Think Outbreak

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Think Outbreak!

• Public-Private Partnership for Bioterrorism/Emerge
  ncy Preparedness
• June 2, 2005

Dr. Rex Archer, M.D., M.P.H Director of Health,
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Communication Collaboration

• It is not what you dont know
• that hurts you,
• it is what you think you know,
• that just aint so.
• 
  -Satchel Paige-

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Acknowledgements

• Barry R. Bloom, PhD
• Senator Bill Frist, M.D.
• Julie L. Gerberding, M.D.
• Paul K. Halverson, PhD
• Donald A. Henderson, MD, MPH
• Thomas V. Inglesby, MD
• Jean M. Malecki, MD, MPH, FACPM
• Michael T. Osterholm, PhD, MPH
• Tara OToole, MD, MPH
• Joseph F. Waeckerle, MD, FACEP

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Public Health (PH) Preparedness(Are we there
yet?)

• The continuous process of improving the Health
  Systems capacity to detect, respond to, recover
  from, and mitigate the consequences of terrorism
  and other health emergencies

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Are we catching up?
?
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State Local

• Regulator
• Grantee (From CDC)
• Grantor
• Coordinator
• Responder/Service Provider

• Responder/Service Provider
• Grantee
• Coordinator
• Regulator
• Grantor

Advocacy?
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Collaboration
Coordination
Commitment
Competency
Communication
Consistency
Compassion
Candor Clinical Laboratories
Community Common Sense
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Visuals and Messages
What image or message does the public associate
with the Anthrax Attacks from October of 2001???
AP Photo, BBC
AP Photo, BBC
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Visuals and Messages

• An Associated Press photo archive search of
  Anthrax in 2001 resulted in 395 pictures. Only
  one was identified as a local public health
  department. Archived photos are used when media
  needs a still photo to accompany a new story or a
  continuation of a previous story.
• The images most associated with the Anthrax
  attacks were
• Hazmat Teams, Moonsuits, FBI/Fire
• Cipro
• Postal workers taking precautions while sorting
  mail
• Political leaders speaking out regarding the
  Anthrax Attacks
• What did the photos convey to the public?

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What is the face of public health?
AP Photo, BBC
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Public Health is the underdog in the fight for
effective and recognizable messages
AP Photo, BBC
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NACCHO Priority Objectives 2004

• Communicate the value of local governmental
  public health agencies to the media,
  policymakers, decision makers and the public.
  (3.2)

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Public Health needs to play the public relation's
game our funding depends on it.
AP Photo, Wichita Eagle, 11.2.01
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Which person below will get the biggest share of
your tax dollars?
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www.cdc.gov
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DYNAMICS OF A HYPOTHETICAL BIOLOGICAL ATTACK In a
75,000 population

• DATE CASES
• 9/12 1
• 9/18 6,674
• 9/23 12,604 (727 deaths)
• In 6 months, 25 of the U. S. Civilian Population
  Infected 4 of the infected Population will die

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Influenza

• Camp Devens, MA , 1918
• 9/12 1
• 9/18 6,674
• 9/23 12,604 (727 deaths)
• US. 25 of Civilian Population Infected
  4/100 Died
• Global In 6 months 20 40 million deaths (In
  4 years of WWI, 15m deaths)
• 2001 20,000 influenza deaths in US
• 100,000 hospitalizations

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What was the number one public safety threat of
the last decade?

• A. Drownings
• B. Burns
• C. Falls
• D. Motor Vehicle Crashes
• E. Homicides
• F. Infectious Diseases

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What was the number one public safety threat of
the last decade?

• A. Drownings
• B. Burns
• C. Falls
• D. Motor Vehicle Crashes
• E. Homicides
• F. Infectious Diseases

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Health Protection PreparednessCritical Elements
Products
Plans
Public Health System
Personnel
Practice
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Protecting People in a Transforming
WorldPreparedness

• Threat Characteristics
• Global threats with local
• impact local threats with
• global impact
• Health
• Security
• Economy
• Small world networks
• Fast transmission
• Fast dissemination

• Response Requirements
• Fast detection
• Fast science
• Fast effective
• communication
• Fast effective integration
• Fast effective action!
• Globalization, connectivity,
• and speed!

