Chrissy Gamboa - Pinal County Public Health

Chris Lyons, RN - Maricopa County Public Health

Public Health Emergencies:

Mass Dispensing in the Community

Role of Public Health in an Emergency

• Disease prevention

• Controlling the spread of disease and preventing further spread

• Surveillance – determining the populations at risk

Communication

Public Health Departments respond many types of community emergencies…

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• Natural Disasters: Floods, Tornados, Earthquakes, Severe weather conditions, and Wildfires

• Disease Outbreaks:

– Communicable diseases – such as flu or measles

– Environmental diseases – such as food borne illness outbreak (salmonella, etc.)

– Zoonotic diseases – such malaria or Lyme disease

• Bioterrorism Events: Use of biological agents such as smallpox or anthrax

• Chemical Terrorism Events: Use of chemical agents such as sarin, cyanide, VX or mustard gas

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Strategic National Stockpile

• The Strategic National Stockpile (SNS) is a

national repository of medical countermeasures

used to augment federal, state, and local public

health agencies in the event of a terrorist attack

or other public health emergency.

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Strategic National Stockpile (SNS)

Contains a wide range of medical assets to enhance county, tribal and state managed response efforts

Within 12-24 hours the CDC can deploy a shipment from the SNS to anywhere in the U.S.

Local public health authorities are required to have a plan in place to dispense these medications to the populace within 48 hours.

SNS Supplies & Countermeasures

• Medical Supplies • IV Administration • Airway Management • Wound Care • Burn & Blast Care

• Pharmaceuticals • Radiation Countermeasures • Antibiotics (Oral and IV) • Nerve Agent Antidotes • Vaccines and Antitoxins • Antivirals

SNS Asset Request Flow

State Requests

Federal Assistance

Federal Officials

Deploy SNS Assets SNS Augments County

& State Resources

Need for Supplies

Exceeds Local & State

Resources

Discussion with key

officials (HHS, DHS, CDC, State, etc)

SNS Delivery Sequence

F

ederal

Storage &

Transport

State

County

RSS Site Local

RSS Site POD

Reasons for SNS Deployment

• Category A Threat Agents

• Smallpox • Anthrax • Botulism • Viral hemorrhagic fevers • Plaque • Tularemia

• Nerve agents • Pandemic influenza • Radiological threats

*Changes to list of countermeasures are directed by Biomedical Advanced Research and

Development Authority (BARDA)

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Contagion • http://www.youtube.com/watch?v=4sYSyuuLk5g

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Public Health Mass Dispensing

Bioterrorism: Biological agents (anthrax, plague, tularemia, smallpox)

Pandemic: Influenza, Emerging Infectious Diseases

Anthrax

• http://www.youtube.com/watch?v=REG-IMQPZAU

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7 Days 1 Day 2 Days 3 Days 4 Days 5 Days 6 Days Immed.

10 Days 84% 78% 71% 62% 54% 45% 36% 28%

7 Days 95% 91% 85% 78% 69% 59% 49% 39%

6 Days 97% 94% 89% 83% 75% 65% 54% 43%

5 Days 98% 96% 92% 87% 80% 71% 60% 49%

4 Days 99% 98% 95% 91% 85% 76% 66% 54%

3 Days 100% 99% 97% 94% 89% 81% 72% 60%

2 Days 100% 99% 98% 96% 92% 86% 77% 66%

1 Day 100% 100% 99% 97% 94% 89% 82% 72%

DELAY in Initiation

DURATION of Campaign

Anthrax Exposure: Proportion of Population Saved

Local Planning Efforts

• Dispensing of antibiotics and/or vaccines is a cornerstone of any mass prophylaxis campaign.

• Every public health jurisdiction in the country has the responsibility to develop and maintain the capability to carry out mass antibiotic dispensing and vaccination campaigns tailored to its local population.

• The county health department is charged to have a plan in place to provide medication to 100% of the at-risk population within 48 hours.

So…

How do we accomplish this daunting task?

Public Dispensing Sites—Open PODs

The SNS program will provide medications for distribution to the general populace at public dispensing sites, called Public or “open” PODs coordinated

by a county.

SNS &PODS

• http://www.youtube.com/watch?v=rIp80d7n2JA

Private Dispensing Site—Closed POD

A County may registers cities, towns, local

jurisdictions, business and healthcare facilities to act as Closed POD Partner Dispensing Sites.

These sites are not open to the public

Healthcare and critical infrastructure will be prioritized to receive medication for employees and their families at their facilities.

How You Can Help?

Prepare! Practice personal preparedness!

Make a plan…

Build a kit!

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• Support the local health dept. by volunteering—assistance will be needed to staff the public PODS and perform many other tasks related to the emergency response. We want YOU!!!

• Healthcare Professions can also join the Emergency System for Advance Registration of Volunteer Health Professionals (ESAR-VHP)

Get Involved!

Become a Dispensing Partner

• Consider becoming a Closed POD

– Helps achieve community

dispensing goal more rapidly

• Benefits your organization

– Protects your employees and

their families

– Helps to ensure your organization’s continuity

of operations

– Exhibits your commitment to our community

Liability Issues

Liability Protection

• Federal legislation

− Public Readiness and Emergency Preparedness (PREP) Act

• State/Local legislation

‒ Arizona State Statues

Pharmacy laws related to dispensing medication

Agreements

County Public Health Responsibilities

• Develop guidelines to ensure

safe dispensing of medication

• Assist in development of

organization’s Closed POD plan

• Provide all medication and

accompanying information sheets

for dispensing

• Provide training and exercise

support

• Provide tools, templates and

ongoing technical assistance

Closed POD Responsibilities

• Designate liaisons to

coordinate with public health

officials

• Develop a Closed POD plan

• Provide staff

• Provide non-medical supplies

(tables, chairs, printers, pens, paper, etc.)

• Participate in training and exercise opportunities

• Operate a Closed POD during an emergency

Presenter Contact Information

Chrissy Gamboa - Emergency Preparedness & Response Planner, Pinal County Public Health Office: 520-866-7328 Chrissy.Gamboa@pinalcountyaz.gov Chris Lyons, RN - Healthcare Coordinator, Preparedness & Response, Maricopa County Public Health Office: 602-372-2671 ChrisLyons@mail.maricopa.gov

For more information…

• CDC Learning Connection http://www.cdc.gov/learning/archive/emergency-preparedness.html

• The Office of Emergency Preparedness & Response http://emergency.cdc.gov/

• Healthcare Preparedness http://www.cdc.gov/phpr/healthcare/about.htm

• Ready.gov http://www.ready.gov/

• Contact your local county Public Health or Emergency Management representative

QUESTIONS?