August 30, 2002
In this issue:
- A Message From the Director
- Is Minnesota Prepared?
- National Pharmaceutical Stockpile Update
- Smallpox Plan Update
- Commissioner’s Terrorism and Health Task Force Update
- Public Health Emergency Tabletop Exercise in Yellow Medicine County
- Message From Dr. John Hick, Medical Director to the MDH Office of Emergency Preparedness
- Hospital Bioterrorism Preparedness Program Update
Thank you for the positive feedback on the first newsletter. I want to remind you that the primary purpose of this newsletter is to provide information to our local public health partners regarding public health emergency preparedness and ongoing grant activities. Please let me know if there is information you would like us to cover in future issues of this newsletter.
We know others may find this information helpful. I received numerous requests from individuals to be placed on the listserv to receive the newsletter. I have responded by directing my staff to add your names to the listserv.
This newsletter is a bit shorter than the last one, and content is prioritized to reflect changing issues that must be relayed to our partners in local public health.
—Robert Einweck, Director, Office of Emergency Preparedness, MDH
On the August 29th addition of Minnesota Public Radio’s Mid Morning Show (a statewide call in show) Katherine Lanpher interviewed Dr. Harry Hull and Robert Einweck in response to a recent CDC press conference regarding the state of preparedness at the local level.
On August 20, Russ Havlak, CDC’s Operations Consultant for the National Pharmaceutical Stockpile (NPS), met with MDH staff to review Minnesota’s NPS Plan. The stockpile is a large cache of medical material that would protect and treat several hundred thousand people from a range of terrorism incidents, and would be deployed by the Federal government to Minnesota if needed.
Our current plan was developed with assistance from of Jane Norbin, Ramsey County, and Ginny Baresch, Hennepin County Community Health Department. To date, Minnesota’s NPS Plan creates the “superstructure” we would need to break down the stockpile, and deploy the supplies. However, Mr. Havlak noted several deficiencies in the MDH-NPS Plan. These areas were 1) dispensing of oral drugs and vaccines at the local sites, 2) communication tools, and 3) training and exercising of the plan.
In order to respond to CDC concerns, MDH is in the process of assembling a questionnaire that will be sent to local public health staff shortly after Labor Day. The questionnaire will seek information regarding the vaccine dispensing sites you will set up, or sites you have already developed. Watch for the questionnaire, and reply to it as soon as possible.
Another area undergoing rapid change is the MDH Smallpox Plan. Robert sent out to all of you this past week a very rough draft document that we are referring to as the, “Smallpox Vaccination Discussion Guide for Consideration: How Minnesota will respond to the Federal Smallpox Vaccination Guidelines.” This is the most recent version of how MDH envisions Minnesota would administer any smallpox vaccine deployed to the state in advance of any smallpox cases in the US. There are plenty of blank spaces for folks to fill in. A copy of this document will also be sent to the Smallpox Review Committee, for comments, and recommendations. Any comments about this document should be addressed to Brent Mather, Principal Planner, who is overseeing the development of these documents.
Statewide participation in bioterrorism planning continues with public participation in the Commissioner’s Terrorism and Health Task Force. The most recent meeting was on August 27 in St.Paul. Assistant Commissioner Aggie Leitheiser and MDH Attorney Steve Shakman spoke to the Task Force on issues surrounding the Emergency Health Powers Act. It was also announced that a new subgroup on Mental Health will have its first meeting on October 4, at 10:00 a.m. – 12:00 noon in the Red River Room at the MDH Snelling Office Park Office. The primary goal of the subgroup is to develop a mental health emergency preparedness plan, and a set of mental health emergency response protocols for use by local public health, MDH staff, and their partner providers and agencies throughout the state, and in local communities.
Emergency preparedness planning is also underway in many forms at the local level. On August 22, Yellow Medicine County conducted a training for a response to a pneumonic plague bioterroist event. Jan Forfang, MDH Epidemiologist in the Mankato District Office developed a scenario that unfolded over a mythical ten-day period. The training was organized and facilitated by Mary Rippke, Mankato District Office, Duane Hoeschen DEM-Regional Emergency Management, Richard Blackwelder, Yellow Medicine Sheriff’s Department, Liz Auch, Administrator of Countryside, Public Health, Michelle Caveney, Yellow Medicine Emergency Department and Cindy Skulstad, Countryside Public Health/Yellow Medicine County. Approximately 70 individuals attended the training. The diversity of the attendees included local elected officials, law enforcement, morticians and the local media.
Participants were asked to respond to the scenario events in small group discussion sessions. The value of the training was evidenced by the collaboration and communication that occurred between state/local public health, and state/county emergency management. Both strengths and weaknesses were recognized in the local response plans. Participants agreed to meet on an ongoing basis to refine their emergency response capabilities.
I’d like to take the opportunity to introduce myself as the Medical Director for the MDH OEP. In my day (and night) job, I am an Emergency Physician at Hennepin County Medical Center and work on emergency preparedness issues that affect the hospital. I’ve been honored to be involved with the MDH bioterrorism planning since 1998, serving on the Commissioner’s Terrorism and Health Task Force and chairing the Clinical Care subgroup. I have served as the Medical Director for the Metropolitan Medical Response System, an emergency planning process to counter weapons of mass destruction attacks directed at Minneapolis and St. Paul. I am also an Associate Medical Director for the Hennepin County Health Department and for Hennepin County Emergency Medical Services. In addition, I sit on, and at times chair, a number of committees related to terrorism or emergency planning.
We have made incredible strides in preparedness in the past several years and in many areas Minnesota is a national leader in preparedness. But we still have a long way to go. I see my role as helping to facilitate the integration of public health and healthcare facility planning into all-hazards emergency preparedness; and helping public health and emergency preparedness partners understand health care resources and limitations.
We will need to have good local and regional command, communications, and control capabilities in order to best utilize our ‘down-sized’ healthcare resources in order to cope with an ‘up-sized’ disaster, pandemic, or terrorist incident. The core of this planning will be the public health and hospital efforts being conducted with assistance from the federal funding available from the CDC and HRSA. The funding affords us an opportunity to build a stable health emergency preparedness system for the future, much the same way that the initial EMS system grants in the early 1970s allowed the development of our current, mature EMS systems.
It’s a scary, rapidly changing environment in emergency preparedness, and public health today, but as always, with change comes opportunity. We have an opportunity to not only better our preparedness for disasters, but to improve our day-to-day response, and system management activities. This will require long-term commitment. However, in the short run, there are more questions than answers, so we need to be flexible and patient, because the rules of the game is prone to change along the way (witness how little we actually knew about anthrax last fall), and we will all be learning new systems and trying out new techniques together. I look forward to working with you all, and helping to understand the needs, and complexities of the problems that we are all facing.
Remember two things: 1) the wheel has already been invented (though it may need a little tweaking to fit your car). 2) You can't swallow a whale whole (and you'll probably need lots of help cutting it up into bite-sized pieces). Good luck and let us know how we can help!
Minnesota hospitals are being asked to work together regionally to develop a plan to handle a sudden surge of 500 acutely ill patients, and be able to handle a progression of more patients than the initial 500 for the weeks following a bioterroist attack.
As noted in the previous newsletter, these plans are develop during Phase II
of the Hospital Bioterrorism Preparedness Program (HBPP). Guidance has recently
been released to hospitals on their Phase II grant applications.
This guidance includes general instructions and a checklist of duties for both individual hospitals and Regional Hospital Resource Centers.