morgue.

American Red Cross of Alaska

1.      Provides trained personnel or volunteers to assist at family assistance centers and to aid in helping to identify the dead.

Health and Human Services

1. Conducts epidemiological surveillance and disease control activities.

Parks and Recreation

1. Supports mass fatality incidents by use of its facilities when requested by the incident commander or the EOC.

MUTUAL AID, STATE, OR FEDERAL ASSISTANCE

All state and federal assistance is coordinated through the State Emergency Coordination Center. 

The Tri-Borough mutual aid agreement may be activated to assist a mass fatality response.

Hospitals in neighboring jurisdictions including the Third Medical Group at Elmendorf Air Force Base, Mat-Su Regional Medical Center, Central Peninsula General Hospital, Bartlett Memorial Hospital, and Fairbanks Memorial Hospital may be able to provide medical or facility support.

The Alaska Funeral Directors Association can provide aid in body recovery, transportation assistance, storage facilities and with victim’s families, and disposition of decedents. 

The Alaska Dental Society maintains a disaster response team to assist in fatality identification.

The Alaska State Troopers will augment local search and rescue efforts with helicopter support and through their management of Alaska Search and Rescue Dogs, Alaska Mountain Rescue group, and the Anchorage Nordic Ski Patrol.

The Alaska State Scientific Crime Detection Laboratory may provide support for laboratory analysis including DNA and evidence testing.

The Federal Emergency Management Agency may provide assistance including the deployment of Disaster Mortuary Teams and Crisis Counseling Assistance Teams.

The Federal Aviation Administration will assist response to aviation mass fatality incidents.

REFERENCES

Anchorage Emergency Operations Plan, Annex 5: Mass Casualty

Anchorage Emergency Operations Plan, Annex 9: Public Information and Warning Annex

State of Alaska Mass Casualty Response Plan

Alaska State Medical Examiner’s Office Mass Fatality Incident Response Plan

AS 12.65.005 Duty to Notify State Medical Examiner

AS 12.65.020 Medical Death Investigations

National Response Plan, ESF #6, Mass Care, Housing, and Human Services

Aviation Disaster Family Assistance Act of 1996

US Public Health Act

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