OU Health Sciences CenterUniversity of Oklahoma

Public Health Topics


Overview

Public Health Preparedness and Response Core Competency Model (PHPR):

Domains: 1 - Model Leadership; 2 - Communicate and Manage Information; 3 - Plan for and Improve Practice; 4 - Protect Worker Health and Safety

 

CDC Public Health Preparedness Capability: National Standards for State, and Local 3/11 Video or Files (3.1 MB)

Taken directly from the CDC:

Brief EXECUTIVE SUMMARY : (click link above to read complete information)

Public health threats are always present. Whether caused by natural, accidental, or intentional means, these threats can lead to the onset of public health incidents. Being prepared to prevent, respond to, and rapidly recover from public health threats is critical for protecting and securing our nation’s public health.
The 2009 H1N1 influenza pandemic underscored the importance of communities being prepared for potential threats. Because of its unique abilities to respond to infectious, occupational, or environmental incidents, the Centers for Disease Control and Prevention (CDC) plays a pivotal role in ensuring that state and local public health systems are prepared for these and other public health incidents. CDC provides funding and technical assistance for state, local, and territorial public health departments through the Public Health Emergency Preparedness (PHEP) cooperative agreement. PHEP cooperative agreement funding provides approximately $700 million annually to 50 states, four localities, and eight U.S. territories and freely associated states for building and strengthening their abilities to respond to public health incidents.
Evolving Threats and Strengthening the Public Health System
Public health departments have made progress since 2001, as demonstrated in CDC’s state preparedness reports (http://www.cdc.gov/phpr/reportingonreadiness.htm). However, state and local public health departments continue to face multiple challenges, including an ever-evolving list of public health threats. Regardless of the threat, an effective public health response begins with an effective public health system with robust systems in place to conduct routine public health activities. In other words, strong state and local public health systems are the cornerstone of an effective public health response.
Today, public health systems and their respective preparedness programs face many challenges. Federal funds for preparedness have been declining, causing state and local planners to express concerns over their ability to sustain the real and measurable advances made in public health preparedness since September 11, 2001, when Congress appropriated funding to CDC to expand its support nationwide of state and local public health preparedness. State and local planners likely will need to make difficult choices about how to prioritize and ensure that federal dollars are directed to priority areas within their jurisdictions.
Defining National Standards for State and Local Planning
In response to these challenges and in preparation for a new five-year PHEP cooperative agreement that takes effect in August 2011, CDC implemented a systematic process for defining a set of public health preparedness capabilities to assist state and local health departments with their strategic planning. The resulting body of work, Public Health Preparedness Capabilities: National Standards for State and Local Planning, hereafter referred to as public health preparedness capabilities, creates national standards for public health preparedness capability-based planning and will assist state and local planners in identifying
gaps in preparedness, determining the specific jurisdictional priorities, and developing plans for building and sustaining capabilities. These standards are designed to accelerate state and local preparedness planning, provide guidance and recommendations for preparedness planning, and, ultimately, assure safer, more resilient, and better prepared communities.
Public health preparedness capabilities. CDC identified the following 15 public health preparedness capabilities (shown in their corresponding domains) as the basis for state and local public health preparedness:

Biosurveillance Community Resilience Countermeasures and Mitigation Incident Management Information Management Surge Management
Public Health Laboratory Testing
Community Preparedness
Medical Countermeasure Dispensing
Emergency Operations Coordination
Emergency Public Information and Warning
Fatality Management
Public Health Surveillance and
Epidemiological Investigation
Community Recovery
Medical Materiel Management and Distribution
 
Information Sharing
Mass Care
   
Non-Pharmaceutical Interventions
   
Medical Surge
   
Responder Safety and Health
   
Volunteer Management

 

NIMS Implementation and Compliance Guidance for Stakeholders PHPR

States and Territories
http://www.fema.gov/pdf/emergency/nims/AllGovernors_2009_NIMS_ImplementationLetterIMSI.pdf

Link for all three of the above
http://www.fema.gov/pdf/emergency/nims/FY2009_NIMS_Implementation_Chart.pdf

http://www.fema.gov/emergency/nims/ImplementationGuidanceStakeholders.shtm

http://www.fema.gov/emergency/nims/AboutNIMS.shtm

http://www.fema.gov/pdf/emergency/nims/NIMS_core.pdf

The National Institute for Occupational Safety and Health (NIOSH)
http://www.cdc.gov/niosh/

 

PERRCS

PHASYS Interactive Models: "Chris Keane developed this model as an extension of his outbreak response model, with embedded spread of virus." PHPR 1.3, 1.4 2.2, 2.3, 2.4, 2.5, 3.1-3.3, 4.2; CDC Capabilities Videos and Files( 3.1 MB):

