Planned Preparedness, Planned Response

If you asked your neighbor, boss, or friend to talk about emergency preparedness 10 years ago their answer might have been simple, something having to do with an ambulance, firefighter, or tornado siren. Maybe they would have expressed vague fears about the Y2K bug.

Fast forward to today. Answers now would be about living through the horrors of 9/11, a string of anthrax attacks, a killer tsunami, and Hurricane Katrina. Vague fears would be replaced by detailed accounts of what could happen in the face of a bioterrorist attack or flu outbreak.

In just five years we have witnessed some of the worst human-made and natural disasters of our time. From these events, we have seen firsthand the complexities of preparedness--how organizations must work together, and how disastrous it is when they don’t. The once behind-the-scenes field of public health preparedness is now front and center, making daily headlines.

While the concepts of preparedness are new to many people, School of Public Health faculty and staff have long been experts in the field. From researching best preparedness practices, to educating the next generation of public health leaders, to training emergency professionals, the school is working to make communities safer and keep the public healthy.

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As associate dean for public health practice education, Debra Olson oversees many of the school’s preparedness activities. She says the SPH conducts a full range of preparedness research, education, and outreach. Partnering with the public health workforce on these programs means critical preparedness skills get into the hands of those who need them most. This can happen in many forms--cuttingedge research, one-day trainings, online resources, certificate programs, graduate degrees. Just as the school offers a spectrum of educational offerings, it tailors those offerings to the needs of specific audiences, including health care workers, volunteers, health department professionals, and first-responders like police and firefighters.

Olson believes there are two essential components to the success of the programs: collaboration and coordination. The school’s strong collaborative ties to leaders in the workforce mean curriculum and research are relevant and up-to-date. And coordination within the school means preparedness trainings and practices aren’t duplicated. “We can’t afford to duplicate efforts, there’s too much work to be done, especially in preparedness and response,” she says.

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Preparing Public Health Leaders

Established in 2002, the University of Minnesota Center for Public Health Preparedness (UMN-CPHP) is charged with keeping state and local public health professionals up to speed on preparing for terrorist attacks, infectious disease outbreaks, and other threats. The Centers for Disease Control and Prevention fund more than 20 of these centers nationally. The Minnesota CPHP works in collaboration with state and local departments of health in Minnesota, North Dakota, and Wisconsin.

In the past year, state partners asked the center to help create a systematic way for public health agencies to train staff according to CDC-established competencies in bioterrorism preparedness and emergency readiness. The UMN-CPHP responded with online and print materials in competency mapping.

“Competency mapping is a system that helps organizations determine if specific training activities effectively contribute to the development of identified competencies,” says Sue Larson, who helps coordinate the UMN-CPHP with primary investigator Debra Olson.

In the event of disease outbreak or other emergencies, establishing dispensing sites for antibiotics or vaccinations will play a critical role in controlling illness. To help train the volunteers who would work at these sites, the UMN-CPHP developed an online primer. After passing a post-training test, users can print out a certificate that they present to their volunteer coordinator.

A self-assessment exercise is included so volunteers can pinpoint which volunteer positions best suit them. One of the latest UMN-CPHP online training projects is “Protecting our Food System from International Attack.” Topics covered include an overview of food system vulnerabilities, best practices in risk communication, and exercises on avian influenza and toxins.

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Preparing Frontline Workers

For 23 years, the SPH has trained more than 12,000 workers in hazardous materials management and emergency response. Firefighters, police, food workers, and first-responders are just some of the groups to sign up for courses ranging from three to forty hours.

Faculty from the school’s Division of Environmental Health Sciences provide expertise in leading some of the trainings. Most courses are taught by frontline workers, and many courses include mock drills.

“We are one of the few universities to provide this handson training for a working population,” says Lois Harrison, who coordinates a federal grant directed by SPH professor William Toscano. “People come to us from throughout the country.”

After Hurricane Katrina hit, a wave of hygienists and engineers came to Minnesota to get skilled in environmental cleanup. Harrison works closely with the community to determine which skills are needed in the workforce. She sees an emerging need in virtually every hazardous materials course.

“Meth lab remediation is a big issue,” she says. “Workers want to learn about the chemicals they’re dealing with and what protective gear to use. We’re working to get people up to speed on these things.”

