ICF
International is engaged in developing pandemic
flu preparedness plans by addressing the
needed coordination among all levels of
government and the private sector, and testing
or exercising the plans in numerous communities/regions.
This assistance results in more efficient use
of budgets for pandemic planning and ultimately
boosts a community's level of preparedness.
ICF has a comprehensive understanding of the
complex issues facing public health departments,
business, and the public. Concerns regarding
outbreaks of pandemic flu require preparedness
efforts to be enchanced. ICF has worked for
several state and local public health departments
and federal agencies to improve their programs
to address bioterrorism outbreaks, conduct
exercises to test their access to the Strategic
National Stockpile (SNS) of vaccines, and prepare
for pandemic events.
A pandemic influenza occurs when a virus (usually originating or preexisting in one or more species of bird) evolves or mutates into a form that can infect and also be transmitted by people. |
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Pandemic diseases have occurred throughout history.
One of the worst on record, a strain known as the "Spanish
influenza," caused the death of an estimated
40 to 50 million people worldwide in 1918. Less virulent
pandemic influenzas occurred in 1957 and 1968, taking
a combined 3 million lives. By contrast, in a more
typical year, 250,000 to 500,000 people die from
influenza or other respiratory-related illnesses.
There is a limit to what government or the health
care community can do in advance of a pandemic outbreak.
The U.S. Federal Government, the World Health Organization,
and others are monitoring the avian, as well as other pandemic threat sources
closely. The United States has active national
as well as international programs for manufacturing,
pre-positioning, and stockpiling antiviral drugs,
masks, and other supplies. However, work on a specific
vaccine generally cannot take place until a virus
strain that infects people is identified and isolated.
From that point, most experts agree that the development
of an effective vaccine can take six months or more.
The next pandemic event could result in 180 to
360 million fatalities (up to 1.9 million in
the United States alone) over what could be an
18-month crisis. In addition, health care providers
and other industries on which the economy depends
(e.g., financial, transportation, information
technology) could be crippled by the absence
of up to 40 percent of their workforce as employees
become ill.
So, what more can we do to prepare? Preparedness
makes the most difference at the local community
level because this is where any lack of preparedness
is felt most acutely. As demonstrated in the aftermath
of Hurricane Katrina, communication and coordination
between the communities, the federal government,
state governments, and the private sector are essential
to a successful disaster
response.
In the United States, Secretary Leavitt
of the Department of Health and Human Services
(DHS) has stated that "any community that
fails to prepare—with the expectation that
the federal government can come to the rescue—will
be tragically wrong" (April 10, 2006). So,
the ultimate question is: are the communities prepared?
In order to demonstrate preparedness, the communities
need to have realistic plans covering functions
such as:
And these plans cannot just be "shelf art." Instead,
they need to reflect the roles of all the key players,
including local health departments, law enforcement,
private health care providers (physicians, nurses,
hospitals, health maintenance organizations, emergency
medical technicians, etc.), other businesses,
and schools. Just as importantly, the plans need
to be "exercised" to
demonstrate their viability in addressing above functions.
The states have developed plans; their communities
are currently doing the same and are seeking assistance
to achieve effective results. Whether they are adequately
prepared is an open question.
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USDA Avian Influenza Playbook
ICF International
assisted the U.S. Department of Agriculture
(USDA), Animal and Plant Health Inspection
Service, in developing a "playbook" outlining
roles and responsibilities for various
federal agencies in detecting and responding
to multiple scenarios regarding outbreak
of avian influenza among bird populations.
The Playbook was intended for use by
a committee of senior federal officials
(i.e., Deputy and Assistant Secretaries)
to improve coordination among key players
in the Executive Branch. ICF reviewed
USDA's Interim Avian Influenza
Response Plan and provided recommendations
for reorganizing the plan to conform
with standard format and terminology
of Homeland Security Presidential Directives
5 (Management of Domestic Incidents)
and 8 (National Preparedness). ICF also
developed a graphic concept illustrating
the Nation's strategy for preparing,
detecting, and responding to an outbreak
of pandemic influenza.
Pandemic
Influenza Plan Development
ICF International
is assisting Montgomery County, New York,
in developing an annex to the county's
comprehensive emergency management plan
to enhance preparedness for a pandemic
event. This is a collaborative effort
with the state's Disaster
Preparedness Commission, the State Office
of Homeland Security, and the State Emergency
Management Office. The evolving state
plan will parallel the national strategy
for responding to pandemic influenza.
However, an effective plan also should
reflect the unique characteristics
of local communities. Therefore, each
New York county has been requested to
develop and submit a Pandemic Influenza
Plan. Specifically, the plan will identify
the roles, responsibilities, and activities
of the local health department during
a pandemic.
