OFFICE OF PUBLIC HEALTH…LEADERSHIP FOR THE 21st CENTURY
BIOTERRORISM PREPAREDNESS AND EMERGENCY RESPONSE
LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALSOFFICE OF PUBLIC HEALTH
Public Health Preparedness
And Response for Bioterrorism
Presented by
Madeline W. McAndrew State Public Health Official
5 February 2003
Building A Successful “Total Force” Response Capacity
OFFICE OF PUBLIC HEALTH…LEADERSHIP FOR THE 21st CENTURY
BIOTERRORISM PREPAREDNESS AND EMERGENCY RESPONSE
Keys to Building a Successful “Total Force” Response Capacity
CommandCommand
ControlControl
CoordinationCoordination
CommunicationCommunication
IntelligenceIntelligence
OFFICE OF PUBLIC HEALTH…LEADERSHIP FOR THE 21st CENTURY
BIOTERRORISM PREPAREDNESS AND EMERGENCY RESPONSE
Public Health Awareness
Ebola SmallpoxAIDS
“Where do our weaknesses and vulnerabilities lie? The greatest of our war machines will not protect our forces against the deadly pathogen. Their
stealth and precision surpass the complexity of human imagination. Their vectors are fully competent. Their tactics have been perfected over millennia.
Their mission…invade and destroy the unsuspecting and unprotected .” Brian Blalock, Osan Air Base, Korea, 2001
OFFICE OF PUBLIC HEALTH…LEADERSHIP FOR THE 21st CENTURY
BIOTERRORISM PREPAREDNESS AND EMERGENCY RESPONSE
Securing the Homeland
Public Health is integral to the National Security Strategy.
Enhancing Security on the HomelandEnhancing Security on the Homeland
Environmental Health InitiativesEnvironmental Health Initiatives
Domestic Preparedness Against Domestic Preparedness Against Weapons Mass DestructionWeapons Mass Destruction
OFFICE OF PUBLIC HEALTH…LEADERSHIP FOR THE 21st CENTURY
BIOTERRORISM PREPAREDNESS AND EMERGENCY RESPONSE
Public Health is an intelligence gathering agency.
Information superiority is obtained via surveillance,
collection and control of vital health statistics and
parish specific disease information and trends.
IntelligenceIntelligence
OFFICE OF PUBLIC HEALTH…LEADERSHIP FOR THE 21st CENTURY
BIOTERRORISM PREPAREDNESS AND EMERGENCY RESPONSE
Public Health is part of a national disease reporting
and surveillance network.
• Centers for Disease Control and Prevention
• State and local laboratory network
• Hospital, EMS, physician, coroner, veterinarian disease reporting
IntelligenceIntelligence
OFFICE OF PUBLIC HEALTH…LEADERSHIP FOR THE 21st CENTURY
BIOTERRORISM PREPAREDNESS AND EMERGENCY RESPONSE
IntelligenceIntelligence
Local Law EnforcementLocal Law Enforcement Military/DoDMilitary/DoD FBI/DOJFBI/DOJ
HospitalsHospitals Public HealthPublic HealthLaboratoriesLaboratories VeterinariansVeterinarians
LSPLSP
CDC/DHHSCDC/DHHS
Law Enforcement Sensitive • Criminal Investigation • Security Clearance • Criminal Surveillance
Patient Sensitive • Medical Investigation • Controlled Access • Disease Surveillance
CROSSING THE GREAT DIVIDE
Prevention and Deterrence Continuum is Intelligence DrivenPrevention and Deterrence Continuum is Intelligence Driven
CoronersCoroners
Intel LinkIntel Link
OFFICE OF PUBLIC HEALTH…LEADERSHIP FOR THE 21st CENTURY
BIOTERRORISM PREPAREDNESS AND EMERGENCY RESPONSE
IntelligenceIntelligence
Emergency ManagementEmergency Management
Public HealthPublic Health
