Epidemic preparedness varies widely from state to state

Published 19 December 2007

If an epidemic breaks out in the United States, you don’t want to find yourself in Arkansas or Mississippi: Research organization scores states’ epidemic preparedness level, and these two states brought up the rear

Trust for America’s Health (TFAH) today released the fifth annual “Ready or Not? Protecting the Public’s Health from Disease, Disasters, and Bioterrorism” report, which found that while important progress has been made, critical areas of the nation’s emergency health preparedness effort still require attention. In addition, the continuing trend of annual cuts in federal funding for state and local preparedness activities threatens the nation’s safety. The “Ready or Not?” report contains state-by-state health preparedness scores based on ten key indicators to assess health emergency preparedness capabilities. All fifty U.S. states and the District of Columbia (D.C.) were evaluated based on data from publicly available sources or public officials in 2007. Thirty-five states and D.C. scored eight or higher on the scale of ten indicators. Illinois, Kentucky, Nebraska, New Jersey, Pennsylvania, Tennessee, and Virginia scored the highest with 10 out of 10. Arkansas, Iowa, Mississippi, Nevada, Wisconsin, and Wyoming scored the lowest with six out of 10.

The improvements in state preparedness are encouraging, but the job of preparing the United States for major health emergencies is not nearly done,” said Jeff Levi, Ph.D., executive director of TFAH. “And, just when we are beginning to see a return on the federal investment in preparedness programs, the President and Congress have continued to cut these funds. These efforts may seem penny wise now, but could prove pound foolish later.”

Among the key findings:

* Thirteen states do not have adequate plans to distribute emergency vaccines, antidotes, and medical supplies from the Strategic National Stockpile

* Twenty-one states do not have statutes that allow for adequate liability protection for healthcare volunteers during emergencies

* Twelve states do not have a disease surveillance system compatible with the Centers for Disease Control and Prevention’s (CDC) National Electronic Disease Surveillance System

* Seven states have not purchased any portion of their federally-subsidized or unsubsidized antivirals to use during a pandemic flu

* Seven states and D.C. lack sufficient capabilities to test for biological threats

There is little doubt that emergency health preparedness is on the national radar,” Levi added. “But until all states are equally well prepared, our country is not as safe as it can and should be.”

The report highlights two areas of particular concern with regard to state-level preparedness:

* Twenty-one states do not provide sufficient legal protection from liability for healthcare volunteers who respond to a call for assistance in an emergency. Lack of such protections has been identified as a key impediment to recruiting sufficient volunteers to respond to a major health emergency. TFAH recommends that states adopt the Uniform Emergency Volunteer Health Practitioners Act (UEVHPA), which has been approved by the National Conference of Commissioners on Uniform State Laws.

* Seven states have made no purchases toward their share of the stockpile of antivirals for pandemic influenza. While this number may seem small, any differences in capacity on a state-by-state basis place the entire nation at risk. States have been asked to purchase 31 million treatment courses of the 81 million course stockpile target set by the federal government. Containment of a pandemic must be a national priority.