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

  1. Physician Team Leader
  2. Public Health Advisors
  3. Medical Epidemiologists
  4. Laboratory Scientist or Technician
  5. Information Technology Specialist / Communications Specialists
  6. Community Liaison Specialist/Anthropologist
  7. 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:

  1. Diagnosing and monitoring adverse events
  2. Medical care for serious adverse events
  3. Reporting
  4. Analysis
  5. 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:

  1. Identify and brief key community partners.
  2. Assist in management of community outreach staff.
  3. Help prepare for and hold partner briefings.
  4. Assist in communication and educational activities for quarantined persons and families, contacts, etc.
  5. 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:

  1. Ensure adequacy of engineering (e.g., ventilation – negative pressure rooms) and administrative controls.
  2. Provide guidance on site safety and health plan. Coordinate with agencies (at all levels) responsible for occupational issues.
  3. Facilitate worker notification regarding exposure and risk of disease.
  4. Facilitate employee and labor representation in meetings.
  5. Technical assistance on occupational illness and exposure surveillance. 
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