Which Part of Emergency Didnt You Understand

1
Which Part of EmergencyDidnt You Understand?

• William F. Raub, Ph.D.
• Department of Health and Human Services

2
The Challenge

• Were at war.
• Were at risk.
• We have serious gaps in public health and
  healthcare infrastructure.

3
Preparedness RequiresVertical Integration of
Assets

• Local Government
• State Government
• National Government

4
Preparedness Requires Horizontal Integration of
Assets

• Linkages of Public Health Entities with
• Veterinary/Agricultural Communities
• Healthcare Entities
• Emergency Management
• Private Sector

5
Local Preparedness is Vital

• All terrorism is local.
• Neither state nor federal government assets will
  be available immediately.

6
Local Response

• Its quality and speed determine
• scope and severity of the crisis
• magnitude and duration of the consequences

7
HHS Investments in State and Local Preparedness

• Focus Bioterrorism, Other Outbreaks of
  Infectious Disease, and Other Public Health
  Emergencies
• Instrument Cooperative Agreements with States,
  Territories, and Selected Cities

8
Recipients of HHS Investments

• State and Local Public Health Departments
• CDC gt 2.7 B (FY02-04)
• Hospitals and Other Healthcare Entities
• HRSA gt 1.1 B (FY02-04)

9
Strategic Framework

• Thematic Areas
• e.g., surveillance, laboratories, information
  technology, hospital surge capacity, linkages to
  emergency management
• Critical Benchmarks
• i.e., milestones on the road to preparedness

10
High-Compliance Milestones

• At Least One Epidemiologist for Every
  Metropolitan Area with Population Greater than
  500,000
• Health Alert Network Coverage for Greater than
  90 of Population

11
Low-Compliance Milestones

• 24/7 Receipt of Emergency Case Reports
• Gap Analysis of Statutes, Regulations, and
  Ordinances re quarantine, isolation, and movement
  restrictions
• Local Distribution and Dispensing of Materiel
  from Strategic National Stockpile

12
Some Responses Will Require Massive Federal Assets

• Mass Chemoprophylaxis up to an Entire
  Metropolitan Area within 48 Hours of Decision
  to Do So
• Medical Care for 100,000 Casualties

13
Major Areas of Disagreement

• Likelihood of Terrorist Act That Will Result in
  Mass Casualties
• Balance of Investment between General Enhancement
  of Public Health Infrastructure and Emergency
  Response
• Balance of Investment among Local, State, and
  Federal Government Assets

14
What to Do Next?

• Communicate Better regarding Risks,
  Vulnerabilities, and Tradeoffs
• Communicate Better Still