SALT LAKE CITY -- The same skills and equipment that would help a public health system respond quickly to a bioterrorism attack are useful for natural crises such as pandemic flu or chemical spills. And Utah is among the states that are much better prepared now than they were five years ago to deal with a broad spectrum of public health crises, the Centers for Disease Control and Prevention and local health experts agree.
Still, notes a report released by CDC last week, "Public Health Preparedness: Mobilizing State by State," Utah does not have the disease surveillance reporting system it needs to interact with other health departments and the CDC. And it is among the many states that find recruiting and retaining epidemiologists in public health a challenge.
Following the terrorist attacks on Sept. 11, 2001, Congress funded a Public Health Emergency Preparedness cooperative agreement. Since that time, more than $5 billion has gone to public health departments to beef up the crisis response system. The report says the results include better detection and investigation of diseases, including expansion of the Epidemic Information Exchange, more epidemiologists watching for and investigating health threats, much-enhanced public laboratory capabilities, creation of pandemic flu plans, a workable national stockpile of medications and many, many hours of education and practice for those who will be expected to deal with crisis.
"We made great progress shoring up our capacity, especially with the laboratory and with the training of the work force to get up to speed to detect problems early," said Sharon Talboys, section director for public health and health-care preparedness for the Utah Department of Health. Emergency plans, training, exercises such as mock disasters and tabletop exercises have all honed plans and skills.
The state's public health lab now offers many previously unavailable state-of-the-art lab services, according to Barbara Jepson, director of microbiology. It's not all about bioterrorism. The same equipment and skills enhance public health efforts to deal with influenza, food-borne disease, West Nile virus or, on the chemical side, air and water quality.
A couple of real-life events have also given public health officials unexpectedly realistic "practice" in crisis management to augment drills and tabletop exercises. Several health departments have gained experience doing mass inoculations, for instance. But it's unlikely any drill was more vivid than the series of events kicked off when a long-haul truck driver went to a Salt Lake emergency room with lesions and fever that could have signaled smallpox infection.
The hospital ER was closed down, Salt Lake Valley Health Department was notified of the potential, the state health department and CDC were all brought into it. Quickly, the state lab confirmed the man had just an unusual chicken pox. But Utah first responders got a taste of what could have been a serious public health event and rose to the occasion well, temporarily isolating others who might be at risk. And because the state lab could run the needed tests quickly, it took hours, not days to determine what was -- or wasn't -- needed, the report noted.
In September, Talboys said, the state lab had a "robust test of pandemic lab surge capacity, dealing with 150 samples at once and returning results quickly."
Nowadays, public health is available 24/7 to deal with natural or man-made crises. "Five years ago," said Talboys, "we were not in first response mode. Now all the health departments in the state have that capability." And they have plans for communicating quickly with the public to get a message out about an emergency.
That's a positive legacy of the national worry about terrorism and disease: Agencies are combining their considerable skills to handle public health crises, she said.E-mail: firstname.lastname@example.org