Public Health Emergencies: Mass Dispensing in the Community

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1 Public Health Emergencies: Mass Dispensing in the Community Chrissy Gamboa - Pinal County Public Health Chris Lyons, RN - Maricopa County Public Health

2 Role of Public Health in an Disease prevention Emergency Controlling the spread of disease and preventing further spread Surveillance determining the populations at risk Communication

3 Public Health Departments respond many types of community emergencies 6/29/2015 3

4 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 4

5 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. 5

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

6 Strategic National Stockpile (SNS) Contains a wide range of medical assets to enhance county, tribal and state managed response efforts Within 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.

Antidotes Vaccines and Antitoxins Antivirals Medical

7 SNS Supplies & Countermeasures Pharmaceuticals Radiation Countermeasures Antibiotics (Oral and IV) Nerve Agent Antidotes Vaccines and Antitoxins Antivirals Medical Supplies IV Administration Airway Management Wound Care Burn & Blast Care

8 SNS Asset Request Flow Need for Supplies Exceeds Local & State Resources State Requests Federal Assistance Discussion with key officials (HHS, DHS, CDC, State, etc) SNS Augments County & State Resources Federal Officials Deploy SNS Assets

9 Federal State County Local SNS Delivery Sequence Storage & Transport RSS Site RSS Site POD

influenza Radiological threats *Changes to list of countermeasures are

10 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) 10

11 Contagion 11

12 Public Health Mass Dispensing Bioterrorism: Biological agents (anthrax, plague, tularemia, smallpox) Pandemic: Influenza, Emerging Infectious Diseases

13 Anthrax IMQPZAU 13

15 Anthrax Exposure: Proportion of Population Saved DURATION of Campaign Immed. DELAY in Initiation 1 Day 2 Days 3 Days 4 Days 5 Days 6 Days 7 Days 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%

16 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.

17 So How do we accomplish this daunting task?

19 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.

20 SNS &PODS JA

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.

21 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.

22 How You Can Help? Prepare! Practice personal preparedness! Make a plan Build a kit! 22

24 Get Involved! 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)

Become a Dispensing Partner Consider becoming a Closed POD Helps achieve community dispensing goal more rapidly Benefits your organization

25 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

26 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

Provide all medication and accompanying information sheets for dispensing

27 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

28 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

29 Presenter Contact Information Chrissy Gamboa - Emergency Preparedness & Response Planner, Pinal County Public Health Office: Chrissy.Gamboa@pinalcountyaz.gov Chris Lyons, RN - Healthcare Coordinator, Preparedness & Response, Maricopa County Public Health Office: ChrisLyons@mail.maricopa.gov

30 For more information CDC Learning Connection The Office of Emergency Preparedness & Response Healthcare Preparedness Ready.gov Contact your local county Public Health or Emergency Management representative

31 QUESTIONS?

Public Health Emergencies: Volunteer Recruitment

Public Health Emergencies: Volunteer Recruitment Purpose To provide an overview of the Cook County Department of Public Health s (CCDPH) role and your municipality s role in planning and responding to