Swine flu shows holes in nation’s emergency response, report says

WASHINGTON -- The swine flu outbreak has exposed gaps in the nation's emergency-preparedness network, according to a report issued Tuesday on how well states can handle a public health disaster.

"The H1N1 outbreak has vividly revealed existing gaps in public health emergency preparedness," said Richard Hamburg, the deputy director of the Trust for America's Health, a nonpartisan public health advocacy group, which co-authored the report with the Robert Wood Johnson Foundation.

Hamburg compared what he called the nation's "Band-Aid approach" to emergency preparedness to "only funding the fire department after the fire has already started."

The report, titled "Ready or Not? Protecting the Public's Health from Disease, Disasters and Bioterrorism," found that:

• 27 states cut funds for public health from 2008 to 2009.

• 13 states have only half their share of federally subsidized anti-flu drugs to stockpile for an epidemic.

• 11 states and the District of Columbia reported they don't have enough lab staff to work the kinds of intense, 12-hour days for six to eight weeks during outbreaks such as swine flu.

No state met all 10 of the report's indicators used to measure their levels of emergency preparedness.

Seven states met nine. Montana met just three.

Nevada scored six out of 10, placing the Silver State in the middle of the pack compared with the rest of the country.

Out of the 10 factors, Nevada did not earn a check mark in four categories:

• The public health laboratory does not have the capacity to assure timely pickup and delivery of disease samples around the clock.

• The state lacks a disease-tracking system compatible with the federal Centers for Disease Control and Prevention database.

• Nevada failed to identify the source of food-borne disease outbreaks at a rate equal to or greater than the national average of 46 percent.

• The state did not meet the Medical Reserve Corps criteria for medical volunteers during an emergency.

State Health Division spokeswoman Martha Framsted said the results can be deceiving, especially regarding the disease-tracking system.

Most of the state uses the CDC's system, except for the Southern Nevada Health District, Framsted said. That agency uses an older system, but the state tallies that data for the CDC anyway, she said.

"That may be why we're not getting full credit," she said.

Still, Nevada met criteria in the other six categories, including having enough staff to work "intense hours" needed during a potential outbreak.

Nevada also met standards by purchasing 50 percent or more of its share of federal antiviral medications in case of a flu pandemic.

In addition, Nevada was one of only 20 states to require child care facilities to have written evacuation and relocation plans in case of emergencies.

The state also increased or maintained public health funding from fiscal year 2007-08 to 2008-09; has a law in place to limit liability against organizations that volunteer during emergencies; and met standards for available hospital beds during the H1N1 response.

The report called for restoring money cut from public health budgets and improving flu-vaccine production. Other recommendations: a post-H1N1 outbreak study to reassess emergency planning and education campaigns about vaccine safety.

"We might think that things like the recent H1N1 outbreak, like Hurricane Katrina or 9/11 should be wakeup calls for politicians and key officeholders and the public," said Dr. Irwin Redlener, the director of the National Center for Disaster Preparedness and a professor of pediatrics at Columbia University. "Unfortunately, events like that are too often more like a snooze alarm.

"We get aroused, we spend money, and we then just drift back into a state of complacency."

Las Vegas Review-Journal writer Mike Blasky contributed to this report.