  1. Agency Coordination and Redundancy
    1. Shows affects of agency coordination on different modes consenus vs.parallel modes.
  2. Distribution Resource;
    1. Allows a view of the distribution across a network.
  3. Foodborne Disease Spread;
    1. "This flexible model allows for two routes of infection, person-to-person and from infected food, and two restaurants with two suppliers."
  4. School Infectious Outbreaks;
    1. "Simulates illness spreading, children, adults and elderly going from home to public places, with surveillance, different vaccination strategies, and agencies with the authority to close schools. It is meant to be very simple, to stimulate thinking about adaptive response. The purpose is not to predict absolute numbers of infections but rather to generate new insights into the type of dynamics at play."
  5. System Response and Infectious Disease Outbreak:

Harvard's LAMPS:

  1. Flu Math Games for teacher and students; PHPR: 2.3 3.1; CDC Capabilities Videos and Files( 3.1 MB):1, 2, 3, 6, 8, 13, 14, 15
    1. Allows individuals the ability to visualize the spread of diseases such as the Flu a

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Risk Communication

PHPR: 1.1, 1.3, 1.4, 1.5, 1.6, 2.1, 2.2, 2.3, 2.4, 2.5; CDC Capabilities Videos and Files( 3.1 MB): 1, 3, 4, 6, 7, 9, 11, 15

Commincating in the First Hours:

Introduction:

The Office of Public Affairs of the U.S. Department of Health and Human Services (HHS) and the Centers for Disease Control and Prevention (CDC) have developed messages and other resources for federal, state, local, and tribal public health officials to use during a response to an emergency.

Provided here are messages that apply to all Category A Biological Agents, as classified by the CDC, as well as messages about chemical and radiological events and suicide bombing.

Purpose:

The messages were written to be used by federal public health officials and to be adapted for the use of state and local public health officials during a terrorist attack or suspected attack. Use these messages as follows:

  • To communicate with the public during a terrorist attack or a suspected attack
  • To adapt for a specific event (These messages were written for fictitious situations, so assumptions were made about an event.)
  • To provide information during the first hours of an event
  • To save precious moments during the initial response time and to buy the time necessary for public health leaders to develop more specific messages

In addition to this federal resource, public health departments in several states and some cities and local governments have developed similar messages. With the permission of the public health departments, state and locally developed messages will be shared on this site so that public health officials throughout the nation can benefit from each other’s work.

 

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Mental Health Workers

CDC Capabilities Videos and Files( 3.1 MB): 1, 2, 3, 6

Section Content

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Emergency Medical Services and Emergency Medical Responders Providers

CDC Capabilities Videos and Files( 3.1 MB): 1, 2, 3, 5, 6, 7, 8, 10, 11

Treatment and Transport of Victims of Hazardous Substances: PHPR competency 1.1, 1.3, 1.4, 1.5, 1.6, 2.1, 2.2, 2.3, 2.4, 2.5, 3.2, 3.3, 4.1, 4.2, 4.3

"OSHA has developed a guide for emergency medical service (EMS) responders who provide medical assistance during an incident involving a hazardous substance release. This guide is intended for employers of EMS responders and discusses the measures these employers need to take to protect their EMS respon- ders from becoming additional victims while on the front line of medical response".

Emergency Response Guide Book 2008: PHPR competency 3.1, 3.2, 2.5,

"This guide book is for First Responders during the initial phase of transportation of dangerous and hazardous goods; proper shipping documents, identifying transport tankers, identifying railroad cars, who to call for assistance, hazardous classification system, placards, hazard identification codes, pipeline transposition, and much more."

Hospital and Community Emergency Response : PHPR competency 1.1, 1.3, 1.4, 1.5, 1.6, 2.1, 2.2, 2.3, 2.4, 2.5, 3.2, 3.3, 4.1, 4.2, 4.3

  1. Heartland Centers for Public Health & Community Capacity Development: PHPR competency 1.1, 1.3, 1.4, 1.5, 1.6, 2.1, 2.2, 2.3, 2.4, 2.5, 3.2, 3.3, 4.1, 4.2, 4.3

    COURSES BELOW are provided by Heartland Centers

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The Community

CDC Capabilities Videos and Files( 3.1 MB): 1, 2, 7, 15

Community and Hospital Emergency Response : PHPR competency 1.1, 1.3, 1.4, 1.5, 1.6, 2.1, 2.2, 2.3, 2.4, 2.5, 3.2, 3.3, 4.1, 4.2, 4.3

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Caregivers of the Mentally Ill

CDC Capabilities Videos and Files( 3.1 MB): 1

PHPR

Section Content

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Teachers, Children, and Adolescents

CDC Capabilities Videos and Files( 3.1 MB): 1

Harvard's LAMPS:

