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Emergency Preparedness Still Lagging in U.S.: Report

Five years after 9/11, states aren't fully prepared for threats like bioterrorism or flu pandemic

TUESDAY, Dec. 12, 2006 (HealthDay News) -- Five years after the Sept. 11, 2001 terrorist attacks, America is still woefully under-prepared to protect the public's health in the event of bioterrorism, bird flu or other emergencies.

That's the assessment of Trust for America's Health's fourth annual report, Ready or Not? Protecting the Public's Health From Disease, Disasters, and Bioterrorism, released Tuesday.

"We wish we could be able to report to you that our nation had moved further in preparedness," said Dr. Margaret A. Hamburg, a member of TFAH's board of directors, and former assistant secretary for planning and evaluation at the U.S. Department of Health and Human Services. "Progress has been clear, but there's still so much more to be done." Hamburg spoke at a news conference Tuesday.

"September 11, the anthrax attacks, and Hurricane Katrina were all wake-up calls," added Jeffrey Levi, Trust for America's Health's executive director. "The country is still at risk."

The report assessed all 50 states and the District of Columbia for their performance on 10 key indicators of health emergency preparedness capabilities. Unlike last year's report, this year's review did not include information on the federal government.

Half of the states scored six or less on the scale of 10 indicators. Kansas and Oklahoma scored the highest, with nine out of 10 and 10 out of 10, respectively. California, Iowa, Maryland and New Jersey scored the lowest, each with just four out of 10.

Among the report's other major findings:

  • Only 15 states were rated at the highest preparedness level in terms of their ability to provide emergency vaccines, antidotes and medical supplies from the Strategic National Stockpile. "Most of the states are still not able to achieve the U.S. Centers for Disease Control and Prevention certification for rapidly deploying emergency supplies in the event of an emergency," Levi said. "This should be disconcerting to all Americans."
  • Half the states would run out of hospital beds within two weeks of a moderate flu pandemic; 47 states would run out of beds within two weeks of a severe flu pandemic. "Experts predict a pandemic would last eight to 10 weeks," Levi said.
  • Forty states currently have a shortage of registered nurses, let alone what would be needed in a crisis.
  • Rates for vaccinating seniors for the "regular" seasonal flu have decreased in 13 states. "The current system of distributing vaccines is lagging," Levi said.
  • Eleven states plus the District of Columbia lack the capability to test for biological threats in laboratories.
  • Four states don't test year-'round for the seasonal flu, a step that's necessary to monitor for a pandemic.
  • Six states cut their public health budgets from the last fiscal year to this fiscal year.

The report also offered a set of recommendations:

  • A single senior official within the U.S. Department of Health and Human Services should be designated to be in charge of and accountable for all public health programs. This official would streamline government efforts and be the clear leader during times of crisis.
  • The federal government should define a limited number of "optimally achievable" priorities that every state should be accountable for.
  • Create a state-of-emergency health benefit to make sure that uninsured and underinsured people will seek care during emergencies. "This is particularly important in the case of infectious disease outbreaks, when delays in seeking care could jeopardize containment strategies," Levi said.
  • Release publicly existing data on emergency preparedness. "Everyone has a right to know how well their particular community is prepared," Levi said.
  • Fully fund existing public health emergency programs and establish new funds for new programs.

"We are not as prepared as we ought to be, and, if something like a [flu] pandemic were to strike the entire country, we are not as prepared to respond and respond as effectively as we could," Levi said. "Some of these events are always, tragically, going to result in illness and loss of life. But the more prepared we are, the greater our capacity to mitigate that impact, and we think we're still a ways from being able to accomplish that."

More information

To view the full report, visit Trust for America's Health.

SOURCES: Dec. 12, 2006, teleconference with Margaret A. Hamburg, M.D., member, board of directors, Trust for America's Health, former assistant secretary for planning and evaluation, U.S. Department of Health and Human Services, and former New York City Health Officer; Jeffrey Levi, Ph.D., executive director, Trust for America's Health; Ready or Not? Protecting the Public's Health From Disease, Disasters, and Bioterrorism
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