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Member Research & Reports

Member Research & Reports

Disaster Planning Gaps Undetected by CDC Measures, Saint Louis Research Finds

If a large-scale aerosol release of anthrax were to occur, we aren’t as prepared as we think we are, a Saint Louis University study has found.

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“Millions of dollars and countless hours have been invested in US public health preparedness, yet this study’s findings indicate that there are still large gaps in readiness to respond to a biological event,” says first author Dr. Terri Rebmann, Associate Professor at Saint Louis University’s College for Public Health and Social Justice.

In the face of a large-scale biologic event, the Centers for Disease Control and Prevention (CDC) relies on point-of-dispensing units to distribute medical countermeasures to the public. The SLU research team found that not all open PODs were sufficiently prepared and the evaluation measures of their preparedness are also lacking.

The study focused on “open” PODs, which are accessible to all members of the community, as compared to “closed” PODs, which are available only to the entity hosting the POD.

A lack of planning and exercises for mass vaccination, insufficient staffing for open PODs in almost half of all jurisdictions, and no planned use of an alternative dispensing modality are some examples of gaps the study found that are not being monitored by the CDC’s Technical Assistance Review (TAR) or other performance measures.

The paper, “Are US Jurisdictions Prepared to Dispense Medical Countermeasures through Open Points of Dispensing? Findings from a National Study,” was published online by Health Security, March 16, ahead of the print version.

It is the first nationwide study to examine POD preparedness for both Cities Readiness Initiative (CRI) and non-CRI jurisdictions, and it is one of the first to assess aspects of POD preparedness not covered by TAR criteria, such as jurisdictions’ ability to mass vaccinate.

One significant gap the study found was that the PODs’ believed they could distribute antibiotics to their entire population within 48 hours; but fewer than half reported that they have adequate staff and/or volunteers to operate their open POD. The research team hypothesized it reflected some “wishful thinking” about the current state of preparedness – a point brought home in fall 2014 with the Ebola outbreak, when occupationally acquired transmission occurred despite hospitals reporting preparedness.

“Wishful thinking about biological preparedness can result in mistakes and increased morbidity and mortality,” warned the research team, which included SLU colleagues: Dr. Travis M. Loux, assistant professor; Mr. Harlan Dolgin, adjunct instructor; Mr.David Reddick, quality assurance analyst; Ms. Mary Wakefield, graduate student; as well as Mr. Zachary Swick, domestic preparedness planner, Oregon Military Department, Oregon Office of Emergency Management.