Posts Tagged ‘disease outbreak’

Annual Preparedness “Reportcard”

January 15th, 2013

Every year a group called the Trust for America’s Health puts out a ‘Report Card” regarding what they believe is an assessment of each state’s readiness for a public health emergency.  They use various measurements that they can find and grade each state against each other.  The implication is that states that do poorly won’t be able to execute in a public health emergency and the ones that do well will do fantastic.  The problem is that they usually pick measuring sticks that have little to do with real public health readiness, things that public health systems have little control over, or both.  Sometimes the points are awarded for things that are cosmetic.  I don’t have any objection to outside entities scoring and passing judgment on states’ preparedness…  but I do object when the criteria they use has little to do with the conclusions they draw. 

For example- in this year’s report AZ lost 3 out of a total of 10 possible points because our whooping cough vaccination rates are 86% (rather than 90%), there’s a $5 co-pay for flu shots under the state Medicaid program, and the fact that AZ doesn’t have a comprehensive global warming action plan.  Using those criteria- are you ready to conclude that our state’s public health preparedness network is unable to effectively respond to a public health emergency?  (That’s a rhetorical question). 

Safeguarding the public’s health is more important than ever.  Whether the threat is a disease outbreak, environmental hazard or natural disaster, the public health system works 24 hours a day, 7 days a week to keep Arizonans safe.  Each year, the CDC evaluates state and local public health preparedness programs in a detailed report that measures what really matters.  This year’s installment is entitled 2012 State-by-State Report on Laboratory, Emergency Operations Coordination, and Emergency Public Information and Warning Capabilities.  This document outlines each state’s ability to perform key laboratory functions, engage in emergency operations, and develop and distribute public health messages.  While Arizona wasn’t perfect in this year’s CDC report- we did pretty darn good. 

For example, our Lab tests thousands of biological and chemical samples each year, and is a cornerstone of our public health system.  As a part of the Laboratory Response Network, we’ve consistently demonstrated its ability to detect high-threat biological agents like anthrax. Our lab team works long hours to test samples from suspicious packages and provide accurate results to our first responder community. As the report indicates, one area for improvement is our turn-around-times for pulsed-field gel electrophoresis testing- a technique used to identify organisms that commonly cause food borne illness.  We’re working to improve these turn-around-times by ensuring we have the right staffing and resources needed to meet these bench marks.  

Another capability addressed in this year’s CDC report is Emergency Operations Coordination.  ADHS has participated in dozens of exercises and drills over the past several years to prepare our staff for public health emergencies.  For the 3rd year in a row, our staff met the 60 minute target for Emergency Operations Center activation.  Similarly, our staff successfully demonstrated our ability to develop and distribute public health messages in a timely manner.  These examples illustrate our ability to manage public health emergencies and safeguard the public’s health during a disaster.  

For our employees that work in preparedness throughout Arizona’s public health system- the work is never done.  But I’m proud to say that we’ve achieved all of our emergency preparedness targets, and nearly all of the lab requirements for this year’s report.  Thanks to all of our preparedness staff for their hard work and dedication.  Well done.

Vaccines & the Social Contract

December 14th, 2012

At the core- vaccines are really about community protection.  Our public health system depends on a solid network of providers that are available to vaccinate kids for all of the nasty infectious diseases that have plagued humanity for millennium. It’s not just access to care and a solid network of providers that vaccinate that are important- we also need folks to fulfill their social contract. In other words, we need just about everybody to participate and get vaccinated in order to get the herd immunity we all need to eliminate the spread of infectious vaccine-preventable diseases.  Vaccinating yourself and your kids is more about community protection than personal protection.  It’s a social contract that we have with each other to keep all of us healthy- just like it’s everyone’s responsibility to be a Good Samaritan when you see a car crash. 

