July 2007 Ready to Respond MDH Preparedness Newsletter
(Aggie Leitheiser, Director of Emergency Preparedness)
As this edition of the Ready to Respond newsletter is being written, we just received the grant guidance for the hospital preparedness programs and are still awaiting this information for public health activities for the next grant year that starts in September. While this makes planning for the coming year more difficult, we know we will continue to be asked to demonstrate our preparedness through planning, exercises and response to events. The delay in information is tied to new national legislation that has complicated activities and expected outcomes for our funding.
Reports from recent events and exercises show that Minnesota continues to make progress in our coordination, use of response tools and preparedness. The Ham Lake fire called on expertise in behavioral health, food safety, worker safety and coordination of efforts. The Slayton food-borne disease outbreak showed that planning for mass distribution clinics makes it possible to rapidly plan for and deliver injections to over 2,300 people in a few days. The Operation Snowball III exercise allowed us to practice several procedures, including requesting the Strategic National Stockpile, coordinating communications from multiple locations and situation reporting. Each event and exercise has highlighted a number of activities that worked well and a few things that need attention. The recent bombings in the United Kingdom are a further grim reminder of the necessity of emergency preparedness and response.
While we are on hold for next year’s grant expectations and funding levels, we should continue to be proud of what has been accomplished these last five years and look forward to continued growth in our expertise.
Editor’s Note: the next three articles give different perspectives on responses to fire and flood emergencies.
Ham Lake Fire Response in NE Minnesota
From May 5th through May 25th, Cook County battled Minnesota’s largest fire. The length of time the fire raged -- 21 days -- made this a very unusual response effort. This article explains the fire, the work Cook County Health and Human Service staff performed during the response, and how other organizations in the region helped.
While there was no loss of life, the Ham Lake fire impacted hundreds of people. Six separate evacuations occurred for families and businesses located at the end of the Gunflint Trail. The fire consumed parts of the Boundary Waters Canoe Area Wilderness; but over half the total acreage burned was in Canada, making this an international response. The fire was over 50 miles from the Emergency Operations Center, so much time and energy was spent driving back and forth to meetings and briefings.
Cook County was as prepared as possible for this fire, with excellent response plans in place. What was not anticipated was the length of time firefighters, emergency managers, county staff and affected citizens had to maintain their 24 hour response stance as the fire continued to grow.
Some statistics (US and Canada)
|Cost:||over $ 10,650,000.00|
|Firefighters:||1,100 from 28 states and 28 Minnesota communities|
|Fire area:||75,851 acres (about 120 square miles)|
|Structures lost:||over 250|
Cook County Public Health & Human Services
From the first evacuation on May 6 through the final lifting of evacuation orders on May 21, PHHS staff (under the leadership of Sue Futterer, Director; Joni Kristenson, PHHS PHN/Preparedness Coordinator and Hilja Anderson, Congregate Care Coordinator) assisted with these and other response activities:
- Evacuation center registry
- Donations for lodging, equipment, money
- Evacuee meals (3 times daily)
- Public briefings twice daily
- One to three Emergency Operations Center meetings each day
- Information for the Joint Information Center (JIC)
- Behavioral health services for families and county staff
The Northeast Minnesota regional Multi-Agency Coordination group met several times via conference calls to stay informed about the situation and to implement mutual aid to Cook County. A “staging” operation was run from Duluth to coordinate the deployment of staff from Carlton and St Louis Counties, from the Grand Portage reservation, and from the regional Hospital Preparedness program. Thirteen people from the region joined Cook County HHS, the regional Red Cross chapter and other volunteer organizations. Besides relieving and assisting staff, several Psychological First Aid courses were presented. Behavioral health professionals also assisted evacuees and other distressed individuals.
“I was lucky to be part of this response effort, spending eight days in Cook County and observing first hand this super-human response,” said Bonnie Holz, MDH public health preparedness consultant. “The county staff, regional folks who assisted and the hundreds of firefighters did a fantastic job under terribly stressful conditions to provide critical services to the affected families.” Cook County is now working on long-range recovery activities that will help families and businesses restore their homes, environment, operations and peace of mind.
MDH Department Operations Center assists during Browns Valley Flood
The ability to communicate quickly, clearly and effectively during an incident is a critical aspect of emergency response. However, if power is lost, telephone lines are down and access to the Internet and email is limited during a disaster, emergency responder communications can be severely impacted. Initiative, cooperation among responders, the implementation of Incident Command Structure (ICS) and a coordinated communications plan are critical to an effective emergency response.