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Preparing Health Care

Health care workers in Minnesota now have access to training that will help protect them and their patients in emergencies like a disease outbreak, natural disaster, hazardous materials spill, or bioterrorist attack. Under a $2.7 million federal grant, the Minnesota Emergency Readiness Education and Training (MERET) program will train 10,000 workers in three years.

Just a year into the project, nearly 5,000 workers have already participated in MERET training, both online and in person. MERET is a joint venture of the SPH and the University of Minnesota School of Nursing.

Calling on nursing expertise--as well as input from agencies like the CDC and Minnesota Department of Heath--“makes the training targeted, relevant, and practical for people in the field,” says Andrea Hickle, an educational specialist who coordinates MERET with primary investigator Carol O’Boyle, an assistant professor in the School of Nursing.

Online training modules address a spectrum of best practices, from basics like washing hands and using masks, to assembling a hospital decontamination team, to designing an airborne-infection isolation room. Stored Webcasts of the Emergency Readiness Rounds series address other key topics in emergency preparedness, made available through a partnership with the University of Minnesota Center for Public Health Preparedness and the Academic Health Center Office of Emergency Response.

MERET has partnered with these two units to offer a series of train-the-trainer workshops on personal and family emergency preparedness. MERET’s online training means both health care facilities and the public can have access to up-to-the-minute, expertly made, no-cost preparedness planning tools--tools that can be tailored to a specific workplace, community, or home.

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Preparing Volunteers

Degrees and Certificates Students in the Executive Program in Public Health Practice (for working professionals) and the Veterinary Public Health Program can focus their M.P.H. degree on one of two preparedness areas: Preparedness, Response, and Recovery or Food Safety and Biosecurity. Want the skills but don’t need a master’s degree? The school offers post-baccalaureate certificates in both areas.

The University of Minnesota’s Medical Reserve Corps (MRC) was just a year into existence when it was deployed to help with one of the country’s most devastating emergencies: Hurricane Katrina. A team of University faculty, alumni, and students volunteered for relief efforts in the wake of the storm.

Eighteen of those volunteers were from the SPH. Since then, the MRC has ramped up its University membership, now at 900 strong, and expanded its training--much of it provided by the SPH. In order to develop expertise, the MRC is creating specialized teams that could be deployed in an emergency to assist with mass dispensing of medications, test the safety of personal protection equipment, and help hospital staff.

Preparing for “Pan Flu” Preparing for the possibility of pandemic influenza is top on the MRC list of training its volunteers. Those efforts came from the request of University leaders and from local and state health departments.

“The MRC was created to meet the needs of our own campus but to also be of service to the broader community,” says Jill DeBoer, director of the Academic Health Center Office of Emergency Response and associate director of the Center for Infectious Disease Research and Policy (CIDRAP).

State and local health departments will soon get additional help preparing for a potential pandemic through a partnership between the Pew Charitable Trusts and CIDRAP, one of the nation’s leading centers of scholarship and action on public health and pandemic flu. The project will identify the biggest problems state and local agencies may confront in a pandemic, and then collect and disseminate innovative options for addressing them. An advisory committee will include many of the nation’s most respected names in public health.

“Right now, too many state and local health departments have to reinvent the wheel as they move through the planning process,” says DeBoer, principal investigator on the initiative. “This project will allow departments to share and build on the work of their peers nationwide, and help speed the process of pandemic preparedness while sparing resources.”

The School of Public Health and College of Veterinary Medicine have just received a three-year, $2.9 million award from the CDC to explore the human-animal interface of avian influenza viruses. SPH professor Marguerite Pappaioanou is principal investigator for the project. She will work with colleagues in the United States and Thailand to establish a research center for international zoonotic influenza. The aim of the center is to better understand how influenza viruses are passed from birds and swine to humans.

A smaller part of the center’s activities will address issues of preparedness. University colleagues Pete Raynor, SPH assistant professor, and John Shutske will work with backyard poultry farmers and swine production employees to analyze their use of personal protective equipment and other hygienic practices. From that analysis, they hope to develop recommendations that would help prevent the transmission of influenza viruses from animals to humans--practices that would prove critical in a global outbreak.