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Bioterrorism and Health System Preparedness

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Slide Presentation by Patrick J. Meehan, M.D.

On April 29, 2002, Patrick J. Meehan, M.D., made a presentation in a Web-assisted teleconference at Session 1, which was entitled "Enhancing Public Health, Health Care System, and Clinician Preparedness: Strategies to Promote Coordination and Communication."

This is the text version of Dr. Meehan's slide presentation. Select to access the slides or to access the streaming video of Bioterrorism and Health System Preparedness.

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

Patrick J. Meehan, M.D.
Division of Emergency and Environmental Health Services
National Center for Environmental Health
Centers for Disease Control and Prevention

Slide 1

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

Slide 2

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.

Slide 3

Federal Level Response Plans

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

Slide 4

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.

Slide 5


  • Presidential Decision Directives (PDD) 39 and 63.
  • Federal Bureau of Investigation (FBI) Lead.
  • Health and Human Services (HHS) Support.

This slide also shows a picture of a "missing" poster made for a victim of September 11th.

Slide 6

Emergency Support Function Slide 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.

Slide 7

Goal 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.

Slide 8

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.

Slide 9

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

Slide 10

NPS Contents

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

Slide 11

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.

Slide 12

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.

This slide also shows a picture of the bins that hold the 12-hour push packages.

Slide 13

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.

Slide 14

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.

Slide 15

Presentations from HHS Preapplication Workshops

  • Review of CDC's Supplemental Program Announcement
    Slide set by CDC.
  • Public Health Preparedness State and Local Component—Technical Assistance Workshops for Fiscal Year 2002 Funding: February-March 2002
    Slide 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 Program
    Slide set by Department of Health and Human Services (HHS)/Health Resources and Services Administration (HRSA).
  • Working Towards a Coordinated National Preparedness Effort
    Slide 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).

Current as of June 2002

Internet Citation

Enhancing Public Health, Health Care System, and Clinician Preparedness: Strategies to Promote Coordination and Communication. Presentation by Patrick J. Meehan at Web-Assisted Teleconference, "Enhancing Public Health, Health Care System, and Clinician Preparedness." Agency for Healthcare Research and Quality, Rockville, MD.

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