Public Health Emergency Preparedness (PHEP) funding program marks 20 years

Photo of three individuals wearing yellow personal protective equipment (PPE).

By Jill Sutton, specialist, Emergency Preparedness and Response, APHL

This year marks the 20th anniversary of the CDC Public Health Emergency Preparedness (PHEP) Cooperative Agreement, a program that was developed in 2002 to strengthen preparedness capabilities in public health departments across the US.

Public health preparedness today can be attributed to developments in policy and funding since the September 11, 2001 terrorist attacks and the anthrax attacks that followed shortly after. Over the last 20 years, public health preparedness has evolved from a bioterrorism focus to an all-hazards approach, a framework that focuses on how we prepare and respond to a wide range of public health threats like infectious diseases and natural disasters as well as biological, chemical, nuclear and radiological events.

What is PHEP?

Since 2002, the PHEP program has been a critical source of funding, guidance and technical assistance for state, local and territorial public health departments. Thanks to PHEP, health departments are able to support preparedness and response activities and strengthen their preparedness capabilities so they are ready when public health emergencies strike.

At the local level, public health departments invest their PHEP funds to:

  • Enhance preparedness infrastructure,
  • Conduct trainings and exercises,
  • Hire dedicated preparedness staff,
  • Establish and maintain systems that enable the early detection of public health threats like monkeypox or COVID-19,
  • Quickly acquire emergency supplies and equipment, and
  • Rapidly share public health data to inform response needs.

As a result of these investments, communities are more prepared for public health emergencies than they were 20 years ago, but there’s still more that needs to be done. Federal preparedness funding has declined over the last 20 years, forcing PHEP recipients to cut positions, preparedness trainings and exercises, and equipment needs from their budgets. This has caused public health departments to be unable to expand or maintain their preparedness capabilities. A lack of sustainable funding directly impacts the capacity of state, local and territorial health departments to prepare for and respond to public health threats that arise in the communities they serve.

As we also celebrate National Preparedness Month, we honor the 20th anniversary of PHEP and all that it has helped our nation accomplish. Whether we are facing a pandemic or not, we need to remain prepared for the next public health emergency. It is our sincere hope that funding for PHEP will rise to ensure our nation’s public health system is prepared for the next emerging threat.

The post Public Health Emergency Preparedness (PHEP) funding program marks 20 years appeared first on APHL Blog.

Give & Take Bins Serve as Small-Scale Food Pantries

A person reaches into a plastic bin filled with nonperishable food and other supplies

In observance of National Preparedness Month, the Center for Preparedness and Response (CPR) will publish posts in September that highlight ways people and organizations are helping to “create community” where they live.

This student-authored post is published by CPR in partnership with Medill News Service and the Northwestern University Medill School of Journalism, Media, Integrated Marketing Communications. The views and opinions expressed in this article are the author’s own and do not necessarily reflect the views, policies, or positions of CPR or CDC.

Customers stared at Beatriz Echeverría in the grocery store. She filled her cart with vegetable oil, rice, beans, and other foods, conscious of looking like a hoarder stocking up to weather the pandemic. By the time she and her son, Nacho Pavón, piled all their goods into their car, the haul filled the trunk.

But they weren’t hoarding. Echeverría and her son were redistributing the items around the city of Evanston, just north of Chicago, through a system of mini-food pantries housed in boxes called Give and Take Bins.

“This is a good, practical thing that you can do in your spare time,” said Echeverría, an Evanston resident. “You know it’s effective because you’re actually filling the bins and you’re actually going to the store to get the food.”

When the COVID-19 pandemic shut down much of the country in March, Evanston neighbors and activists created the network of bins to support growing needs in the community. These weather-proof containers placed on porches, in yards, and at schools are filled by volunteers who donate food, cleaning supplies, menstrual products, and other necessities. Anyone may take items from the box, free of charge.

Evanston, like Chicago, is located in Cook County, where more than one in 10 people were food insecure before the pandemic, according to 2018 data from Feeding America. Food insecurity spiked nationwide, however, as a result of COVID-19. Relative to predicted rates for March, food insecurity doubled in April and tripled in households with children, reported an analysis from the Institute for Policy Research at Northwestern University.

“I feel like the need is there,” said Stephanie Mendoza, a facilitator of the Give and Take Bins program. “There’s a huge need.”

The existing need grew as COVID-19 shut down some local food pantries run by seniors, a population that is at increased risk for severe illness from the virus. Some people couldn’t go to grocery stores, and those who could often encountered empty shelves, said Michele Hays, another program facilitator.

