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2010 Report: Public Health Preparedness

New York City FlagSection 2: Snapshots of Public Health Preparedness in States and Directly Funded Localities: New York City

Related Website: New York City Department of Public Health

A healthy population is more resilient in public health emergencies. People with chronic conditions may require additional care such as specialized medications, equipment, and other assistance. To develop an effective response plan, a state or locality must consider the unique needs of its own population. In New York City, 7.5% of adults reported having asthma, 6.9% diabetes, 4.7% heart disease, and 2.4% had a stroke. In addition, 17.4% reported a limiting disability and 55.0% were overweight or obese.*
*CDC, ONCDIEH (NCCDPHP) Behavioral Risk Factor Surveillance System, 2008

All response begins at the local level. Being prepared to prevent, respond to, and recover from all types of public health threats requires that states and localities improve their capabilities in surveillance, epidemiology, laboratories, and response readiness. Facts on laboratories and response readiness activities appear below. See appendices 1 and 7 for a more detailed description of data points and data sources.

Table 1. Laboratories: General

Category of Activities Specific Activity Response
Maintaining core laboratory functions during an emergency

Status of continuity of operations plan (COOP):1

No data collected

Ensuring availability of Laboratory Response Network (LRN) laboratory results for decision making

State had a standardized electronic data system capable of messaging laboratory results between LRN laboratories and also to CDC2

Note: For a description of LRN laboratories, see appendix 1.

Yes

1APHL; 2008 2CDC, OSELS; 2008

Table 2. Laboratories: Biological Capabilities

Category of Activities Specific Activity Response
Participation in LRN for biological agents LRN reference and/or national laboratories that could test for biological agents3 1 reference lab
Assessing if laboratory emergency contacts could be reached 24/7 LRN laboratories successfully contacted during a nonbusiness hours telephone drill3 1 out of 1 lab
Evaluating LRN laboratory capabilities Proficiency tests passed by LRN reference and/or national laboratories3 4 out of 4 tests
Rapid identification of disease-causing bacteria by PulseNet laboratories Rapidly identified E. coli O157:H7 using advanced DNA tests (PFGE)4
  • Samples for which state performed tests
-
  • Test results submitted to PulseNet database within 4 working days (target: 90%)
-
Rapidly identified L. monocytogenes using advanced DNA tests (PFGE)4
  • Samples for which state performed tests
-
  • Test results submitted to PulseNet database within 4 working days (target: 90%)
-
Assessing laboratory competency and reporting through exercises State public health laboratory conducted exercises to assess competency of sentinel laboratories to rule out bioterrorism agents1 -

CDC-funded LRN laboratory ability to contact the CDC Emergency Operations Center within 2 hours during LRN notification drill3

Note: There is one CDC-funded LRN laboratory in DC and in each state, with the exception of CA, IL, and NY, which have two.

Passed

1APHL; 2008 2CDC, OSELS; 2008 3CDC, OID (NCEZID); 2008 4CDC, OPHPR (DSLR); 2008 5CDC, ONDIEH (NCEH); 2009 6CDC, ONDIEH (NCEH); 2008 7State data; 2008 8CDC, OPHPR (DEO); 2009 9CDC, OPHPR (DEO); 2008

Table 3. Laboratories: Chemical Capabilities

Category of Activities Specific Activity Response
Participation in Laboratory Response Network for chemical agents (LRN-C)

LRN-C laboratories with capabilities for responding if the public is exposed to chemical agents5

Note: There are three levels, with Level 1 having the most advanced capabilities. See appendix 1.

One
Level 3
lab
Evaluating LRN-C laboratory capabilities through proficiency testing Core methods successfully demonstrated by Level 1 and/or Level 2 laboratories to rapidly detect chemical agents5 N / A
Additional methods successfully demonstrated by Level 1 and/or Level 2 laboratories to rapidly detect chemical agents5 N / A
Assessing LRN-C laboratory capabilities through exercises LRN-C laboratory ability to collect, package, and ship samples properly during LRN exercise5 Passed
Chemical agents detected by Level 1 and/or Level 2 laboratories in unknown samples during the LRN Emergency Response Pop Proficiency Test (PopPT) Exercise6 N / A
Hours to process and report on 500 samples by Level 1 laboratory during the LRN Surge Capacity Exercise (range was 71 to 126 hours)5 N / A

1APHL; 2008 2CDC, OSELS; 2008 3CDC, OID (NCEZID); 2008 4CDC, OPHPR (DSLR); 2008 5CDC, ONDIEH (NCEH); 2009 6CDC, ONDIEH (NCEH); 2008 7State data; 2008 8CDC, OPHPR (DEO); 2009 9CDC, OPHPR (DEO); 2008

Table 4. Response Readiness: Communication

Category of Activities Specific Activity Response
Communicating emerging health information

State public health department had a 24/7 reporting capacity system that could receive urgent disease reports any time of the day7

Yes

Responded to Health Alert Network (HAN) test message within 30 minutes8

-

State public health laboratory used HAN or other rapid method (blast email or fax) to communicate with sentinel laboratories and other partners for outbreaks, routine updates, training events, and other applications1

-

Epidemic Information Exchange users responded to system-wide notification test within 3 hours9

-
Improving public health information exchange

Participated in a Public Health Information Network forum (community of practice) to leverage best practices for information exchange10

