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Planning, Training, and Exercising—Public Health Prepares for Emergency Health Threats

CDC has shifted the strategic focus of its preparedness investments from building infrastructure to improving the speed at which partners respond to public health emergencies.

The strategic focus of CDC’s preparedness investments involve improving the speed at which CDC and its partners respond to public health emergencies. CDC’s preparedness goals are designed to directly measure how quickly we prevent, detect, investigate, and control public health emergencies.

Protecting the nation’s health from emerging health threats, such as the threat of an influenza pandemic, is one of CDC’s most important responsibilities. While a pandemic has not occurred in more than 40 years, it is important that the United States and the world remain vigilant and be ready to respond despite having little knowledge of when or where the threat may appear. Mostly occurring in Indonesia, the current circulation of the highly pathogenic strain of avian influenza A (H5N1) in poultry, wild birds, and, to a much smaller extent, in humans is not expected to decline greatly in the near future.

To help prepare for a possible pandemic, CDC’s work begins internationally with its Global Disease Detection Centers to carefully monitor changes in the virus that might allow it to evolve into a strain that could result in a pandemic. Under the leadership of the State Department, CDC’s collaboration with the World Health Organization and national ministries of health have proven to be effective and important not only in the early identification of suspected cases of avian flu, but in improving influenza surveillance, laboratory testing, and rapid response.

In 2007, CDC has conducted one 24-hour exercise in January and two 48-hour functional exercises in April and August; each building on the successes and information gained from the previously conducted exercise. CDC staff from across the agency manned their posts in CDC’s Emergency Operations Center, referred to as the DEOC, to practice what they would do in response to a real emergency situation. Staff played out their roles in specific scenarios that might take place in an emergency event. National media covered the exercises including coverage from such outlets as MSNBC, The New York Times, The Washington Post, and even members from the Canadian press.

In January, the exercise focused on a single identified case of avian influenza in a young college student who had just returned from a trip to Indonesia to visit his family. In April, the practice grew in complexity affecting more people in more places, and, in August, the most frightening scenario of all was played out, with people around the world dying of H5N1, and with a pandemic seemingly imminent.

These exercises are designed to reach out to other federal agencies, as well as state, local, territorial, and tribal partners and to exercise coordination and response efforts before a real event occurs. These exercises have brought together representatives from the Department of Health and Human Services, the Food and Drug Administration, the American Red Cross, state representatives, the private sector, and others to learn how to enhance networking and improve coordination. CDC is now better prepared to respond to a possible pandemic and to other events such as hurricanes, food-borne outbreaks, and terrorist attacks.