Public Health Preparedness Update

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Public Health Preparedness Update

• Jay ShraderProgram CoordinatorWestern Region
  Partnership for Public Health Preparedness

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PH Threats

• BOIDOOPHTE
• Bioterrorism, Other Infectious Disease Outbreaks
  and Other Public Health Threats and Emergencies

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Public Health Threats

• Anthrax - 728 Anthrax samples were tested by the
  WSLH between Oct 01 May 02
• Severe Acute Respiratory Syndrome (SARS)
• Monkeypox
• West Nile Virus
• Pandemic Influenza
• Tuberculosis
• Hepatitis
• Pertussis (Whooping Cough)
• 5,641 cases in 2004 (CDC)
• 697 cases in 2003 (CDC)
• Food borne Waterborne Outbreaks
• Bioterrorism

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Wisconsins PH Preparedness System

• Formed in 2003, with CDC / Homeland Security
  Funds
• 12 Public Health Consortiums
• Staffed with Program Coordinator, Training
  Coordinator, Epidemiologists, and PA.
• Monitored by the Division of Public Health with
  consolidated contracts
• Work continues with the CDC Critical Tasks in
  Preparedness

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Preparedness 2003-06

• Public Health Emergency Plans developed,
  integrated with other ER partners and exercised
  regularly
• PHEP, Mass Clinic, IPS, SNS, 24/7 Notification,
  Mutual Aid, Pandemic Influenza, CHEMPACK
• Mass Clinic Sites obtained with MOU (18 in
  region)
• Floor plans, patient throughput, mass clinic
  go-kits, staffing
• Post Emergency Response Teams formed in LPHD
• LPHD implement Respiratory Protection Program
• Enhanced surveillance and disease reporting with
  hospitals and clinics
• Wisconsin Electronic Disease Surveillance System
• Purchase of videoconferencing, satellite phones
  and use of command caller for redundant
  communications
• LPHD purchase Emergency Preparedness Go-Kits

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Preparedness 03-06 Continued

• Cross Border Meetings with Minnesota DOH
• Cities Readiness Initiative (CRI)
• Wisconsin Emergency Assistance Volunteer Registry
  (WEAVR) Program Implementation
• Public Health Workforce and other Emergency
  Response Partners trained in
• Incident Command System, HEICS, NIMS, Emergency
  Operations Planning, Risk Communication, Public
  Information Officer Training, Health Alert
  Network, Mass Clinic Operations, Special
  Populations, FEMA Crisis Counseling, WMD and
  Biological Agents, Infection Control,
  Epidemiology and Forensic Epidemiology, Tabletop
  Exercise Design, Annual Fit-test Training for
  RPP, Integrated Communications Workshops

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Plan for the Worse Hope for the Best

• St. Croix County Population
• 74,339
• 9.9 over the age of 65
• 7.0 under the age of 5
• 7,336 with a disability (age 5)
• 3.1 Language other than English spoken at home
• 10,279 per day
• 429 per hour
• 7.2 per minute

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The PH Tornado
RECOGNITION OF BIOLOGICAL / INFECTIOUS DISEASE
OUTBREAK INCIDENTScene of ReleasePatient(s)
present at hospital, Clinics, ERReported
Absenteeism in schools, workplace, etc.Large
does of particular prescription
Notification of Community PartnersImplement
Incident CommandConduct Public Health
InvestigationsAgent / Disease ConfirmationBegin
Ring Treatment / Prophylaxis
Consult with Community PartnersActivate the
Public Health Emergency Plan
THE PUBLIC HEALTH FORECAST Will Incident
Grow? Will Local Resources be sufficient? Will
large-scale treatment or prophylaxis need to
occur?
Consult with Community Partners Request Interim
Pharmaceutical Stockpile Request Declaration of
Public Health Emergency to Governor Request
Strategic National Stockpile Activate the Mass
Clinic Plan
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Public Health Emergency Plan
The PHEP is PHs All Hazards Emergency Response
Plan. All other plans are referenced in the
PHEP. Sections included in the PHEP Active
Surveillance, Mutual Aid, Isolation, Quarantine
Homecare, Personal Protective Equipment,
Decontamination, Disposal of Waste, Laboratory
Procedures, Strategic National Stockpile, Mass
Clinics, Responder Workforce, Special Needs
Populations, Residential Facilities,
Transportation, Mental Health Services, Crisis
Communication, Integrated Communications, Mass
Fatality Management, Environmental Health Risks
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Mass Clinic Plan

• To distribute medical supplies and
  pharmaceuticals (e.g. medication and
  vaccinations) from local inventory, the Strategic
  National Stockpile (PUBLIC) and the Interim
  Pharmaceutical Stockpile (FIRST RESPONDERS) to a
  given population during a biological agent
  release (Category A Agents) or infectious disease
  outbreak.
• Total of 18 Mass Clinic Sites in region.

