A Safe Community Starts With You

South Los Angeles Youth Active in CERT Training
Youth from the South Los Angeles area engage in a Community Emergency Response Team exercise. In partnership with the DHS Center for Faith-based & Neighborhood Partnerships, the Los Angeles Fire Department and Los Angeles County Public Health division have been able to reach a diverse group of youth to introduce disaster preparedness to build positive relationships with local first responders and increase public safety.


The minutes, hours, and days immediately following a disaster are the most critical for saving lives. In times of crisis, local communities are first to respond. It’s up to each of us to make sure our communities are resilient and can bounce back from disaster. We do this by being prepared to help ourselves and those around us.

“[Reducing the risks of disasters] begins at home – in our schools, places of work and worship, and throughout our local communities,” says a United Nations report. “It is here where we will either save lives – or lose them – depending on the steps we take today to reduce our vulnerability to tomorrow’s hazards.”

Volunteers Help With Cleanup
re·sil·ient \ri-ˈzil-yənt\: able to become strong, healthy, or successful again after something bad happens

But what makes a community more resilient? It starts with you.

Save yourself, save others                                 

In an emergency, we often look to trained responders in our community to come to the rescue. But we can’t always look to others to save us in times of need. Earthquakes and floods can wipe out roads, cutting off neighborhoods from outside help. Widespread devastation may overwhelm services, and trained responders can’t be everywhere at once. Most of all, help from outside will take time to arrive, and time is precious following a disaster.

Experts are not the only people who can – or should — take action. Each of us has the power to save lives. And by being ready to help yourself or others, you become part of the solution instead of the problem. All it takes is knowledge, planning, and practice to create a more resilient community.

Make a plan for yourself and your family

Resilient communities are prepared. Plan for your own home. Do you have an emergency kit? Does everyone know where to meet if you get separated? Have you practiced what to do, especially if you have children? Have you accounted for your pets and for anyone who may have special needs?

Do you know where your nearest hospital is and how long it takes to get there? What about the nearest emergency shelter – is it in a school gymnasium, stadium, or community center? What are the evacuation routes for your community?

Start by making sure you have the answers to these questions.

Learn about your community

Community Based Disaster Risk Reduction Study, International Federation of Red Cross and Red Crescent Societies, Geneva, 2012

Resilient communities are connected. Get to know the people around you. Start by meeting your neighbors. Attend a religious service. Go to a PTA meeting. Volunteer. Reach out.

Find out what organizations are already in place in your area, and how to connect with them. Get in the habit of serving your community. Help your local food bank or other charity – ask how you can contribute to the effort, so that help is nearby when you need it most. Find out what the specific needs are around you; every community is different.

Get it together

Together, you can make a plan and set goals. Remember to track your progress as you work toward your goals, and celebrate your successes.

Once you have plans, practice putting them into action. Have a fire or tornado drill at your school or office. Practice getting to your designated meeting place, and make sure everyone knows how to text message, which can be a more reliable way to communicate in an emergency.

Stay aware

Resilient communities are knowledgeable. Know your resources, and stay aware of what’s happening around you. In addition to watching or listening to local news and talking with neighbors, resources like CDC emergency and FEMA’s mobile app can help you stay informed when disaster strikes and/or you’re away from home. Many local governments use emergency notification systems to notify residents of severe weather, evacuations, etc. Use them – both to get and to give information.

By spreading knowledge before, during, and after emergencies, you can make sure that “everyone, from a local school child to a village grandmother to the municipal mayor, knows how to protect him or herself,” says the UN report.

Remember, all disasters – and all responses – are local. Even if an emergency is widespread, it is local communities who suffer the impact of the disaster and must bear the responsibility for the initial emergency response. How a community reacts, survives, and rebuilds following a disaster will depend largely on the resources it has put in place beforehand.

When every minute counts, the more of us are prepared, the safer we all are.

Learn how you can get involved in your community:

 October 13 is the International Day for Disaster Reduction, which “celebrates how people and communities around the world are reducing their exposure to disasters and raising awareness about the importance of reining in the risks they face.” For more information about how we can all work to lessen the impact of disasters, visit the United Nations Office for Disaster Risk Reduction.

Protect Your Child this Flu Season: Get a Flu Shot!