The Give and Take Bins were a “more nimble way” to get food and other necessities to neighbors in need, Hays said. Volunteers spread the word about these bins through a Facebook page that Mendoza advertised in local parenting, COVID-19 support, and Latinx Facebook groups. There’s also a Google map showing all the bins’ locations, and a QR code to the map is placed on some of the bins.

To find out what items people most needed, Hays conducted an informal poll in her mutual aid group and came up with a list of suggested donations. Volunteers may print that list and attach it to the bins. Now, with about 25 boxes placed around the city, a box is within “at least a few blocks’ walking distances for just about most people,” Mendoza said. Based on census data, Hays suggested locations for new bins, such as near the parking lot of the local high school.

Anyone may fill the bins; anyone may take from the bins. Volunteers emphasize stocking bins with culturally specific foods in certain areas.

“We would buy, I don’t know, like Sazonador, which is a typical Latin American seasoning. We would buy pinto beans. We would buy things that were very specific of certain groups,” Echeverría said. “People, if given a chance, they’ll take the foods they’re used to.”

While there’s a large need for food, Mendoza said the items that disappear quickest from the bin on her front porch are menstrual products, soap, and toilet paper. These can’t be bought with a SNAP card or Illinois Link card, and they’re often not found at food pantries, either.

“Folks who get food stamps can’t use that money to buy cleaning supplies. They can only use it for food,” said Alyce Barry, a volunteer who manages a box near her home.

Barry recalls starting a bin as soon as she heard about them. Though Hays said she’s received reports that bins are being used less, Barry said her bin is seeing more traffic now than it did earlier this year. She wishes, however, that there was a way to know for sure what the individuals using her bin need, rather than being so distant.

“Before the pandemic, I was of the opinion that ways like this of helping the community weren’t a very good idea because they are so detached,” Barry said. “Racism and a lot of other social ills are the results of people who have being distant from the people who don’t, and this is just another way of being distant. But unfortunately, with the pandemic, that all changed.”

Volunteers also keep their distance to respect the privacy of their neighbors who use the boxes. Barry hasn’t spoken to anyone who uses her bin, because she doesn’t want to embarrass them. Mendoza once saw a family taking items from her bin as she was arriving home, but she said she kept driving down the street as if the house wasn’t hers.

Hays and Mendoza said this program has grown “organically,” fueled by the passion, generosity, and ingenuity of volunteers and community members who often solve problems without supervision to keep everything running smoothly. They insist the program doesn’t require a lot of central coordination and that it’s easy to participate in something like this.

“Anybody can do it. You don’t even have to be in Evanston,” Hays said. “You can do it wherever you are just with stuff that you have in-house — whatever the bin is that you have in your basement that you store stuff in.”

Once boxes are set up, volunteers don’t even need extra income to be what Hays and Mendoza call a “box fairy,” or someone who fills a bin with donations, unbeknownst to the facilitators.

“To be a box fairy, you don’t even necessarily have to buy things, you can just go around and take stuff out of the [bins] that are full and put them into the ones that are empty,” Hays said.

The Give and Take Bins program isn’t without its flaws — occasionally, bins go missing and have to be replaced. Most bins hold only non-perishables, though there are a couple of coolers. Fresh food placed in the bins often spoils, and volunteers remove those items.

Still, the bins are having an impact: They continue to be emptied — and filled. Volunteers see the impact in small ways. Hays met a man at the local homelessness organization drop-in center and he said he had used the box at her house. Once, her neighbor came over to take a few things as she was filling the bin. Someone wrote a thank-you note on a torn-off corner of a shopping bag and left it in a box.

In early July, Mendoza’s children left some chalk on her front steps. When she went outside, she noticed someone had written a chalk message on the lid of her bin: “Gracias.” Finding that, she said, was “just heartwarming.”

The Power of Preparedness: Prepare Your Health

Group of people kneeling around a CPR dummy.

The devastating hurricanes of 2017 reminded us how important it is to prepare for disasters. These potentially life-threatening situations have real impacts on personal and public health. During Hurricane Irma, existing medical conditions and power outages increased the likelihood of death. Being prepared with supplies and an Emergency Action Plan can help you protect the health of your family until help arrives.