State PoliceState Police
Law Enforcement Sensitive • Criminal Investigation • Security Clearance • Criminal Surveillance
Patient Sensitive • Medical Investigation • Controlled Access • Disease Surveillance
Prevention and Deterrence Continuum is Intelligence DrivenPrevention and Deterrence Continuum is Intelligence Driven
CROSS POLLINATION PARADIGM
OFFICE OF PUBLIC HEALTH…LEADERSHIP FOR THE 21st CENTURY
BIOTERRORISM PREPAREDNESS AND EMERGENCY RESPONSE
State Public Health OfficialState Public Health OfficialPublic Health Assistant Secretary Public Health Assistant Secretary
Madeline W. McAndrewMadeline W. McAndrew
Center for Health PromotionCenter for Health PromotionInformation and PolicyInformation and Policy
Center for Center for Community HealthCommunity Health
Center for Center for Preventive HealthPreventive Health
Infectious Disease Epi
Laboratory Services
Engineering/H2O Safety
Sanitarian Services
Environmental Epi
Vital Records
OPH Emergency ResponseOPH Emergency ResponseCDC BT Grant CDC BT Grant
DHH Communications
OPH Human ResourcesOPH Human Resources
DHH Emergency Response DHH Emergency Response
Center for Center for Environmental HealthEnvironmental Health
HRSA/Hospital GrantHRSA/Hospital Grant
Nursing Services
Pharmacy Services
Bureau of EMS
Regional OfficesRegional Offices
TB Prevention & Control
STD Services
Immunization Services
Administrative & Technical Administrative & Technical
Public Health Incident Command Structure
PIO
C2
Plans
Finance
Ops
OFFICE OF PUBLIC HEALTH…LEADERSHIP FOR THE 21st CENTURY
BIOTERRORISM PREPAREDNESS AND EMERGENCY RESPONSE
OPHOPHLaboratoryLaboratory
DirectorDirector
OPH IT OPH IT DirectorDirector
Public HealthPublic HealthVeterinarianVeterinarian
Chief ofChief ofNursingNursingServicesServices
State State PharmacyPharmacyDirector Director
(NPS)(NPS)
OPH OPH EmergencyEmergencyResponse Response
DirectorDirector
State EMSState EMS
OPH OPH ImmunizationImmunization
Medical Medical DirectorDirector
State State EpidemiologistEpidemiologist
Center Center DirectorsDirectors
Assistant State Assistant State Health OfficerHealth Officer
Public Health Public Health Assistant Assistant SecretarySecretary
DOJDOJ
FEMAFEMA
EPAEPA
CDCCDC
State Level Public Health Command and Control
LSP HAZM ATLSP HAZM ATResponse UnitResponse Unit
LOEPLOEPState EOCState EOC
Louisiana Louisiana State PoliceState Police
EOCEOC
DHH Emergency DHH Emergency ResponseResponse
LANGLANG6262ndnd CST/WMD CST/WMD
Dept. Environmental Dept. Environmental QualityQuality
MMRS MMRS
DHH SecretaryDHH Secretary
Isolation & Isolation & QuarantineQuarantine
OFFICE OF PUBLIC HEALTH…LEADERSHIP FOR THE 21st CENTURY
BIOTERRORISM PREPAREDNESS AND EMERGENCY RESPONSE
DiologicsDiologicsOperatorOperator
PHPHVetVet
TB/STDTB/STDDirectorsDirectors
OPHOPHLaboratoryLaboratory
DirectorDirector
StateStateEpidemi-Epidemi-ologistologist
EnvironEnvironEpiEpi
DirectorDirector
ContractingContractingOfficerOfficer
DHHDHHTeleComTeleCom
AgentAgent
ITITDirectorDirector
FinanceFinanceDirectorDirector
DHHDHHPurchasingPurchasing
AgentAgent
CHCHCenterCenterDirectorDirector
PPHIPPHICenterCenterDirectorDirector
OPHOPHHumanHuman
ResourcesResources
PHPHCenterCenterDirectorDirector
ENVSENVSCenterCenterDirectorDirector
