public health emergency

public health emergency

Public Health Emergency Preparedness

1. Introduction to Public Health Emergencies

While there is an increased awareness of the necessity for emergency preparedness within public health, the field still faces a number of challenges. It is difficult for policy makers to rationalize funding allocation for preparedness, as it is hard to measure how much money may be saved if an emergency is averted because of preventive measures. There is also the issue of a lack of workforce and resources, and an absence of health care providers and workers that are willing to serve in the event of an emergency due to high demand, low incentives, and the liabilities involved.

Emergency preparedness has traditionally been in the domain of the military and emergency services, focusing on the response to events such as natural disasters, industrial accidents and terrorist attacks. Through rigorous research and policy implementation, it has become apparent that public health and the public health infrastructure play a vital role in protecting communities from the risks posed by emergencies. This can be demonstrated by events such as the SARS epidemic within Canada in 2003, where health measures utilized for containment are estimated to have saved the Canadian economy billions of dollars. Measures taken for emergency preparedness often result in added protection and promotion of public health long after the emergency has passed.

Public health emergency preparedness (PHEP) is the capability of the public health and health care systems, communities and individuals, to prevent, protect against, quickly respond to, and recover from health emergencies, particularly those whose scale, timing or unpredictability threatens to overwhelm routine capabilities. PHEP is a relatively new and still developing field, with the core concepts being brought to the attention of governments and policy makers in recent years in response to increased threats of bioterrorism, the 2001 anthrax attacks and the threats of pandemic influenza.

Public health emergencies, whether naturally occurring or man-made, can occur at any time and place without warning. Emergencies can have lasting effects throughout a community, with the potential to weaken public confidence in the ability to protect and promote the public’s health. An emergency is an event which requires a response to protect the safety and health of the public. Emergencies can range from a small outbreak of an infectious disease to a bioterrorist attack.

2. Importance of Emergency Response Planning

Sound emergency response planning is founded on a comprehensive assessment of potential hazards and threats and an understanding of the likely emergency scenarios. This is followed by the development and regular testing of a ‘system of systems’, the identification of roles and procedures for activating and managing the systems during an emergency, and specific operational planning for individual types of emergencies. The ultimate goal is to enhance preparedness for an effective response to any emergency.

Effective emergency response planning is essential for public health organizations. It is critical to the health and well-being of a community and necessary for the performance of most of the activities described in this paper. Response planning for any type of public health emergency is based on the same basic principles. The specific procedures undertaken in response to an emergency will depend on the type, severity, and scope of the event, the resources available, and the personnel involved. Nevertheless, the emergency planning process in general, and the specific activities described in this paper, are applicable to a wide range of public health emergencies.

3. Key Components of Public Health Emergency Preparedness

In its 1988 report, “The Future of Public Health,” the Institute of Medicine (p. 125) defined public health preparedness as the capability of the public health and healthcare systems, communities, and individuals to prevent, protect against, quickly respond to, and recover from health emergencies, particularly those whose scale, timing, or unpredictability threatens to overwhelm routine capabilities. This is a broad and challenging mandate. Subsequent work by public health and emergency management professionals has delineated the many aspects of preparedness and has made efforts to translate these into practice. The US Centers for Disease Control and Prevention funded eight academic centers of public health preparedness beginning in 2000, and it has provided considerable resources and technical help for states and localities to build preparedness. These efforts are now being expanded under the Department of Health and Human Services Office of Public Health Emergency Preparedness. Key documents and resources for defining and building preparedness include the CDC’s framework for public health preparedness, the National Response Plan and National Incident Management System, and the development of performance standards and indicators for public health preparedness. A comprehensive summary of this work is beyond the scope of this text, so here we will focus on the key components of preparedness and the challenges that ascertaining preparedness presents.

Key components of public health emergency preparedness. One of the key lessons from recent disasters and a result of bioterrorist attacks has been the importance of preparedness. The events of September 11, 2001, led to the recognition that public health and healthcare systems needed to be better prepared to respond to acts of bioterrorism. The subsequent anthrax attacks reinforced the need to assure that the public health infrastructure was capable of detecting and responding to bioterrorist events. However, preparedness is not only important for terrorism, but also for responding to the many types of disasters and public health threats that communities may face. For all these reasons, there has been increasing effort to build and sustain public health preparedness at the local, state and national levels. This objective requires an understanding of what preparedness involves, and how it can be ascertained.

4. Strategies for Effective Emergency Response

Use the progress made since September 11, 2001, and the anthrax attacks which followed as a foundation on which to build effective emergency response strategies. Progress to date includes significant federal funding commitments to bioterrorism preparedness and improvements in public health infrastructure and capacity, the development of a bioterrorism response plan, and establishment of the CDC’s Office of Terrorism Preparedness and Emergency Response, and the creation of a Strategic National Stockpile which will greatly enhance the capacity of local and state health departments to respond to large-scale public health emergencies. Learn from and continue application of lessons learned in the field and through simulated exercises to improve prospective identification and solve problems before they result in injury. The capacity to effectively respond to new or emerging public health threats in the event of an emergency will be greatly enhanced through the multidisciplinary research supported by the public health preparedness research initiative at the CDC. This research initiative was developed in response to specific recommendations from the CDC’s external advisor, the Advisory Committee to the Director, and critiques from the scientific and public health community on the nation’s response to recent public health emergencies, which resulted in injury and identifiable gaps in knowledge and demonstrable ability. Assure rapid and effective communication. Deploy a communication system, which integrates the principles of the CDC Crisis and Emergency Risk Communication course, and the CDC’s Public Health Academy module on communication. This will enhance the ability of public health officials to rapidly and effectively communicate with the public at large and provide accurate and timely information. Development of a system to rapidly provide public health emergency expertise and deploy assets to federal, state, and local health agencies will allow for immediate response in the event of a public health emergency. This will be greatly enabled by the development of advanced emergency and support teams within the US Public Health Service.

5. Conclusion and Call to Action

The warnings from recent events have proven that local and state health departments do not have adequate resources to effectively respond to today’s emergencies. Often times, resources are pulled from other states which can be an effective response, but can also leave gaps in the responding state’s public health needs. The sole purpose of improving public health emergency preparedness is to prevent illness and injury. An effective system needs to be able to ensure the right response for the right event and be able to effectively manage any emergency with minimal effects on public health. Public health emergency preparedness must be a coordinated effort with all agencies working together to achieve a common goal. This requires education and direction for all parties involved in emergency events.

The recent years have tested public health emergency preparedness with many catastrophic events such as the anthrax letters and other bioterrorism events, severe acute respiratory syndrome (SARS), the West Nile Virus outbreaks, the Avian Influenza outbreak, and the onslaught of natural disasters such as Hurricane Katrina and the tsunami in Southeast Asia. These events have challenged the local, state, and federal governments to better prepare for emergency events. Giving public health workers the tools and information needed to effectively respond to and manage emergency events is the key to preventing further sickness and death. This is often a challenge in an era of technology where information cannot be effectively managed due to systems that are outdated.

Public health emergency preparedness is crucial to the health of the United States as a whole. Emergencies occur often, whether they are natural disasters, disease outbreaks, or bioterrorism attacks, and being prepared is the key to preventing further illness and injury. The key components to preparedness are communication, resources, information, assessment, and education. There have been many areas in public health emergency preparedness that have been challenged by recent events. Exploring where the system has failed is the key to preventing future failures in the system. Focusing on changes that can be made will help to better prepare public health emergency preparedness systems at the local, state, and federal levels.