September is National Preparedness Month (#NatlPrep), and the perfect time of year to remind people of The Power of Preparedness. This year’s call-to-action of Prepare Your Health (#PrepYourHealth) and four weekly themes highlight the roles that individuals, state and local public health, and CDC play in creating community health resilience. It takes everyone “pulling in the same direction” to create families, communities, and a nation that can withstand, adapt to, and recover from personal and public health emergencies.

The first week focuses on personal preparedness, and the importance of nonperishable food, safe water, basic supplies, and the personal items you need to protect your health until help arrives.

Personal needs

A large-scale disaster or unexpected emergency can limit your access to food, safe water, and medical supplies for days or weeks. However, nearly half of adults in the U.S. do not have an emergency kit for their home; they don’t have the provisions, supplies, and equipment necessary to protect the health of their families in a disaster. This list will get you started:

  • Special foods—such as nutrition drinks—for people with dietary restrictions, food sensitivities and allergies, and medical conditions such as diabetes.
  • Prescription eyeglasses, contacts and lens solution
  • Medical alert identification bracelet or necklace
  • Change of clothes
  • Emergency tools (e.g., manual can opener; multi-use tool; plastic sheeting; etc.)
  • Durable medical equipment (e.g., walkers; nebulizers; glucose meters; etc.)
  • Medical supplies, including first aid kit
  • Pet supplies
  • Baby and childcare supplies

Prescriptions

The hands of an elderly man holding a pill organizer

Many people need daily medications and medical equipment. Nearly half of Americans take at least one prescription drug, and a quarter of Americans take three or more medications. A large-scale natural disaster, like a hurricane, could make it difficult to get prescription and over-the-counter medicines.  You and your family may need to rely on a prepared emergency supply. There are some basics to include:

  • A 7 to 10 day supply of prescription medications stored in a waterproof container.
  • An up-to-date list of all prescription medications, including dosage and the names of their generic equivalents, medical supply needs, and known allergies.
  • Over-the-counter medications, including pain and fever relievers, diuretics, antihistamines, and antidiarrheal medications stored in labeled, childproof containers.
  • A cooler and chemical ice packs for storing and keeping medicines cold in a power outage.

Paperwork

Over half of Americans do not have copies of important personal paperwork. Collect and protect documents such as insurance forms, and medical, vital, and immunization records. Here are some of the basics:

  • Health insurance and prescription cards
  • Shot records
  • Living wills and power of attorney forms
  • Vital records (e.g., birth and death certificates; adoption records)
  • User manuals, model and serial numbers, and contact information for the manufacturer of medical devices (e.g., blood glucose meters; nebulizers)
  • Hardcopies of your Emergency Action Plan

Power sources

A portable generator sitting outside in the snow.

A power outage can close pharmacies, disrupt medical services, and can be life threatening for over 2.5 million people who rely on electricity-dependent medical equipment. Be ready for a lengthy blackout with an emergency power plan and back up. You will need alternative power sources for your cellphone, refrigerator , and medical equipment. Here’s a checklist:

  • Extra batteries, including those for hearing aids, in standards sizes (e.g., AA and AAA)
  • Fully-charged rechargeable batteries for motorized scooters
  • Hand-crank radio with USB ports
  • Car chargers for electronic devices, including cell phones and breast pumps
  • A generator

Practical skills

Finally, it’s important to know some basic do-it-yourself skills to stay healthy and safe until help arrives. Here are the basics to get you started:

  • Call 911 in a life-threatening emergency
  • Get trained in cardiopulmonary resuscitation (CPR). If you do not know CPR, you can give hands-only CPR—uninterrupted chest compressions of 100 to 120 a minute—until help arrives.
  • Learn how to use an automated external defibrillator (AED).
  • Learn Handwashing is one of the best ways to protect yourself, your family, and others from getting sick.

The good news is that it is never too late to prepare for a public health emergency. You can take actions, make healthy choices, and download free resources to help you prepare for, adapt to, and cope with adversity.

The Power of Us

Evacuteer checking someone in during 2017 full-scale city assisted evacuation exercise.

“I am a Katrina survivor.” These were the first words out of Joan Ellen’s mouth when I spoke with her. And she was one of the lucky ones. She made it out of New Orleans before Hurricane Katrina made landfall on August 29, 2005. But not everyone was so fortunate. One of Joan Ellen’s neighbors did not evacuate because she could not bring her old dog with her to a shelter and would not leave him behind. Her neighbor died in the flooding. Joan Ellen recalls, “If I had known I would have taken her with me.”

