Title: Enhancing Public Health, Health Care System, and Clinician Preparedness: Strategies to Promote Coord
1Enhancing Public Health, Health Care System, and
Clinician Preparedness Strategies to Promote
Coordination and Communication
- Patrick J. Meehan, M.D.
- Director
- Division of Emergency and Environmental Health
Services - National Center for Environmental Health
- Centers for Disease Control and Prevention
2What is a Disaster?
- A disaster is the result of a vast ecological
breakdown in the relation between humans and
their environment, a serious and sudden event
(or slow, as in a drought) on such a scale that
the stricken community needs extraordinary
efforts to cope with it, often with outside help
or international aid
(From Noji, Gunn and
Lechat) - Disasters, terrorism and other public health
emergencies all require rapid mobilization of
resources and experts across agencies and across
jurisdictional lines
3To be Prepared, What Does Public Health Need
- Incident command and support structure
- Preparedness and response plans
- Communications
- Epidemiology and surveillance
- Laboratory
- Environmental/occupational health
4Federal Level Response Plans
- National Oil and Hazardous Substances Pollution
Contingency Plan (NCP) - Federal Radiologic Emergency Response Plan
- Federal Response Plan
5Federal Response Plan
- Supports the Robert T. Stafford Disaster Relief
and Emergency Assistance Act (P.L. 99-288) - Signed by 27 Federal agencies and the Red Cross
- Incident command system approach
- Primary means for coordinating Federal response
to presidentially declared disaster - State/local government overwhelmed
6Terrorism
- Presidential Decision Directives (PDD) 39 and 63
- FBI Lead
- HHS Support
7Emergency Support Function 8 (ESF 8) Health
and Medical
- HHS is lead agency
- Assessment of health/medical needs
- Surveillance
- Medical care personnel
- Health and medical supplies
- Patient evacuation
- Hospital care
- Food/drug/medical device safety
- Worker health and safety
8Goal of the Bioterrorism Cooperative Agreement
Program
- To upgrade State and local public health
jurisdictions preparedness for and response to
bioterrorism, other outbreaks of infectious
disease, and other public health threats and
emergencies
9Bioterrorism Cooperative Agreement Program
- 7 Focus areas State and local preparedness
- Epidemiology and surveillance
- Biologic lab
- Chemical lab
- Health alert network
- Communication
- Training
- Response happens at the local level
10National Pharmaceutical Stockpile (NPS)
Components a Two-Tiered Response
- Eight 12-Hour Push Packages
- To reach designated airfield within 12 hours of
Federal activation - Pre-positioned in environmentally controlled and
secured facilities - Pre-configured for rapid identification and ease
of distribution - Vendor Managed Inventory (VMI) Packages
- Are held at several sites
- Will be shipped to arrive within 24 and 36-hour
periods - Pharmaceuticals and supplies delivered from one
or more VMI sources - Tailored" to provide specific materiel depending
upon suspected or confirmed agent
11NPS Contents
- Pharmaceuticals
- Antibiotics
- Mark I kits, diazepam, atropine, pralidoxime
- IV Supplies
- Airway Management Supplies
- Other Emergency Medications
- Bandages and Dressings
12Some Lessons Learned
- Communication media, public information, health
care community - Operations Issues how to manage a large event
- Lack of science
- Components of response teams
- Worker health and safety
- Capacity to deal with environmental health issues
13Each NPS 12-hour Push Package
Weighs over 50 tons Fills a wide-body
aircraft Occupies over 100 cargo
containers Requires 5000 square feet
ground/floor space for proper staging
14Public Health Role in Nuclear, Radiologic and
Chemical Emergencies
- Health and medical evaluation and recommendations
- Worker health and safety
- Risk assessment and communication
- Population monitoring and follow up
- Exposure assessment
15CDC Cooperative Agreement Program Requirements
- Enhanced Capacities
- Defined as the additional expertise and
infrastructure (i.e., over and above the Critical
Capacities) to enable public health systems to
have optimal capacities to respond to
bioterrorism, other infectious disease outbreaks,
and other public health threats and emergencies. - If selected, these must also be addressed in the
work plan similar to the Critical Capacities.
16Presentations from HHS Preapplication Workshops
- Review of CDCs Supplemental Program
AnnouncementSlide set by CDC - Public Health Preparedness State and Local
Component - Technical Assistance Workshops for
Fiscal Year 2002 Funding FebruaryMarch
2002Slide set by Department of Health and Human
Services (HHS) - Metropolitan Medical Response System (MMRS)Slide
set by Department of Health and Human Services
(HHS)/Office of Emergency Preparedness (OEP) - HRSA Bioterrorism Hospital Preparedness
ProgramSlide set by Department of Health and
Human Services (HHS)/Health Resources and
Services Administration (HRSA) - Working Towards a Coordinated National
Preparedness EffortSlide set by Federal
Emergency Management Agency (FEMA)/Office of
National Preparedness (ONP) - Program Overview of the Office for Domestic
Preparedness (ODP)Slide set by U.S. Department
of Justice (DOJ)/Office of Justice Programs
(OJP)/Office for Domestic Preparedness (ODP)