Arizona is ill-prepared for a major health crisis

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Arizona is ill-prepared for a major health crisis

By Carla McClain, Arizona Daily Star

Tucson, Arizona | Published: 12.13.2006

If pandemic flu, an anthrax attack or a killer storm strikes Arizona,

we will be poorly prepared to handle it, a national survey released

Tuesday says.

In fact, Arizona ranks among the bottom 12 states for its ability to

respond to a catastrophic health emergency, the survey found.

Specifically, Arizona is not ready to deliver vital drugs or vaccines

quickly to its population, cannot handle a massive surge of patients

at its hospitals, and is not vaccinating enough of its older,

high-risk citizens against flu and pneumonia.

Though the nation as a whole remains inadequately prepared for a

disaster that sickens or injures millions — even five years after the

Sept. 11 terrorist attacks — Arizona fares worse than most, the report

concludes.

Titled " Ready or Not? Protecting the Public Health from Disease,

Disasters and Bioterrorism, " the rankings are issued by the nonprofit

disease-prevention group Trust for America's Health.

The nation's public-health emergency-response system is underfunded

and lacks accountability and strong national leadership, the survey

found. Some unsettling scenarios could develop should disaster strike,

it suggested.

" The overall message is, to some degree we are doing better, " said

Levi, the group's executive director. " But we're not as

prepared as we ought to be. There is tremendous unevenness across the

states. "

Out of 10 factors signaling emergency preparedness, Arizona achieves

five. Just four states — California, Iowa, land and New Jersey —

do worse, while only one state — Oklahoma — scored a 10.

That's a fairly accurate picture of the situation in Arizona right

now, admitted a top state health official. But the state's rapid

growth gets much of the blame for the problem.

" We have a shortage across the state of health-care workers,

especially nurses and doctors, and that of course affects our surge

capacity. We rightly got hit for that, " said Will Humble, head of

public-health preparedness for the state Department of Health Services.

One of Arizona's most critical weaknesses is a lack of " surge

capacity " in hospital beds, meaning hospitals would be overrun by

patients in the event of pandemic flu.

" In an indirect way, this is the result of our fast growth — we just

can't recruit enough health-care workers and open enough hospitals to

keep up, " Humble said. " We tend to sort of build malls ahead of the

people, but we build health-care facilities after the fact, to be sure

they're full, and that certainly is the case in Arizona. "

Arizona is hardly alone with this problem. Fully half of the states

would run out of hospital beds within two weeks of a moderate outbreak

— defined as eight to 12 weeks — of pandemic flu, the survey found.

Forty states, including Arizona, have a nursing shortage.

Arizona can effectively respond to a single major disaster, on the

scale of a toxic truck spill endangering a community, Humble said.

" But a full-fledged influenza pandemic? No, we would have problems.

Everything would be overwhelmed, " he said.

Arizona's two major urban centers — Phoenix and Tucson — likely would

have trouble getting lifesaving drugs distributed in time to stave off

a bioterror attack, such as anthrax, Humble also acknowledged. That

was another major finding against Arizona in the report.

" The logistics of getting medication to 3.5 million people in one

city, Phoenix — that will be very difficult. You need so much

infrastructure in such a short period of time. Any city of this size

is going to struggle with this, " Humble said.

That appears to be the case across the country. Only 15 states are

prepared to deliver vaccines and medicine quickly from the federal

government's Strategic National Stockpile, a repository of medical

supplies kept in 12 secret locations around the country.

Even so, Pima County continues to run drills to practice disaster drug

delivery. The most recent was a " pandemic preparedness " event to test

how fast county health workers could give flu shots to hundreds of

children.

" We have a pretty good sense that we're ready to accept the medicine

when it gets here, " said Farlow, the county's bioterrorism

communications coordinator.

" We work constantly to be ready to do that — to secure it and to get

it to the right people. We've been practicing that for more than four

years. "

The county also has been steadily buying equipment to set up " portable

hospitals " to treat patient overflow in a medical disaster.

The disaster most often practiced now is pandemic flu, rather than the

bioterror attack drills run shortly after Sept. 11.

" In 2002, the focus was on a smallpox outbreak. We still need such

plans, but we are now taking what we call an all-hazards approach, a

massive response to any type of health crisis, " Farlow said.

Arizona also lost points for failing to meet flu and pneumonia

vaccination standards for senior citizens. But initiatives are in the

works — with $100,000 from the state's Health Crisis Fund — that

should improve that with a widespread education campaign, Humble said.

Since the 2001 terrorist attacks, $4 billion in federal funds has been

doled out to help states prepare for disaster. But the federal

government doesn't tell the public if that's being used effectively,

the Trust for America's Health report said.

" There are no working standards that have to be met by states. The

money is basically going out the door with very little accountability

or direction, " said Irwin Redlener, an adviser on the report and

associate dean at Columbia University's Mailman School of Public Health.

The trust recommended that a single federal official from the

Department of Health and Human Services oversee all public-health

programs to better coordinate national preparedness strategy. It also

proposed an emergency health benefit to protect the uninsured and

underinsured after a disaster so they'd feel free to get treatment,

particularly if the emergency involves an infectious disease.

http://www.azstarnet.com/dailystar/160156