Evacuations are more common than you might think. Every year people across the United States are asked to evacuate their homes due to fires, floods, and hurricanes. However, there are many reasons people may not be able to evacuate– including issues that New Orleans’ residents face, like lack of transportation, financial need, homelessness, and medical or mobility issues.

No one left behindJoan Ellen returned to her home in New Orleans 48 days after Hurricane Katrina. She likes to tell people, “I only had a foot of water – but it was a foot over my roof.” The thing she remembers most vividly about going home was not the destruction, but the smell. When Joan Ellen heard a radio announcement that they were recruiting volunteers to help in a mandatory evacuation she signed up. She has been training other Evacuteers since she joined the organization in 2009. She loves the casual definition of family that keeps people together in the event of an evacuation. “Family is anybody we say is family, and we will keep everybody together. In New Orleans we are only two degrees of separation.”

According to FEMA’s Preparedness in America report, people in highly populated areas were more likely to rely on public transportation to evacuate in the event of a disaster. In the event of a mandatory evacuation, approximately 40,000 people living in New Orleans will need assistance to evacuate because they don’t have a safe or alternative option.

After learning from Hurricane Katrina, the City of New Orleans will now call a mandatory evacuation nearly three days in advance of a dangerous or severe storm making landfall on the Louisiana coast. Everyone must leave during a mandatory evacuation until officials declare the city safe for re-entry.

Mobilizing the Evacuteers

The City also started City Assisted Evacuation (CAE) to help people who are unable to evacuate on their own. Through this program, the city provides free transportation for residents, along with their pets, to a safe shelter. CAE counts on volunteers from Evacuteer.org, a local non-profit organization that recruits, trains, and manages 500 evacuation volunteers called “Evacuteers” in New Orleans. As the Executive Director of this organization I tell people, “We are a year-round public health preparedness agency that promotes outreach to members of the community that aren’t always easy to reach, nor trusting of government, about their options and the evacuation process. The goal is to make sure that everyone using CAE is treated with dignity throughout the entire process.”

Lit evacuspot in Arthur Center
Evacuspot outside of Arthur Monday Multipurpose Center

Evacuteers receive a text message if the City of New Orleans calls for a mandatory evacuation. Teams are assigned to seventeen pickup points, called Evacuspots, placed in neighborhoods around the city. The Evacuteers help register people and provide information about the evacuation process. When residents go to an Evacuspot, Evacuteers will give every person a ticket, a wristband, and a luggage tag to help track their information and ensure that families stay together. After the paperwork is filled out, evacuees are transported to the downtown Union Passenger Terminal bus station where they will board a bus, and for a smaller percentage, a plane, to a state or regional shelter. When the city is re-opened after the storm passes, the process will bring residents back home to New Orleans.

An artistic approach to save lives

Each Evacuspot is marked by a statue of a stick figure with his arm in the air, and looks as though he is hailing a safe ride out of the city. Erected by international public artist, Douglas Kornfeld, the statues are a public art initiative led, and fundraised, by Evacuteer.org. Installed at each of the pick-up points in 2013, the stainless steel statues measure 14-feet tall, and stand as a reminder to residents year-round that there is a process to ensure everyone has the opportunity to safely evacuate.

Do you know what to do?

  1. Have a plan. Know where your family will meet, both within and outside of your neighborhood, before a disaster.
  2. Fill ‘er up. Make sure you have a half a tank of gas at all times in case of an unexpected evacuation. If an evacuation seems likely, make sure your tank is full.
  3. Keep your options open. Have alternative routes and other means of transportation out of your area. Choose several destinations in different directions you can go to evacuate.
  4. Leave early. Plan to take one car per family to reduce congestion and delay.
  5. Stay alert. Do NOT drive into flooded areas. Roads and bridges may be washed out and be careful of downed power lines.

Learn more

Read our other National Preparedness Month blogs:

Preparing for the Worst-case Scenario

"ROTTERDAM, HOLLAND - SEPTEMBER 5, 2010: Demonstration of handling of car crash victim by medics at the annual World Harbor Days in Rotterdam, Holland on September 5"
New York City completed a functional exercise to help the city’s hospital system prepare for emergency medical personnel to treat and transport children, like this young girl, after a catastrophic event.

Setting the Stage

Celia Quinn
Celia Quinn, MD, MPH CDC Career Epidemiology Field Officer assigned to NYC Department of Health and Mental Hygiene

Imagine this: Explosions across New York City target elementary schools. Hundreds of severely injured and traumatized children, teachers, and parents flood hospital emergency departments in the five boroughs. Municipal emergency medical services (EMS) are rushing to respond.