Brave patient is a good patient

As fall approaches, cold weather isn’t the only thing you and your family need to prepare for. Flu season is on its way, and it will be here before you know it. Now is the time to make sure that you and your family are protected from flu by getting your flu vaccine by the end of October, if possible.

 The Best Way to Protect Your Family

Even healthy children can get the flu. Did you know that children, especially school-aged children or children in day care, are more likely to get sick from flu? Your child is likely to be exposed to flu in a classroom or daycare setting, and millions of children get sick with flu every season. It’s important to make sure that your child is protected this flu season, and the first and most important step in protecting you and your family from flu is by getting everyone an annual flu vaccine.

Nasal Spray Flu Vaccine is Not Recommended This Season

Young mother kissing her toddler sonFlu shots can sometimes be difficult, scary, and uncomfortable for kids (and parents). For several years, some parents have opted to get their children the nasal spray flu vaccine, commonly known as FluMist®, to avoid another shot for their kids. Doctors and scientists also appreciated having the nasal spray flu vaccine as an option that might help encourage needle-averse people to get vaccinated. Studies done soon after the nasal spray flu vaccine was approved showed it was performing as well as (and sometimes better than) flu shots.

Unfortunately, recently there have been problems with how well that vaccine has worked. The reason for this is not known, but experts are looking into the situation with the hopes that nasal spray flu vaccine might again be an option for kids and parents. In the meantime, CDC and the American Academy of Pediatrics (AAP) recommend flu shots this flu season, not the nasal spray flu vaccine. Flu shots work and can keep your child from getting sick!

As you are planning to get your family vaccinated this fall, remember that some children 6 months through 8 years of age require two doses of flu vaccine. If your child is 6 months through 8 years and is getting vaccinated for the first time, or has only previously gotten one dose of vaccine, then they should get two doses of vaccine this season. The two doses need to be given at least four weeks apart.  For children who will need two doses of flu vaccine, the first dose should be given as early in the season as possible to allow time for the second vaccine to kick in before flu starts to spread in your community.

For other children, it is good practice to get them vaccinated by the end of October; however, getting vaccinated later can still be protective as long as flu viruses are circulating. Ask your child’s doctor or other health care professional if your child needs two doses of flu vaccine.

Visit Children, the Flu, and the Flu Vaccine for more flu and flu vaccine information specific to children.

Flu Can Be Dangerous for Some Children

The flu may be more serious than the common cold for children. Flu symptoms can be severe and flu illness can lead to serious complications that require hospitalization.

Some children are at especially high risk of serious flu-related complications:Close up of baby looking at camera with blue eyes

  • Children younger than 6 months old are too young to be vaccinated. The best way to protect them is to make sure you and others around them are vaccinated.
  • Children aged 6 months up to their 5th birthday, even those that are healthy, are at risk simply because of their age.
  • In some studies, American Indians and Alaskan Natives are more likely to have severe flu illness that may result in hospitalization or death.
  • Children aged 6 months through 18 years with certain chronic health problems, such as asthma, diabetes, or neurological and neurodevelopmental conditions.

It’s important to make sure young children and children with certain chronic health problems are vaccinated against flu, as well as any family members and caregivers in contact with your family.

Vaccinate the Whole Family

CDC recommends that everyone 6 months of age and older get a seasonal flu vaccine. You and your family should be vaccinated every year for the best protection against flu. Many children get sick from flu every flu season, and some of those illnesses result in death. Every year in the United States, an average of 20,000 children younger than 5 years old are hospitalized due to flu complications. Flu vaccination can reduce flu illness, doctors’ visits, and missed work and school due to flu, as well as prevent flu-related hospitalizations for you and your family.

Flu vaccines are offered in many locations, including doctor’s offices, clinics, health departments, pharmacies, and college health centers, by many employers, and even some schools. You may not have to see your doctor to get your child a flu shot! There are plenty of locations available that provide vaccinations. The Vaccine Locator is a useful tool for finding areas in your community offering flu vaccine.

More information for parents is available at: http://www.cdc.gov/flu/parents/index.htm.

Ready Now!

Cars driving on a highway are stuck in traffic because of a snow storm.

Nickole Cheron, Disability Coordinator for the city of Portland, Oregon
Nickole Cheron, Disability Coordinator for the city of Portland, Oregon

A rare winter storm in 2008 buried Portland, Oregon under more than a foot of snow, leaving the city gridlocked. Like many others around the city, Nickole Cheron was stuck in her home for eight days. But for Nickole—who was born with spinal muscular atrophy, a genetic disease that weakens the body’s muscles over time—the storm was potentially life-threatening.

