Public Health Emergency Preparedness and Response. An Update November 20,2012 Naveena Bobba MD, MPH

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1 Public Health Emergency Preparedness and Response An Update November 20,2012 Naveena Bobba MD, MPH

2 The capability of the public health system, communities and individuals to prevent, protect against, quickly respond to and recover from health emergencies, particularly those whose scale, timing or unpredictability threatens to overwhelm routine capabilities. Public Health Emergency Preparedness

3 Emergency / Disaster Operations Assess public health/medical needs Provide public health expertise & information Communicate both internally and externally with partners and the public Manage infectious disease emergencies Ensure a safe environment Coordinate disaster medical care medical surge Support mass care and shelter Support fatality management Provide EOC representative Continuity of operations (COOP) SFDPH Primary Responsibilities

4 Leadership changes: Erica Pan director till 10/2011 Karen Holbrook director till 11/2012 Staffing changes Logistics coordinator Staffing shortages Section Changes

5 Naveena Bobba MD, MPH Acting Director Amanda Kwong/ Lorna Garrido Administrative Analyst TBD Healthcare & Community Outreach Shannon Limjuco PHEPR Manager Alice Kurniadi Mass Prophy TBD Mass Prophy Assistant Mary Macaluso HPP Coordinator Kenpou Saechao Operations/ Planning Support Tanya Bustamante DPH Planning TBD Logistics Coordinator TBD Logistics Assistant Carmen Nolasco Administrative Support Current Org Chart

6 Emergency Operations Plan & Continuity of Operations Plan

7 Information Sharing

8 Medical Surge

9 Total # licensed beds: 3300 Staffed ICU: 300 adult/ 85 pediatric 1 level 1 Trauma Center / 1 burn unit 320 Gurneys COOP all have plans to sustain staffing -96 hrs All have space for alternate staging MOUs for critical resources Discharge: - >½ can d/c up to 15% w/in 24 hrs Transportation: ~ 100 hospital vans All have evacuation & building assessment plans Collective Capability of SF Hospitals

10 Exercise Purpose: Health care facilities are able to evaluate current response concepts, plans, and capabilities for a response to a loss of the power supply. Particular emphasis will be placed on participant discussions to identify gaps and vulnerabilities at the facility level. Statewide Medical Health Exercise 2012

11 Internally (at the hospital level) there is no systematic way of identifying an outage; individual department must notify facilities/building engineer. PG&E does not have the ability to identify whether or not a hospital(s) has outage unless notified directly by the hospital. Disaster scenario dictates resource allocation Power outage: Fuel and generators are critical Hospitals can maintain essential services with backup power for at least 96 hrs Recognized vulnerability that relying on back up generators for extended period resulted in potential for a single point of failure Hospitals have identified critical services that should be maintained during a disasterthese differ by hospital Observations from Power Loss Tabletop

12 The purpose of the Mass Prophylaxis Plan is to provide mass dispensing of preventive vaccines and/or antimicrobials. Objectives include Set up and operate Point of Dispensing (POD) sites Operate POD sites in a scalable fashion to serve the appropriate number of clients (200 to 1.2 million) in a timely manner. Distribute antibiotics to pre-partners (Push Partners) who serve groups unable or unwilling to use PODs and to those whose self-dispensing capacity can reduce the demand on PODs Activate the local cache and distribute antibiotics to Emergency Responder Agencies that have elected to do self dispensing. Mass Prophylaxis Plan

13 Resource Management & Distribution

14 Funding Section is completely grant funded Must work through both local and state funding barriers Difficult to get revisions done in timely manner Ability to address local needs is reduced Limited in directing money to SFDPH emergency preparedness needs Resource Management Tracking Maintaining Storing Deploying Challenges

15 Trainings Scope Incident Command Structure (ICS) Disaster Service Worker (DSW) Logistics EOP training Disaster Clinician Trainings Policy Coordination with EMS Roles and Responsibilities Challenges

16 San Francisco Medical / Health Response 911

17 MHOAC Program Health Officer/EMS Medical Director Current training to widen number of people that can fill this role Scale and Scope inform location within CCSF ICS Overarching Responsibilities Establish, maintain and share a common operating picture of the event Coordinate services & resources Provide technical information & guidance Medical/Health Coordination

18 All Disasters Start and End Locally San Francisco Fires after 1906 earthquake, Sacramento Street SF City Hall after 1906 earthquake and today.