Fortunately this scenario wasn’t really happening – it was part of an exercise conducted on May 25, 2017. The exercise was designed to test the ability of the New York City (NYC) Healthcare System to respond to a massive surge of pediatric trauma patients, exceeding the usual resources of this large and complex healthcare system.

Identifying the Players

As a CDC Career Epidemiology Field Officer assigned to NYC, I worked with the experts in the Pediatric Disaster Coalition and the Fire Department of New York (FDNY). We designed an exercise that reflected the number of injured children who would need to go to the hospital and the type of injuries they might experience if a similar event really happened.

NYC has 62 acute care hospitals that participate in the 911 system. Of these, 16 are level 1 trauma centers designated by the NYC Department of Health  (this includes three pediatric level 1 trauma centers and 4 burn centers). A total of 28 hospitals care for pediatric patients and have, during the past seven years with the assistance of the NYC Pediatric Disaster Coalition, developed pediatric-specific components of their overall disaster plans to prepare them to receive pediatric patients from an incident like the one invented for this exercise. All 28 hospitals participated in the exercise.

Coordinating Resources

Hospitals who participated in the exercise were challenged to rapidly respond to more than 60 simulated patients with a range of injuries and conditions:

  • a 7-year-old boy unresponsive after a traumatic injury to his head

    Hospital nursing leadership reports on the status of nursing staff, while the hospital’s Public Information Officer looks on.
    Hospital nursing leadership reports on the status of nursing staff, while the hospital’s Public Information Officer looks on.
  • A toddler with burns to the face, chest, and abdomen
  • A 12-year-old distraught after witnessing another child lose arms in an explosion

Hospitals had to assess the resources that were available to care for the patients, including

  • What nursing and specialty staff could be made immediately available?
  • What medications and equipment, including imaging equipment and burn supplies, were needed to care for the children?
  • What communications and incident command processes would each hospital use to mobilize staff and other resources in the situation described in the exercise?
  • Which patients needed to be transferred to specialty hospitals to receive care for their injuries?

Coordination between FDNY and hospitals was critical to the success of this exercise – it supported interfacility transfers for patients who required specialty care or to better match hospital resources with patient needs. During the exercise, I met with FDNY leadership from EMS and Office of Medical Affairs physicians, and leaders from NYC Emergency Management and the Health Department at the Fire Department’s Operations Center. There, we tested the communications between hospitals, FDNY, and a volunteer pediatric intensive care physician who was trained to assist FDNY’s Office of Medical Affairs to prioritize patients for urgent interfacility transfers.

Measuring Success

Hospital Incident Command leadership discusses the availability of resources to make more pediatric beds available.
Hospital Incident Command leadership discusses the availability of resources to make more pediatric beds available.

This exercise revealed that 28 NYC hospitals were able to rapidly and dramatically increase their pediatric critical care capacity. It was the largest exercise NYC has done that was focused primarily on caring for injured children. During the exercise, these hospitals:

  • More than doubled the number of beds in pediatric intensive care units (PICUs) and added 1,105 pediatric inpatient beds, so children could stay in the hospital for an extended period of time
  • Opened 203 operating rooms that could treat children who needed surgery

During the exercise, we also identified some challenges, including

  • More than half of the hospitals did not have enough supplies that could be used to treat critically injured children
  • A limited number of pediatric specialists, including doctors who could perform brain surgery on children as well as ear, nose, and throat specialists
  • Hospital resources (beds, supplies, and staff) would have been further strained if the disaster scenario had also included large numbers of adults

We were able to identify ways to improve each hospital’s process and further develop our citywide plans to respond to any emergency that strains our healthcare system. As a pediatrician and a parent of two young New Yorkers, I’m grateful that so many dedicated people are working together to make sure that city and hospital plans account for the unique needs of children in disasters.

The NYC Department of Health and Mental Hygiene receives federal funds used to support state and local public health and healthcare system preparedness through the aligned Hospital Preparedness Program (HPP) – Public Health Emergency Preparedness (PHEP) cooperative agreement. NYC used HPP funds to fund the NYC Pediatric Disaster Coalition to design and conduct the exercise, and coordinate participation of hospitals in the exercise.

Read our other National Preparedness Month blogs:

Preparing for the Worst-case Scenario

"ROTTERDAM, HOLLAND - SEPTEMBER 5, 2010: Demonstration of handling of car crash victim by medics at the annual World Harbor Days in Rotterdam, Holland on September 5"
New York City completed a functional exercise to help the city’s hospital system prepare for emergency medical personnel to treat and transport children, like this young girl, after a catastrophic event.