  1. Flu Math Games for teacher and students; PHPR

Nursing: Perspectives on Suicide Prevention among American Indian and Alaska Native Children and Adolescents: A Call for Help

 

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The Elderly

CDC Capabilities Videos and Files( 3.1 MB): 1

PHPR

Section Content

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The Military and Their Families

CDC Capabilities Videos and Files( 3.1 MB): 1

PHPR

Section Content

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For Families

CDC Capabilities Videos and Files( 3.1 MB): 1

PHPR

Section Content

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Videos

CDC Capabilities Videos and Files( 3.1 MB): 1, 2, 3, 4, 6, 7, 8, 9, 10, 13, 14

PHPR

Section Content

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Team Members

CDC Capabilities Videos and Files( 3.1 MB): 11, 15

PHPR

Section Content

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Training

CDC Capabilities Videos and Files( 3.1 MB): 14

1. Heartland Centers for Public Health & Community Capacity Development: PHPR competency 1.1, 1.3, 1.4, 1.5, 1.6, 2.1, 2.2, 2.3, 2.4, 2.5, 3.2, 3.3, 4.1, 4.2, 4.3

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Publications

CDC Capabilities Videos and Files( 3.1 MB): 1, 2, 3, 4, 6, 7, 13, 14

CPHD: Harzard Risk Assessment Workbook: PHPR 1.1, 1.2, 1.3, 1.4, 1.5, 2.2, 2.3, 3.1, 4.1, 4.2, 4.3

A guide to enable state and local public health agencies to conduct a risk assessment of their community. The tool is designed for use as a standard approach to hazard risk assessment that is adapted to the public health impacts of hazards. HRAI will allow public health agencies to assess the probability of hazards for a particular geographic area and the magnitude of impact given the local resources, allowing for prioritization of response and mitigation options.

PHICS: Public Health Incident Command System PHPR: 4.3, 4.2, 4.1, 3.3, 3.1, 2.5, 2.3, 2.2, 2.1, 1.6, 1.5, 1.4, 1.1, 1.2,

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Post Traumatic

CDC Capabilities Videos and Files( 3.1 MB): 1, 2

Coping with Traumatic Events PHPR: 1.2, 1.3, 1.4, 1.5, 2.2, 2.3, 3.1, 4.1, 4.2, 4.3

http://www.nimh.nih.gov/health/topics/coping-with-traumatic-events/index.shtml

 

Traumatic Incident Stress

CDC Capabilities Videos and Files( 3.1 MB): 1, 2; PHPR:1.2, 1.3, 1.4, 1.5, 2.2, 2.3, 3.1, 4.1, 4.2, 4.3


http://www.cdc.gov/niosh/topics/traumaticincident/


Recommendations to Monitor and Maintain Health On-Site

Responders need to take care of their own health to maintain the constant vigilance they need for their own safety. Responders must be able to stay focused on the job in the dynamic, changing emergency environment. Often responders do not recognize the need to take care of themselves and to monitor their own emotional and physical health. This is especially true if recovery efforts stretch into several weeks. The following guidelines contain simple methods for workers and their team leaders to help themselves and their team members. These guidelines should be read while at the site and again after workers return home.

Control the organization and pace of the rescue and recovery efforts

    • Pace yourself. Rescue and recovery efforts at the site may continue for days or weeks.
    • Watch out for each other. Coworkers may be intently focused on a particular task and may not notice a hazard nearby or behind.
    • Be conscious of those around you. Responders who are exhausted, stressed, or even temporarily distracted may place themselves and others at risk.
    • Take frequent rest breaks. Rescue and recovery operations take place in extremely dangerous work environments. Mental fatigue, particularly over long shifts, can greatly increase emergency workers' risk of injury.

Maintain adequate nutrition and rest

    • Eat and sleep regularly. Maintain as normal a schedule as possible and adhere to the team schedule and rotation.
    • Drink plenty of fluids such as water and juices.
    • Try to eat a variety of foods and increase your intake of complex carbohydrates (for example, breads and muffins made with whole grains, granola bars).
    • Whenever possible, take breaks away from the work area. Eat and drink in the cleanest area available.

Monitor mental/emotional health

    • Recognize and accept what you cannot change—the chain of command, organizational structure, waiting, equipment failures, etc.
    • Talk to people when YOU feel like it. You decide when you want to discuss your experience. Talking about an event may be reliving it. Choose your own comfort level.
    • If your employer provided you with formal mental health support, use it!
    • Give yourself permission to feel rotten: You are in a difficult situation.
    • Recurring thoughts, dreams, or flashbacks are normal—do not try to fight them. They will decrease over time.
    • Communicate with your loved ones at home as frequently as possible.

