The Narrative describes CDC preparedness and response activities in 2016 and 2017 and demonstrates how investments in preparedness enhance the nation’s ability to respond to public health threats and emergencies.
In late summer 2017, three major hurricanes—Harvey, Irma, and Maria—made landfall in the United States and territories. This was the first time the United States experienced three Category 4 or greater hurricanes during a single hurricane season. CDC activated its Emergency Operations Center (EOC) on August 31, 2017 and the response is ongoing. CDC epidemiologists, environmental health specialists, emergency managers, health communicators, and scientists with expertise in waterborne and vector-borne diseases continue to work together to monitor and address public health threats in the aftermath of the storms.
Learn more about CDC’s role in the hurricane response.
The Opioid Epidemic
From 2000 – 2015, drug overdoses killed more than half a million people in the U.S. Six out of 10 of these deaths involved an opioid. CDC’s National Center for Injury Prevention and Control and the PHEP Program work together to support communities responding to the opioid epidemic. State health departments are using PHEP funds to identify communities hardest hit by the epidemic and to support the distribution of naloxone, a medical treatment to prevent death from opioid overdose.
Between 2017 and 2019, CDC and Public Health Emergency Preparedness (PHEP) program recipients will conduct nearly 500 medical countermeasure operational readiness reviews nationwide. Nearly 60% of the U.S. population resides in 72 metropolitan areas that are included in the reviews of 400 local jurisdictions. The reviews evaluate a jurisdiction’s ability to execute a large response that requires the rapid distribution and dispensing of life-saving medicines and medical supplies.
In 2017, CDC’s Federal Select Agent Program (FSAP) developed a new electronic information system to improve the efficiency of information sharing and exchange between FSAP and registered entities.
If you have any feedback about the 2018 National Snapshot, please email us at preparednessreport@cdc.gov. We welcome your suggestions and will use your feedback to improve future editions of the Snapshot.
CDC’s Public Health Emergency Preparedness (PHEP) cooperative agreement is a critical source of funding, guidance, and technical assistance for state, local, tribal, and territorial public health departments to strengthen their public health preparedness capabilities. Since 9/11, the PHEP program has saved lives by building and maintaining a nationwide public health emergency management system that enables communities to rapidly respond to public health threats.
The following stories are examples of how PHEP has equipped states for each of the four stages of preparedness: Ready. Steady. Show. Go!
READY: Planning for the inevitable
Often the emergency managers and public health professionals who respond to an emergency are personally impacted by the same event. The ability of emergency response staff to take action during a disaster is limited when they are stranded in their homes due to an ice storm, without power, or unable to make it into the office.
The Connecticut State Department of Health, led by Jonathan Best, took on the challenge to ensure that operations can run smoothly even when their own staff are directly impacted by an emergency. They developed the Red Sheet Program, which trains three people for every key position in the emergency management structure – a primary contact with two back-ups. This means the health department can be fully staffed and ready to respond to a crisis within 20 minutes.
STEADY: Solving two problems at once
As the saying goes, even the best laid plans often go awry. Planning is an essential part of any preparedness program, but it is often difficult to imagine every scenario and obstacle that may arise during an emergency. But we also know that practice is the best way to identify and address those gaps– and practice is exactly what the Oklahoma State Department of Health does to improve its preparedness programs.
In September 2016, the Oklahoma Strategic National Stockpile team prepared to conduct a full-scale exercise of its ability to distribute medical countermeasures – medications and other products used to prevent and treat health conditions that may arise during a public health emergency. Before the exercise began, the state realized they had shipments of flu vaccines that they needed to distribute around the state and the team distributed the vaccines as part of their regularly scheduled exercise. The team transported 11,960 doses of vaccine to eight local health departments while simultaneously completing this practice exercise.
SHOW: Creating a culture of preparedness
Emergencies impact all sectors of health, and experts from across departments are often asked to weigh in, from epidemiologists, to laboratorians, to mental health experts. However, public health staff in these positions may not often consider their roles in an emergency situation.
To build a culture of preparedness across the entire Oregon Health Authority, the Emergency Operations Division provided all staff with a 72-hour emergency kit, worked to enroll staff in the Health Alert Network, and trained staff on the Incident Management System. Since this initiative, staff personally feel more prepared for an emergency, and more staff are now prepared to respond should the need arise. “The culture has shifted. People are now talking in the elevator about what they would do in the event of a large-scale disaster,” acting PHEP director Akiko Saito said. “If we can build this culture of preparedness here, then we’re better equipped to build community resiliency on a larger scale.”
GO! Putting plans into action
While we all hope that emergencies never occur, they are inevitable and the true test of any preparedness system. Washington experienced an outbreak of mumps that affected more than 800 people of all ages in late 2016 and early 2017.
During this outbreak, the state and local health departments in Washington investigated new cases, advised local school districts on prevention measures, and developed culturally appropriate risk communication materials. Due to a robust preparedness system and the efforts of the health department staff and partners, more than 5,000 more people were vaccinated for measles, mumps, and rubella compared to previous years.