Setting the Stage

Celia Quinn
Celia Quinn, MD, MPH CDC Career Epidemiology Field Officer assigned to NYC Department of Health and Mental Hygiene

Imagine this: Explosions across New York City target elementary schools. Hundreds of severely injured and traumatized children, teachers, and parents flood hospital emergency departments in the five boroughs. Municipal emergency medical services (EMS) are rushing to respond.

Fortunately this scenario wasn’t really happening – it was part of an exercise conducted on May 25, 2017. The exercise was designed to test the ability of the New York City (NYC) Healthcare System to respond to a massive surge of pediatric trauma patients, exceeding the usual resources of this large and complex healthcare system.

Identifying the Players

As a CDC Career Epidemiology Field Officer assigned to NYC, I worked with the experts in the Pediatric Disaster Coalition and the Fire Department of New York (FDNY). We designed an exercise that reflected the number of injured children who would need to go to the hospital and the type of injuries they might experience if a similar event really happened.

NYC has 62 acute care hospitals that participate in the 911 system. Of these, 16 are level 1 trauma centers designated by the NYC Department of Health  (this includes three pediatric level 1 trauma centers and 4 burn centers). A total of 28 hospitals care for pediatric patients and have, during the past seven years with the assistance of the NYC Pediatric Disaster Coalition, developed pediatric-specific components of their overall disaster plans to prepare them to receive pediatric patients from an incident like the one invented for this exercise. All 28 hospitals participated in the exercise.

Coordinating Resources

Hospitals who participated in the exercise were challenged to rapidly respond to more than 60 simulated patients with a range of injuries and conditions:

  • a 7-year-old boy unresponsive after a traumatic injury to his head

    Hospital nursing leadership reports on the status of nursing staff, while the hospital’s Public Information Officer looks on.
    Hospital nursing leadership reports on the status of nursing staff, while the hospital’s Public Information Officer looks on.
  • A toddler with burns to the face, chest, and abdomen
  • A 12-year-old distraught after witnessing another child lose arms in an explosion

Hospitals had to assess the resources that were available to care for the patients, including

  • What nursing and specialty staff could be made immediately available?
  • What medications and equipment, including imaging equipment and burn supplies, were needed to care for the children?
  • What communications and incident command processes would each hospital use to mobilize staff and other resources in the situation described in the exercise?
  • Which patients needed to be transferred to specialty hospitals to receive care for their injuries?

Coordination between FDNY and hospitals was critical to the success of this exercise – it supported interfacility transfers for patients who required specialty care or to better match hospital resources with patient needs. During the exercise, I met with FDNY leadership from EMS and Office of Medical Affairs physicians, and leaders from NYC Emergency Management and the Health Department at the Fire Department’s Operations Center. There, we tested the communications between hospitals, FDNY, and a volunteer pediatric intensive care physician who was trained to assist FDNY’s Office of Medical Affairs to prioritize patients for urgent interfacility transfers.

Measuring Success

Hospital Incident Command leadership discusses the availability of resources to make more pediatric beds available.
Hospital Incident Command leadership discusses the availability of resources to make more pediatric beds available.

This exercise revealed that 28 NYC hospitals were able to rapidly and dramatically increase their pediatric critical care capacity. It was the largest exercise NYC has done that was focused primarily on caring for injured children. During the exercise, these hospitals:

  • More than doubled the number of beds in pediatric intensive care units (PICUs) and added 1,105 pediatric inpatient beds, so children could stay in the hospital for an extended period of time
  • Opened 203 operating rooms that could treat children who needed surgery

During the exercise, we also identified some challenges, including

  • More than half of the hospitals did not have enough supplies that could be used to treat critically injured children
  • A limited number of pediatric specialists, including doctors who could perform brain surgery on children as well as ear, nose, and throat specialists
  • Hospital resources (beds, supplies, and staff) would have been further strained if the disaster scenario had also included large numbers of adults

We were able to identify ways to improve each hospital’s process and further develop our citywide plans to respond to any emergency that strains our healthcare system. As a pediatrician and a parent of two young New Yorkers, I’m grateful that so many dedicated people are working together to make sure that city and hospital plans account for the unique needs of children in disasters.