To live well with her disability, Nickole depends on outside assistance to get through her days, relying on a wheelchair and full-time caregivers for most routine tasks. Being alone and without assistance was not an option. Fortunately, Nickole had taken steps to prepare. She had signed up for Ready Now!, an emergency preparedness training program developed by the Oregon Office of Disability and Health, and she quickly put what she learned into action.

The Ready Now! training, presented in partnership with Oregon Health Sciences University, is specially designed to educate people with disabilities on how to prepare themselves for a disaster or an emergency situation.

“The most important thing I learned from the training was to have a back-up plan in case of an emergency,” Nickole says. “When I heard the snowstorm was coming, I emailed all my caregivers to find out who lived close by and would be available. I made sure I had a generator, batteries for my wheelchair, and at least a week’s supply of food, water and prescription medication.”

Nickole says the training was empowering and reinforced her confidence to face an emergency situation with a disability. She felt better informed about the potential risks people with disabilities could encounter during a disaster. For example, clinics might close, streets and sidewalks might be impassable, or caregivers might be unable to travel.

Preparedness is a mindset

 Preparedness means always thinking about what might happen and how it might affect you and those around you, and then taking steps ahead of time to stay safe and healthy. Everyone faces a unique set of risks and has unique needs. People with disabilities – like Nickole – often must rely more on others, especially in emergencies.

For the millions of Americans who have disabilities, events like extreme weather, fires, floods, acts of terrorism, and disease outbreaks present a special set of challenges. One of the important lessons from the response to Hurricane Katrina was that gaps existed in pre-disaster planning among people with disabilities and local emergency management agencies.

While no one can predict every emergency, Ready Now! and other programs like it help people with disabilities and their family members plan ahead to protect themselves. For Nickole, it may have saved her life.

Share Nickole’s story and the following resources with friends, family, and neighbors:

Read our other National Preparedness Month blogs:


How to Be Smart (About Preparedness)

Dramatic sky in contrast with the afternoon sun on a November afternoon in Limburg, the Netherlands

Emergencies are everywhere: from floods to flu, tornadoes to terrorists… How do you prepare for all of it?

Trying to prepare for every possibility can seem impossible. But you can be smart about preparing for the emergencies and situations you are most likely to experience. Start by looking around at where you live, the people in your life, and the places you go on a day-to-day basis. Ask yourself questions, then figure out what steps you can take.

For example:

  • Are you living in tornado alley? Pick a safe place in your home to take shelter.
  • Do you work in a large office building? Know how to evacuate during a fire.
  • Do you travel often? Make a kit with prescription and over-the-counter medicines, your health insurance cards, and copies of your prescriptions.
  • Do you have children? Make a plan with them about where to meet up if you are separated.
  • Do you have a loved one with diabetes? Have a plan if they run out of insulin or if they have low blood sugar.
  • Do you have pets? Make sure your emergency plan includes them, too.

Emergencies come in all different shapes and sizes. We often hear about preparedness in the context of natural disasters and infectious disease outbreaks, but preparedness is also about getting your flu shot every year and wearing your seatbelt when you drive. Preparedness is knowing what to do if your child starts choking or how to help if your coworker has a seizure.

Preparedness also means reaching out to those around you. Do you know someone with a disability who may need extra help when evacuating during an emergency? Are there elderly people living in your neighborhood who are particularly vulnerable to extreme heat?

Of course, something unusual can always happen. (After all, who would have anticipated Snowpocalypse 2014 in Atlanta, Georgia?) But in preparing for the most likely situations, you may find yourself better prepared for the unexpected.

Get a kit. Make a plan. Be informed.

Read our other National Preparedness Month blogs:

Recognizing the Vital Work of Our Nation’s Public Servants

Greg Burel receiving SAMMIE award.
Photo credit: Aaron Clamage/clamagephoto.com

In April 2015, an Ohio doctor made an urgent call to CDC concerning a possible life-threatening botulism outbreak that posed a risk to as many as 50 people who had attended a church potluck dinner.

Within hours, CDC, the Ohio Department of Health, and a local hospital had determined that botulism antitoxin was needed to treat the food-borne illness. They made an immediate request to the only U.S. source: CDC’s Strategic National Stockpile (SNS).

