CDC’s Office of Public Health Preparedness and Response (OPHPR) Releases Their State Preparedness Report

By Tony Barkey, Senior Specialist, Public Health Preparedness and Response, APHL 

On September 21, 2010, CDC’s Office of Public Health Preparedness and Response (OPHPR) released their third preparedness report, Public Health Preparedness: Strengthening the Nation’s Emergency Response State by State. The report highlights success and challenges of preparedness and response efforts taking place at state and local health departments across the nation.

As was reported, states continue to make progress implementing Continuity of Operations Plans (COOP). COOP ensures that vital public institutions, like public health laboratories, continue to function during and after an emergency. Today’s changing threat environment and recent emergencies, including localized acts of nature, accidents, technological emergencies and terrorist attacks, have increased the need for COOP capabilities and plans. All 50 states and DC either have a laboratory- specific COOP, are part of their state’s COOP or are in the process of developing their own plan. As we saw during the novel influenza A H1N1 outbreak, having these preparedness plans in place enabled the quick response that was seen. 

The report also revealed that 49 out of 50 states and DC conducted exercises to assess the competency of sentinel clinical laboratories within their state to rule out potential bioterrorism agents. This demonstrates the outreach from the LRN reference laboratories, funded via the CDC Public Health Emergency Preparedness Cooperative Agreement, to their partners who are often on the front line receiving samples during an emergency.

These positive results come at a time when many states are experiencing difficulties maintaining the workforce necessary for an effective response. 41% faced hiring difficulties and 28% faced retention issues. For those that reported hiring difficulties, 36% identified a lack of funding as a primary reason and another 31% reported hiring freezes. 

APHL staff and members played a prominent role in the publication by providing laboratory- and state- specific data to the report. APHL’s data points, collected from the annual All-Hazards Laboratory Preparedness Survey, were used to describe issues such as workforce shortages, continuity of operations, sentinel clinical outreach and training, emergency communication, and general laboratory testing capability. If you are interested in finding out more, the report can be found here. 

APHL Briefs Experts on Biosecurity in Public Health Laboratories

By Sikha Singh, MHS, Specialist, Laboratory Response Network, APHL 

APHL was invited to participate in the September 16th meeting of the Federal Experts Security Advisory Panel (FESAP) to provide a perspective on how potential changes in biosecurity requirements would impact public health laboratories, especially those in the Laboratory Response Network (LRN). Dr. Michael Pentella, associate director of disease control at the Iowa State Hygienic Laboratory, and Rosemary Humes, APHL’s senior advisor for scientific affairs, spoke to the group.

FESAP was created by the recently signed Executive Order on Optimizing the Security of Biological Select Agents and Toxins in the United States to provide advice to the Secretaries of the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) on Select Agent Program security including:

• The composition and potential reduction of the Biological Select Agents and Toxins (BSAT) list, including the development of “Tier 1 agents,” which pose the greatest risk for intentional misuse 
• Measures to enhance reliability of personnel with access to Tier 1 BSAT 
• Standards for physical and cyber security for facilities possessing Tier 1 BSAT 
• Emerging policy issues relevant to the security of BSAT. 

During the course of their presentation to the panel, Humes and Pentella highlighted the robust biosecurity and biosafety practices implemented within public health laboratories, as well as the distinction between public health laboratories and academic and production laboratories. Public health laboratories perform detection, surveillance and diagnostic testing that provides a front-line of defense against health threats in our nation. Their ability to detect agents of biological terrorism and public health significance plays a significant role in national security, as witnessed by the response of LRN laboratories to the 2001 anthrax events and to daily threat detection in all 50 states. 

Pentella echoed the sentiments expressed in the comments provided by APHL on the current HHS list of select agents and toxins. He commented that existing biosecurity measures have proven successful and that increased biosecurity measures would be burdensome and costly to public health laboratories, impacting their ability to provide immediate testing and response capabilities to potential bioterrorism and other threats of public health significance. Pentella further emphasized the funding issues facing laboratories, particularly in light of economic constraints leading to furloughs and extensive budget cuts. 

In response to the many questions raised by the panel, Pentella and Humes noted that current personnel controls are adequate and are further strengthened by regulatory requirements that specify stringent biosafety and biosecurity controls within public health laboratories. Laboratory directors and responsible officials remain empowered to make decisions necessary to maintain the integrity of their laboratories. 

In a heartening conclusion to the discussion, Dr. Gerald Parker, DVM, PhD, MS, Principal Deputy Assistant Secretary, Office of the Assistant Secretary for Preparedness and Response, HHS stated that, "The LRN is one of best investments we've collectively made in bioterrorism preparedness and response." 

APHL and its members value opportunities to shed light on issues that affect public health laboratories and will continue to promote the role of these laboratories in detecting and responding to bioterrorism, emerging infectious diseases and other public health threats.