Flooding began in Browns Valley, Minnesota on Tuesday, March 13, 2007. Floodwaters continued to rise for several days, impacting approximately 50 homes and 100 people. Emergency responders took action immediately. The Browns Valley School was used as the Recovery and Service Center, where residents received food and shelter. Stevens-Traverse Public Health and Grant County Public Health staff worked with displaced people, helped with the care of their pets, distributed flood-related health information and maintained communications with the Minnesota Department of Health Fergus Falls, Mankato and St. Cloud District Offices.
The Incident Command Structure was implemented and included these roles:
- Browns Valley Mayor served as Incident Manager
- Katie Jensen, Public Health Incident Manager
- Dona Greiner performed multiple public health roles
- Karen Moser, MDH public health preparedness consultant, served as on-site Liaison Officer. Moser coordinated communications with local public health responders, MDH district offices and the MDH Department Operations Center (DOC).
On Wednesday, March 14th, the MDH DOC was activated to help coordinate response with the District Offices, Stevens, Traverse and Grant Counties public health staff, the on-site Liaison Officer and health partners throughout the state of Minnesota.
Because responders were dealing with people displaced from their homes, some of whom had limited literacy, responders used innovative ways of communicating critical information. Bullhorns were used to address people on the street. Public health used the buddy system to conduct person-to-person communications with residents who could not read the printed information about food and water safety.
During one conference call between the DOC and on-site Liaison Officer, the DOC phone system went down and the conference call had to be conducted via a cell phone set in the middle of the conference table. This experience was a good reminder that communication systems can fail anywhere, not just at the site of an emergency, and a backup system should always be in place and regularly exercised.
Implementation of the Incident Command System and the coordinated communication between the MDH DOC and the on-site Liaison Officer ensured the DOC distributed timely and accurate information to health partners throughout the state via situation reports posted to the MDH Workspace. The DOC also helped coordinate the distribution of flood-related health and behavioral health literature to Browns Valley residents.
The good news is the flood resulted in no major injuries, no missing people and no deaths.
Environmental Health staff respond to flood
“One of the most challenging and rewarding areas in environmental health is the honor of emergency response during disasters,” said Glenn Donnay, sanitarian from the Minnesota Department of Health’s (MDH) Environmental Health Services, West Central District Office in Fergus Falls. “We have a lot of combined experience with flood relief work, major power outages, tornado recovery efforts, major foodborne outbreaks and diseases,” Donnay reflected.
As flooding started in Browns Valley in March 2007, environmental health professionals* mobilized. They coordinated onsite and offsite emergency response activities with partners. “Everyone was prepared and knew their role in helping during the crisis,” explained Kim Larsen, engineer from MDH Community Public Water Supply Unit, Central District Office in St. Cloud. “We feel communication is the key, with each other as responders, and with city employees and community members regarding available services.”
“My part was to ensure the safety of the community water system. I was in close contact with city staff, including the water operator, both during and after the flood. They knew I was testing the water for bacterial contamination and were kept informed of those results. It was a relief to the community to know the water was safe to drink,” Larsen said.
“Flexibility is vital because each emergency is unique,” stated Sharon L. Smith, public health sanitarian supervisor, MDH Noncommunity Drinking Water Supply Unit in the West Central District Office in Fergus Falls. Smith advised “Be sure to listen and observe. Prepared materials may not be appropriate to meet the needs. Information doesn't have to be in a multi-page handout. A simple message printed on poster board with markers may be the answer.” Smith shared these comments during the MDH Browns Valley hotwash, when environmental health workers discussed successes and lessons learned from an emergency response.
Partnerships, communications and emergency response procedures are continually strengthened during disasters. Environmental health professionals aspire to the challenge, reward and honor in serving people during disasters.
- Environmental health professionals include sanitarians, industrial hygienists, toxicologists, risk assessors, health physicists, hydrologists, well inspectors, engineers, mobile water testing laboratory technicians, and other environmental and emergency preparedness staff.
Flood damage to homes, businesses and communities can pose environmental health risks.
Clean up of debris can lead to physical injuries or asbestos exposure.
- Foodborne, waterborne and infectious disease may develop.
- Flooded wells can contaminate drinking water.
- Loss of power needed for drinking water, refrigeration, cooking, heating and cooling is a common occurrence.