Greg Burel received the request just after 2 p.m. that day. He quickly issued his approval and set in motion a process that rapidly deployed and delivered botulism antitoxin to Ohio just after midnight to help save the lives of 18 people who had become seriously ill.

For Burel, this was all in a day’s work.

Burel serves as Director of the Division of Strategic National Stockpile at CDC, where he manages the federal government’s $7 billion Strategic National Stockpile of emergency medicines and medical supplies, which are stored in warehouses across the country.

In a public health emergency, the U.S. pharmaceutical supply chain may be unable to immediately provide a medical countermeasure that may be required to prevent, mitigate, or treat adverse health effects resulting from an intentional, accidental, or naturally occurring public health emergency. SNS ensures the right medicines and supplies are available when and where they are needed to save lives.

And The Sammie Goes To…

In recognition of his exceptional leadership and unmatched excellence in the management of CDC’s SNS, Burel was the recipient of one of this year’s prestigious Samuel J. Heyman Service to America Medals―also known as the “Sammie” award―specifically in the Management Excellence category. In his decade-long tenure as Director of SNS, Burel has spearheaded 10 large-scale responses, including national responses to flooding, hurricanes, and influenza pandemics, and more than 30 small-scale deployments for the treatment of individuals with life-threatening infectious diseases including the botulism outbreak and the Ebola crisis.

Burel’s most recent challenge has been dealing with the Zika virus. In the wake of the Zika virus outbreak, SNS is working with diverse partners such as CDC Foundation, commercial pharmacies, and vector control companies to implement public health interventions that wouldn’t have been possible without the expertise and capability of SNS staff to bring it all together. “It’s more than just having the right product on the shelf and an established plan to use it,” Burel said. “We recognize the shifting realities of today’s public health threats and work with partners spanning the public and private spectrum to develop the capacity to respond to any public health emergency.”

Under Burel’s watch, the SNS has steadily expanded its focus so that it is capable of responding to all the global hazards of the 21st century. He says, “I am honored to receive the prestigious Sammie Award, and privileged to work alongside the many esteemed public servants who play an instrumental role in the stockpile’s daily operations.”

With more than 30 years of civil service, Burel has risen through the ranks of the federal government to become a proven leader in medical supply chain logistics, disaster and emergency management, financial management, quality improvement, and organizational design. He began his career at the Internal Revenue Service, and served in leadership roles in the General Services Administration (GSA) and the Federal Emergency Management Agency (FEMA).

The “Oscars” of Government Service

Burel is one of many dedicated and hardworking federal employees across the world. The Sammie Award is an award program that publically highlights excellence in the federal workforce. The awards are also known as the “Oscars” of government service and honor those employees who have made the commitment to make our government and our nation stronger. They are named for the Partnership for Public Service’s late founder, Samuel J. Heyman, who was inspired by President Kennedy’s call to serve in 1963. These awards align with his vision of a dynamic and innovative federal workforce that meets the needs of the American people. The prestigious medals are awarded to a handful of federal employees each year for outstanding service to their country and humanity.

For More Information

Fred the Preparedness Dog—Tails from Kansas

Fred witnesses the governor of Kansas signing a proclamation naming September "National Preparedness Month"

It all started when Fred jumped into the bathtub.

It was one of those warm, Kansas summer days, back in 2013. Fred the German Shepherd had just joined our family, and my wife eagerly captured all his adorable dog-moments with her camera. So when Fred hopped into the tub, she quickly snapped a photo and sent it to me.

Having worked in emergency preparedness for ten years, I saw something more in that picture: Fred was doing a good job of being prepared.

The bathtub is where my family shelters when there are weather warnings in our area. I posted Fred’s photo on social media at work and added a caption: “Fred knows where to go in case of severe weather. You should too.”

Continuing the theme, we had the idea to put a child’s backpack on Fred. We filled the backpack with basic supplies every family needs in an emergency. The next photo went up online: “Even Fred has an emergency kit!”

It skyrocketed from there. What began as a series of photos of Fred turned into a full-blown preparedness campaign for children ages 6-12 all across the state.

Lessons from a dog

Fred in bathtub
Fred knows where to take shelter in case of severe weather.

It turns out Fred has a lot to teach kids about preparedness, and he’s perfect for the job. Kids are always curious about Fred and relate to him in a special way.

