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CDC Terrorism Preparedness and Emergency Response Activities Report

February 18, 2009

cdc The capability of the public health system, communities, and individuals to prevent, protect against, quickly respond to, and recover from health emergencies, particularly those in which scale, timing, or unpredictability threatens to overwhelm routine capabilities.

That’s the definition of public health preparedness given by the IOM in their 2008 report on research priorities for emergency preparedness and response for public health systems. It’s also the definition given at the beginning of last month’s CDC report on Terrorism Preparedness and Emergency Response (TPER) – Funded Activities, entitled, “Public Health Preparedness: Strengthening CDC’s Emergency Response.” This rather hefty report gives us a nice listing of what CDC thinks they’ve accomplished with the 2007 funds appropriated for terrorism preparedness in public health.

Divided into seven chapters, this report goes into some detail about the strides made in surveillance, epidemiology, laboratory science, response and recovery and public health system support. Way more detail than I could do justice reviewing for you, so I encourage everybody to download a copy and read it over several long weekends. Some things stuck out to me though—especially in the chapters that I actually know something about—and I wanted to bring them to your attention. They’re in order only as I read them and made notes. The first thing is not the coolest or most egregious; conversely, the last item is not the least of our worries.

First, and for my long time readers you can skip this paragraph, is the call-out about NC-DETECT, a North Carolina Department of Health system that is funded by the PHEP cooperative agreement and BioSense (two very preparedness oriented funding streams), and how it was used to track heat wave-related morbidity and alter the public messaging for future heat waves (young folks need to be aware of heat, too). This is the essence of all-hazards, of using preparedness dollars to support traditional public health goals and processes.

The report describes at least five systems for collecting surveillance data, not including surveillance done during disasters. And I know there are several others that perform that particular task in addition to those mentioned. In response to HSPD-21, CDC created the Biosurveillance Coordination Unit. I’d love to see future reports focus on how this Unit, and similar efforts at DHS are sipping from this firehose of life or death information. And if there’s any impetus to include FDA/USDA surveillance in this morass (obligatory peanut butter plug).

There is, of course, the highly successful Epidemic Intelligence Service (EIS) and Career Epidemiology Field Officer (CEFO) programs that place experienced epidemiologists in state and local public health departments. These folks, in addition to their smart uniforms, fulfill a range of needed services ranging from outbreak identification and control to pandemic influenza planning. Funded with TPER monies, they provide essential capacity across the country.

CDC used the SNS aircraft fourteen times! Twelve more international quarantine stations! New website!

I’ve been interested in the Crisis and Emergency Risk Communication field for some time, and because it’s mentioned a couple of times in the report, I wanted to make sure that I passed along a link to the CDCynergy website for anyone else so disposed.

To close, I give you this challenge:

Strengthening public health preparedness at federal, state, and local levels in a climate of decreasing resources.

This is something all state and local health departments are dealing with right now. I know that in Philadelphia the Mayor has asked all departments to submit plans to cut 10, 20, and 30% of their discretionary budgets. Now, put the financial needs and agitable populations of the health department up against those of the police, fire, courts, schools, libraries… It’s depressing to think about what could happen. And as I mentioned in an earlier post, all preparedness funding was cut out of the American Recovery and Reinvestment Act, with health care (not public health specifically) getting only a small portion of the total. Trust for America’s Health has mentioned, seemingly with every report, that public health expenditures experience either functional or actual cuts yearly.

Cuts at the local level, no help from the feds, and mounting needs. I’ll say that quoted text above is a challenge.

Image credit: CDC report

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