- Leaking fuel or chemical storage tanks, or sewage overflow can pollute the environment and threaten public health.
- Indoor misuse of portable power generators and gas grills can lead to carbon monoxide poisoning.
- Mold growth in damp buildings can cause poor indoor air quality and allergy symptoms.
One thing is certain during any emergency. Reporters will want details -- immediately. And if they fail to get what they need from official sources, they will look for answers elsewhere.
So, be fast, but don’t sacrifice accuracy or engage in speculation, and assure media they will get all the information the public needs as soon as it is available.
At a minimum, media – and the public – initially will want answers to the “five Ws” and an “H”:
- What happened
- When did it happen
- Where did it happen
- Why did it happen
- Who was involved, and
- How did it happen?
The Centers for Disease Control and Prevention recommend informing the public about some of these questions within an hour of an incident.
Basic details about what has happened, when and where, might be the only information available in such a short time. To fill in the blanks, some reporters might ask for opinions. But personal speculations are not facts, and facts are what people need to understand about the situation so they can make informed decisions and take steps to secure their personal safety. Additionally, speculations that turn out to be wrong can damage credibility and trust, which is difficult to earn back.
A better approach is to not speculate and instead, explain what is being done to get answers to outstanding questions, with the pledge to release more information as it becomes available. While this will not stop reporters from interviewing unofficial sources willing to talk about their opinions and observations, it reinforces that the public can rely on official sources for timely and accurate information.
Since purchasing the MN.TRAIN Learning Management System in November 2006, the Minnesota Department of Health Office of Emergency Preparedness staff have made significant progress to customize the site. MN.TRAIN (Trainingfinder Real-time Affiliate Integrated Network) is a free, password-protected online Learning Management System for the continuing education of professionals who protect the public’s health.
Initial MDH activities w/MN.TRAIN:
- Become familiar with key functions of MN.TRAIN for administrators, learners and course providers.
- Sponsor a pilot study with representatives from Carver and Dakota County Public Health, and Hennepin County Medical Center.
- Work with the University of Minnesota’s Center for Public Health Education and Outreach (CPHEO) and Minnesota Emergency Readiness and Training (MERET) as course providers.
- Deb Grundmanis and Emily Parsons presented “All Aboard! Introduction to MN.TRAIN” at the Ready to Respond Conference in May. A MN.TRAIN exhibit and round table discussion were also held at the conference.
- Two staff attended a national two-day conference for TRAIN Administrators.
- Staff continue to develop marketing and training materials, and assist new administrators, learners and course providers.
- Develop a MN.TRAIN Fact Sheet.
Finalize training sessions and materials, then conduct trainings for local administrators in the fall, 2007.
For more information about MN.TRAIN, contact email@example.com
How to design, conduct and evaluate a functional exercise using HSEEP Guidelines
Whether you are working with a consultant or designing an exercise for your worksite, preparedness staff need to know how a functional exercise is developed, conducted and evaluated using Homeland Security Exercise and Evaluation Program (HSEEP) guidelines. This course will be presented by regional instructors using regionally appropriate scenarios.
Tuesday and Wednesday, August 7-8, 2007
Ramada Minneapolis Northwest in Brooklyn Park, MN
Sponsored by the University of Minnesota Center for Public Health Preparedness and Minnesota Emergency Readiness Education and Training
Target audience: Public health and healthcare personnel with emergency planning responsibilities.
Pre-requisites: IS 100, IS 200 or equivalent
Highly recommended: IS 139
For online training visit: Emergency Management Institute NIMS Information
For more information and registration, visit: MERET: Minnesota Emergency Readiness Education and Training or call 612-626-4515. Or visit the HSEEP Website.
The Call to Care: Faith Communities and Emergency Preparedness – An All
Persons Approach Conference
Thursday August 16, 2007
8:30 am registration (pre-registration is required)
9:00 am to 4:00 pm
Offered via Interactive Television
Participants will identify methods for communities to work together to establish preparedness for all citizens. This is an inclusive approach to prepare, respond and recover from emergencies or disasters, including pandemic flu. People from faith/community organizations, public health agencies, emergency management, persons with disabilities, persons concerned with aging and minority communities are all encouraged to attend.
This event is sponsored by the Minnesota Department of Health, the Minnesota Board on Aging, Minnesota State Council on Disability, Minnesota Division of Homeland Security and Emergency Management, University of Minnesota Institute on Community Integration and the Minnesota Faith Health Consortium.
