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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Stephen S. Morse, PhD, Center for Public Health Preparedness, Columbia University Mailman School of Public Health, 722 West 168th Street, New York, NY 10032, 212-305-8054, ssm20@columbia.edu
The anthrax incidents of September and October 2001 revealed a number of shortcomings in responding to bioterrorist attack. The first notice came through case recognition and response by public health. Public health responded well, but was necessarily reactive. Gaps, and possible solutions, will be discussed. In addition to capacity and logistics issues, some major lessons can be grouped into 3 main categories: (1) Risk assessment and environmental management: While there were compelling similarities to an unexpected infectious disease outbreak, the environmental public health component proved equally critical. There is need to integrate the environmental and medical management expertise, and to develop assessments integrating environmental risk and health effects. Some shortcomings are due to fragmentation of knowledge, and lack of information sharing. Information outside the public health domain that might have aided risk assessment (such as an earlier Canadian study modeling a similar scenario) should have been available to public health. (2) Risk communication: There is continuing need for reliable and timely information to the public and media, further complicated by likelihood that the perpetrator(s) could monitor the media and act to undermine official assurances. (3) Systems analysis: The focus on reactively identifying and responding to the outbreaks, while necessary, did not encourage a systems analysis. A systems approach would address the possibility of environmental contamination along the chain of "transmission", more critically assessing population at risk (e.g., mailhandlers). To address these gaps, an integrated approach to preparedness is required, with special consideration of assessment and communications issues and information sharing. (Supported by CDC/ASPH Cooperative Agreement S1544-20/20.)
Learning Objectives: At the conclusion of the presentation, the participant will be able to
Keywords: Bioterrorism,
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.