Recommendations to Maintain Health Following the Incident

Over time, workers' impressions and understanding of their experience will change. This process is different for everyone. No matter what the event or an individual's reaction to it, workers can follow some basic steps to help themselves adjust to the experience:

  • Reach out—people really do care.
  • Reconnect with family, spiritual, and community supports.
  • Consider keeping a journal.
  • Do not make any big life decisions.
  • Make as many daily decisions as possible to give yourself a feeling of control over your life.
  • Spend time with others or alone doing the things you enjoy to refresh and recharge yourself.
  • Be aware that you may feel particularly fearful for your family. This is normal and will pass in time.
  • Remember that "getting back to normal" takes time. Gradually work back into your routine. Let others carry more weight for a while at home and at work.
  • Be aware that recovery is not a straight path but a matter of two steps forward and one back. You will make progress.
  • Appreciate a sense of humor in yourself and others. It is okay to laugh again.
  • Your family will experience the disaster along with you. You need to support each other. This is a time for patience, understanding, and communication.
  • Avoid overuse of drugs or alcohol. You do not need to complicate your situation with a substance abuse problem.
  • Get plenty of rest and normal exercise. Eat well-balanced, regular meals.
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Signs and Symptoms

CDC Capabilities Videos and Files( 3.1 MB): 1, 2, 4, 11

Symptoms of Stress PHPR: 4.3, 4.2, 4.1, 3.1, 2.5, 2.3, 2.2, 2.1, 1.6, 1.5, 1.4

    Workers may experience physical, cognitive, emotional, or behavioral symptoms of stress. Some people experience these reactions immediately at the scene, while for others symptoms may occur weeks or months later.

Physical symptoms

Workers experiencing any of the following symptoms should seek IMMEDIATE medical attention:

  • Chest pain
  • Difficulty breathing
  • Severe pain
  • Symptoms of shock (shallow breathing, rapid or weak pulse, nausea, shivering, pale and moist skin, mental confusion, and dilated pupils)

Workers may also experience the following physical symptoms. If these symptoms occur over time or become severe, workers should seek medical attention. Additional physical symptoms include:

  • Fatigue
  • Nausea/vomiting
  • Dizziness
  • Profuse sweating
  • Thirst
  • Headaches
  • Visual difficulties
  • Clenching of jaw
  • Nonspecific aches and pains

Cognitive symptoms

If these symptoms occur on the scene workers may not be able to stay clearly focused to maintain their own safety or to rescue injured victims. Workers may experience momentary cognitive symptoms; however, if symptoms are chronic or interfere with daily activities, workers should seek medical attention. These symptoms include:

  • Confusion
  • Disorientation
  • Heightened or lowered alertness
  • Poor concentration
  • Poor problem solving
  • Difficulty identifying familiar objects or people
  • Memory problems
  • Nightmares

Emotional symptoms PHPR

Strong emotions are ordinary reactions to a traumatic or extraordinary situation. Workers should seek mental health support from a disaster mental health professional if symptoms or distress continue for several weeks or if they interfere with daily activities. Emotional symptoms include:

  • Anxiety
  • Guilt
  • Denial
  • Grief
  • Fear
  • Irritability
  • Loss of emotional control
  • Depression
  • Sense of failure
  • Feeling overwhelmed
  • Blaming others or self
  • Severe panic (rare)

Behavioral symptoms

As a result of a traumatic incident, workers may notice the following behavioral changes in themselves or coworkers:

  • Intense anger
  • Withdrawal
  • Emotional outburst
  • Temporary loss or increase of appetite
  • Excessive alcohol consumption
  • Inability to rest, pacing
  • Change in sexual functioning
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Critical Incident

CDC Capabilities Videos and Files( 3.1 MB): 1, 4, 5, 7, 9, 11

  1. Emergency Preparedness and Response: PHPR: 1.2, 1.3, 1.4, 1.5, 2.2, 2.3, 3.1, 4.1, 4.2, 4.3
    Resilience Resources for Emergency Response

    Federal and federalized employees involved in emergency response may be physically and emotionally impacted by this experience. Employees involved in response efforts should be encouraged to care for their own health by maintaining normal sleeping habits, trying to exercise, eating well-balanced meals, drinking plenty of non-caffeinated, non-alcoholic beverages, taking rest breaks when possible, and talking about their feelings as needed.

    Emergency response can be both rewarding and stressful, and it is important to recognize that some emotional reactions are to be expected. Support can be provided by family, friends, and consider utilizing community or faith-based organizations. Employers (agencies and contractors) should also make information available to employees about resources for addressing emotional and physical health issues that may arise before, during, and after emergency response efforts. Educational materials and counseling are important options, and employers should encourage the use of these resources to help support their employees.
    http://www.osha.gov/SLTC/emergencypreparedness/resilience_resources/index.html

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Therapists

CDC Capabilities Videos and Files( 3.1 MB): 1, 10

Section Content

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