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Civil Unrest and Security Resources in Advance of Election Day

Election Day, November 3, or the days that follow require advanced preparation by Health Centers (and other healthcare facilities) including reviewing security, safety and incident response/coordination plans. Health Centers are encouraged to contact their local police precinct or department with any questions.

For the 5 boroughs, New York City Emergency Management (NYCEM) will activate a virtual Situation Room on Election Day, and starting this week there is an increased police presence across the City. The New York City Police Department (NYPD) Police officers are currently at all 88 early voting locations, and on Election Day will be present at all 1,200 polling locations.

Although the resources below are for hospitals, health centers may find them helpful in reviewing their own emergency preparedness plans.


Assistant Secretary for Preparedness and Response’s (ASPR) Technical Resources, Assistance Center, and Information Exchange (TRACIE) Resources:

Ballantyne, B. (2006). Medical Management of the Traumatic Consequences of Civil Unrest Incidents: Causation, Clinical Approaches, Needs and Advanced Planning Criteria. Toxicological Reviews. 25(3):155-197.

  • This article addresses how hospitals can prepare for situations of civil unrest. It also describes the types of injuries that patients may present with at hospitals (e.g., eye and respiratory tract effects, bone injuries, and exposures to chemical agents). Note: This article is outdated but may provide useful pieces of information.

Hospital News. (n.d.). Planning for the Worst: How Hospitals Prepared for the Stanley Cup Riot in Vancouver. (Accessed 6/1/2020.)

  • This article describes how staff at St. Paul’s Hospital in Vancouver, Canada prepared for possible mass casualties and responded to individuals injured during the riots that erupted after the 2011 Stanley Cup series. 

Hospital Safety Center. (2020). Hospital Preparedness, Security Paramount During the Baltimore Riots.

  • This article addresses hospital preparedness and response during the April 2015 riots in Baltimore after the death of Freddie Gray. Four major hospitals within Baltimore city limits worked to determine alternate routes to get their staff to work and prepared for increasing security during this time of civil unrest.

Jenkins, J.L., and Mason, M. (2015). A Long Night in the Emergency Department during the Baltimore, Maryland (USA) Riots. Prehospital Disaster Medicine. 30(4):325-326.

  • The authors of this article provide a firsthand account of how their hospital prepared for and responded to the 2015 Baltimore riots after the death of Freddie Gray.

Lavin, R., Veenema, T.G., Clavert, W.J., et al. (2017). Nurse Leaders’ Response to Civil Unrest in the Urban Core. Nursing Administration Quarterly. 41(2):164-169.

  • The authors of this article provide a list of 10 “musts” for nurses when planning for a crisis such as civil unrest. They provide examples of how hospitals responded in Ferguson, Missouri after the death of Michael Brown and in Baltimore after the death of Freddie Gray.

Additionally, ASPR TRACIE maintains many topic collections that may be helpful: Mass Gatherings/Special Events, Responder Safety and Health, and Workplace Violence.


Greater New York Hospital Association (GNYHA) Resources:

  • Mass Casualty Incident (MCI) Response Toolkit: Designed to help hospitals develop and improve their mass casualty incident response plans. It includes suggested preparedness and response actions for the many clinical and non-clinical departments that would be involved in an MCI response. 

  • GNYHA’s Safety and Security Considerations for Hospitals: Synthesizes safety and security strategies compiled by a GNYHA-led workgroup of health care security directors and external law enforcement representatives. Considerations are organized into four sections—staff and vendor management, patient and visitor management, physical security, and emergency department security. A fifth section provides links to tools and resources.


(We would like to thank our colleagues from GNYHA for sharing all of the resources).

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