Biosecurity Briefing Subscribe | About | Current Issue | RSS | Archive CDC Issues First Report on States’ Public Health Preparedness By Jennifer Nuzzo, February 22, 2008 On February 20, 2008, the U.S. Centers for Disease Control and Prevention (CDC) released a report that evaluated, on a state-by-state basis (and the District of Columbia), the cumulative impact of the agency’s Public Health Emergency Preparedness cooperative agreements (“cooperative agreements”). This report will likely be the first in a series of reports chronicling preparedness efforts at the state level. CDC Director Dr. Julie Gerberding and Dr. Richard Besser, Director of CDC’s Coordinating Office of Terrorism Preparedness and Emergency Response (COTPER), stressed in a telebriefing that this report evaluated each state’s capacity to respond to public health emergencies. Dr. Gerberding noted that the CDC hopes future reports will have a “greater emphasis on results.” The report notes that CDC cooperative agreements have provided "more than $5 billion to state, local, tribal and territorial” public health departments since they were first authorized by Congress in 2002.1 Through the completion of this report, the CDC evaluated progress among awardees in meeting “three critical areas of public health preparedness:” disease detection and investigation, public health laboratory capacity, and response. The report found that since the beginning of the cooperative agreement program, “public health departments have improved their ability to respond to emergencies.” Specifically, the report notes that: | 1. | Disease detection and investigation. Public health departments are better able to detect and investigate diseases outbreaks as a result of “improvements in the public health workforce and in data collection and reporting systems.” Since the creation of the CDC grants program: | | | | - The number of epidemiologists working on emergency response in public health departments has doubled from 115 in 2001 to 232 in 2006.
- The number of users for CDC’s secure epidemic communications system, the Epidemic Information Exchange (Epi-X), increased from 890 in 2001 to 4,646 in 2006. Seventy-five percent of these users are from state and local health departments.
- All state public health departments can receive and evaluate “urgent” health reports 24 hours a day, 7 days a week, 365 days a year. This number is an improvement from 1999, when only 12 state health departments had this capacity.
| | 2. | Public health laboratory capacity. Since the creation of the CDC grants program, more public health laboratories have “increased capability to test for biological and chemical threats and to communicate information.” | | | | - The number of state and local public health laboratories able to detect biological agents increased to 110 in 2007, up from 83 in 2002.
- The number of state and local public health laboratories able to detect chemical agents has increased to 47, from 0 in 2001.
- “All states now have public health laboratories that can quickly communicate with clinical laboratories.” This figure is an improvement since 2001, when only 20 states reported having this capability.
- The number of state public health laboratories that conduct exercises to test their ability to handle, confirm, and report results for chemical agents has increased from 16 in 2003 to 38 in 2006.1
| | 3. | Response. Since 2001, more states have "developed response plans, implemented a formalized command structure, and conducted exercises." | | | | - All states now have plans to receive, store, and distribute the Strategic National Stockpile (SNS). Of those states that have had their SNS plans reviewed by the CDC, 73% “have satisfactorily documented their SNS planning efforts.”
- “In 2005, public health departments in 50 states and DC trained public health professionals about their roles and responsibilities during an emergency as outlined by the Incident Command System, while in 1999 only 14 did so.”
- 100 percent of states participate in the Health Alert Network, which allows for the rapid exchange of critical public health information.1
|
Despite evidence of progress, the CDC report notes that “challenges remain” for state health departments. When asked during the telebriefing which issues pose the greatest challenges to further development of public health preparedness, Dr. Gerberding said “complacency.” Dr. Besser noted that further progress in the area SNS distribution is a priority. In addition to these challenges, the CDC report notes that “building on progress in public health preparedness will require ongoing commitment” in the following areas: - Recruiting and retaining qualified epidemiologists and laboratory scientists to work at public health departments and public health laboratories;
- Strengthening disease surveillance systems. The report notes that in 2007, “16 states did not report any plans to electronically exchange health data with regional health information organizations (networks of healthcare provider organizations that allow the electronic sharing of health information among members).”
- Ensuring that state public health departments have “appropriate” legal frameworks to support surveillance and to allow sharing of public health information across jurisdictions;
- Increasing the use of advanced technology and broadening testing abilities at public health laboratories. The report notes that no state lab is currently able to rapidly conduct radioactive analysis of clinical samples.
- Sustaining public health departments’ “system of all-hazards planning, training, exercising, and improving.” Specifically, the report addresses the need to help “help at-risk populations [in]…controlling chronic diseases.”
- Developing interoperable emergency communication systems across jurisdictions and levels of government.1
According to the report, the CDC is working with state and local public health departments to address these and other ongoing challenges through the following initiatives: - “Increasing the use of electronic health data for preparedness and response by networking surveillance systems and using real-time data;
- Expanding laboratory testing;
- Establishing commercial partnerships to supply needed medicines to at-risk populations during an emergency;
- Developing and evaluating a core curriculum for preparedness through the Centers for Public Health Preparedness, a national network of academic institutions with a common focus on public health preparedness;
- Improving legal preparedness by helping states and other jurisdictions implement public health mutual aid agreements, which enable sharing of supplies, equipment, personnel, and information during emergencies;
- Exercising public health systems to continuously improve capability and demonstrate readiness; and
- Collaborating with partners to develop accreditation programs for state and local public health preparedness.”1
Reference - Centers for Disease Control and Prevention. U.S. Department of Health and Human Services. Public health preparedness: mobilizing state by state. February 2008. http://www.bt.cdc.gov/publications/feb08phprep/pdf/feb08phprep.pdf. Accessed February 22, 2008.
|