For decades vaccination rates in the US and AZ have been pretty good.  The problems we had were due to the lack of access to care.  Low vaccination rates were mainly in low income areas where folks weren’t able to get to the doctor on time to get their shots or didn’t have insurance.  Over the decades, the public health and healthcare systems have closed many of those gaps- and immunization rates responded.  But now we have a new problem- more and more parents are purposely deciding to not vaccinate their kids.  The trend is increasingly jeopardizing us all.  It’s called a “personal exemption”. 

In order to figure out what to do next, we began working with the UA College of Public Health to find out the who, what, when, where, and why of this group of parents that are increasingly deciding to not vaccinate their kids.   Today the UA investigators published a preliminary report in the Journal Vaccine that gives us some insight into this population. 

The research team used data about personal exemptions from our 2010- 2011 kindergarten Immunization Data Report and linked it to data about education statistics to determine if there are similarities between the areas where there are more exemptions.  They found that schools where mostly white students attended, those with fewer students who use free and reduced lunch, and charter schools were more likely to have high exemption rates.  There are geographic differences too – those in the northern part of the state were more likely to have personal exemptions than those in the south – and the number of exemptions increased from west to east. 

These geographic and demographic details are important in designing the right intervention to help bring up herd immunity in the state.  This information will help the AZ public health system to improve the vaccination uptake and pay close attention to those areas if there is a disease outbreak.  A follow-up study is on the way that’ll look in more depth into why parents are increasingly choosing “personal exemptions” over vaccination.  We hope to use the combined data to develop intervention strategies to improve immunization rates moving forward.

2012 State by State Preparedness Report

October 2nd, 2012

Safeguarding the public’s health is more important than ever.  Whether the threat is a disease outbreak, environmental hazard or natural disaster, the public health system works 24 hours a day, 7 days a week to keep Arizonans safe.  Each year, the CDC evaluates state and local public health preparedness programs in a detailed report.  This year’s installment is entitled 2012 State-by-State Report on Laboratory, Emergency Operations Coordination, and Emergency Public Information and Warning Capabilities.  This document outlines each state’s ability to perform key laboratory functions, engage in emergency operations, and develop and distribute public health messages. 

Our Lab tests thousands of biological and chemical samples each year, and is a cornerstone of our public health system.  As a part of the Laboratory Response Network, we have consistently demonstrated its ability to detect high-threat biological agents like anthrax. Our lab team works long hours to test samples from suspicious packages and provide accurate results to our first responder community. As the report indicates, one area for improvement is our turn-around-times for pulsed-field gel electrophoresis testing- a technique used to identify organisms that commonly cause food borne illness.  We’re working to improve these turn-around-times by ensuring we have the right staffing and resources needed to meet these bench marks. 

Another capability addressed in this year’s report is Emergency Operations Coordination.  ADHS has participated in dozens of exercises and drills over the past several years to prepare our staff for public health emergencies.  For the third year in a row, our staff met the 60 minute target for Emergency Operations Center activation.  Similarly, our staff successfully demonstrated our ability to develop and distribute public health messages in a timely manner.  These examples illustrate our ability to manage public health emergencies and safeguard the public’s health during a disaster. 

For our employees that work in preparedness, the work is never done.  But I’m proud to say that we have achieved all of our emergency preparedness targets, and nearly all of the lab requirements for this year’s report.  Thanks to all of our preparedness staff for their hard work and dedication.

 

Adult Vaccination Rates

February 8th, 2010


The Trust for America’s Health released a report about adult immunization rates across the country last week at: healthyamericans.org.  The Complete Report (PDF 0.2Mb) provides all of the details…  but for a snapshot, the report says that about 69% of Arizona’s seniors have been vaccinated for pneumococcal disease.

Vaccinations are an important part of public health strategy.  When people are vaccinated, it not only protects them from catching that virus, it reduces the chance they will infect someone else.  The term herd immunity means enough people are immune to a disease through vaccination or exposure that a community is protected from a major outbreak.

Arizonans can learn what vaccinations are available to them and their family on the ADHS website.

It is not too late to get seasonal and H1N1 influenza vaccines.  Find out where at StoptheSpreadaz.com