The conference will be held via Interactive Television (ITV) at eight sites throughout Minnesota: Bemidji, Duluth, Fergus Falls, St. Cloud, Marshall, Mankato, Rochester and a metro location to be determined.
Hidden Heroes: How Deployment impacts “suddenly military” kids
The deployment of MN National Guard and Army Reserve Units impacts over 15,000 children. Free workshops are being held throughout Minnesota this summer and are open to any member in the community---neighbors, business people, youth and family service providers, educators, counselors, clergy – anyone who wants to become aware of how to support those families with “suddenly military” kids in your community before, during and after deployment. Certificates for two contact hours will be available.
We have to keep meeting like this!
Due to the large geographical area in northwestern Minnesota, the emergency preparedness planners continue to be challenged with getting all the players together to discuss issues and plan collaboratively. In this part of the state, a two-three hour meeting can easily be a whole day of work when travel time is included.
Several months ago we began discussions about Interactive Television (ITV) as a possibility to conduct meetings in the13 counties and tribes. Wendy Kvale, public health nurse consultant in the Bemidji Minnesota Department of Health (MDH) district office and Pat Kiesling, MDH distance learning coordinator, discussed how to use these resources for meetings.
The result? Now we use this Interactive Television for our quarterly meetings. All players in our hospital preparedness planning activities are invited to go to any identified sites. We establish a specific topic for this meeting because the logistics of conducting a meeting using technologies are quite different than face-to-face meetings.
Since several county-based sites are located in the judicial system, court proceedings take precedence for use of the equipment. We have identified several different locations in the counties and continue to look for other potential sites that have larger rooms. Many hospitals in this region are connected through SISU (an ITV bridging service) and several clinics are connected through Meritcare’s bridging system. A regional clinic meeting was held between these two providers to see how they could connect without using the MDH system.
Though meetings via Interactive Television may have a few glitches, people are very appreciative of this option to conduct meetings and are patient with the process as we work with the systems. The meeting time and agenda is focused, many people can participate, and the work day isn’t entirely consumed with meeting times and travel. We may offer regional training using ITV in the near future.
Health professionals assisted runners at Grandma's Marathon
When people run in a marathon, preparedness activities are needed in case of an emergency. On Saturday, June 16, 2007 in Duluth Minnesota, over 15,000 people ran in the 31st annual Grandma’s Marathon and Half Marathon.
Jo Thompson, northeast coordinator for the Medical Reserve Corp (MRC), recruited and facilitated the process of five other MRC volunteers who worked as nurses in first aid stations for the marathon. They provided treatment for minor injuries, cramping, dehydration and heat-related conditions. More severe conditions were referred to local hospitals.
Jim Gangl, emergency preparedness coordinator for St Louis County Public Health and Human Services, helped four new St Louis County Ham* radio operators to assist with emergency communications during the races. Grandma’s relies primarily on amateur radio for its race course communications. Radio operators monitor the race course and assist at medical tents and first aid stations, calling for assistance when needed. They also assist the authorities to keep the race course clear and safe for the runners. This year, over 500 runners used the medical tents; 28 runners were transported by ambulance to local hospitals.
Jim has recruited and trained 25 Ham radio operators from St. Louis County Public Health & Human Services by offering grant funds to pay their expenses, including books, class and exam fees. The people volunteer their time and mileage to attend classes and other activities. This has increased communications capacity for his agency during emergencies and provided additional resources for the community as well.
It was great to be able to provide actual experiences for these volunteers!
* Amateur radio, often called Ham radio, is enjoyed by six million people throughout the world.
MDH Public Health Lab Hosted Spring Conferences on Emergency Preparedness
In March and April 2007, the Emergency Preparedness and Response (EPR) unit of Minnesota Department of Health’s Public Health Laboratory (MDH-PHL) offered its third annual Minnesota Laboratory System Regional Laboratory Conferences. The EPR unit held ten day-long conferences at eight locations around Minnesota. These conferences focused on emergency preparedness issues pertinent to clinical laboratories.
The EPR unit began holding regional conferences in 2005. The first year’s conferences concentrated on chemical terrorism and the clinical laboratory’s role in collecting, packaging, and shipping blood and urine samples after an unknown chemical exposure event. The conference included a tabletop exercise focused on such an event that allowed participants to play through a chemical poisoning scenario and package and ship simulated laboratory specimens. Last year’s conferences focused on the Hospital Incident Command System (HICS) and laboratory preparedness for pandemic influenza. The conference included a tabletop exercise focusing on pandemic influenza in a small Minnesota town and allowed participants to play through a variety of scenarios in various hospital and HICS roles.
