Pandemic Influenza Response – In Action

A couple of weeks ago, a reader posted a story to my del.icio.us page about the successful implementation of a pandemic influenza plan in Erie County, NY.  Now, wait one second before heading to CNN to see when the pandemic started and where you can pick up those Hello Kitty masks.  The pandemic hasn’t started, I assure.  All that has happened is some health folks up in Erie County took a potentially bad situation, a Hepatitis A outbreak, and with a little out-of-the-box thinking, managed to vaccinate more than 10,000 people in less than five days.

A few readers have asked why I continue to support spending on preparedness efforts in public health when traditional public health functions are being bled dry and can’t afford to sustain any level of care and activity.  My answer is always the same: being prepared means more than being prepared for natural disasters, bioterrorism and pandemics.  Until health departments (local, state and federal) learn how to incorporate preparedness planning into everyday public health, it will seem that public health is turning into homeland security-lite.  But know that every grant I’ve read for health preparedness funding talks about building capacity.  Every.  Single.  One.  This article is a great example of how that newly realized capacity (and planning) can be used in a non-disaster, or huge emergency type of situation.

An employee at the Wegmans store at 5275 Sheridan Drive in Amherst was diagnosed last Friday with hepatitis A, a liver disease caused by a virus. In food-related outbreaks, the illness is spread primarily by eating raw produce handled by an infected person who didn’t wash his or her hands adequately after using the bathroom. Within 24 hours, the county was offering hepatitis A vaccine or immune globulin for protection. The first few hours proved chaotic when more than 1,000 people showed up Saturday in a freezing rain and were forced to wait more than three hours in line.

That’s when the pan flu planning kicked in.

Officials retooled on the fly, bringing in more workers and a fleet of buses to “stage” the overflow patients in a warm, safe place.

And regarding the need for staffing?

Staffing also proved a challenge. Officials needed doctors, nurses, security, paramedics, administrators, epidemiologists and an assortment of helpers, especially with patients divided into five different treatment groups, depending on their age-related dose and choice of drug, and needing privacy if they received an injection in the buttocks.

[T]he state, which provided the 5,437 doses of vaccine, as well as critically needed nurses and other personnel, will provide more financial help.

Any problems?  Or as they say in homeland security, lessons learned?

“If I were to list the three top problems we experienced, they are communication, communication and communication,” said Billittier. “The challenge is coordinating the message.”

The county Health Department learned that there was no one on duty over the weekend to update its Web site, and the state Health Department telephone hotline was so swamped that callers initially could not get through.

So, where does this fit in for preparedness as public health?

The county pandemic flu plan, put together under federal guidelines, calls for vaccinating 950,000 people in less than a week if a new, deadly strain of influenza spreads around the globe.

And how did it work?

Hundreds of county and state workers, backed up by volunteers, pitched in at the mass vaccination clinics for hepatitis A at Erie Community College North. By most accounts, they coped well with the challenge.

Their training and preparations paid off. As a result of lessons learned, officials already see potential improvements to avoid problems that did arise.

I think it’s important to get stories like these out because they show that folks who work in public health preparedness aren’t just leaching off of the good name of public health while tearing down what public health has wrought.

That’s why I got such a kick out of the Mobilizing State by State report from the CDC (which I just haven’t had a chance to write up, but soon, I promise).  It’s chock full of stories where preparedness has helped the public health.  Preparedness can become another tool in the toolbox of public health, but it seems we both have to learn how to play with each other.

Photo courtesy: DefenseLink public domain