Together, Fred and I travel to schools and events across Kansas, teaching kids how to keep themselves and their families safe. Fred now has his own purple hiking bag, which he wears everywhere, because you never know when an emergency might happen. When we go to schools, kids help unpack the kit and see what’s inside. As they take out the items, we talk about each one. We talk about the flashlight, the maps, the contact numbers, the hand wipes, the first-aid kit.

“We can just put a Band-Aid on Fred, right?” I ask the kids.

“No!” they yell back.

I take out a compress and wrap Fred’s head, demonstrating the importance of knowing about different kinds of first aid and how and when to use them.

I also show them Fred’s teeth. We talk about how strong he is and how hard he can bite. We show kids how to approach Fred safely and avoid animal bites.

We talk about making sure family pets are accounted for in an emergency plan. During Hurricane Katrina, we saw that many people will not leave home without their pets, even when their own lives are in danger. We encourage kids and their families to find hotels ahead of time where pets can stay too, or to find a kennel nearby that can be used in case of emergency.

At the end of each school visit, as the children clap, Fred barks his appreciation in return.

Fred gets the message out  

Fred keeps a busy schedule these days. Last month, we met the governor of Kansas as September was officially declared Preparedness Month for the state. As part of National Preparedness Month, we have plans to attend the 10th Annual Emergency Services Showcase, which lets kids meet first responders like firemen and policemen face-to-face so they’re not afraid of them when they need them. We’re also going to Preparedness Day at the Kansas State Fair, and then off to a hospital. Along the way, we’ll be seeing more classrooms full of kids around the state.

Today, Fred’s efforts are backed with funding from CDC that has enabled us to create a suite of materials, including preparedness-themed coloring books and stickers we send home with kids after we meet them. The materials reinforce the three most important things everyone can do to be ready: Get a kit. Make a Plan. Be informed.

Fred also has his own iPhone app, and a website and Facebook page where he posts about his latest adventures.

Fred the Preparedness Dog is the mascot for the Kansas Department of Health and Environment Preparedness Program. His mission is to increase family and pet preparedness for all types of emergencies.

Read our other National Preparedness Month blogs:

West Nile to Zika: How One Virus Helped New York City Prepare for Another

New York City helicopter used for larviciding.

No one told the Aedes mosquito that New York is the city that never sleeps.

The type of mosquito that can spread Zika virus (Zika) is most active during the day and hides at night when our city’s mosquito control efforts are in full swing, meaning that our scientists had to find a way to reach it during pre-dawn hours. The solution? Wake it up, force it to take flight, and then kill it.

This is just one of many innovations New York is using to bolster the fight against Zika.

A tale of two mosquitoes

By the time the Zika outbreak was making news, causing birth defects and threatening pregnant women, New York City already had over a decade of experience in tackling mosquito problems related to the spread of West Nile virus. In facing Zika, we have been able to apply many of our existing resources and lessons learned from the West Nile virus response.

However, the mosquito that carries Zika is different than the one that carries West Nile virus, and it needs to be handled differently. New York is home to Aedes albopictus, which has been known to carry Zika – although, unlike the Aedes aegypti of the south, it has not yet been determined how likely Aedes albopictus is to spread the virus to humans in the United States. Because this is still unknown, people need to protect themselves.

To find out more about the risks, we need to catch the mosquitoes and test them. But we can’t use the same traps to catch the Aedes albopictus that we use to catch the West Nile virus-carrying Culex. Culex mosquitoes can be trapped with a combination of carbon dioxide and light. Being daytime creatures that prey mostly on people, Aedes albopictus don’t fall for the same tricks. So we developed traps that use human pheromones to lure them in.

Building on what we have

Aedes albopictus mosquito feeding.
Aedes albopictus mosquito

Meanwhile, some of the things we have always done for West Nile virus work well in the current response.

We know from previous mosquito-control efforts that pesticides are a last resort. Although there are lots of ways to kill a mosquito, West Nile virus taught us that an effective response takes cooperation on many fronts. In New York, we have laboratories for testing, disease control experts to track cases in people, and a call center that manages tests and information from clinicians. Our communication department gets the word out because the best thing we can do for viruses like West Nile and Zika is educate people about how to prevent mosquito bites – wearing the right repellent, removing standing water, and staying indoors when you can.