This year’s main topics were personal and family preparedness, emotional health, and pandemic influenza. In addition, EPR staff presented a series of short, interactive case studies on infectious organisms that could be used as agents of bioterrorism, emphasizing that these organisms can also produce naturally occurring disease. Case study titles and topics are listed below:
- Plague Jeopardy: The game of Jeopardy, complete with the game board and theme music, was used to convey information relating to the disease symptoms and laboratory diagnosis of plague.
- Demon in the Freezer: This talk discussed smallpox and its laboratory diagnosis, including a case study excerpted from Richard Preston’s “Demon in the Freezer.”
- Time Bomb: This was a presentation of an actual case of latent melioidosis.
- St. Patrick’s Day Surprise: This imaginary scenario presented an occurrence of chemical terrorism in a Minnesota casino and included an exercise on packaging and shipping of clinical specimens.
- A Tale of Two Laboratories: This presentation of an actual case study of laboratory-acquired brucellosis was in a one-act play format and used members of the audience as actors. Actors were awarded chocolate Oscars for their performances.
- The Case of the Fevered Dancer: This inhalational anthrax case study was a fictionalized account of the naturally occurring case that occurred last year in Pennsylvania.
- The Case of the Perplexing Preschooler: This oropharyngeal tularemia case study was presented in conjunction with “Agent Bingo.” Participants scored a bingo by answering questions and crossing off key words on their bingo cards.
In addition to the presentations, these conferences provided a chance for the clinical laboratory staff in each region to continue to build relationships with each other and with the EPR staff. These conferences gave MDH the opportunity to provide important information and training to clinical laboratorians around the state. It also provided a chance for EPR staff to give clinical labs a glimpse inside the Minnesota Public Health Laboratory and put a human face on a state agency that the clinical labs must interact with. The EPR unit received many positive comments from participants on all aspects of the conferences and considers this year’s conferences a success.
Hepatitis A outbreak uses Incident Management System
When two cases of hepatitis A were identified in food workers at a pizza restaurant in Slayton, Minnesota on May 2nd, it was a little more than just business-as-usual at the Minnesota Department of Health (MDH). Coincidentally, it was the second day of the Ready to Respond conference, a first-of-its-kind conference sponsored by the MDH Office of Emergency Preparedness. It was also the first day of the kick-off for codeReady, the state’s all-hazard preparedness public information campaign, with the fly-around tour scheduled to stop in Marshall that Friday.
In spite of all these events within the Department, response activities began almost immediately with incredible cooperation and partnership with Lincoln, Lyon, Murray and Pipestone Public Health Services. Within MDH, the outbreak investigation and response relied on the collaboration of six different divisions: Infectious Disease Epidemiology, Prevention & Control (IDEPC), Environmental Health (EH), Public Health Laboratory (PHL), Community & Family Health (CFH), Office of Emergency Preparedness (OEP), and Finance & Facilities Management (FFM). As has been the case for several years, emphasis was placed on integrating emergency preparedness principles (i.e., the Incident Management System--IMS) into somewhat more “routine” response situations, such as this one.
So what does this mean and how well did it work? First, incident command was initiated—a crucial first step. Communications to the media and public was a primary concern. Work ensued to identify media outlets, prepare press releases and develop talking points. A number of partner and public communication tools were used in this response, including the Health Alert Network, blast fax, IDEPC hotline, EH electronic notification via the MIR-3 system, and the MDH website (external, intranet, Workspace). The hotline handled 288 calls over two full days. Additional emergency response tools used successfully included regular conference calls and small group meetings (huddles). Several after action meetings were conducted and a written report followed.
Areas for improvement were identified:
- Translation needs for consent forms and other information
- Improved checklists for notification and communication steps
- More complete use of and adherence to incident management (especially finance and logistics)
- Greater use of regularly planned update meetings
- Need for an improved plan to finance costs of emergency events.
Ultimately, seven cases of hepatitis A were associated with the outbreak. Nearly 2300 doses of IG were administered quickly to area residents by local public health and local providers. Looking back on the event, Claudia Miller, supervisor of the Vaccine-Preventable Disease Surveillance Unit at MDH, felt good about the response. “Every time we go through an incident like this, we get better at it and move a little farther toward truly incorporating IMS and other emergency preparedness concepts into our regular response framework.”
