Public Health Preparedness Tim O’Hea, MBA Principal Planner Public Health Preparedness Section Division of Public Health Presentation Overview  Emergency Responsibility  Public Health and Medical Services  Emergency Medical Service  Public Health Preparedness & Planning  Preparedness Programs Presentation Overview  DPH’s Response Modular Medical Expansion System  State Health Operations Center Medication Mass Distribution Alternate Care Facilities  Pandemic Influenza & Novel H1N1  Delaware Medical Reserve Corps Emergency Responsibilities Delaware Division of Public Health (DPH) Our mission is to develop, implement, and maintain a comprehensive program to prepare for, mitigate against, respond to, and recover from public health threats and emergencies. Emergency Responsibilities Authority  Title 20 Public Health Emergencies  Authority and responsibility to respond to or plan for public health emergencies  Control of Health care supplies  Vaccination & Treatment  Isolation and Quarantine Public Health Threats As one considers the many unique and distinct threats challenging us…. …..public health preparedness is a cross discipline need and requires integrated planning across all sectors Emergency Responsibilities  DPH is lead agency  Public Health and Medical Services  Emergency Medical Services  Command and control  Representatives at State and Local Emergency Management Agencies (EMAs) Emergency Responsibilities  Mechanism for coordinated assistance  i.e. Evacuation of hospitals  Supplement and support local resources Medications and medical supplies Emergency Responsibilities Preparedness Programs  Mass Medication Distribution & Countermeasure  Medical Surge  Surveillance  Evacuation Support  Mass Fatality Management  Risk Communications & Call Center Emergency Responsibilities Preparedness & Planning  Stockpile Medications Medical Supplies  Plans All Hazards Multiple planning scenarios  ‘At risk’ community Risk communications to the public Emergency Responsibilities Preparedness & Planning  Outreach  A Guide for Emergency Planners (Considerations for Individual with Non-Typical Functional Needs)  Emergency Preparedness for Non-Typical Functional Needs Guide  Pandemic Influenza Outreach Emergency Responsibilities Partner Agencies  Delaware National Guard  Delaware State Police  Hospitals  Emergency Management Agencies – local and state  Delaware Department of Transportation DPH’s Response Modular Medical Expansion System (MMES) State Health Operations Center (SHOC)  Command & Control  Centralizes coordination  Staffed by DPH and DHSS employees  Technical Expertise Neighborhood Emergency Help Center (NEHC)  Mass prophylaxis & immunization  SNS dispensing point  Counseling  Community outreach  Mobile asset  1000 to 2000 per hour dispensing  600 per hour vaccination In-State Stockpile (ISS)  Countermeasure stockpile of medications to treat essential workers and the public during a public health emergency  Medications stockpiled are:  Antiviral Medication  Antibiotics  Nerve agent anti-dotes  Medication for Radioactive Exposure  Designed to counter the effects of:  Pandemic influenza  Biological agents (i.e. Anthrax)  Nerve agents  Radioactive exposure  Other medical equipment Acute Care Center (ACC)  Mass inpatient care  400 beds  Austere care  Mobile asset  Hospitals operate in conjunction with DPH Acute Care Center Photo Courtesy of United States Department of Health and Human Services: http://1918.pandemicflu.gov/pics/photos/Iowa_Flu2.jpg DPH Alternate Care Facilities Medical Needs Shelter (MNS)  4 facilities for a total of 200 beds  Mobile asset  Operated by Delaware National Guard in conjunction with DPH  Stand alone or part of the general shelter system  House individuals who require support with their medical needs and can’t be accommodated in a regular shelter Medical Needs Shelter (MNS) Mobile Medical Facility (MMF)  Portable medical facility  HVAC  Oxygen delivery  Hygiene stations  Plumbing  Operate as a:  Alternate care facility  Command Center  Mobile Morgue Mobile Medical Facility (MMF) MMF – Mobile Morgue Pandemic  A disease outbreak that spreads easily as most people are susceptible  Effective human to human transmission is