Many of the resources we acquired for fighting West Nile virus are proving indispensable for fighting Zika. Ten years ago, we got a hand-me-down helicopter from the NYPD, and we’ve been able to use this for aerial spraying over marshlands and unpopulated areas. In the city, we use the same late-night spray trucks. A police car moves ahead of the truck, warning anyone who may still be out on the street. The distinctly New York voice bellowing from the loudspeaker (that of retired assistant commissioner Allan Goldberg) is even the same one we’ve always used.

 Sharing what we know

Zika presents us with a very steep learning curve, and it reinforces the need for transparent communication. We’ve set up an interactive website where we can share what we’re discovering with the public. We put out data on a weekly basis: people can zoom in and out on their screens to see where we’re finding mosquitoes. We want everyone to understand about the preventive work we’re doing to help keep Zika at bay.

The complex nature of Zika reveals the strongest and weakest points of the public health system. One thing in particular public health has always struggled with is how to change people’s behavior, which is critical and must happen if we want to stop Zika. We really hope that pregnant women or women who plan to become pregnant will not travel to areas with Zika, but it’s hard to stop people from visiting family or simply enjoying the world.

So far, all of the reported Zika cases in New York – including, as of August, 49 among pregnant women – have been the result of global travel. But just because we haven’t seen local transmission doesn’t mean the potential isn’t there.

This is why we’ve expanded our efforts by hiring extra staff and extending the areas where we do mosquito control and education. We need to continue to collaborate across agencies and in the field – and, in fact, all over the world – to manage a complex response that touches on so many areas. Working together and staying vigilant is our only hope for getting – and staying – ahead of this potentially devastating disease.

Read our other National Preparedness Month blogs:


When Preparation Meets Opportunity: Cameroon Gets a Jump on Outbreak Response


When Dr. Aristide Abah stepped off the plane that brought him from Atlanta back to his home in Cameroon, there was no time to waste. An outbreak of H5N1 flu threatened the country, and it was up to Dr. Abah to lead the response.

Fortunately, he was prepared.

Dr. Abah had just spent four months at CDC headquarters as part of CDC’s Public Health Emergency Management Fellowship, which invites public health experts from all over the world to learn how to organize an emergency response in their country.

A deadly threat

In Cameroon, H5N1 was raging in poultry, putting people at risk. The virus can spread to people who come into contact with infected birds, and the result can be devastating. An estimated 60% of people who get the disease, die.

A swarm of activity took place around Cameroon’s response: culling chickens, contact tracing, delivering Tamiflu to people who needed it, providing personal protective equipment (PPE) to workers, and more. The country faced challenges; with over 500 sets of PPE needed each day, animal health workers ran out and had to repurpose supplies that were never used for the 2014 Ebola outbreak.

If they were to stop the deadly virus from spreading to humans, the country needed to act fast and be efficient. For Dr. Abah – and for Cameroon’s public health emergency operations center – it was time to put some newfound knowledge to the test.

From fellowship to field

Dr. Abah leads Cameroon H5N1 response
Dr. Abah leads Cameroon’s H5N1 response

Dr. Abah returned home from his fellowship on a Sunday night. On Tuesday, he stepped in as Incident Manager for the response. On Wednesday, he walked around the room and put nameplates at every desk.

This simple action served two important purposes.

The first was to make sure everyone knew their designated roles. In an emergency, we use an organizational structure called an Incident Management System to assign specific roles and responsibilities to every person. This ensures that everyone knows exactly what they and others are doing.

Nameplates also meant that everyone had an assigned seat, so that people who worked on the same tasks sat near each other. When information has to travel fast, proximity is priceless.

After he organized the people, Dr. Abah organized their time. He set up a system that gave everyone an allotted number of minutes to speak at meetings. He even appointed a timekeeper to help stay on track. “As you may or may not know,” joked Kerre Avery, a CDC Emergency Management Specialist who works closely with Cameroon, “it’s the French custom to talk a lot.”

Dr. Abah also improved the way information traveled, both within the response and outside it.  He adopted the CDC template for daily update slides and situation reports in the EOC, and added a communications team to the incident management structure to help get critical messages out to the public.

For Dr. Abah, these were the opening steps of a wider plan to respond to the crisis. During his fellowship, he had learned the critical importance of planning and organization. “For me, the planning was key,” he said. “I now know that we can’t do anything without a plan.”

