States Unprepared for Emergencies

The U.S. is largely unprepared to respond to a major public health emergency such as bioterrorism or pandemic flu, according to the fourth annual Trust for America's Health report released Tuesday, McClatchy/Arizona Republic reports.

The report, titled "Ready or Not? Protecting the Public's Health From Diseases, Disasters and Bioterrorism," measured all 50 states and Washington, D.C., using 10 preparedness benchmarks (Goldstein, McClatchy/Arizona Republic, 12/13). The measures included whether each state is capable of distributing drugs and antidotes from a national stockpile, whether there are enough hospital beds and nurses to accommodate an excess of patients, and whether states have enough laboratories and scientists to test for biological threats and other outbreaks (Hall, USA Today, 12/13).

This year's report placed particular emphasis on pandemic flu preparedness because of growing concern about avian flu (Sheridan, Washington Post, 12/13). According to the report, Oklahoma was the only state to satisfy all 10 evaluative measures. California, Iowa, Maryland and New Jersey scored the lowest, with four points out of 10 (USA Today, 12/13).

Half of the states met seven or more of the 10 measures. The report also found the following:

12 states do not have disease-tracking computer systems that are compatible with the federal government's tracking system (Olson, St. Paul Pioneer Press, 12/13).
15 states are CDC certified as capable of distributing drugs and antidotes from the national stockpile;
Half of states would run out of available hospital beds within two weeks of a moderately severe pandemic flu outbreak;
40 states have a nursing shortage;
The rate of flu vaccination among the elderly decreased in 13 states over last year;
Four states do not test for the flu year-round, a measure officials regard as essential to monitoring a pandemic; and
11 states and Washington, D.C., are not well-equipped to test for biological threats (USA Today, 12/13).

The report recommends that the federal government define standards that every state would be required to meet. It also advises the federal government to provide appropriate levels of funding to the states to meet those standards.

It says that a single official should be appointed to HHS to oversee all public health programs, with the Department of Homeland Security having a secondary role in public health emergencies (Reichard, CQ HealthBeat, 12/12).

Comments

Jeff Levi, director of TFAH, said, "[T]he nation is nowhere near as prepared as we should be for bioterrorism, bird flu and other disasters." He said that while progress is being made, "Americans face unnecessary and unacceptable levels of risk" (Shideler, Wichita Eagle, 12/13).

Laura Segal, a spokesperson for TFAH, said, "It's been an ongoing concern" that states including New Jersey, Maryland and California were ranked poorly by the report "because they may be perceived as more vulnerable." She added, "The more condensed population centers have a higher hurdle to jump" (Bergen Record, 12/13).

Jonathon Fielding, Los Angeles County's public health director and advisor on the report, said, "It's very hard to compare what goes on in a small, homogenous state with what goes on in California."

California Department of Health Services Director Sandra Shewry said California's ranking did not take into account a $250 million preparedness effort that Gov. Arnold Schwarzenegger enacted this year (Lin, Los Angeles Times, 12/13).

Broadcast Coverage

NPR's "All Things Considered" on Tuesday reported on the report.

The segment includes comments from Sen. Richard Burr (R-N.C.) and Levi (Rovner, "All Things Considered," NPR, 12/12). Audio of the segment is available online.

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