Jul 19, 2006 (CIDRAP News) – The role of state officials in an influenza pandemic has been hazy, but the focus became clearer yesterday when the National Governors Association (NGA) released a guide that spells out key planning issues for top state officials.
The guide, Preparing for a Pandemic Influenza: A Primer for Governors and Senior State Officials, was released during a telephone news conference. It was produced for the NGA by Stephen Prior, PhD, who is founding research director at the National Center for Critical Incident Analysis in Washington, DC. Prior is an expert on the medical response to biological weapons and bioterrorism.
The primer isn't a template for a pandemic plan; rather, it walks governors through the considerations they need to keep in mind when forming a plan. For example, in addition to coordinating healthcare during a disease outbreak, state officials may have to curb disease spread by restricting public gatherings, limiting travel, and closing schools.
Arizona Gov. Janet Napolitano said at the news conference that a pandemic presents states with a set of challenges that are much different than a natural disaster such as Hurricane Katrina. Napolitano, coleader of the NGA's pandemic and avian flu efforts, said states wouldn't be able to draw from nationwide resources during a pandemic as the Gulf states did after Katrina.
Officials at the Department of Health and Human Services have warned states not to rely solely on the federal government for help during a pandemic. Minnesota Gov. Tim Pawlenty, coleader of the NGA pandemic and avian flu initiatives, said at the news conference, "I think that's a fair and realistic warning." He said states have equal or lead responsibilities in planning for and responding to a pandemic.
The overall theme of the pandemic primer is state self-reliance. Examples include increasing food storage at government facilities such as schools and prisons and stockpiling key equipment and supplies such as masks, ventilators, and antiviral medications. According to the guide, the main goals for states are to:
- Continue essential state services
- Manage medical resources, such as prioritizing who will receive antiviral medications
- Work with the private sector to ensure that critical operations and services such as power and food supplies are maintained
- Forge and test key partnerships
States are urged to develop plans now to continue state government operation during a pandemic. Telecommuting may be a way to keep essential state services going, but the report says officials will need to test plans now and ensure that they have enough bandwidth or server capacity to allow such a workforce arrangement. The report also suggests government and private sector telecommuting as tool that may be useful for social distancing purposes.
Governors are advised to establish broad coordinating committees that represent all sectors having a role to play, including public safety, healthcare, critical service industries, and volunteer organizations. The purpose of the committee is to coordinate health resource delivery, maintain personnel and equipment supplies, and continue critical services.
Legal issues that arise during a pandemic are detailed, along with some suggestions for reviewing state laws. For example, state laws about activity restrictions or quarantine may be needed to curb the spread of the disease; however, differences between state laws may make enforcement difficult at the regional level. In April 2005 President Bush signed an executive order that extends federal quarantine regulations to cover novel or reemergent flu strains capable of causing a pandemic. However, other situations may require individual state or local action, such as restricting public transportation or limiting public gatherings. Procedures on health credentialing should also be reviewed to see if they allow health providers from other states to provide care during an emergency.
Public education campaigns and other communications strategies are another major focus of the report. "Public education campaigns should be developed now to enhance the public's understanding of pandemic flu and build a trusted relationship with the response community," said the author. To build greater support for pandemic plans, state officials should heavily involve citizens.
Pawlenty said in an NGA press release about the report that thorough pandemic preparations will have wide-ranging benefits. "Done well, pandemic flu planning will help the nation become better prepared for all types of hazards," he said.
NGA report on pandemic preparations
NGA press release on pandemic preparation report