Knowledge can’t wait                                                                  

When Dr. Abah first learned of the H5N1 outbreak, he had not yet completed his fellowship, but he knew that the lessons he was learning would help his colleagues back home. He set up an internet-based platform so they could all see and benefit from the lessons. He also reached out with new ideas: “I wanted to speak to higher management,” he said. “I told them they had to have an Incident Manager [in the EOC].”

Cameroon was already getting better and better at responding to health threats. A year ago, it took the country eight weeks to activate their public health emergency operations center in response to a cholera outbreak. Several months later, when Lassa fever erupted, they had reduced their response time to a week. By the time H5N1 appeared in local poultry, it took the country less than 24 hours to activate the PHEOC.

Cameroon’s recent improvements – including their investment in sending Dr. Abah to the fellowship – are all part of a worldwide effort to better prevent, detect, and respond to public health emergencies. And their efforts in preparedness are paying off: during the latest outbreak, there were zero transmissions of H5N1 to humans.

Inspiring lessons

The lessons the Public Health Emergency Management Fellowship teaches are designed to be applied to virtually any crisis situation. Since the 2013 inaugural class, CDC has hosted 39 fellows from 25 countries, giving them important education they can take back and use in their home countries.

While in the U.S., Dr. Abah was particularly inspired by a visit to meet Dr. Nicole Lurie, the Assistant Secretary for Preparedness and Response in Washington, D.C. Her advice to him summarizes perhaps the most important lessons from the fellowship.

“I keep in my memories three words of advice from Dr. Lurie.” Dr. Abah recalls. “Never give up, stay connected, and get better.”

The Public Health Emergency Management Fellowship is implemented by CDC’s Division of Emergency Operations. The program helps countries meet the goals of the Global Health Security Agenda, including having an emergency operations center that can respond within two hours of a public health emergency.

Learn More

 Read our other National Preparedness Month blogs:

The Power of Preparedness

The Power of Preparedness. National Preparedness Month 2016.

Dr. Stephen Redd, Director, Office of Public Health Preparedness and Response
Dr. Stephen Redd, Director, Office of Public Health Preparedness and Response

If there were one thing I’d wish for, it would be the ability to predict when and where the next infectious disease outbreak would occur and stop it before it starts. I can’t do that. And neither can anyone else.

At this moment, in addition to combating Zika in the United States and polio in Nigeria and Pakistan, we’re putting out the last embers of Ebola in West Africa, stomping out cholera in Tanzania and Kenya, and fighting yellow fever in Angola. We’re keeping vigilant for the re-emergence of H5N1 influenza and Middle East respiratory syndrome, and monitoring chikungunya, dengue, monkeypox, Lassa fever, measles…the list goes on.

It’s a lot to do. And these are just the diseases we know about. The brutal fact is that there are diseases we haven’t discovered yet. They’re out there, waiting to expose the cracks in our systems – to find the places where we aren’t watching, the areas where we aren’t prepared. And we can’t know the potential danger.

Finding – and filling – the gaps

The fact is, if you leave an opening – any opening – disease will find it. This is why it’s critical to have strong public health systems in place before emergencies happen. We can do more to recognize what causes outbreaks, respond to them faster, and bring them under control more effectively.

Around the world and at home, we need to know the level and types of disease that are normally present, so we can detect when there’s a change that requires our attention. We need safe laboratories that can rapidly diagnose the cause of illness close to the source. We need emergency operations centers that can bring experts together quickly to make decisions. Until we have these things, there will be gaps.

And where there are gaps, there is the potential for disaster. The unexpected eruption of Ebola in West Africa showed us this clearly. Before that there were others: HIV raged undetected for a decade; SARS spread to 37 countries across three continents in four months; Anthrax drew the world’s attention to the threat of intentional releases of lethal pathogens.

The human and economic costs are dear. SARS killed nearly 800 people and cost an estimated $40 billion. Ebola has killed over 11,000 people and cost billions. The potential costs of Zika to the lives of our children are unfathomable.

The value of being prepared

Each day, we continue to learn by doing. Every disaster teaches us how to do better the next time. We are seeing results, both here at home and in countries around the world.

We know that preparedness can stop unexpected health threats, even when the disease is fast moving and deadly. Take Nigeria as an example: with a highly trained team of disease detectives and an emergency operations center at the ready, Nigeria was able to thwart Ebola’s spread in Lagos and elsewhere in Nigeria, stopping the outbreak at 20 cases and averting a potential public health catastrophe.