New Web resources at Office of Emergency Preparedness
- Ready to Respond Conference presentations now online! Summaries and presentations are available from the MDH Ready to Respond Conference, held May 1 and 2, 2007 at the Earle Brown Heritage Center in Brooklyn Park, Minnesota.
- Index of articles for MDH Emergency Preparedness newsletters available. Now you can find that article you were looking for but didn’t know which issue it is located.
- Click on Ready to Respond: MDH Preparedness Newsletter
- Go to a specific year to find titles of articles that appeared in each issue
What’s New at CPHP!
The University of Minnesota Center for Public Health Preparedness offers free, innovative online learning opportunities and resources. These new activities are designed to enhance the participant’s ability to prepare for, respond to and recover from public health threats and emergencies.
Three ways to access these learning opportunities:
- Go to University of Minnesota Center for Public Health Preparedness and scroll down to “Featured Links/What’s New” on lower right side of page, or
- Email firstname.lastname@example.org, or
- Go to MN.TRAIN (the MDH learning management system).
Disaster in Franklin County: A Public Health Simulation
Disaster in Franklin County: A Public Health Simulation is available from the University of Minnesota Center for Public Health Preparedness (CPHP) at the School of Public Health and the Centers for Public Health Education and Outreach (CPHEO). Using this free online training tool, the learner will assume the perspective of various public health professionals as they respond to a natural disaster. They will make decisions on behalf of a county public health director, a public health nurse, an environmental health specialist, and other public health professionals.
This simulation focuses on the application of public health response and recovery principles related to:
- Incident Management System
- Risk Communication
- Food Safety
- Disaster Mental Health
- Disaster Preparedness
For more information:
- Go to Disaster in Franklin County: A Public Health Simulation, or
- Contact CPHEO at 612-626-4515, or
- Send email to email@example.com
Evacuate your facility!
These are words no hospital wants to hear. Writing a comprehensive evacuation plan can be a daunting task. The South Central Minnesota Regional Hospital Resource Center (RHRC) has developed an Evacuation Toolkit CD to assist their 15 hospitals to develop their evacuation plan or expand a current plan.
Contents of Evacuation Toolkit
- A 60-90 minute PowerPoint presentation, designed as a Tabletop Exercise, can identify gaps in the facility’s current plan by asking 36 questions to help administration, nursing supervisors, department directors and other safety officials determine if preparedness issues are adequately addressed in their current plan.
- A checklist for hospitals to assure they meet the Joint Commission and OSHA requirements. The checklist includes requirements for each entity for hospitals that are not Joint Commission accredited.
- A disaster recovery checklist.
- Two draft evacuation plans.
No one ever wants to have to evacuate their facility. The toolkit was developed to help our facilities be better prepared in case they are ever faced with this emergency. For more information or to receive a copy of the Evacuation Toolkit CD, contact Lavida Gingrich at Gingrich.Lavida@mayo.edu.
Emergencies can occur while you're at home, work, school or in the car. Be prepared with a codeReady Plan and Kit that you've discussed with all family members.
How Ready are you? codeReady
To receive timely, national health alerts and emergency preparedness information prepared by the Centers for Disease Control and Prevention (CDC), here are several ways to get this information.
1. View the PHIN Website
The CDC Web site for Public Health Information Network (PHIN) includes information about public health activities, frequently accessed information, education, news and conferences. CDC phin
2. Subscribe to PHIN newsletter
Articles in the first issue of newsletter, PHINews:
- In and around PHIN
- PHIN collaborative forum
- Laying the groundwork for a unified public health voice
- Keeping track, promoting health.
To subscribe to newsletter, contact firstname.lastname@example.org
CDC has developed a registry for the rapid dissemination of information to clinicians called Clinician Outreach and Communication Activity (COCA). Many CDC Health Alerts are also distributed via COCA.
4. CDC Health Alerts
CDC has a “locals” distribution list for their Health Alerts. If you would like your name added to this list, send an email to email@example.com .We will pass your request to CDC.
Ready to Respond/MDH Preparedness Newsletter
Editorial Board members include representatives from MDH divisions that receive preparedness funds. If you have an idea for an article, please contact any of these people.
Aggie Leitheiser, Director of Emergency Preparedness
Contributors to this issue