Yes

1APHL; 2008 2CDC, OSELS; 2008 3CDC, OID (NCEZID); 2008 4CDC, OPHPR (DSLR); 2008 5CDC, ONDIEH (NCEH); 2009 6CDC, ONDIEH (NCEH); 2008 7State data; 2008 8CDC, OPHPR (DEO); 2009 9CDC, OPHPR (DEO); 2008

Table 5. Response Readiness: Planning

Category of Activities Specific Activity Response
Assessing plans to receive, distribute, and dispense medical assets from the Strategic National Stockpile and other sources

Cities Readiness Initiative (CRI) jurisdiction 2007- 2008 technical assistance review (TAR) score11,12

New York City: 99 (part of Cohort 1, which was established in 2004)

Note: A score of 69 or higher indicates a CRI jurisdiction performed in an acceptable range in its plan to receive, distribute, and dispense medical assets.

See appendix 6 for the average TAR score for the metropolitan statistical area of New York City, NY, which has multiple contributing jurisdictions in addition to New York City.

Enhancing response capability for chemical events

CHEMPACK nerve-agent antidote containers11

55
Meeting preparedness standards for local health departments

Local health departments meeting voluntary Project Public Health Ready preparedness standards13

0

1APHL; 2008 2CDC, OSELS; 2008 3CDC, OID (NCEZID); 2008 4CDC, OPHPR (DSLR); 2008 5CDC, ONDIEH (NCEH); 2009 6CDC, ONDIEH (NCEH); 2008 7State data; 2008 8CDC, OPHPR (DEO); 2009 9CDC, OPHPR (DEO); 2008

Table 6. Response Readiness: Exercises and Incidents

Category of Activities Specific Activity Response
Notifying emergency operations center staff

Pre-identified staff notified to fill all eight Incident Command System core functional roles due to a drill, exercise, or real incident14

Note: State must report 2 and could report up to 12 notifications.

4 times

Pre-identified staff acknowledged notification within the target time of 60 minutes14

4 out of 4 times

Conducted at least one unannounced notification outside of normal business hours14

Yes
Activating the emergency operations center (EOC)

Public health EOC activated as part of a drill, exercise, or real incident14

Note: State must report 2 and could report up to 12 activations.

2 times

Pre-identified staff reported to the public health EOC within the target time of 2.5 hours14

2 out of 2 times

Conducted at least one unannounced activation14

Yes

1APHL; 2008 2CDC, OSELS; 2008 3CDC, OID (NCEZID); 2008 4CDC, OPHPR (DSLR); 2008 5CDC, ONDIEH (NCEH); 2009 6CDC, ONDIEH (NCEH); 2008 7State data; 2008 8CDC, OPHPR (DEO); 2009 9CDC, OPHPR (DEO); 2008

Table 7. Response Readiness: Evaluation

Category of Activities Specific Activity Response
Assessing response capabilities through after action report/ improvement plans (AAR/IPs)

AAR/IPs developed following an exercise or real incident14

Note: State must report 2 and could report up to 12 AAR/IPs.

2
AAR/IPs

AAR/IPs developed within target time of 60 days14

2 out of 2
AAR/IPs

Re-evaluated response capabilities following approval and completion of corrective actions identified in AAR/IPs14

Yes

1APHL; 2008 2CDC, OSELS; 2008 3CDC, OID (NCEZID); 2008 4CDC, OPHPR (DSLR); 2008 5CDC, ONDIEH (NCEH); 2009 6CDC, ONDIEH (NCEH); 2008 7State data; 2008 8CDC, OPHPR (DEO); 2009 9CDC, OPHPR (DEO); 2008

In addition to the activities listed above, CDC supported other projects and activities to enhance preparedness efforts. Snapshots of these CDC efforts are provided below.

Project Location/Project Name Amount
Centers for Public Health Preparedness15 Columbia University - Mailman Center for Public Health $525,674
Preparedness and Emergency Response Research Centers15 - N / A
Advanced Practice Centers16 - N / A
Centers of Excellence in Public Health Informatics17 New York City Department of Health and Mental Hygiene $930,959

Table 8. Research, Training, Education, and Promising Demonstration Projects

Pandemic Influenza Promising Practices Demonstration Projects14

Collaborative Planning for Delivery of Essential Healthcare Services;


Countermeasure and State Immunization Information Systems Integration

$850,681

 


$387,082

14CDC, OPHPR (DSLR); 2008 15CDC, OPHPR (OD); 2008 16NACCHO; 2008 17CDC, OSELS; 2008 18CDC, OPHPR (DEO); 2008 19CDC, OID (NCEZID); 2008

Project Description
Epidemic Intelligence Service
  • Investigations conducted by Epidemic Intelligence
    Service Field Officers17
3
  • Investigations conducted by Epidemic Intelligence
    Service Field Officers17
8
Deployments
  • Type of Incident (number of CDC staff)18
Bacillus Infections (3)
Career Epidemiology Field Officers15 2
Quarantine Stations19 JFK International Airport, New York City

Table 9. Additional CDC Resources Supporting Preparedness in States and Localities

14CDC, OPHPR (DSLR); 2008 15CDC, OPHPR (OD); 2008 16NACCHO; 2008 17CDC, OSELS; 2008 18CDC, OPHPR (DEO); 2008 19CDC, OID (NCEZID); 2008

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