Public Health Preparedness Modeling

How will global climate change affect public health departments? The National Association of County and City Health Officials (NACCHO), Environmental Defense Fund (EDF) and George Mason University have conducted a survey of local public health directors to answer this question. The report, published by EDF, shows that local public health directors worry that climate change will cause serious public health problems, believe that they are not ready to deal with the impacts of climate change that could occur, and desire additional resources to improve their preparedness. (Their most common concerns were heat waves, poor air quality, poor water quality, droughts, fires, and storms.) The report’s recommendations follow naturally from these beliefs. Included is the recommendation to “Develop improved climate and weather modeling capacity for local scale assessments.”

Interestingly, the report includes the following observation:

there are many opportunities for synergy between existing public health preparedness activities
(e.g. bioterrorism, pandemic flu, and all-hazard preparedness) and those addressing health threats from climate change.

If you have data on the time needed to dispense antibiotics (or other oral medications) in a drive-through POD, please let me know - we would like to include such data in our Clinic Planning Model Generator, and there are other planners who need that data also.  Thank you!

As always, my email is jwh2@umd.edu.

David Dickerson, a Strategic National Stockpile Coordinator at the Texas Department of State Health Services, has made available a set of resources for POD planning. In particular these tools are designed to help educate and recruit volunteers. You can access the resources at the following URL: www.snstools.info by using the user name “sns” and the password “tools” (note: Mr. Dickerson has given me permission to post this information).

In addition to brochures and posters to recruit volunteers, there is a large (10 MB), animated Powerpoint presentation that describes the SNS and PODs, when they would be used, and their operations. There are computer-generated videos and images of what a POD might look like if the whole thing (including a station for watching an educational video) were setup in a typical high school gymnasium, which was interesting because some jurisdictions plan to use many different rooms within a school. I’m not sure it would work very well in a gym due to possible congestion problems. But it is useful as a demonstration.

In general, the whole site is easy to use and navigate. I’m sure that public health planners around the country can benefit from these resources.

On April 3, I had the opportunity to present some of our recent work on POD resupply planning to some folks at the Metropolitan Washington Council of Governments. My presentation and the subsequent discussion focused on the operational phase, after PODs have received some initial supplies, but more needs to be delivered (because not everything arrived in time or because those directing the effort want to avoid distributing medication to the wrong place). The key idea of the plan I presented is that PODs would be continuously resupplied (from one or more local depots) during an event. Each POD would be assigned to a truck route, and each truck would continuously loop from a depot to the PODs on its route and back to the depot. At each POD, the truck would deliver just enough medication to bring the inventory at that POD back to a predetermined target level. I also presented a rough-cut planning model (implemented in a spreadsheet) for this type of operation.

The planning questions involve determining what size trucks are needed for each route (or, are evaluating whether the available trucks are large enough) and determining what the target inventory level should be at each POD. We also discussed the problem of what if deliveries to the depot (from the state or federal level) are delayed and issues related to PODs of different sizes.

If any planners are considering this problem and have developed models that they would like to share or would like more information about the models that we’re developing, please let me know at jwh2@umd.edu.

Over at LiveSmarter, Laura Milligan has included our blog in her list of top 100 academic medical blogs.  Her list covers a range of topics, including research, health news, medical technology, hospitals, and various medical conditions.  We thank her for noticing our work.