The NYC Department of Health and Mental Hygiene receives federal funds used to support state and local public health and healthcare system preparedness through the aligned Hospital Preparedness Program (HPP) – Public Health Emergency Preparedness (PHEP) cooperative agreement. NYC used HPP funds to fund the NYC Pediatric Disaster Coalition to design and conduct the exercise, and coordinate participation of hospitals in the exercise.

Read our other National Preparedness Month blogs:

Empowering Kids to Make Their Families Safer

American-Red-Cross-volunteer-with-pillowcase-in-Alaska_BLUR

After graduating from college I moved to Anchorage, Alaska for a year of post-graduate service through the Jesuit Volunteer Corps NW and AmeriCorps. I served as the Preparedness and Casework Specialist for the American Red Cross of Alaska. Though often overlooked, Alaska is the largest state in the country (more than twice as big as Texas!) and has more coastline than the rest of the United States combined. While a large portion of the population lives in Anchorage, dozens of Native Alaskan villages are scattered all across the state, often hundreds of miles apart.

Education in action If I learned one thing about disaster preparedness education, it’s that you never know when your students will need to put what you taught them into action. I specifically remember one Friday afternoon teaching a group of students on the military base about what to do during an earthquake. We discussed various scenarios such as what to do if you are sleeping or playing at recess when an earthquake occurs. Two days later, a 7.1 magnitude hit the Anchorage area in the middle of the night, one of the larger earthquakes the area had experienced in a few years. The next morning, the teacher contacted me to tell me about how the students were able to use what I had taught them just days before to stay safe during the earthquake. This reaffirmed my belief of the value and effectiveness of The Pillowcase Project and educating students about disaster preparedness.While in Alaska, I spent a good portion of my time managing The Pillowcase Project, a Red Cross youth preparedness program for students between the ages of 8 and 11. The program educates children about how to prepare for emergencies they might experience in their communities. Since the program started in Alaska, The Pillowcase Project has reached youth all over the state and has even crossed the Arctic Circle!

Pillowcases are not just for pillows

During Hurricane Katrina, a Red Crosser noticed college students were carrying their belongings in pillowcases as they evacuated to emergency shelters. Their actions inspired The Pillowcase Project, which uses an everyday household item to hold the necessary items for an emergency kit. Putting all of these supplies in one place makes it easier to grab and go in the event of an emergency.

The Pillowcase Project has reached over 800,000 children both nationally and globally. Trained instructors, mostly volunteers like me, share the curriculum with children in schools, after-school programs, summer camps, scout groups, and various venues.

Beyond the standard preparedness education curriculum, students decorate a pillowcase with symbols that are personal reminders of things that make them feel safe and brave. They are instructed to fill it with emergency essentials such as a first aid kit, flashlight, batteries, spare clothes, and a toothbrush. We also encourage students to include a comfort item such as a favorite stuffed animal or photographs of their friends and family to provide additional support during a stressful time. We also teach coping skills such as breathing exercises and positive visualization techniques, so our students know how to stay calm in stressful situations.

Learn. Practice. Share.Pillowcase Project education session in Los Angeles, CA

Research from FEMA shows that one of the best ways to promote family preparedness is by educating children, who then feel empowered to share what they learned with their families. It is often difficult to convince adults of the negative impact a disaster could have on their family and how important it is to be prepared. This is why The Pillowcase Project seeks to educate students; 8-11 year-olds who are able to accurately relay information and comprehend the curriculum to share it with others. The curriculum centers around three pillars:

  • LEARN. Kids learn about the types of natural disasters that are most likely to happen in their community or neighborhood. In the case of Alaska, we focused on earthquakes and home fires.
  • PRACTICE. We talked through different scenarios that were tailored to the children in the group, because one child might live in a trailer, one on the 7th floor of an apartment building, and one in a two story house.
  • SHARE. We always encouraged the kids to go home and share the information and skills they have learned with their family and friends. The kids I worked with were always so enthusiastic and excited to tell people about what they had learned, which makes this a very proactive preparedness education program.

Sounding the Alarm

7 people are killed in a home fire, and another 36 people are injured every day in the United States.No matter where or what kind of home you live in, you are at risk of experiencing a home fire. That is why every child educated through The Pillowcase Project learns home fire safety and prevention, not limited to how to properly maintain a smoke alarm to how to safely get out of a burning home.

Red Cross volunteers and partners all across the country install free smoke alarms, replace batteries in existing alarms, and help families create escape plans. This year, this Sound the Alarm effort will install its one-millionth smoke alarm. An impossible feat without the dedication and passion of those who believe in the value of disaster preparedness education and prevention.

