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  • New Mexicans should be prepared to be self-sufficient

    http://www.freenewmexican.com/news/53818.html

    New Mexicans should be prepared to be self-sufficient

    By MARK EVANS | Associated Press
    December 16, 2006

    ALBUQUERQUE — Unlike damage from a flood, earthquake or other natural disaster, the tentacles of an influenza pandemic probably would stretch across the nation, profoundly taxing resources in scores of cities and communities at once.

    In New Mexico, preparations and practice drills for such a crisis, whether from the Asian bird flu or another dangerous strain, have been under way for several months. Yet the effort, including solutions to ethical quandaries involved in responding to a health crisis with limited resources, remains a work in progress, said C. Mack Sewell, the state’s epidemiologist.

    Sewell, a key planner in getting the state ready, stresses that New Mexicans should be prepared, if need be, to be self-sufficient — without the expectation of immediate federal help.

    States across the country “are all going to be pinched at the same time” in the event of a flu pandemic, he said. “We’re not going to be able of rely on someone else. We’re going to have rely on ourselves.”

    That would mean families and neighbors, along with local organizations, school personnel and other volunteers, might need to help out to maintain basic infrastructure in a community, he added.

    Below are other answers provided by Sewell and his office to questions about the state’s readiness and what remains to be done:

    Has the state run practice drills of its pandemic plan?

    Such drills are in progress. They include “tabletop” exercises, or scenarios, targeting dozens of hospitals in New Mexico, including seven Indian Health Service hospitals serving the American Indian populations and the VA medical center.

    Among the objectives of these exercises is to raise awareness about the impact of pandemic influenza on a specific hospital. They also provide an opportunity for hospital leadership to discuss and self-assess gaps in planning, response capabilities, resources, and internal coordination.

    Another exercise, also a tabletop, will be conducted five times, once in each of the state’s five public-health regions. These exercises will be conducted electronically, over the Internet. Participants will likely include hospitals, primary care, long term care, home health care, public health, behavioral health, EMS, and other health-care providers; local planning groups; community organizations; business; schools; volunteer groups; and others.

    Have these exercises conducted so far identified any gaps in the system?

    That’s being assessed. Anecdotally, they reveal the need for increased local coordination with emergency management and other health system entities to accommodate the large numbers of expected patients.

    Also, the lack of reserve health professional staff to provide additional care is a possible gap.

    How will the state prioritize scarce supplies of drugs and vaccine?

    First responders who will be caring for sick patients will be first priority. After that, it will depend on the nature of the disease.

    Is there an estimate available of the surge in need for hospital beds during a pandemic? If so, what’s that estimate?

    The New Mexico Department of Health is working with hospitals statewide to determine this, based on the tabletop exercises. Specific populations are identified and studied to project surge numbers at community hospitals. This is a local preparedness issue and the state is supporting the communities.

    What would the command structure be (i.e., who’s in charge) during a pandemic?
    Unified command includes the Department of Health, the Department of Public Safety and local emergency managers with others as appropriate for pandemic influenza.

    Who decides when to close schools?

    Most likely, it would be a joint decision of the governor, the secretary of education and the secretary of health.

    Who at the state level communicates with the public?

    Deborah Busemeyer, the main public information officer for the New Mexico Department of Health, would be the first contact and would disseminate information to the public.

    Unified command would also include the governor’s communication director as well as the governor’s Office of Homeland Security public information office.

    Have you started any projects to educate the community about what will happen during a pandemic, and any individual preparations they should make?

    During wide-scale disasters, community members need to be prepared to meet their own needs before state and federal assistance becomes available.

    In case of a pandemic, individuals, families, neighbors and local organizations may need to perform a range of nontraditional activities to maintain a basic level of community infrastructure. These activities could include home-based health care to family members and others who have become ill, shopping for or preparation of food for others, providing mail services, etc.

    To this end, the Department of Health’s Office of Health Emergency Management has been working with county-based Community Health Councils, CHCs, throughout the state for more than two years to provide training in community outreach and to assist them with becoming partners in the emergency preparedness and response planning activities led by local emergency managers.

    CHCs are seen as connectors to their communities, at the grass roots level, as they coordinate and advise on the array of health services in their counties and involve a full spectrum of health care professionals, social service agencies and local responders such as fire, law enforcement and emergency managers.
    The Prepared Community initiative has provided training in the core capabilities needed by a prepared community, psychosocial consequences of disasters, and information on community resilience.

    Each CHC has developed a socio-economic/psychosocial profile of their community, a description of populations with special health care needs, a resource directory of agencies and organizations that would perform response roles and identification of networks that could be mobilized to assist vulnerable populations, such as frail elderly or persons with disabilities in an emergency.

    During the coming year, additional training will be provided on the unique challenges of pandemic influenza and planning needs for vulnerable populations, and will include school personnel, and local responders. This training will include exercises with emergency managers and integration with local pandemic planning activities.

    Is the private sector involved in your planning of how to assure availability of critical needs such as food, pharmacies, etc.?

    The outreach effort to the business sector mentioned will include critical infrastructure entities, including the full array of health care services, as well as discussions with grocers associations and individual supermarket chains.

    The Health Department will work with Public Service Company of New Mexico, water authorities and other utilities to ensure consistency in planning efforts.

    During a pandemic, how do you plan to avoid a breakdown in services to particularly vulnerable populations, such as homebound elderly who depend on Meals on Wheels?

    Interruption of services will be inevitable. However, the planning activities are considering the needs of all individuals, especially vulnerable populations.

    The Department of Health, with the state Office of Emergency Management and other state agencies, are striving to ensure “pre-positioning” of services required to maintain the state’s critical infrastructure. A special state-level activity to address and improve the response infrastructure to vulnerable populations is under way, and will involve the efforts of state and local agencies that provide services to these groups.
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