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Report says most states still aren't prepared for major emergencies

WASHINGTON—Five years after the Sept. 11 terror attacks, the country still isn't fully prepared to respond to a major public health emergency such as bioterrorism or pandemic flu, a health policy group said in a report released Tuesday.

The Trust for America's Health said the public health emergency response system is underfunded and lacks accountability and strong national leadership. The report suggests some unsettling scenarios should disaster strike.

"The overall message is, to some degree we are doing better," said Jeffrey Levi, the group's executive director. "But we're not as prepared as we ought to be. There is tremendous unevenness across the states."

The trust's fourth annual report, "Ready or Not? Protecting the Public's Health from Diseases, Disasters and Bioterrorism," can be accessed at

Half of the states met only six or fewer of the 10 benchmarks the group established to provide "a composite snapshot of preparedness, including strengths and vulnerabilities."

Only Oklahoma met all 10 benchmarks. Only Kansas met nine. California, Iowa, Maryland and New Jersey got the worst scores, meeting only four.

"We're trying to be prepared for any disaster, from tornadoes and ice storms, to mumps and pandemic flu, to any act of terrorism," said Mindee Reece, director of Kansas' Center for Public Health Preparedness. "It's so much more broad than in 2002 when we initiated these activities."

Among the report's findings:

_Half of the states would run out of hospital beds within two weeks of a moderate outbreak—defined as eight to 12 weeks—of pandemic flu. Forty states have a nursing shortage.

"Frankly, we could have lots of hospital beds," Levi said, "but if we don't have health care workers to take care of those beds, we could be in bad shape."

_Only 15 states, along with New York City and Chicago, are prepared to deliver vaccines and medicines quickly from the federal government's Strategic National Stockpile. This is a repository of medical supplies kept in 12 secret locations around the country.

_Eleven states and Washington, D.C., aren't fully capable of testing for biological threats.

_Four states—Iowa, New Jersey, Ohio and Louisiana—don't test for the flu year-round, which the report said was crucial for tracking a pandemic outbreak.

"The whole thing has been in slow motion since 9/11," said Irwin Redlener, an adviser on the report and an associate dean at Columbia University's Mailman School of Public Health. "There are no working standards that have to be met by states. The money is basically going out the door with very little accountability or direction."

Washington has doled out $4 billion since the 2001 terrorist attacks and anthrax deaths to help states better prepare for disasters. But the federal government doesn't tell the public if states are well prepared, Levi said.

Von Roebuck, a spokesman for the federal Centers for Disease Control and Prevention, said some information is withheld for security reasons. But he complimented the report, calling it "a valuable tool because it raises awareness for public health emergency efforts to continue."

The trust recommended that a single federal official from the Department of Health and Human Services oversee all public health programs to better coordinate national preparedness strategy.

It also proposed an emergency health benefit to protect the uninsured and underinsured after a disaster so they would feel free to get treatment, particularly if the emergency involves an infectious disease.

Other recommendations included full funding of all public health emergency programs, a push for new vaccines and the release of all state preparedness data.

"The public believes that more is being done and we are better prepared than we are," said Margaret Hamburg, a trust board member and former top Health and Human Services official.


(c) 2006, McClatchy-Tribune Information Services.

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