HANHAN
NPSNPSCoordinatorCoordinator
CDC BTCDC BTAdvisorAdvisor
BTBTDirectorDirector
BT BT OperationsOperations
OfficerOfficer
Public HealthPublic HealthAssistant SecretaryAssistant Secretary
&&OPH Medical DirectorOPH Medical Director
DHH Public Affairs/PIODHH Public Affairs/PIO DHH Emergency ResponseDHH Emergency Response
OPH Legal CounselOPH Legal Counsel LSP OfficerLSP Officer LANG OfficerLANG Officer
LDHHLDHHSecretarySecretary
CDC LiaisonCDC LiaisonMetro City HDMetro City HD
LiaisonLiaison
Public Health Emergency Operations Center and Incident Command
PharmacyPharmacyDirectorDirector
Immuniza-Immuniza-tionstions
DirectorDirector
NursingNursingDirectorDirector
EMSEMSDirectorDirector
VitalVitalRecordsRecords
PIOPIO
C2C2
PlansPlans
FinanceFinance
OpsOps
HNBC GISHNBC GIS
Radio ComRadio Com
RunnerRunner
EmergencyEmergencyAction CellAction Cell
IT SupportIT Support
EOCEOC SupportSupport
OFFICE OF PUBLIC HEALTH…LEADERSHIP FOR THE 21st CENTURY
BIOTERRORISM PREPAREDNESS AND EMERGENCY RESPONSE
Public Health Command and Control
88
66
44
33
C2C2
OPH
C2C2
C2C2
Regional PH C2
State PH C2
PH Headquarters
State PH Lab
55
77
11
9922
OFFICE OF PUBLIC HEALTH…LEADERSHIP FOR THE 21st CENTURY
BIOTERRORISM PREPAREDNESS AND EMERGENCY RESPONSE
Public Health Command and Control Expanded
C2C2
OPH
77 88
66
5544
22
33 11
99
c2c2
C2C2
Regional PH C2
State PH C2
Parish Health Unit
State PH Lab
OFFICE OF PUBLIC HEALTH…LEADERSHIP FOR THE 21st CENTURY
BIOTERRORISM PREPAREDNESS AND EMERGENCY RESPONSE
Statewide Command and Control Network
C2C2
LSP
C2C2
DHH
5544
11
A
IC
I
DL
77
99
33
B
CDCCDC
88
22
C2C2 C2C2
LANG
State EOC
C2C2
C66
B
OPH
C2C2
DEQ
LHA/DRC
C2C2
OPH
MMRS
C2
LSP
LOEP
OFFICE OF PUBLIC HEALTH…LEADERSHIP FOR THE 21st CENTURY
BIOTERRORISM PREPAREDNESS AND EMERGENCY RESPONSE
Public Health “Total Force” Response Capacity
1
3
9
87
11
22
33
55
6
44
7 8
99BATBAT
CATCAT
ERTERT
C2C2
PIOPIO
CETCET
44
6
55
78
99
1133
22
PATPAT
99
87
6
5544
33
22
11
44
6
55
78
99
1133
22
99
8877
66
5544
33
22
11
Communications/IT
Immunization Teams
Incident Response Teams
Regional Command/Control Teams
State Level PH Teams
OFFICE OF PUBLIC HEALTH…LEADERSHIP FOR THE 21st CENTURY
BIOTERRORISM PREPAREDNESS AND EMERGENCY RESPONSE
Regional EpidemiologistRegional Epidemiologist
Disease Surveillance Spec.Disease Surveillance Spec.
Regional SanitarianRegional Sanitarian
Regional NurseRegional Nurse
Public Health ER CoordinatorPublic Health ER Coordinator
Regional Administrator/C2Regional Administrator/C2
Regional Medical DirectorRegional Medical DirectorTEAM CHIEFTEAM CHIEF
Regional EngineerRegional Engineer
COMMET/IT TeamCOMMET/IT Team
Administrative Support TeamAdministrative Support Team
Facility Manager/C2Facility Manager/C2
ParishParishEOCEOC
OPHOPHCCCC
StateStateEOCEOC
Hospital ED
Biological Aug. Teams (3)Biological Aug. Teams (3)
Immunization Teams (9x2)Immunization Teams (9x2)
Pharmacy Teams (2)Pharmacy Teams (2)
Public Affairs (2)Public Affairs (2)
Chemical Aug. Teams (2)Chemical Aug. Teams (2)
Epidemic Surveillance Epidemic Surveillance Response Teams (2)Response Teams (2)
Deployable S
upport Team
s
PH Nurse PH Nurse
PH Sanitarian PH Sanitarian
Disease Intervention Spec.Disease Intervention Spec.
