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Homeland Security Focus Areas New Training Program to Standardize National Response to Emergencies The American Medical Association (AMA) announced on 16 June the development of voluntary training courses to standardize emergency response practices across the civilian and military medical communities in the event of natural disasters or terrorist attacks, according to an AMA statement. The courses will standardize how physicians respond to a variety of disasters including natural and manmade disasters, radiological weapons attack, biological and chemical events, medical decontamination, and mass fatality incidents. Acting Assistant Secretary for Public Health Emergency Preparedness at the Department of Health and Human Services (HHS) Jerome Hauer said that the coursework will "significantly enhance our national security when it comes to acts of terrorism," the Chicago Sun Times reported. The first training sessions are set to begin in August at the University of Georgia. The classes are expected to become available at other institutions across the U.S. and also online over the next few months. ANALYSIS: While efforts in the medical community to prepare for disaster response to date have been somewhat disjointed, Dr. James James, director of the newly-established AMA Center for Disaster Preparedness and Emergency Response, commented that he believes "physicians' current level of readiness is decent," due to efforts following the 11 September attacks. He recommended incorporating emergency response training into nursing and medical school curriculums to ensure continuity of emergency response practices. "These courses will provide physicians with the information they need to be a part of a national response to terrorism," Hauer said. "The training provided will strengthen out nation's public health infrastructure." June 4, 2003 Report says public health labs unprepared for chemical attack By David McGlinchey, Global Security Newswire U.S. security officials and lawmakers have long fretted over the possibility of chemical or biological terrorism in the United States, but the public health system remains "woefully unprepared" to deal with such an attack, according to a study released Wednesday by a public health group. "Thirty years of inadequate training, staffing, equipment and funding have left our public health system in serious disrepair," according to the report from Trust for America's Health. U.S. leaders have made repeated efforts to meet the terrorist WMD threat, but the report says "America's public health system is not up to the job." The report conducted a state-by-state analysis of public health facilities and found that laboratories suffered from inadequate staffing, obsolete facilities and poor communications. Trust for America's Health called on lawmakers to allocate $200 million annually through fiscal 2006 to upgrade state public health laboratories and prepare them for a chemical or biological attack. Thereafter, Congress should spend $100 million each year, according to the organization. The findings received some support from Congress. "This report is further evidence that 20 months after Sept. 11, we are still not prepared to deal with a chemical attack ... our public health laboratories clearly need help if we expect them to be up to the task," said Senator Jon Corzine (D-N.J.). CDC Says Improvements Are Coming The U.S. Centers for Disease Control and Prevention must set standards for chemical testing and training, the report says. CDC officials have read the report and agree with its recommendations, CDC spokesman Von Roebuck told GSN Wednesday. "We recognize there is work to be done," Roebuck said. The CDC recently sent terrorism preparedness guidance to the states along with grant money, and chemical preparedness is part of that, he added. There are numerous public health issues, however, and the CDC cannot focus entirely on the possibility of chemical attacks. "I wouldn't say that the whole thing is centered around chemical" agents, Roebuck said of the guidance. He also noted that the CDC can recommend action, but "we have to work within the state systems. It's a collaboration." When asked if the chemical portion of the guidance is a priority, Roebuck said that "everything in it is a priority." Chemical Analysis Lacking Researchers surveyed five state laboratory directors and found that technicians are prepared to test for more common health risks, such as mercury or lead, but not for a wide range of chemicals that are likely to be used in a chemical attack. None of the laboratories surveyed could test for incapacitating gases or blister and nerve agents, such as VX gas or sarin. The report cited a situation from a Boston Celtics professional basketball game this year in which pepper spray or mace was released as a prank and players were forced to cover their faces with towels and warm-up clothes. If the gas had been a lethal chemical agent, officials would probably not have been able to identify it quickly enough to take appropriate medical action, according to the report. In the report's imagined scenario involving a deadly gas, "a crew of terrorists sitting behind the home team's bench spray a noxious chemical. Instead of momentary gagging, players and fans in the immediate vicinity begin choking ... at this point, the survival of all those exposed depends upon prompt, proper identification of the hazardous substance." Study shows smallpox vaccine protects much longer than once thought Two researchers at the Oregon Health & Science University's Vaccine and Gene Therapy Institute in Portland, Oregon recently announced the preliminary findings of a study that showed "smallpox vaccine protection lasts longer than previously thought," according to 23 May statement released by the school. Instead of the widely accepted three to five period of protection against the disease, the new research findings indicated that the smallpox vaccine provides "significant, partial protection [that] may last many decades after inoculation." Mark Slifka, Ph.D. and his colleague Erika Hammarlund presented their preliminary findings at a meeting of the American Society for Microbiology in Washington, D.C. during the week of 19 May. The researchers examined the blood samples of 306 people who had been inoculated for smallpox, with immunizations occurring "as recently as one month" before the study to "as long ago as 75 years." They focused on two types of immunity. One type "is linked to levels of antibody produced...in response to the vaccine. These antibodies protect patients by forming the first line of defense against smallpox if an exposure occurs." The other type of immunity involves "T-cells programmed by the vaccine to attack the smallpox virus." Dr. Slifka's team found "that while T-cell immunity declines slowly over time, antibody immunity can last throughout a person's life." ANALYSIS: Over 90 percent of Americans over 35-year-old already have been vaccinated against smallpox. Based on the study's findings, that means some 150 million people "are likely to have some level of detectable immunity against this disease," according to Slifka, who added, "These results are likely to have a profound impact on current models and theories on how rapidly smallpox would spread..." Even though he views the Bush administration's "pre-event vaccination" plan as "necessary," these preliminary findings are likely to further retard the national program, which has fallen well short of its initial goal of inoculating 450,000 frontline responders in hospitals and public health departments within a month of its January 2003 start. Some 10 million emergency responders and healthcare workers were expected to be immunized in the second phase of the program. Fewer than 35,000 people have been vaccinated to date mainly because of the vaccine's rare but serious side affects, which include death. The Department of Health and Human Services earlier this month provided an additional $100 million to shore up the sagging vaccination plan. National Medical Response Training Program Subject of Meeting Approximately 100 emergency health care workers convened in Dallas, Texas on 21 February to participate in a run-through of a newly developed national disaster response training program. The training program, called Advanced Disaster Life Support (ADLS), "was developed with suggestions from civilian, military and academic experts," with financial support from the Centers for Disease Control and Prevention (CDC). It is intended to be the "national standard for dealing with bioterrorism, explosions, chemical threats, and natural disasters." ADLS "makes use of interactive scenarios and drills in which the participants treat simulated patients in a disaster," according to the Medical College of Georgia. ANALYSIS: Dr. Richard Hatchett, senior medical adviser for the Office
of the Assistant Secretary for Public Health Emergency Preparedness at
the Department of Health and Human Services, told AP that the response
by the medical community to the 11 September attacks was problematic.
"Their contributions were inspiring, but there was a lack of common
vocabulary," he said. According to the Medical College of Georgia,
the ADLS run-through in Texas includes material from ADLS programs developed
throughout the 1990s by several academic institutions. These institutions
"agreed to assimilate their pre-existing ADLS educational programs
under a federal appropriation managed by the [CDC]" in response to
the 11 September attacks.
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Focus Area Current News Emergency
Preparedness and Response
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