There’s a specific kind of stress that comes with running two emergency responses at once. During my time with a municipal COVID-19 response team, I spent a stretch managing pandemic operations and an emerging Monkeypox outbreak simultaneously — separate case definitions, separate reporting lines, separate stakeholder groups, and one team that had to hold all of it without dropping either.
That experience taught me more about emergency management than any single crisis could have on its own, because it forced a question every public health leader eventually has to answer: what actually makes an emergency response work when the volume exceeds what your normal systems were built for?
Structure beats heroics
The instinct in a crisis is to work harder. The thing that actually saves an operation is working more structured. Incident Command System (ICS) principles exist for a reason — clear roles, defined reporting lines, a single point of coordination — and the responses that held up under pressure were the ones where people trusted the structure enough to stay in their lane instead of everyone trying to do everything.
During peak COVID-19 operations, our team was processing several hundred case reports a week while also managing contact tracing, cluster investigations, and daily situation reports for department leadership. That volume is only sustainable if the workflow is designed for it in advance — not improvised in week one of the outbreak. The response that scales is the one where the process was built before the crisis peaked, not during it.
Data has to move at the speed of the decision
In a steady-state public health program, a weekly or monthly reporting cadence is often fine. In an emergency, it isn’t. Decision-makers — health department leadership, the mayor’s office, state and federal partners — need current information to allocate resources correctly, and “current” during an active outbreak can mean daily, not weekly.
That’s where predictive modeling and real-time dashboards earn their keep. Forecasting case trends and healthcare burden isn’t an academic exercise during a surge — it’s what tells a department where to deploy mobile testing, where to expect strain on hospital capacity, and where community transmission is accelerating before the case counts alone would show it clearly.
Coordination is the actual job
The part of crisis response that’s easiest to underestimate from the outside is how much of it is coordination, not analysis. Serving as a liaison between a local health department, state health authorities, and the CDC means constant alignment — on case definitions, on data reporting formats, on resource requests — often on daily calls, often with information changing in both directions in real time.
Get that coordination wrong, and even excellent local data collection doesn’t translate into an effective regional response. Get it right, and a team a fraction of the size of the affected population can meaningfully shape outcomes for that entire community.
What carries over to normal operations
The uncomfortable truth is that most of what makes emergency response effective isn’t unique to emergencies — it’s just good public health practice under time pressure. Clear escalation paths. Data systems that don’t require manual reconciliation. Relationships with state and federal partners built before you need them urgently.
Programs that only build that infrastructure once a crisis is already underway are always going to be one step behind. The departments that respond best to the next emergency are the ones quietly investing in that foundation right now, while things are calm enough to do it properly.