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Strategic National Stockpile

• The SNS is a national repository of antibiotics,
  chemical antidotes, antitoxins, life-support
  medications, IV administration, airway
  maintenance supplies, and medical/surgical items.
• Delivered in 12 hour push pack or Vendor Managed
  Inventory (VMI) to one of 5 warehouses in WI
  after federal decision to deploy
• Local Public Health Officer requests SNS to DPH.
  DPH Medical Officer consults with Governors
  office.
• Federal responsibility to deliver the assets
  state responsibility to distribute the assets
  local responsibility to dispense assets

12 HR Push Pack contains 120 Pallets weighing
over 50 ton
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SNS Response Track Record

• 9/11/01 response to NYC
• Delivered 50 tons of medical supplies, including
  prophylaxis and intravenous fluids to NYC within
  7 hrs of attack on World Trade Centers
• Oct 15 Dec 30, 2001 response to anthrax attack
• Delivered 3.79 million tablets of antibiotics for
  post-exposure preventive treatment of postal
  workers, mail handlers, and other occupants of
  affected buildings, the first within 8 hrs

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Interim Pharmaceutical Stockpile (IPS)

• 7 sites in WI (State Patrol HQ)
• 3 day supply of antibiotic prophylaxis for
  emergency responders and there families
• Critical to emergency response field continuity
• 4 hours or less to receive
• 1 hr for State Patrol to arrive at Cache Site
• 2 hrs for State Patrol to deliver to Dispensing
  Sites (operated by public health)
• 1 hr for Dispensing Sites to package and begin
  administration

The State Patrol now has only 5 districts by
combining 1 5, and 6 7. This will not effect
IPS deployment
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Pandemic Influenza Plan

• Not a matter of if but a matter of when!
• May last up to 2-3 years
• Wisconsin
• 1.9 Million Ill
• 22,000 require hospitalization
• 8,000 become fatal
• Plan focus is on Command and Control,
  Surveillance, Communication, Vaccine and
  Antiviral, and emergency response

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CHEMPACK

• Part of CDC SNS Program
• Placement of repositories of nerve agent
  antidotes in communities throughout WI (30 plus)
  and US.
• Reasons for CHEMPACK
• Severity of chemical agents
• Local supplies inefficient
• 12HR response from CDC too long
• Each CHEMPACK contains antidotes for 1000
  severely exposed
• Mark 1 Auto Injectors, Atropine, Diazepam
• Administered by EMS and Hospital
• 2 Hours or less for activation

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CHEMPACK Response

• Initial First responders arrive on scene with
  chemical antidotes in vehicle (15 min)
• Secondary First responders call for regional
  nerve agent antidote assets stored in state
  hospitals or EMS stations and have them delivered
  to scene (30-60 min) CHEMPACK
• Tertiary Federal stockpile of chemical antidotes
  are requested and arrive in-state in about 12 hrs

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Cities Readiness Initiative

• The primary goal of CRI is to minimize loss of
  lives during a catastrophic public health
  (anthrax) event by dispensing needed drugs to
  100 of the each citys population within a
  48-hour timeframe.
• St. Croix and Pierce County
• Postal Service, HOH

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Biologic Detection System (BDS)

• Aerosolized anthrax monitoring
  system for 300 U.S. Postal
  Service sites
• Implemented in eight
  Wisconsin postal facilities (Eau Claire)
• The system continuously tests air samples from
  the Advanced Facer Canceller System by using
  sophisticated DNA matching.
• Oral post-exposure prophylaxis for workplace
  exposure as detected by BDS system

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Thought of the Day!!!

• Men, I want you to fight vigorously and then run.
  And as I am a bit lame, I am going to start
  running now.
• George Stedman
• (U.S. Army, Civil War)

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Contact Information

• Jay Shrader
• Program Coordinator
• Western Region Partnership
• For Public Health Preparedness
• www.co.polk.wi.us/wrpphp
• [phone]
• jasons_at_co.polk.wi.us