Snow and drills test New York State's flu preparations

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Snow, floods and drills test state's flu preparations

12/16/2006, 12:28 p.m. ET

By CANDICE CHOI, The Associated Press

ALBANY, N.Y. (AP) — During a massive flu drill in western New York

this summer, health officials found a glaring gap in the plan to

monitor infections: Hospital staff didn't know how to use FedEx or UPS

to ship lab samples to the state's biomedical testing center in Albany.

When a real emergency, a surprise snow storm, hit Buffalo in October,

it exposed another hole in emergency planning. Health officials

activated New York's emergency reserve of medical personnel, sending

extra nurses to Buffalo within hours. But other professionals, like

respiratory therapists and nursing assistants, weren't dispatched.

" This was a real event. Erie County is a major metropolitan area — all

the issues that occurred there are ones that would happen in a real

disaster, " said Gus Birkhead, director of the Health Department's

Center for Community Health.

In the past year, storms, summer flooding and emergency drills have

helped the state prepare for a calamity such as a flu pandemic and

helped illustrate flaws in the state's disaster plan.

" It's one thing to say, 'Here's our plan.' It's another thing to do

it, " said Burhans, director of the state Health Department's

public health preparedness.

Some of the problems, like the shipping and emergency reserve

foul-ups, have been addressed. And, when officials learned during the

flu drill they weren't collecting all the necessary medical data to

electronically map infection rates and patterns, they expanded the

patient information that hospitals must enter into a statewide

tracking system.

But the drill, which ran a month and involved 1,400 people in eight

counties, exposed other questions that are still unanswered: Who

decides whether to close schools, and what criteria would they use?

How would school closures affect food stockpiles at home and the

ability of businesses to stay open as parents stay home with children?

The state Health Department is also still in the process of developing

a game plan for helping the homebound, chronically ill and other

" special populations " during a flu pandemic.

" Those are challenges we continue to face. Some of the stuff we may

never come up with good answers, " said Billittier, Erie

County's health commissioner.

In 2006-2007, New York state (not including New York City) got $49.1

million for health emergency preparedness, of which $7.8 million was

earmarked for pandemic flu. The state has set aside another $29

million in the current budget for flu preparedness. Here's what the

state has done:

The state Health Department plans to buy enough anti-viral medications

to treat 25-30 percent of the population. As of Nov. 1, 1,050,000

treatment courses of Tamiflu had been delivered. Another 230,000 doses

of Rulenza have been ordered.

The stockpiles are kept in three undisclosed locations throughout the

state. The locations also store equipment including 4 million surgical

masks, 500,000 better-filtering N95 respirator masks and medical

supplies like IV tubes and ventilators. The medication and supplies

would be distributed to " receiving sites " like warehouses or hospitals

picked by counties.

Local officials would be responsible for getting vulnerable

populations — the elderly, sick and very young — priority for

immunizations. Those least at risk would be encouraged to stay home

during the first wave of immunizations.

The state Health Department performed its first mass vaccination

exercise last November by administering flu shots to 2,000 state

employees over five hours. Similar drills are being carried out by

county health departments. In rural Oswego County, one drill

determined health officials could immunize more than 1,000 people in

less than six hours.

" But in a flu pandemic situation, the issue is going to be

sustainability, " said Oswego County Health Commissioner Kathleen

. " We need to look at our ability to vaccinate 50,000 people

within a week. "

That effort will likely include community clinics and private

hospitals, she said. She said one problem is making sure enough

medical personnel would show up to work. State health officials have

said state law on medical licensing could be waived during a flu

pandemic to allow unlicensed people to deliver shots and care for the

sick.

Hospitals over the past year have developed plans to handle a surge of

patients in the case of a flu pandemic.

According to the state Health Department, eight centers across the

state are ready to make space for a surge — of 500 beds per million

population — by canceling elective surgeries, setting up makeshift

treatment areas in hallways and coordinating with neighboring

hospitals to handle overflow.

Counties are also identifying public spaces that could be used to

house large gatherings of people who have fallen ill.

June flooding that chased hundreds of families from their homes across

12 upstate counties also highlighted flaws. As flooding victims were

struggling to get their lives back in order, the last thing on their

minds were the pamphlets and public health advisories issued by the

health department.

Instead, state officials realized the best way to reach victims was at

disaster registration sites. Health department officials were

stationed at centers in the region, and explained face-to-face the

dangers of drinking contaminated water or eating spoiled foods.

Before the snow storm hit in October, Erie County officials had been

planning and hosting disaster and flu pandemic drills for months. But

unforeseen obstacles arose during the storm — like having more than

half the county without power, knocking out communications, said

Billittier.

Now, county officials are considering using letter carriers or

firefighters to deliver information — or, in the case of a flu

pandemic, antibiotics — door-to-door in an emergency.

" Planning gets you through first 24 hours, but you have to keep

planning as you go through it, " he said.

New York State Health Department, http://www.health.state.ny.us/

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