Regional Public Health Command Center
OPH Medical DirectorOPH Medical Director
FBI
LSPLSPLocal Local Law Law
NPS
Regional Public Health Incident Response Team
OFFICE OF PUBLIC HEALTH…LEADERSHIP FOR THE 21st CENTURY
BIOTERRORISM PREPAREDNESS AND EMERGENCY RESPONSE
Public Health ClerkPublic Health Clerk
Public Health ClerkPublic Health Clerk
Public Health NursePublic Health Nurse
Public Health NursePublic Health Nurse
Public Health Nurse Public Health Nurse
Immunization ConsultantImmunization Consultant
EMT ParamedicEMT Paramedic
HRSA Hospital Nurse HRSA Hospital Nurse
Public Health ClerkPublic Health Clerk
Public Health ClerkPublic Health Clerk
EMT ParamedicEMT Paramedic
Public Health NursePublic Health Nurse
Public Health Nurse Public Health Nurse
Public Health Nurse Public Health Nurse
EMT ParamedicEMT Paramedic
HRSA Hospital Nurse HRSA Hospital Nurse
Regional Medical DirectorRegional Medical Director
Regional Immunization Teams
OFFICE OF PUBLIC HEALTH…LEADERSHIP FOR THE 21st CENTURY
BIOTERRORISM PREPAREDNESS AND EMERGENCY RESPONSE
ID Epidemiologist 1ID Epidemiologist 1
ID Epidemiologist 1ID Epidemiologist 1
ID Epidemiologist 1ID Epidemiologist 1
ID Epi Supervisor ID Epi Supervisor
ID Epidemiologist 1ID Epidemiologist 1
Assistant State EpidemiologistAssistant State Epidemiologist
State EpidemiologistState Epidemiologist
State Health OfficerState Health Officer
DHH Emergency Resp. DHH Emergency Resp.
ID Epidemiologist 1ID Epidemiologist 1
ID Epidemiologist 1ID Epidemiologist 1
ID Epidemiologist 1ID Epidemiologist 1
ID Epi SupervisorID Epi Supervisor
ID Epidemiologist 1ID Epidemiologist 1
TB Inter. Spec. TB Inter. Spec.
TB Inter. Spec. TB Inter. Spec.
STD Inter. Spec. STD Inter. Spec.
STD Inter. Spec. STD Inter. Spec.
State PH OfficialState PH Official
Admin SupportAdmin Support
Admin SupportAdmin Support
Admin SupportAdmin Support
OPH Medical DirectorOPH Medical Director
Regional Medical DirectorRegional Medical Director
Regional Incident ResponseRegional Incident Response
Regional Medical DirectorRegional Medical Director
Regional Incident ResponseRegional Incident Response
DHH Public Info OfficerDHH Public Info Officer
State Level Epidemic Response Teams
OFFICE OF PUBLIC HEALTH…LEADERSHIP FOR THE 21st CENTURY
BIOTERRORISM PREPAREDNESS AND EMERGENCY RESPONSE
Env EpiEnv Epi
Env EpiEnv Epi
Env Epi PhysicianEnv Epi Physician
Env Epi Supervisor Env Epi Supervisor
Env EpiEnv Epi
Env EpidemiologistEnv Epidemiologist
Center DirectorCenter DirectorEnvironmental ServicesEnvironmental Services
State Health Officer/C2State Health Officer/C2
DHH Emergency/Plans DHH Emergency/Plans Response DirectorResponse Director
State PH OfficialState PH Official
Admin SupportAdmin Support
Admin SupportAdmin Support
Admin SupportAdmin Support
OPH Medical DirectorOPH Medical Director
Env EpiEnv Epi
LSP HAZMATLSP HAZMAT
LSP HAZMAT LSP HAZMAT
LSP HAZMATLSP HAZMAT
LSP HAZMATLSP HAZMAT
LSP HAZMATLSP HAZMAT
LSP HAZMAT LSP HAZMAT
LSP HAZMATLSP HAZMAT
LSP HAZMATLSP HAZMAT
LSP HAZMATLSP HAZMAT
LSP HAZMAT LSP HAZMAT
LSP HAZMATLSP HAZMAT
LSP HAZMATLSP HAZMAT
Dept. Environmental QualityDept. Environmental Quality
Dept. Environmental QualityDept. Environmental Quality
LSPLSPEOCEOC
Regional Medical Director/C2Regional Medical Director/C2
Regional IncidentRegional IncidentResponse Team Response Team
Dept. Environmental QualityDept. Environmental Quality
DHH Public Info OfficerDHH Public Info Officer
StateStateEOCEOC
State Level Chemical Augmentation Team
OFFICE OF PUBLIC HEALTH…LEADERSHIP FOR THE 21st CENTURY
BIOTERRORISM PREPAREDNESS AND EMERGENCY RESPONSE
Public Health Preparedness Challenges
Preparedness and Readiness
Education and Training
Cultural Shift
Integration and Cross Pollination
Communication Gaps
Risk Communication and Public Info
Continued Funding