Pre-Event
Planning
Response
Teams
Sending
in Response Teams – Thing to Remember
Community physicians,
hospitals, and Local Public Health Officials will be the real first
responders. Most of the smallpox response work will be done by
local public health officials. The local government knows their
area. Don’t see it as “taking over.” Level of
the national response will depend partly on Local Area Capacity
and Political Realities. Another confounding factor will be the
involvement of other national agencies that deal with emergency
response and criminal investigation. Response teams from all coordinating
agencies should be trained to understand their roles and responsibilities
in an outbreak so as to avoid unnecessary confusion during a response.
Response
Team Composition – The U.S. Response Team Structure
- Physician
Team Leader
- Public Health
Advisors
- Medical Epidemiologists
- Laboratory
Scientist or Technician
- Information
Technology Specialist / Communications Specialists
- Community
Liaison Specialist/Anthropologist
- Occupational
Health Specialist
Physician
Team Leader
The Physician
Team Leader will coordinate all team activities. This position
will most likely spend the bulk of his time coordinating with local
and state policy makers in order to coordinate decisions consistent
with national policy. Based on the needs of the local area, this
position will also designate tasks for the other team members.
Senior Public
Health Advisor
The Senior Public
Health Advisor is an employee with management skills. While they
are not usually a nurse or physician, they are trained in public
health and medical issues and understand what needs to happen during
a response. The Senior Public Health Advisor serves as deputy to
team leader for management and operations oversight. Other duties
of this position include representing the team leader at operational
meetings, managing non-technical aspects of activities and key
problem solver and expediter. The role of the Senior Public Health
Advisor frees up the team leader to concentrate on medical issues.
Public Health
Advisors
The general
Public Health Advisors are also management positions. However,
their training in epidemiology consists of contact tracing and
researching skills. They also have experience in doing things for
other medical personnel, as well as translating scientific theories
into lay language for the public. These positions can also be trained
to administer vaccinations, if necessary. By doing all the footwork
in the investigation, the public health advisors free up the medical
staff to work on medical issues and evaluation of the outbreak.
Medical Epidemiologists
The Medical
Epidemiologists are either physicians, nurses, or PhD epidemiologists
who server as technical consultants in the response. They have
a strong understanding of epidemiology and can assist the local
area in investigation procedures, conducting surveillance and analyzing
that surveillance. They can also help the local area understand
technical information in order to make good decisions about how
to manage the outbreak. Medical Epidemiologists serve as technical
consultants for outbreak investigation, surveillance, data collection,
isolation, hospital infection control and Communication of technical
info to local Health Departments.
The Medical
Epidemiologist coordinating vaccine safety issues assists with
establishing surveillance for vaccine adverse events. They coordinate
activities for:
- Diagnosing
and monitoring adverse events
- Medical care
for serious adverse events
- Reporting
- Analysis
- Coordinating
safety and risk messages with communications specialist
Laboratory
Scientist or Technician
The CDC also
maintains a group of laboratory scientists and technicians who
can deploy to help train medical providers and laboratories on
all aspects of laboratory diagnosis, from specimen collection and
handling to the processing of tests. They also help to coordinate
the referral of specimens to the national laboratory, including
shipping, specimen quality and results. Laboratory Scientists would
advise medical care providers and laboratories on all aspects of
specimen collection, handling, processing and safety.
Communications
Specialists
The Communications
Specialists help to coordinate all messages between the various
health agencies, emergency response agencies, criminal agencies,
and political offices. During a smallpox outbreak, rumor control
and consistent messages will be key to keeping the public calm.
These specialists can also help the local area with dealing with
the press.
Community
Liaison Specialists/Anthropologist
The Community
Liaison Specialists can maintain contact with key partners and
hold briefings for those partners to keep them up-to-date on the
most current recommendations. They serve as contact to local hospitals,
infectious disease specialists, health department officials, and
other key community responders to:
- Identify
and brief key community partners.
- Assist in
management of community outreach staff.
- Help prepare
for and hold partner briefings.
- Assist in
communication and educational activities for quarantined persons
and families, contacts, etc.
- Report outreach
progress and requirements to team leader and CDC
The Community
Liaison Specialists also facilitates flow of information to places
where community goes for information and answers, e.g., hotlines,
etc.
Information
Technology Specialists
The Information
Technology Specialists are key to assisting with technology issues.
These positions should be familiar with database construction and
have a broad understanding of various software and hardware in
order to facilitate the exchange of data between various levels
of government. They should be able to create and implement databases
onsite, as needed. IT Specialists should assist and coordinates
data management for surveillance, lab specimens and results, contact
tracing, vaccinations and adverse events. They should also act
as a problem solver for software and connectivity issues with team
and local counterparts.
Occupational
Health Specialist
The Occupational
Health Specialist is key to ensuring that the controls are in place
to protect all personnel, from the national response team to the
local level healthcare providers. Some of their tasks should include
training the teams and exposed workers on personal protection equipment,
ensuring that negative pressure rooms are working correctly, and
providing and developing guidance on occupational health issues.
Other tasks that the Occupational Health Specialists is responsible
for are:
- Ensure adequacy
of engineering (e.g., ventilation – negative pressure rooms)
and administrative controls.
- Provide guidance
on site safety and health plan. Coordinate with agencies (at
all levels) responsible for occupational issues.
- Facilitate
worker notification regarding exposure and risk of disease.
- Facilitate
employee and labor representation in meetings.
- Technical
assistance on occupational illness and exposure surveillance.
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