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Integrating Partners and
Resources to Enhance
Community Preparedness
August 30, 2016
Amanda Lubit DVM, MS, MPH
@NACCHOalerts | www.naccho.org | 1100 17th St NW Washington, DC 20036
Disaster Anthropology
• Holistic, all-hazards approach
• Understanding forces that make
people vulnerable to disaster
Consulting
• Libya – post-conflict context
• Nepal – post-natural disaster context
• NACCHO – preparedness approach
About Me
All-Hazards Approach
@NACCHOalerts | www.naccho.org | 1100 17th St NW Washington, DC 20036
The National Association
of County and City Health Officials
(NACCHO) represents the nation’s
2,800 local health departments
(LHDs) and 162,000 employees.
NACCHO’s mission:
To be a leader, partner, and voice for
LHDs in order to ensure conditions
that promote health and equity,
combat disease, and improve quality
and length of all lives.
About NACCHO
Radiological Chemical
Biological Nuclear
@NACCHOalerts | www.naccho.org | 1100 17th St NW Washington, DC 20036
Local Health Departments:
Size of Population Served
@NACCHOalerts | www.naccho.org | 1100 17th St NW Washington, DC 20036
Identifying underutilized community resources
1. Leveraging existing infrastructure
2. Cultivating community partnerships
3. Using social media tools to increase capacity
@NACCHOalerts | www.naccho.org | 1100 17th St NW Washington, DC 20036
1. Leveraging Existing Infrastructure
• Identify existing infrastructure and build relationships
• Community organizations and businesses already exist
• Leveraging these resources expands capabilities to respond
• Cost-effective
@NACCHOalerts | www.naccho.org | 1100 17th St NW Washington, DC 20036
Example – Flu on CallTM:
• Flu on CallTM – national network of telephone triage lines
• Partnership with United Way 2-1-1 and Poison Control
• Have existing business model and expertise
• To increase surge capabilities in case of pandemic influenza
@NACCHOalerts | www.naccho.org | 1100 17th St NW Washington, DC 20036
• Existing relationships with social, ethnic and religious groups
• Invest time in relationship building before disaster
• Increases local capacity
• Resources for risk messaging, MCM distribution and services
2. Cultivating Community Partnerships
@NACCHOalerts | www.naccho.org | 1100 17th St NW Washington, DC 20036
Example – Pharmacies
• Profound access to populations – 93% of US population
• Trained medical professionals
• Experience with processing large numbers of patients
• Have existing procedures to manage a pandemic scenario
@NACCHOalerts | www.naccho.org | 1100 17th St NW Washington, DC 20036
3. Using Social Media
• Often underutilized for surveillance and response
• 91% of population owns a cell phone, 72% a smart phone
• 99% of users will check text messages within 3 minutes
• Quick, easy, non-invasive way to communicate
@NACCHOalerts | www.naccho.org | 1100 17th St NW Washington, DC 20036
Example – Mobile Symptom Monitoring
• Use mobile texting system for symptom monitoring
• Replaces monitoring by phone or in-person visits
• Began with Avian Influenza responders
• Expanded to other diseases and audiences
• Significant reduction in time and effort
of local health departments
@NACCHOalerts | www.naccho.org | 1100 17th St NW Washington, DC 20036
Recap
Mass casualty events will result in a surge on medical
facilities as large numbers of people need care.
I have discussed three ways communities can increase
response capabilities
1. Leveraging existing infrastructure
2. Cultivating community partnerships
3. Using social media tools to increase capacity
@NACCHOalerts | www.naccho.org | 1100 17th St NW Washington, DC 20036
Thank You
Amanda Lubit, DVM, MS, MPH
DHC Global Consultant
Amanda.Lubit@gmail.com
Dhcglobal.org
NACCHO’s Pandemic & Catastrophic Prep.
