January 20, 2017
4 min read

More than half the country not adequately prepared for health emergency

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An annual report issued by the Trust for America’s Health suggests that if a large health emergency occurred in the United States without warning, much of the country would be ill-equipped to sufficiently combat it.

With Anthony S. Fauci, MD, the director of the National Institute of Allergy and Infectious Diseases, earlier this month discussing the certainty of a “surprise” outbreak in the next few years, this report spotlights the need for greater public health preparedness.

As part of those efforts, primary care physicians can play a vital role in helping their communities be better prepared, according to experts.

“The nation has an inconsistent approach to preparing for health emergencies, which creates a situation where we are often caught off guard when new threats arise, such as Zika or the Ebola outbreak or a bioterrorist threat,” Rich Hamburg, interim president and CEO, Trust for America’s Health (TFAH), said in a recent conference call discussing the report, Ready or Not? Protecting the Public from Disasters, Diseases and Bioterrorism. “We aren’t adequately maintaining a strong and steady defense. And the result is that we consistently see health emergencies disrupting, derailing and diverting resources from other ongoing priorities and efforts from across government — in addition to leaving Americans at unnecessary risk.”

Rich Hamburg
Rich Hamburg

The study assessed a state’s ability to respond to health threats and trends in public health awareness over the past 15 years, a TFAH press release stated. Indicators such as influenza vaccination rates, public health funding commitments and accreditations, national health security preparedness indexes and public health laboratories were among the criteria TFAH used to rank the states.


Massachusetts was the only state in the report that scored a 10 out of 10, according to the release. Washington, D.C., and 26 other states scored 6 or lower on the indicators TFAH used to judge preparedness.

States that did well have taken “…sufficient action … to support adequate public health preparedness,” Hamburg said, while states that ranked lower in the survey, are where “…improvements must be made to overcome obstacles to achieving a solid baseline of preparedness to protect every American, no matter where they live.”

One of the report’s collaborators said resistance to preparing for emergencies is futile.

Eric Toner
Eric S. Toner

“The likelihood of a disaster befalling any one individual is relatively small but the consequences can be enormous, which makes the risk significant,” Eric S. Toner, MD, and senior associate, UPMC Center for Health Security, told Healio Family Medicine. “It’s like insurance; it makes sense to invest a small amount in an ongoing way to limit the impact of an unlikely but catastrophic potentiality. And although state and federal agencies will be there to help eventually, they cannot make up for all the harm that could be mitigated by a modest amount of preparedness.”


What primary care physicians can do

A doctor from the highest-ranking state in TFAH’s survey said everyone must prepare for emergencies, and discussed some of the resources available to medical professionals to help them do so.

“Every physician should be prepared … Preparedness is everyone’s responsibility,” Eric Goralnick, MD, MS, medical director of emergency preparedness, Brigham and Women's Hospital, Boston, told Healio Family Medicine.

He added that websites such as Ready.gov, HHS.gov and CDC.gov are just some of the resources primary care doctors and medical professionals can use to prepare themselves, their staffs and their patients in the event of an emergency.  

Eric Goralnick
Eric Goralnick

“Get involved in your state’s medical society’s preparedness activities … If you have some time to attend some fantastic in-person training, you can attend courses at the Federal Emergency Management Agency’s Center for Domestic Preparedness,” Goralnick said.

The need for emergency preparedness extends beyond states that are considered ‘hot zones’ of infectious diseases such as Ebola and the Zika virus, Mary Clark, Massachusetts’ director of preparedness and emergency management said.

“We relied on hospitals and physicians and other providers to be able to get correct information about Ebola out to the people and to answer questions and to help us deal with the rumors and the misinformation,” Clark told Healio Family Medicine. She also noted primary care physicians played a critical role in her state to ensure more common prevention measures, such as influenza vaccinations, occur.

Mary Clark
Mary Clark

“Primary care physicians are key to making sure that vaccinations happen on an annual basis or that information gets out to clients on what a health issue might be. I think they serve not only to provide medical services, but also to serve as providing information and education to the patients that they serve.”

Clark also pointed to the importance of health professionals working together and not becoming complacent as critical to handling emergencies.

“We really look at what we do as a collaborative system, it’s no one part of the system that does everything. It’s having everyone working together towards a common goal that really I think makes everything work,” she said. “Preparedness is really a process, it’s not a destination, so it’s really an ongoing effort to keep improving and finding ways to do things better. Even if you think you can do things fairly well there’s always a new way you can try something that will be more effective or more efficient than the way you’ve done it before.”


What to tell patients

Goralnick said primary care doctors can also advise their patients to come up with a strategy that addresses several questions.

“These plans should include some key questions: How will my family get emergency alerts and warnings? How will my family get to safe locations? How will my family get in touch if cell phone, internet, or landline doesn’t work? How will I let loved ones know I am safe? How will family/household get to a meeting place after the emergency?” he said. “Having a plan is critical.”

According to TFAH, communities also need to be broadly resilient, find solutions specific to their area, and broaden their health sector preparation base to handle emergencies. – by Janel Miller

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Disclosures: Clark, Goralnick, Hamburg and Toner all report no relevant financial disclosures.