New Jersey Preparedness Training Consortium

Continuing Education for Health Care Professionals

SPH 13th Annual Summer Institute for TeachersPreparing for Bioterrorism and Other Health Threats

August 11, 2006

Patricia L. Fleming, PhD, MSProfessor, NJ Medical School &School of Public Health, UMDNJ

Objectives

• Describe components of NJ’s system for recognizing and responding to health threats

• Identify NJ’s hazards and vulnerabilities

• Identify steps to preparedness– Personal– Workplace/School– Other

Public HealthPublic Health

EmergencyEmergencyManagementManagement

Healthcare DeliveryHealthcare DeliverySystemSystem

com

pete

ncy

capability

capacity

The Health Emergency The Health Emergency Preparedness and Response TriadPreparedness and Response Triad

Emergency Management

• New NJ Dept. of Homeland Security

• Office of Emergency Management

• State of emergency

• Local police, fire, rescue

• Incident Command System in disasters

Unified Command

Unified Command(Representatives From Local

Jurisdictions)

Finance/ Administratio

n

LogisticsPlanningOperations

EOC Organization

EOC Manager

Coordination Communications

Resource Management

Information Management

Key Public Health Components

• New Jersey Department of Health and Senior Services

• Laboratory response network

• Local health departments• Local Information Network & Communications

System (LINCS)

NJ Local Information Network & Communications System: LINCS

• 22 local (county/city) public health agencies• Secure, encrypted web portal access and email

messaging • Health Alert Network (HAN)

• Role of LINCS• Staff: epi, nurse, planner, coordinator• NJDHSS networks to > 30,000 local personnel• Communications hub• Coordinate/Activate with local health depts., emergency

management, law enforcement, first responders, hospitals, etc.

• http://www.nj.gov/health/lh/lincs/index.html• http://www.nj.gov/health/lh/directory/lhdselectcounty.htm

Public Health Activities

• Detection - Health surveillance by clinical providers and laboratories– Notify Public Health (Local HD/NJDHSS)

• Rapid Laboratory Diagnosis– Laboratory response network (LRN)

• Epidemiologic Investigation– Public health workers identify exposure risks

• Implementation of Control Measures• Pharmaceutical Stockpile• Medical Reserve Corps

Healthcare Delivery System

• >250,000 health professionals in NJ

• Hospitals

• Regional Medical Coordination Centers

• Professional organizations

• NJHA, VA, others

• FQHCs

NJDHSS HECCSupport NJDHSS

(NJHA, Associations,VA, others)

Local/CountyEOC

State EOC

New JerseyNew JerseyHealth EmergencyHealth EmergencyResponse NetworkResponse Network

State Regional Team

Hospital

FQHC

Other Health OrganizationsIncident

Commander

MCCRegional Medical Coordination Center

MCC

MCC MCC

MCC

MCC

Strategic National Stockpile & Strategic State Stockpile

Purpose:• Determine NJ’s need for pharmaceutical and medical

supplies in case of CBRNE eventActivities:• Planning for mass medication and/or mass vaccination

acquisition and distribution • Preparing to meet needs of pediatric and geriatric

communities• State owned caches are stored strategically in NJ for

deployment prior to the receipt of federal assets• Request federal assistance if need exceeds capacity

Readiness/ResponseHow SNS Assets are Deployed

Readiness/ResponseHow SNS Assets are Deployed

State Requests Federal Assistance

Need for Drugs and Medical Supplies Exceeds Local & State Resources

In Consultation with the Surgeon General, Secretary HHS, HHS Office of Emergency Preparedness (OEP), FEMA and the FBI

Augments Local/State

MedicalMateriel

Resources

SNS

CDC Director Deploys

SNS Assets

Oral Antibiotics

IV Supplies

Nerve Agent Antidotes

Airway supplies

Med/Surg Supplies (Clear)

RSS Site

Hospitals 22 Local Agencies(LINCS Agency Health Departments )

POD PODPOD

N.J.A.C. 8:57

• New Jersey Administrative Code Title 8, Chapter 57

• Purpose: to expedite reporting of certain diseases or outbreaks of disease for appropriate public health action

Communicable Diseases(infectious diseases, bioterrorism agents)

• Reporting of listed diseases is required by NJ state law and vital to protecting public health

• See list of reportable diseases in handouts

• Contact local/county health department

• Emergency notification to the state health department:

• 1-609-588-7500• 1-609-392-2020 (after hours)

• Visit http://www.nj.gov/health/cd/izdphome.htm

Chemical Exposure(Poisons, Nerve Agents, Vesicants, Bio-toxins,

Hazardous Chemicals)• Contact your City/county LINCS

• NJ Poison Information & Education System• 24/7 hotline • Emergency treatment advice about exposure to poisons, medications, etc.

• 1-800-222-1222

• NJ Department of Environmental Protection• 24/7 hotline• Report environmental incidents, hazardous chemical exposures

• 1-877-WARNDEP (1-877-927-6337)

• NJ Office of Emergency Management (NJ State Police)• Coordinates all disaster mitigation and response statewide • Hazardous Materials Emergency Response Planning Unit

• 1-609-882-2000

Radiation/Nuclear Exposure(dirty bomb, nuclear facility accident, sabotage,

radioactive materials, nuclear weapons)

• Medical Consultation:• Radiation Emergency Assistance Center/Training Site

(REAC/TS)» 1-865-576-1005

• Notification:• City/County LINCS • Local law enforcement • NJ Office of Emergency Management

» (Radiological Emergency Response Planning and Technical Unit)

» 1-609-882-2000

Important phone numbers:

• Your city/county LINCS contact (see handout)• NJ Dept. of Health & Sr. Services

• 1-609-588-7500 or -3121• 1-609-392-2020 (after hours)

• NJ Poison Information and Education System• 1-800-222-1222

• NJ Office of Emergency Management• 1- 609-882-2000

• NJ Dept. of Environmental Protection• 1-877-WARNDEP (1-877-927-6337)

Hazard Vulnerability Assessment

• Previously “all hazards”

• Post-Katrina, shift to state/local HVA, state/local responsibility to focus resources on priority hazards

• Federal lead limited to “societal transforming events”

• What are NJ’s hazards and vulnerabilities?

NJ’s Hazards & Vulnerabilities

Why should teachers and students be prepared?

• Natural events: risk of emerging/re-emerging/unusual infections

• SARS, West Nile, HIV and TB, monkeypox, pandemic flu

• Natural catastrophic weather-related and geophysical events

• Flooding, hurricanes, earthquakes

• Global political instability: risk of bio, chem, rad/nuclear terrorism

• Anthrax, Sarin gas • “Conventional” terrorism climate of mass casualties from

explosions/incendiary events• WTC, OK City

• Failures of technology• Bhopal, Chernobyl, Three Mile Island, flu vaccine shortage

If disaster strikes, where are you likely to be?

sleep 56 hrs

home 47 hrs

school 40 hrs

car 13 hrs

shop/recreation 12hrs

N=168 hrs/week

Ready Together (hand out)

• Personal preparedness– Teachers– Students

• School emergency plan– Shelter-in-place– Evacuate

• Car

What can you do in your classroom?

• Have your own preparedness plan in place, reassure students that if disaster strikes while at school, you will be ready to respond

• Know your workplace emergency plan, chain of command, and your role and responsibilities

• Stimulate students to discuss their family preparedness plans at home, report back, identify gaps

• Familiarize students with the school’s emergency plan

• Assign students topics for research, report back, critique

Other Classroom Activities

Are we Prepared?

• Thank you

• Please complete the evaluation form