New
York Public Health Drills and Exercises
For New York State Department of Health
(NYSDOH), ICF developed a toolkit for
public health drills and exercises in
an effort to build consistency and sustainability
in the statewide public health exercise
program. The toolkit also is being
disseminated to the hospitals and emergency
management agencies. NYSDOH created subcommittees
for each of five public health threat
scenarios. The subcommittees were made
up of state and local public health experts.
ICF, along with the subcommittees,
developed the scenarios including Chempack,
Pandemic Flu, Environmental Health Incident, Biological Detection System (BDS),
and Mass Fatalities. ICF is conducting more than 20 exercises in the summer
of 2006, the majority of which involve
a pandemic flu scenario.
Virtual
Pandemic Flu Exercise for the State of
Iowa
ICF supported the Iowa Department
of Public Health (IDPH) and the State
of Iowa's
six public healthcare regions in developing
and executing a virtual functional exercise
(VFX) to test objectives consistent with
Iowa's Statewide Domestic Preparedness
Strategy. The exercise, which took place
over a three-week period from March 31
through April 18, 2006, was designed
to specifically test the Iowa state and
local public health and medical plans
for response to pandemic flu. Exercise
participants included the IDPH and representatives
from local public health departments,
emergency medical services, hospitals,
and emergency management agencies from
the six regions across the state. The
"virtual" nature
of the exercise allowed exercise participants
to continue to work from their normal
places of business, where they responded
to message injects submitted via e-mail,
telephone, or fax through a simulation
cell.
Integrated
Statewide Exercise Program Support
ICF supported both
the Massachusetts Department of Health
and the Executive Office of Public
Safety in their development of an Integrated
Statewide Exercise Program. This
program:
(1) involved coordination among the
various relevant agencies, including
the Department of Public Health,
and community response agencies and
partners (i.e., hospitals, EMS providers,
and community health centers
(2) built
state capacity to carry out
exercises by utilizing a cycle of exercise
activities of varying degrees of
complexity
(3)
involved exercise scenarios that
focus on hazardous materials, bioterrorism,
and weapons of mass destruction
events
(4) enhanced the state's
overall level of preparedness
A total of 40
tabletop and functional exercises were
conducted.
Integrated
Emergency Management Course for the Metropolitan
Medical Response System
For Federal Emergency Management Agency
(FEMA), ICF developed and conducted Integrated
Emergency Management Course (IEMC) programs
for Metropolitan Medical Response System
(MMRS) communities across the country.
Exercise development involved close coordination
with local responders such as fire, police,
EMS, public health, hospitals, and emergency
management to obtain copies of plans,
procedures, and insight into each jurisdiction's
capabilities.
Smallpox
Vaccination Exercises for the State of
Iowa
ICF supported Linn County, the
Iowa Department of Public Health, and
the State of Iowa in developing and
delivering six tabletop exercises and
a full scale terrorism chemical-biological
exercise to test regional capabilities
to implement mass smallpox vaccination
plans and hospital chemical decontamination
plans. The exercises were conducted in
two phases with a total of six counties
and more than 1,200 persons participating.
Six hospitals exercised their chemical
decontamination plans, and six emergency
vaccination clinics exercised their mass
vaccination procedures. The exercise
play included activation and operation
of one public health clinic in each of
the participating counties to administer
the smallpox vaccine to the public.
Emergency Response and Crisis Management
Technical Assistance (ERCM TA) Center
ICF Caliber, an ICF International Company,
operates the U.S. Department of Education
(ED) Emergency Response and Crisis
Management (ERCM) Technical Assistance
(TA) Center, ensuring safety and security
for the whole school community, including
students, staff, and visitors with disabilities
and special needs. The ERCM TA Center
assists local education agencies (LEA) to build their emergency preparedness
capacity at both the district and school building level. The ERCM TA Center
provides training and resources focused on schools developing all-hazards plans
framed within the four phases of emergency response (mitigation/prevention,
preparedness, response, and recovery). LEAs also are provided with guidance
for developing community partnerships
with local law enforcement, public safety,
public health, and mental health agencies for collaboration in all emergency
preparedness activities (i.e., functional exercises). The ERCM Center works
closely with the U.S. Department of Education and designated federal
agency partners to provide all-hazards assistance. Currently, the ERCM TA Center
is working with ED and staff from the U.S. Department of Health and Human Services
(HHS) Centers for Disease Control to
provide schools guidance to address the
pandemic flu as one component of the
all-hazards school emergency plan. |
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