Emergency Preparedness

Intense stress can severely degrade one's ability to process and utilize new kinds of information.1 This psychological phenomena may partially explain why epidemiologist are challenged to communicate and establish the value of SyS information with emergency management professionals (EMPs). Despite the timely and useful insights that SyS data and methods can provide, it is very difficult to convey what these data are when EMPs and epidemiologists are working to make intense, highly-scrutinized and high-consequence emergency decisions. If state and local authorities want emergency plans and responses that benefit from the powerful insights that SyS can provide, epidemiologists need to learn how to best report information and establish a strong rapport before emergencies strike. Over the past ten months, ISDS’s NSSP’s Syndromic Surveillance and Public Health Emergency Preparedness, Response and Recovery (SPHERR) Committee has worked to identify gaps, potential best practices, document use cases, and identify tools for integration of SyS data in EM activities. During SPHERR practice exchange meetings, SyS professionals have consistently cited effective communication between SyS staff and emergency preparedness staff as a top priority in integrating SyS more fully into all phases of emergencies.

Objective: Identify and document strategies that enhance the value of syndromic surveillance (SyS) data and information for the response, recovery, mitigation and preparedness needs of local and state emergency management professionals in the U.S.

Austin Public Health creates a variety of syndromic surveillance reports for events throughout the Austin, Texas metropolitan area. These events range from responses to major disasters such as the 2017 Hurricane Harvey sheltering to ongoing special event monitoring such as University of Texas football games and the Austin City Limits music festival. Partnerships within the Austin metropolitan region are crucial to ensuring the information-sharing necessary to create robust reports, as well as during the follow-up process of requesting feedback from partners on the usefulness of the reports. Austin Public Health's Public Health Emergency Preparedness program utilizes a variety of tools and resources to create informative, event-specific, and engaging reports, fulfilling multiple reporting needs for all partners.

Objective: Austin Public Health's Public Health Emergency Preparedness program utilizes a variety of tools and resources to create informative, event-specific, and engaging syndromic surveillance reports to share 1) internally within Austin Public Health; 2) with City of Austin and Travis County partners; 3) local health care coalition members; and 4) the public during events that affect the Austin, Texas metropolitan area.

Description: The Centers for Disease Control and Prevention (CDC) works to save lives and protect people during major public health events. In an effort to support these processes, CDC established the Countermeasure Tracking Systems (CTS), which is maintained within the Division of Informatics Solutions and Operations, in the Public Health Informatics and Technical Program Office. CTS consists of four system components which interoperate to improve communications and event response efficiency while still functioning independently, recognizing the unique requirements and use cases for each system. Collectively, the data consolidated from these systems can show population coverage, numbers of untreated individuals, drug and equipment shortages, need for resupply and more. The Web-based applications are deployed centrally at CDC and use the CDC's secure data access method for security.

The first of these components is the Inventory Management and Tracking System (IMATS), currently under development. IMATS provides state and local public health providers with a tool to track medical and non-medical countermeasure inventory and supplies during daily operations or an event. The solution tracks quantities of inventory, monitors reorder thresholds, and facilitates warehouse operations including receiving, staging, and storing of inventory.

The Communications Portal is a web based content management system in development which consolidates important event response details into one place and will provide timely and adequate information to states and other jurisdictions. This system is complementary to the IMATS as it manages communications related to, but not limited to, Emergency Use Authorization, Investigational New Drug and recall notices.

Objective

To describe the CDC CTS, and the impact of its four closely related informatics components toward enhancing federal, state, and local public health capacity to track and manage medicine and other medical or non-medical supplies during daily operations and all hazards public health events.

On 27 April 2005, a simulated bioterrorist event—the aerosolized release of Francisella tularensis in the men’s room of luxury box seats at a sports stadium—was used to exercise the disease surveillance capability of the National Capital Region (NCR). The objective of this exercise was to permit all of the health departments in the NCR to exercise inter-jurisdictional epidemiological investigations using an advanced disease surveillance system. Actual system data could not be used for the exercise as it both is proprietary and contains protected, though de-identified, health information about real people; nor is there much historical data describing how such an outbreak would manifest itself in normal syndromic data. Thus, it was essential to develop methods to generate virtual health care records that met specific requirements and represented both ‘normal’ endemic visits (the background) as well as outbreak-specific records (the injects).

Objective

This paper describes a flexible modeling and simulation process that can create realistic, virtual syndromic data for exercising electronic biosurveillance systems.

Timely outbreak detection, and monitoring of morbidity and mortality among Katrina evacuees, and needs assessment for better planning and response were urgent information intensive priorities during Katrina relief efforts at Houston, and called for immediate deployment of a real-time surveillance and needs assessment system ad hoc, in order to collect and analyze relevant data at the scene. Initial requirement analysis revealed the following capabilities as essential to sustain effective response within the shelters:

• The ability to securely collect and integrate data from evacuees seeking any form of health services from all care providers (academic, volunteers, federal, NGOs and international aid organizations, etc), including demographic information, vital signs, chief complaints, disabilities, chronic conditions, current and past medications, traumas and injuries, exposure to toxic materials, clinical laboratory results, past medical history, discharge notes and diagnoses, and ability to collect free text entries for any other information (similar to a full-blown electronic medical records system).

• Proactive survey of demographic profile, physical and mental health status, as well as special needs assessment (e.g., dialysis, medications, etc) from all evacuees.

• The ability to collect uniform information, using any network-enabled device available: PCs, tablets, and handheld devices. 

• The ability to classify observations by processing sign and symptom, chief complaint, medication, and other diagnostic data (including free text entries) through ad-hoc definition of concepts such as (Gastrointestinal, Respiratory, Fever and Rash, etc). 

Objective

This paper presents lessons learned from leveraging Internet-based technologies and Services Oriented Architecture in providing timely, novel, and customizable solutions, just in time and for preparedness against unprecedented events such as natural disasters (e.g., Katrina) or terrorism.

This paper describes lessons learned from a regional tabletop exercise (TTX) of the National Capital Region (NCR) Syndromic Surveillance Network, from the perspective of the Maryland Department of Health and Mental Hygiene (DHMH).

Analysis of the BioSense data facilitates the identification, tracking, and management of emergent and routine health events, including potential bioterrorism events, injury related incidents and rapidly spreading naturally occurring events (1).  BioSense enhances coordination between all levels of public health and healthcare by providing access to the same data at the same time which can ultimately produce a faster and more coordinated response.  BioSense is a network of networks rather than a stand-alone program. Analysts at the BioIntelligence center (BIC) analyze and track BioSense data activity at a national level and support state and local public health system users (2).

Objective:

BioSense is a national human health surveillance system designed to improve the nationís capabilities for disease detection, monitoring, and real-time health situational awareness.