The deliberate release of viruses, bacteria, or other germs (agents) used to cause illness or death in people, animals, or plants. Examples of biological agents include anthrax, botulism, Q fever, and tularemia. For more information, please visit the CDC page on bioterrorism.
Connecticut experiences a wide array of seasonal hazards, such as severe winter storms, hurricanes, and floods, and it must also prepare for accidents stemming from man-made disasters, infectious disease, or incidents at the two nuclear power plants located within its region. The effect of Tropical Storm Irene on the East Coast in summer 2011 and a rare October Nor’easter two months later highlighted Connecticut’s susceptibility to a variety of natural/seasonal hazards.
Background
More than half the US population lives in cities and metropolitan areas. If a public health emergency, such as a bioterrorist attack or a disease epidemic, were to affect one of these areas, a significant number of people would require treatment and/or prophylaxis. CDC’s Cities Readiness Initiative (CRI) funds 72 metro areas to develop plans for providing antibiotics or antivirals to their entire population in the event of a large-scale emergency.
Specific issues
The Oklahoma Department of Health developed a Push Partner Program in response to Homeland Security Presidential Directive 21, which asked all communities to be prepared to provide prophylaxis to their entire population within 48 hours. The "push" strategy involves distributing medications to partner agencies, which then dispense the medications to their employees, employees' family members, and the agencies' clients.
The North Carolina Division of Public Health (NC DPH) developed a program to increase surveillance for potential bioterrorist or infectious disease events by placing public health epidemiologists in 10 of the state's largest hospital systems. Increased partnerships between public health and hospitals, along with the enhanced surveillance skills epidemiologists bring to large healthcare systems, led to a program with great potential for responding quickly to an emerging health crisis.
Points of dispensing (PODs) sites located in schools or community buildings are a standard part of preparing to provide medication or vaccine to the public during an infectious disease outbreak or bioterrorist attack. Push methods – ways to get antibiotics or other forms of treatments to people's residences – are less common, yet may offer significant benefits in terms of social distancing, traffic control, and personal comfort during an emergency.
A NIMS-based approach provides a framework to establish an acute care center (ACC) for a bioterrorism event, but much of the information could easily be extrapolated to a pandemic situation. The materials describe a coordinated approach between local hospitals and acute care centers by including scenarios for which an ACC might be needed and defining the level of care provided outside of a hospital. For instance, the document limits ACCs to the provision of basic care, hydration, antibiotics, and possibly oxygen.
The Closed Dispensing Site Workbook is designed to help community organizations become closed dispensing sites to administer medication to their staff and/or clients during an emergency. The workbook is an alternative to traditional prophylaxis dispensing site and is intended to disburse preventive medication to an entire population within 48 hours.
A Nevada health department established a potential Memorandum of Understanding with resorts in the Las Vegas region for distribution of Strategic National Stockpile medications in the event of a public health emergency. The MOU template provides an avenue of collaboration between local public health and private resorts or casinos in which resort employees and citizens needing treatment all benefit from this agreement. The agreement allows for treatment of resort staff and requires that public health officials guide storage, security, and distribution of medications through resort staff.
A concept of operations describes an integrated approach to developing surge capacity plans between multiple hospitals. Four hospitals in Brooklyn, New York, developed a collaborative plan by conducting inventories of various hospital assets and identifying surge capacity resources at each facility. Although surge planning should be a standard practice for all hospitals, this concept is noteworthy in that it used an integrated approach between several hospitals in a well-defined geographic area.