alubit@nacho.org
Naccho.org

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Integrating Partners and Resources to Enhance Community Preparedness, Amanda Jenifer LUBIT

  • 1. Integrating Partners and Resources to Enhance Community Preparedness August 30, 2016 Amanda Lubit DVM, MS, MPH
  • 2. @NACCHOalerts | www.naccho.org | 1100 17th St NW Washington, DC 20036 Disaster Anthropology • Holistic, all-hazards approach • Understanding forces that make people vulnerable to disaster Consulting • Libya – post-conflict context • Nepal – post-natural disaster context • NACCHO – preparedness approach About Me All-Hazards Approach
  • 3. @NACCHOalerts | www.naccho.org | 1100 17th St NW Washington, DC 20036 The National Association of County and City Health Officials (NACCHO) represents the nation’s 2,800 local health departments (LHDs) and 162,000 employees. NACCHO’s mission: To be a leader, partner, and voice for LHDs in order to ensure conditions that promote health and equity, combat disease, and improve quality and length of all lives. About NACCHO Radiological Chemical Biological Nuclear
  • 4. @NACCHOalerts | www.naccho.org | 1100 17th St NW Washington, DC 20036 Local Health Departments: Size of Population Served
  • 5. @NACCHOalerts | www.naccho.org | 1100 17th St NW Washington, DC 20036 Identifying underutilized community resources 1. Leveraging existing infrastructure 2. Cultivating community partnerships 3. Using social media tools to increase capacity
  • 6. @NACCHOalerts | www.naccho.org | 1100 17th St NW Washington, DC 20036 1. Leveraging Existing Infrastructure • Identify existing infrastructure and build relationships • Community organizations and businesses already exist • Leveraging these resources expands capabilities to respond • Cost-effective
  • 7. @NACCHOalerts | www.naccho.org | 1100 17th St NW Washington, DC 20036 Example – Flu on CallTM: • Flu on CallTM – national network of telephone triage lines • Partnership with United Way 2-1-1 and Poison Control • Have existing business model and expertise • To increase surge capabilities in case of pandemic influenza
  • 8. @NACCHOalerts | www.naccho.org | 1100 17th St NW Washington, DC 20036 • Existing relationships with social, ethnic and religious groups • Invest time in relationship building before disaster • Increases local capacity • Resources for risk messaging, MCM distribution and services 2. Cultivating Community Partnerships
  • 9. @NACCHOalerts | www.naccho.org | 1100 17th St NW Washington, DC 20036 Example – Pharmacies • Profound access to populations – 93% of US population • Trained medical professionals • Experience with processing large numbers of patients • Have existing procedures to manage a pandemic scenario
  • 10. @NACCHOalerts | www.naccho.org | 1100 17th St NW Washington, DC 20036 3. Using Social Media • Often underutilized for surveillance and response • 91% of population owns a cell phone, 72% a smart phone • 99% of users will check text messages within 3 minutes • Quick, easy, non-invasive way to communicate
  • 11. @NACCHOalerts | www.naccho.org | 1100 17th St NW Washington, DC 20036 Example – Mobile Symptom Monitoring • Use mobile texting system for symptom monitoring • Replaces monitoring by phone or in-person visits • Began with Avian Influenza responders • Expanded to other diseases and audiences • Significant reduction in time and effort of local health departments
  • 12. @NACCHOalerts | www.naccho.org | 1100 17th St NW Washington, DC 20036 Recap Mass casualty events will result in a surge on medical facilities as large numbers of people need care. I have discussed three ways communities can increase response capabilities 1. Leveraging existing infrastructure 2. Cultivating community partnerships 3. Using social media tools to increase capacity
  • 13. @NACCHOalerts | www.naccho.org | 1100 17th St NW Washington, DC 20036 Thank You Amanda Lubit, DVM, MS, MPH DHC Global Consultant Amanda.Lubit@gmail.com Dhcglobal.org NACCHO’s Pandemic & Catastrophic Prep. alubit@nacho.org Naccho.org

Editor's Notes

  1. Thanks for the introduction, just as a point of clarification today I’m representing NACCHO (the National Association of County and City Health Officials) but I am an independent consultant and work on other disaster projects as well.
  2. To start with a little information about me, as a disaster anthropologist, I take a holistic approach to disaster That means understanding the complex forces that contribute to making people and communities vulnerable to disasters –looking at economic, social, cultural, religious, environmental and/or political factors I also take an all hazards approach to disaster, and have worked in a variety of contexts This includes post-conflict Libya, post-earthquake Nepal, and disaster preparedness with local communities in the United States. In each of these cases, I worked to develop integrated community-based programs for reducing risk and improving resilience
  3. What I’m going to talk about briefly today is my work in disaster preparedness at NACCHO The organization as a whole represents the nation’s more than 2800 local health departments I have worked on various programs with them, with a focus on helping local communities to mitigate, respond to and recover from mass casualty events Those include biological, chemical, radiological and nuclear threats
  4. This graphic is to give you an idea of the sizes of health departments in the United States The majority of health departments are small, serving populations less than 50 thousand At the same time, the majority of the population of the United States is served by the smallest group of health departments, which serve populations in excess of 500 thousand like in Los Angeles and New York City.