For 15 years, PHEP has been there, from Katrina to SARS; Joplin to H1N1 influenza. To find out more about how the PHEP program has equipped jurisdictions to prepare for, respond to, and recover from public health emergencies, check out our Stories from Field.
Dr. Stephen Redd, Director, Office of Public Health Preparedness and Response
One of the best parts of my job is the opportunity to learn from a wide range of experiences. We have an obligation to not only respond to emergencies today, but to prepare for tomorrow by learning from the past. Our work extends to households affected by disease, communities ravaged by disasters, and U.S. territories battling new and changing threats. In fact, all over the world – we try to get ahead of, and manage, complex responses that touch many lives through ever changing circumstances. In an ideal world the health in every community would be at a level that would make recovery and reliance easier. The reality is that emergencies happen in all kinds of environments and populations.
The Public Health Preparedness and Response National Snapshot is our annual report that gives us an opportunity to showcase the work that we and our state partners do. The report reminds us that no matter how big the emergency, we need to work together to respond to the best of our ability—with the cards we are dealt.
1) Four Responses at Once: An Unprecedented Challenge
CDC experts continue to provide 24/7 monitoring, staffing, resources, and coordination in response to natural disasters, terrorist attacks, and infectious disease threats. In early 2016, CDC managed four public health emergencies at the same time through our Emergency Operations Center :
Ebola
Flint, Michigan, Water Quality
Zika Virus
Polio Eradication
See us in action:
Watch this video to learn how the CDC Emergency Operations Center (EOC) works
CDC scientists and responders were activated in CDC’s Emergency Operations Center, where they combed through research, developed and distributed diagnostic tests, and provided on-the-ground mosquito control and education to protect people at higher risk for the virus, including pregnant women and infants.
CDC’s Strategic National Stockpile is ready to send critical medical supplies quickly to where they are needed most to save lives. The stockpile is the nation’s largest supply of life-saving pharmaceuticals and medical supplies that can be used in a public health emergency if local supplies run out.
Last year, we helped conduct 18 full-scale exercises and provided training for 2,232 federal and state, local, tribal, and territorial emergency responders to ensure that systems for delivering medicines are functioning well before they are needed in an actual emergency. We continue to work with our federal, state, local, and commercial partners to make sure every step of the medical supply chain – from manufacture to delivery – is coordinated.
CDC connects with state and local partners to provide support and guidance, helping every community get ready to handle emergencies like floods, hurricanes, wildfires, or disease outbreaks.
This year, we created a new process to evaluate how well state and local jurisdictions can plan and execute a large-scale response requiring the rapid distribution of critical medicines and supplies. Through this program, we conducted assessments of 487 state and local public health departments. The information from these assessments will be used to help improve the ability to get emergency supplies quickly to those who need them most.
To protect lifesaving research, CDC experts in biosafety and biosecurity conducted approximately 200 laboratory inspections and thousands of assessments of those who handle dangerous select agents and toxins like anthrax, plague, and ricin to keep these materials safe, secure, and out of the hands of those who might misuse them.
CDC’s Laboratory Response Network (LRN)l also develops and deploys tests to combat our country’s most pressing infectious and non-infectious health issues, from Ebola to Zika virus to opioid overdose. The network connects over 150 labs to respond quickly to high priority public health emergencies.
CDC supports efforts all across the country to help those who may not be able to help themselves when a crisis strikes. Some populations, like children, older adults, and others with functional and access needs may need extra help during and after an emergency.
From planning for the 69 million children who may be in school when disaster strikes to the millions of Americans who need to make sure prescriptions are filled, medical equipment is working, and help arrives even if power is out and roads are blocked, it’s up to us to protect our most vulnerable in emergencies.
Learn about an innovative program to help people with disabilities stay safe in emergencies
7) Emergency Leaders: The Future of Incident Response
When every minute counts, we need people who have the knowledge to step in and take immediate action. Learning and using a common framework like the CDC Incident Management System helps responders “speak the same language” during an event and work more seamlessly together.
CDC experts train leaders from around the world—25 countries in 2016—through an innovative, four-month fellowship based at our Atlanta headquarters. Lessons learned from this course were put to work immediately to head off an outbreak of H5N1 influenza in Cameroon.
8) The Power of Preparedness: National Preparedness Month
Throughout September, CDC and more than 3,000 organizations—national, regional, and local governments, as well as private and public organizations— supported emergency preparedness efforts and encouraged Americans to take action.
The theme for National Preparedness Month 2016 was “The Power of Preparedness.” During our 2016 campaign , we recognized the successes of countries and cities who have seen the direct benefits of being prepared, looked at innovative programs to help children and people with disabilities get ready for emergencies, and provided tips for home and family on making emergency kits.
As part of the Global Health Security Agenda, teams of international experts travel to countries to report on how well public health systems are working to prevent, detect, and respond to outbreaks. In May, a team made a five-day visit to the U.S. to look at how well we’re doing.
In the final report, the assessment team concluded that, “the U.S. has extensive and effective systems to reduce the risks and impacts of major public health emergencies, and actively participates in the global health security system.” They recognized the high level of scientific expertise within CDC and other federal agencies, and the excellent reporting mechanisms managed by the federal government.