necessary  Measure by how fast the virus spreads  Wide geographic spread Seasonal vs. Pandemic Flu  The seasonal flu usually occurs annually between December and March  Pandemic flu is caused by a novel virus strain that humans have no resistance against  Pandemic flu infects large numbers of people of different ages globally and can causes serious illness and deaths Influenza Pandemics of the 20th Century 1918 “Spanish Flu” 1957 “Asian Flu’ 1968 “Hong Kong Flu” 20–40 Million Deaths 1–4 Million Deaths 1-4 Million Deaths 675,000 U.S. 70,000 U.S. 34,000 Pandemic Waves  Pandemics occur in multiple waves of disease outbreaks  Waves can last six to eight weeks  The time between pandemic waves varies and cannot be easily predicted Novel H1N1 Influenza “SWINE FLU” NovelH1N1Influenza“SWINEFLU” H1N1 Facts & Figures  On March 18, 2009 the World Health Organization (WHO) reported an outbreak of Influenza Like Illness in Mexico. Laboratory analysis confirmed (Novel) Swine Influenza A/H1N1virus had emerged.  April 24, 2009 – WHO reported Influenza Like Illness in Mexico & U.S. Mexico (854 cases / 59 deaths) U.S. (7 cases / 0 deaths) Healthy Young Adults  April 28, 2009 – University of Delaware – Public Health Responds H1N1 Facts & Figures  June 11, 2009 – WHO Reported: 74 Countries 28,744 Cases 144 Deaths  U.S. 13,217 Cases (46%) / 27 Deaths (19%) W H O Declares “Global Pandemic”  51 Reporting States & Territories as of 8/13/2009  7511 Hospitalized Cases  477 Deaths H1N1 Facts & Figures  Occurred very late in the flu season  Affected young people disproportionately  Caused widespread illness; some severe or fatal  Socially disruptive, especially for schools – closures and canceling of events  Thousands of healthcare and public health workers respond in the U.S. Mortalities Novel H1N1 Confirmed & Probable Case Rate in the United States, By Age Group It’s Not Over . . .  Continuing spread in U.S.  Outbreaks in summer camps, some colleges, and communities across the U.S.  Southern Hemisphere Patterns  Substantial disease in Argentina, Chile, and Australia  Reported cases from Africa & Asia  Reported strain on health care system in some localities  CDC anticipates pattern will continue in the U.S. this fall. Preparing for a Pandemic What can you do? It’s a Shared Responsibility  Develop, Review & Update Emergency Plans & Policies  Medical & healthcare providers should take PPE Precautions Seriously  Institute & Practice Healthy Hygiene  Have employees stay home if they are sick!  Develop Continuity of Operations Plans  Follow Delaware & CDC issued guidance  Get vaccinated when H1N1 vaccine is available  Keep yourself informed Preparing for a Pandemic What are we doing?  Preparing for a vaccination campaign  Enhanced Surveillance  Communicating accurate and timely information  Enhancing policies and plans  Enhancing stockpiles Delaware Medical Reserve Corps (DMRC) Purpose  Supplement existing medical and public health staff during and after an emergency  Emergency roles performed by DMRC members may include:  Mass vaccination  Dispensing medications  Administrative duties DMRC Volunteer Members  >400 Volunteers  Medical  7 Dentists  4 EMT Basic & Paramedics  140+ Pharmacists  32 Physicians  14 Licensed Practical Nurses  69 Registered Nurses  Many others – language interpreters, accountants, IT, etc. DMRC Participation Activities  Bi-monthly meetings  Exercise participation with DPH and other state agencies  Response to H1N1  Training  Outreach event  DMRC Leadership Team  Chair & Co Chair  Focus Groups (Recruitment & Training) Additional Information  For Public Health Preparedness Section:  Contact Timothy O’Hea at (302) 223-1720 or at Timothy.O’Hea@state.de.us  Get additional information about Public Health Preparedness, Health Alerts, and Influenza information at: http://www.dhss.delaware.gov/dhss/dph/php/index.html http://www.dhss.delaware.gov/dhss/dph/swineflucomm.html http://www.dhss.delaware.gov/dhss/dph/index.html  For Pandemic/Influenza Planning and Information go to: http://www.Flu.gov  For Delaware Medical Reserve Corps:  Contact Public Health Preparedness at (302) 223-1720 or at servde@state.de.us or register at www.servde.org Questions........