  5. Most health departments are expected to protect their communities with limited resources and hardships like staff shortages and yearly budget cuts. I’m going to briefly outline three different ways that we’ve helped health departments to identify and tap into underutilized community resources, as a way to do more with the little that they have Those are to leverage existing infrastructure to expand local surge capabilities, to cultivate community partnerships to access networks of resources, and to develop social media tools to complement existing strategies The graphic here shows the response gap that exists in a disaster. As I’m sure many of you are aware, in the first day or two of an event, a local community is almost entirely on its own since federal support takes at least 2 days to arrive. In any type of mass casualty event, there will be large numbers of people needing medical care With this high demand comes a surge on medical facilities. They become crowded, and people experience growing delays in getting access to care and information The projects I’ll briefly describe were designed with this surge scenario in mind, aiming to strengthen the local capacity to respond, regardless of the size of the health departments
  6. The first strategy is leveraging existing infrastructure. All communities have existing infrastructure in place that is often an untapped resource in emergency preparedness and response Health departments canto take advantage of these by identifying existing organizations and businesses that already specialize in relevant and crucial activities Examples are organizations with triage phone lines, poison control, or social service support. It’s important to build relationships with these organizations before a disaster so that roles, responsibilities and procedures are established and tested ahead of time The benefit is that this approach builds on something that already exists, meaning that health department can expand their response capabilities with relatively small investment
  7. A key example of this is NACCHO’s work with the Centers for Disease Control to develop a national network of telephone triage lines that can be turned on during an influenza pandemic. Flu On Call was created by leveraging existing triage line infrastructure and personnel When activated, the public calls into a centralized phone number where a staff member assesses their health status, provides health education, directs them to the appropriate level of care, and can even prescribe antivirals if appropriate The system works through a partnership with regional and national organizations such as United Way 2-1-1 and poison control The business model for United Way 211 focuses on providing information about community resources to the public by phone using trained information specialists Similarly, poison control employs trained medical professionals who can provide triage, advice and treatment Together these two partners can provide both medical and informational services through the flu-on-call system Since these organizations have existing infrastructure and already specialize in these services, they were ideal resources for local health departments to tap into
  8. health departments can also increase their capabilities by forming relationships with groups that are embedded in their communities and have existing relationships with social, ethnic and religious groups This relationship can increase the reach of health departments into the community, providing them with help in public messaging, medical countermeasure distribution and service delivery Tapping into these resources requires that health departments invest a significant amount of time and effort into relationship building beforehand, so that once an incident occurs all partners are familiar and comfortable with one another NACCHO has worked on many different projects, engaging partners such as pharmacies, healthcare coalitions and cancer centers in this way
  9. Pharmacies are a prime example In the United States there are an estimated 82 thousand pharmacies, with 93% of the country’s population living within just 5 miles of a pharmacy. This gives pharmacies profound access to the country’s population, making them an ideal partner in disaster preparedness and response Pharmacy staff are not only highly trained medical professionals, but they also know their communities and are well trusted and respected They also have daily experience with providing customer service, counseling patients and processing large numbers of patients. And they already have procedures to manage surge in a pandemic scenario, including ways to manage patient flow, dispense medication and administer vaccines All of these characteristics make them ideal partners in local, regional and national preparedness and response
  10. NACCHO has also invested in the use of social media tools such as mobile texting platforms and mobile applications We found that these tools are often underutilized by local health departments for disease surveillance and response activities but there is a lot of potential In the US, 91% of the population owns a cell phone with 72% having a smart phone Not only that, 99% of text messages are read within just 3 minutes of being sent This makes text messaging an ideal way to reach the majority of the population quickly and easily with little cost
  11. NACCHO has worked with the Centers for Disease Control to make several text messaging systems available to health departments throughout the country. This includes using the technology for vaccine reminders and antiviral adherence Most recently we’ve expanded this technology for use as a disease surveillance tool, testing it with avian influenza. In an avian outbreak, all responders returning from the field require 10 days of symptom monitoring, which is traditionally done by local health departments through daily phone calls and home visits. This requires substantial investments of time and manpower, placing an unmanageable burden on health departments Using text messaging, they can now monitor responders for symptoms indirectly by having them answer a question over text Then health department personnel only need to contact those responders who report symptoms, leaving the healthy to self-monitor. Pilot tests of this technology have been extremely successful and suggest there is a great deal of potential for other applications For instance, at the request of health departments, we’ve already rolled it out in mumps and swine influenza outbreaks, and there’s been a lot of interest in expanding it to other diseases.
  12. Just to recap, mass casualty events of any kind will cause a surge on medical facilities that needs to be planned for. Three different ways local health departments have addressed this problem are to: Leverage existing infrastructure Cultivate community partnerships And use social media tools
  13. If there are any questions, please feel free to come up after or contact me here. Thank you!