Learn More

Read our other National Preparedness Month blogs:

7 times public health preparedness proved critical

7 times public health preparedness proved critical | www.APHLblog.org

Our nation’s public health system responds to emergencies such as natural disasters, infectious disease outbreaks, bioterrorism attacks and more both domestically and globally. There’s no way to know what the next threat will be or when it will strike. To quickly and effectively respond to these threats, the public health system – including public health laboratories – must be prepared.

Here are seven stories that highlight the value of public health preparedness and response:

  1. Massive Molasses Mess and the Laboratory Response
  2. Testing for MERS-CoV: The Indiana Lab’s Story
  3. System Built for Responding to Bioterrorism Confirms Plague in Colorado Girl
  4. September 30, 2014: As Ebola Arrived, the Texas Public Health Lab was Ready
  5. Anthrax in Minnesota? The Laboratory Response Network Springs Into Action
  6. Responding to the Animas River disaster: Who’s testing what?
  7. Not Even Superstorm Sandy Could Stop Newborn Screening in New Jersey

In US, Massive Effort to Detect and Respond to Ebola Already Underway

By Tyler Wolford, MS, Specialist, Laboratory Response Network, APHL

Our curiosity and fears have been running wild since the 2014 Ebola* outbreak in West Africa hit headlines. Scenes from Outbreak, the 1995 box office hit that focused on a fictional outbreak of an Ebola-like virus in Zaire, begin running through our minds. We need to stray from these dramatizations and focus on the facts. Movies are supposed to build suspense and fear, but real life outbreaks don’t happen like they do in the movies. This isn’t Hollywood.

In US, Massive Effort to Detect and Respond to Ebola Already Underway | www.aphlblog.orgThe most common question on the minds of people around the United States: Are we fighting Ebola well enough to keep it from coming to my community?

The truth with many emerging infectious diseases including Ebola, is that the only way to fight it is to be prepared to respond. In the United States, we’re doing just that.

Although the Ebola-Zaire virus circulating in West Africa has not arrived in the United States, a massive effort is underway to detect and control any isolated cases of the disease should they occur in this country. The Centers for Disease Control and Prevention (CDC), the United States Department of Defense (DoD), pharmaceutical companies, public health laboratories and many more are all working domestically and abroad to minimize the potential threat. The DoD has long been studying Ebola virus and successfully developed a test to detect the Zaire strain. On August 5, 2014, the DoD Ebola detection test received emergency use authorization (EUA) by the Food and Drug Administration (FDA) to be used in this extreme circumstance. (An EUA expedites the FDA approval process for unapproved medical devices that could benefit response efforts when no adequate alternatives exist.) After the EUA was issued, CDC worked quickly to deploy the test to select public health laboratories across the United States. As the supply of test kits increases, CDC will look to expand the number of laboratories qualified to detect the Ebola-Zaire virus.

The public health laboratories receiving the Ebola detection assay are part of the Laboratory Response Network (LRN), a specialized network of laboratories that are capable of responding to biological, chemical, radiological and other emerging threats. This preparedness and response effort is not unique to Ebola. Most recently, the LRN has been leveraged to respond to emerging infectious diseases like Middle East Respiratory Syndrome – Coronavirus. The LRN provides a strong infrastructure of trained personnel, clear communication lines, and advanced technology to launch an effective response to emerging infectious disease.

The race to contain Ebola is on since the World Health Organization (WHO) declared the Ebola outbreak a Public Health Emergency of International Concern (PHEIC) in early August 2014. Moreover, the CDC has activated its Emergency Operations Center at the highest response level to help with the outbreak. As Dr. Tom Frieden, CDC director, said in a press conference this week, “We know how it spreads. We know how to stop it from spreading. The challenge is to do that everywhere that’s needed. In order to do that effectively, speed is key.”

While we all are concerned for the health and safety of the people in the most affected nations, we can find some comfort in knowing that a coordinated effort of qualified scientists, doctors, public health officials and organizations is underway to minimize the threat of outbreak in the US.

*Did you know there are five known strains of Ebola virus? The most dangerous one, Ebola-Zaire, is responsible for the outbreak in West Africa. The virus spreads person to person through direct contact with blood and other bodily fluids; despite what you may have read in fear-mongering articles, the spread of the virus through the air has never been documented. Once inside the host, the virus works by weakening the immune system and starving the host organs to the point of failure.