CRI Program 2004 2005 Public Health Seattle

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CRI Program 2004 2005Public Health -
Seattle King County
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Overview

• Our Goals and Objectives for CRI
• What We Achieved
• Challenges We Experienced
• Future Planning Issues
• Overall Observations of CRI Year 1

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Our Goals for the CRI Project

• Make progress toward CDC requirements
• Develop capabilities for mass dispensing of
  antibiotics during anthrax events
• Build capabilities for real world events
• Anthrax 2001, Wash. D.C., FL, NJ
• Hepatitis A, Philadelphia 2002, Pittsburgh 2003
• Meningitis, Mankato, Minn. 1995

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CRI Program Objectives

• What is our geographic planning area?
• Population determined by CDC (560,000)
• Area determined by Public Health (county-wide
  health department)
• Puget Sound region directly involved due to
  commuter population

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CRI Program Objectives

• Where will we focus our limited time and
  resources?
• Build POD capability
• POD Model
• Site Selection and Site Planning
• Risk Communications Planning
• Training and Drills
• Grab Low Hanging Fruit
• Identify large health partners / facilities that
  could manage their own PODs

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CRI Program Objectives

• Who are our response partners?
• State health department
• Local law enforcement
• Fire / EMS
• Emergency managers
• Parks departments
• Local pharmacists
• University

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Benefits Achieved With CRI

• Enhanced staff training on preparedness, ICS,
  disease outbreak response
• Built valuable relationships with response
  partners
• Developed real capability for responding to most
  outbreaks

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Benefits Achieved With CRICreative and
Unexpected Solutions

• Exploring registration of HHS staff as volunteers
  under MRC
• Agreement with local university to staff and
  operate a POD for 60,000 people
• Coordinating with local health cooperative to
  dispense to 200,000 members

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Challenges Experienced with CRI

• Limited and inconsistent guidance from CDC on the
  program and requirements
• Strict limitations on how funding could be spent
  (no drugs, limited staffing)
• Getting contract completed with CDC

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Challenges Experienced with CRI

• CRI based on unrealistic anthrax scenario hard
  to keep staff involved and motivated
• Liability issues surrounding volunteer medical
  staff
• Pre-deployment to responders (lots of support but
  complicated)

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Challenges Experienced with CRI

• No standards or best practices for any aspect of
  this project
• No centralized communication of progress made by
  cities, successes, challenges, lessons learned
• USPS delays, inconsistencies, restrictions -
  now required by CDC

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Future Planning Issues

• Plans for on-site credentialing
• Evaluating the efficiency of POD models
• Assessing how the public is likely to respond

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Future Planning Issues

• Identify triggers for activating various
  dispensing options
• Tracking pharmaceutical inventory
• Identifying, registering, training volunteers
  (Progress made by the University)

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Overall Observations

• Catastrophic anthrax scenario (crop duster) not
  the right place to start
• Lowered credibility of the program
• Jeopardized our ability to maintain involvement
  of key staff
• Ignored a scaled approach building capabilities
  for smaller, real-world events

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Overall Observations

• The time and expense of extensive legal review
  was not anticipated
• Time frames established for completion of
  deliverables are not achievable
• Future CRI priorities should focus on local needs
  and likely scenarios

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Overall Observations

• With CRI we have built surge capacity for mass
  dispensing and vaccinating
• Because
• We adapted CRI to meet our needs