Cameroon’s emergency operations center was recently able to head off an outbreak of H5N1 influenza by activating within 24 hours of notification. Through investments in training and preparedness, they have dramatically improved their response times – just one year ago, it took that same center eight weeks to respond to an outbreak of cholera.

At home, our flu program serves as a gold standard for how to be flexible and responsive in an emergency. When H1N1 influenza hit, we were able to act faster and more effectively through systems we already had in place for vaccine shipping, coverage, and monitoring. The outbreak response also demonstrated how we can work effectively across sectors – across CDC, between levels of government, and with global partners like the World Health Organization and ministries of health.

Despite these successes, nearly 70 percent of countries remain unprepared to handle a public health emergency. That’s a scary number – and a lot of vulnerable people.

Building well for the future

We cannot accept the status quo; we must put our investments into work that will make the world a safer place for us all. In doing this, we must first believe – as I do – that it is possible to create positive change and get results.

In a time when what pops up in one corner of the world can find its way across the globe in a matter of hours, we all have a responsibility to each other to be prepared.

We cannot take this responsibility seriously enough.

More resources to learn about global preparedness:

Read our other National Preparedness Month blogs:

Small Changes, Big Dividends: A Global Look at Preparedness

Soumbedioune fish market in Dakar, Senegal

Dr. Stephen Redd, Director, Office of Public Health Preparedness and Response
Dr. Stephen Redd, Director, Office of Public Health Preparedness and Response

There’s a big difference between seeing something in a picture and experiencing it in 360-degree reality, saturated with sounds and smells. In the summer of 1987, I traveled to Senegal for three weeks. This was the first time I had really traveled and seen firsthand what the rest of the world was like.

In Dakar, fishermen brought their catches to beach on the edge of town. An open sewer drained directly into the ocean almost in the middle of where the fishermen landed their boats. In addition to the smells, that sewer pipe seemed guaranteed to make people sick. It also seemed that something simple, like moving the drain, could prevent illness. It might have been a naïve idea, but it struck me that there were many opportunities to make small changes that would improve people’s health.

Many of us came to public health because, at some point in our life, we had a similar realization. As a clinician, treating one patient at a time undoubtedly helps people and is rewarding, but working to protect and benefit the community as a whole can provide larger-scale benefits.

Preparedness at the forefront

This is why I’m passionate about being prepared. When an emergency hits, having trained people who know what to do, and having the resources in place to allow them to do their jobs, saves lives. And – as we have seen all too clearly – a lack of preparedness can turn an outbreak into an epidemic, or a natural disaster into a crucible for infectious disease.

Planning ahead and being ready are the most critical things we can do to keep people safe. The world recognizes this, which is why countries have signed international agreements like the International Health Regulations and the Global Health Security Agenda that commit them to being prepared for a public health emergency. We have a long way to go, but we have a clear roadmap for what needs to be done.

And, here in the U.S., we are doing our part to fulfill our obligation to the global community. Recently, we invited a team of international experts to evaluate the ability of the U.S. to prevent, detect, and respond to public health threats. Looking at 19 different areas, they gave us feedback on where we are succeeding, and where we can do better. We will use the results of their report as we continue to build on our expertise.

Knowledge benefits everyone

The benefits of improving our expertise are twofold: not only do we protect ourselves, but we gain knowledge that we can share across the globe as other countries build their capabilities to respond to health threats. We are doing this every day.

CDC’s efforts in developing our Emergency Operations Center provide a great example. What we’ve learned is that the most important investment a country can make is having highly trained people at the ready. When people know what to do, a conference room and a few computers is all it takes to coordinate a response that can mitigate disaster and save lives.

CDC is able to share this kind of information with partners in countries around the world who may not have the resources to do everything at once. From working with Kenya on how to regulate the labs that handle the world’s deadliest germs and poisons, to working with Cameroon and Ethiopia on how to manage an emergency stockpile of medicines, we are helping others learn from our experience, and also learning from them as we go.

We are all connected

Our connection to other countries is more important than ever. As we help build capacity across the globe, we also protect our health here at home. We have to think globally as we build the knowledge we need to prepare for, and respond to, emergencies.

We must keep in mind that, somewhere in the world, there is a draining sewer that might be ground zero for an outbreak. And, somewhere, there is a conference room we could fill with trained responders to help stop it.

Read our other National Preparedness Month blogs: