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Enhancing Public Health, Health Care System, and Clinician Preparedness: Strategies to Promote Coord


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Title: Enhancing Public Health, Health Care System, and Clinician Preparedness: Strategies to Promote Coord

Enhancing 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
  • National Center for Environmental Health
  • Centers for Disease Control and Prevention

What 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
  • Disasters, terrorism and other public health
    emergencies all require rapid mobilization of
    resources and experts across agencies and across
    jurisdictional lines

To be Prepared, What Does Public Health Need
  • Incident command and support structure
  • Preparedness and response plans
  • Communications
  • Epidemiology and surveillance
  • Laboratory
  • Environmental/occupational health

Federal Level Response Plans
  • National Oil and Hazardous Substances Pollution
    Contingency Plan (NCP)
  • Federal Radiologic Emergency Response Plan
  • Federal Response Plan

Federal 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

  • Presidential Decision Directives (PDD) 39 and 63
  • FBI Lead
  • HHS Support

Emergency 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

Goal of the Bioterrorism Cooperative Agreement
  • 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

Bioterrorism 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

National 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
  • Pharmaceuticals and supplies delivered from one
    or more VMI sources
  • Tailored" to provide specific materiel depending
    upon suspected or confirmed agent

NPS Contents
  • Pharmaceuticals
  • Antibiotics
  • Mark I kits, diazepam, atropine, pralidoxime
  • IV Supplies
  • Airway Management Supplies
  • Other Emergency Medications
  • Bandages and Dressings

Some 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

Each 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

Public 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

CDC 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.

Presentations 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)
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