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Major Focus on State and Local Assets

• All Terrorism is Local
• An Effective National Response Requires an
  Effective Local and State Response
• Local Public Health is the First Responder for
  most of the nation in an outbreak (natural or
  intentional)

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MAJOR FOCUS ON STATE AND LOCAL ASSETS(continued)

• Timeliness and Quality of Initial Engagement
• Determine
• Course and Duration of Crisis
• Character and Magnitude of Consequences

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BioResponse the Foundation of Our Defense
E SNS
D BioShield
C BioWatch

B BioSense
A BioResponse

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Case Study Smallpox 1894

• Facing a citywide outbreak, Milwaukee health
  authorities forcibly removed infected individuals
  to isolation hospitals, selectively using this
  technique among impoverished immigrants and not
  the well-off.
• Perceived to be discriminatory and authoritarian,
  these measures caused month-long riots and
  ultimately abetted the spread of smallpox.
• Outbreak Impact 1,079 cases, 244 deaths

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Case Study Smallpox 1947

• NYC officials effectively quelled outbreak by
  implementing a voluntary mass vaccination
  campaign that was universally applied, carrying
  out an elaborate public relations campaign, and
  involving grassroots organizations.
• Outbreak impact 12 cases, 2 deaths

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A True All Hazards Approach vs. Limited Hazards
Approach Five Fatal Flaws?

• When did the emergency begin? (No Bang!)
• Short Crisis Period? (days to weeks)
• Manage Extra Volunteers/Resources?
• Mass Casualties (thousand fold increase)?
• True Triage (not EMS)?

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Regional Homeland Security Coordination Committee
- RHSCC

• Provides bi-state multi-disciplinary and
  multi-jurisdictional support
• Provides leadership and coordination
• Maximizes public and private resources

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RHSCC Subcommittees

• Training and Exercise
• First Responders
• Resource Coordination
• Personnel Accountability Security System (PASS)
• Metropolitan Emergency Information System (MEIS)

• Policy
• Plan
• Law Enforcement
• Public Health
• Medical Reserve Corps
• Hospital
• Mental Health

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Public Health SubcommitteeTask Forces

• Strategic National Stockpile
• Plans
• Epidemiology and Surveillance
• Isolation and Quarantine
• Risk Communication

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Urban Area Security Initiative (UASI)

• Funds awarded to the bi-state Kansas City
  Metropolitan area
• Funds used for planning, training, exercises,
  equipment, management and administration, added
  security, and critical infrastructure protection

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UASI PH Objectives

• Increase the regions surveillance and
  investigation capability.
• Develop regional capability to mass immunize
  large numbers of persons.
• Develop capability to manage large numbers of
  casualties.
• Build capability to stop the spread of disease(s)
  that are resistant to treatment.

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Public Health Related UASI Projects

• SNS Trailers 10 trailers with equipment and
  supplies to mass prophylax emergency responders
• Medication Distribution System Improves the
  speed and accuracy of medication distribution and
  tracking of persons receiving treatment for
  prevention of diseases

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Urban AreaSecurity Initiative Public Health
Projects
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Countries within 4 ½ yearsLife Expectancy of
the U.S.A.

• Japan 81.9 (higher)
• Switzerland 80.6
• Australia 80.4
• Canada 79.8
• U.S.A. 77.3 (25th place)
• Venezuela 73.9
• Bosnia 72.8
• Jamaica 72.8
• Libya 72.6 (lower)

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cynthia_carlson_at_kcmo.org
Public-Private Partnership for Bioterrorism/Emerge
ncy Preparedness June 2, 2005

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