Since the events of September 11, 2001 and the Anthrax scares of October 2001, there has been a great deal of attention on public health’s role in emergency response, particularly in relation to Weapons of Mass Destruction, or WMD. WMD include biological, chemical, or nuclear threats. Preparedness activities for WMD threats differ from natural events such as hurricanes, flooding, etc. People affected by a biological agent my take days to develop symptoms and seek medical care; a large geographic area may be affected, or persons may travel long distances and unwittingly infect others, including hospital personnel. Furthermore, traditional hazardous materials and emergency medical procedures may be inadequate to respond to a WMD event. Developing appropriate public health response has been on the agenda at the national, state, and local levels. However, public health’s role in responding appropriately to a biological, chemical, or nuclear incident continues to evolve.
Here are some of the activities to assure adequate public health response:
AT THE NATIONAL LEVEL:
The Centers for Disease Control and Prevention (www.cdc.bt.gov) is the primary public health resource at the national level. The CDC is involved in disease surveillance and research into bioterrorism response.
The Department of Homeland Security (http://www.dhs.gov/dhspublic/) was formed to protect the nation against further terrorist attacks. Some public health functions are organized under this department.
Bioterrorism Performance Standards: The National Association of County and City Health Officials is working with the Centers for Disease Control and Prevention (CDC), Public Health Practice Program Office to support the Public Health Preparedness and Response Inventory tools developed by the CDC. The Public Health Preparedness and Response Capacity Inventory provides a rapid assessment of a public health agency's ability to respond to public health threats and emergencies. The Inventory includes measures to assess progress towards meeting each of the benchmarks and critical capacities described in the grant guidance for Fiscal Year 2002 Supplemental Funds for Public Health Preparedness and Response for Bioterrorism (Announcement Number 99051). Click here to download the Local Inventory (PDF 476KB) or State Inventory (PDF 481KB). This effort is connected to the National Public Health Performance Standards Program (NPHPSP), thereby promoting appropriate bioterrorism prevention capacities within seamless state and local public health systems.
AT THE STATE LEVEL:
North Carolina Public Health Preparedness and Response (PHP&R) is within the Division of Public Health in the NC Department of Health and Human Services. PHP&R response includes
- Creating seven Public Health Regional Surveillance Teams (PHRSTs) to provide support to local health agencies serving all 100 counties. Person County is within the Durham RST. Each team includes an epidemiologist, an industrial hygienist, a nurse consultant, and administrative specialist.
- Expanding capacity of the N.C. State Laboratory of Public Health has expanded its capacity and is working with the local health departments in Buncombe, Mecklenburg, and Pitt counties to develop regional bioterrorism laboratory testing capabilities.
- Another key component to the effort is communications. DPH deployed its first version of the North Carolina Health Alert Network (NCHAN) in October of 2002. This secure, internet based alerting system provides 24/7 flow of critical health information among North Carolina's state and local health departments, hospital emergency departments, and law enforcement officials. The NCHAN database system provides secure, tiered health alerts to key personnel through simultaneous use of phone, fax, email, and pagers to communicate urgent health information.
AT THE LOCAL LEVEL:
An effective response to a WMD event focuses on two key areas: joint efforts between the medical community and public health agencies and better trained and coordinated first responders (i.e., law enforcement, public safety, hospital personnel, and public health officials). The Person County Health Department is developing its capacity to respond to public health emergencies, including threats of WMD. An initial Public Health Bioterrorism Preparedness and Response plan was developed in March 2002. This annex to the Person County Emergency Operations Plan sets forth procedures and protocols to be followed in the event of a bioterrorist event, whether real or perceived. The mission of the local public health response is to protect the health and safety of Person County’s residents by assuring that the necessary preparedness and response capacity exists for a bioterrorist event affecting, or likely to affect, Person County. The goals of the plan are:
- To increase the county’s ability to detect a covert biological attack;
- To increase and improve the County’s response to an overt or covert bioterrorist attack;
- To reduce the response time by critical County agencies;
- To reduce the severity of injuries or disease caused by a bioterrorist attack;
- To reduce the loss of life due to a bioterrorist attack; and
- To reduce the economic impact to the County.
In the winter of 2003, the Person County Health Department was awarded a series of grants from the NC Office of Public Health Preparedness and Response to improve public health’s public health response capacities. A grant of $25,700 was used to improve the public health infrastructure and was used to enhance communications and technology equipment. Additional grants of $3,000 and $4,300 were used to enhance public awareness and training capacities. As a result of these funds, the health department has vastly improved capability to operate within the existing Person County emergency response system and with the state and federal health alert systems. The department is also able to communicate effectively to the local medical community and with the general public.
Isolation and Quarantine Authority
In the fall of 2002, the North Carolina General Assembly enacted a new law that more clearly defined the role of public health in responding to bioterrorism. For text of this law click here. For an analysis of this law click here.
Links:
Biological Signs and Symptoms