Report: Gaps in emergency preparedness

A new report says the H1N1 flu has exposed serious gaps in the nation’s ability to respond to public-health emergencies, and the economic crisis is straining the system even more.
The seventh annual “Ready or Not? Protecting the Public’s Health from Diseases, Disasters and Bioterrorism” report, issued by the Trust for America’s Health and the Robert Wood Johnson Foundation, found that 20 states scored six or less out of 10 key indicators of public health emergency preparedness developed by experts using public data.
Only eight states got the highest score earned by anyone, nine out of 10. Rhode Island and Connecticut each scored six; Massachusetts, seven.
“The H1N1 outbreak has vividly revealed existing gaps in public health emergency preparedness,” said Richard Hamburg, deputy director of TFAH. “The Ready or Not? report shows that a Band-Aid approach to public health is inadequate. As the second wave of H1N1 starts to dissipate, it doesn’t mean we can let down our defenses. In fact, it’s time to double down and provide a sustained investment in the underlying infrastructure, so we will be prepared for the next emergency and the one after that.”
Overall, the report found the investments made in pandemic and public health preparedness in the past several years had “dramatically” improved the nation’s readiness for the H1N1 outbreak. But it also found that decades of chronic underfunding continued to hinder public health systems, and that 27 states had cut public health funding from fiscal 2008 to fiscal 2009.
Major concerns cited by the report included a lack of real-time coordinated disease surveillance and laboratory testing, outdated vaccine production capabilities, limited hospital surge capacity, and a shrinking public health work force.
The report also found that 13 states, including Rhode Island, had purchased less than 50 percent of their share of federally subsidized antiviral drugs to stockpile for use during an influenza pandemic; and 14 states do not have the capacity in place to assure the timely pick-up and delivery of laboratory samples on a 24/7 basis to the Laboratory Response Network.
In addition, the report shows 11 states, including Rhode Island, and Washington, D.C., say they do not have enough laboratory staffing capacity to work five 12-hour days for six to eight weeks in response to an infectious disease outbreak, such as H1N1.
The two other indicators that Rhode Island failed on were identifying the pathogens responsible for reported foodborne disease outbreaks at a rate that met or exceeded the national average of 46 percent; and requiring licensed child care facilities to have a multi-hazard written evacuation and relocation plan for emergencies, and verifying that the laws are implemented.
“State and local health departments around the country are being asked to do more with less during the H1N1 outbreak as budgets continue to be stretched beyond their limits,” said Michelle Larkin, public health team director and senior program officer at the Robert Wood Johnson Foundation. “Public health provides essential prevention and preparedness services that help us lead healthier lives. Without sustained and stable funding, Americans will continue to be needlessly at risk for the next public health threat.”
The report includes several recommendations to improve preparedness, including ensuring stable and sufficient funding; conducting an H1N1 “after-action” report and updating preparedness plans with lessons learned; and increasing accountability and transparency.
A full listing of Rhode Island’s performance on the preparedness measures is available on TFAH’s Web site, at www.healthyamericans.org.