Statewide Advisory Committee for Preparedness October 7, 2004

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Statewide Advisory Committee for
PreparednessOctober 7, 2004

• Jeffrey Blystone
• Strategic National Stockpile Coordinator
• Bureau of Community Health Systems
• PA Department of Health

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CDC Enhancements to the Strategic National
Stockpile (SNS)

• Initial push package
• As of 9/1/2004, push package contains 300,000
  unit of use medications.
• Pill counters removed from the push package
• Vendor-managed Inventory (VMI)
• Tailored follow-up shipment (based on specific
  event)
• Attempting to have VMI in unit-of-use medications
  by early 2005.

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PA Enhancements to the SNS

• DOH strategy changed from decentralized to a more
  centralized plan
• DOH will be responsible for Receipt, Stage and
  Store (RSS) site management with personnel
  assistance from RCTTFs
• RCTTFs will be responsible for the Points of
  Dispensing (PODs). DOH will provide a liaison
  between the PODs and RSS sites
• Full-time SNS Coordinator hired

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PA DOH SNS Planning

• SNS Plan is being reviewed and enhanced to
  reflect the strategy change
• Receipt, Storage and Staging (RSS) Site
  verification by CDC and US Marshal Service
• Integrate new programs associated with SNS as
  part of the enhanced SNS plan
• Cities Readiness Initiative (CRI)
• CHEMPACK

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Next Steps

• Continue to review and enhance the State SNS Plan
• Brief the plan to the RCTTFs
• Provide technical assist to the RCTTFs with
  enhancements to their plan on items such as
• RSS Volunteer requirements
• POD designation, volunteer requirements, and flow
  capacity

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CHEMPACK PROJECT Mission

• Implement a nationwide project for the forward
  placement of nerve agent antidotes. To provide
  state and local governments a sustainable
  resource that increases their capability to
  respond quickly to a nerve agent event.
• State participation in the CHEMPACK Project is
  voluntary

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CHEMPACK

• Why Pennsylvania?
• SNS Program has a 12-hour response time, too long
  in the event of a nerve agent attack
• Some state and local governments dont have any
  nerve agent antidote stocks
• Hospitals carry limited supplies of treatments
  for nerve agent exposures
• Nerve agent antidotes have variable shelf lives
  (are not an easily sustainable resource)

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CHEMPACK PILOT

• Pilot
• New York City (highly urban)
• South Dakota (primarily rural)
• Washington State (mixture of urban and rural)
• Goals
• Develop and implement the concept of forward
  placement of nerve agent antidotes
• Develop basic guidelines and project procedures
• Validate cost, time, equipment, and procedures
• Refine procedures, processes, guidelines and
  techniques for nationwide project deployment

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ASSUMPTIONS

• Potential terrorist use of chemical weapons will
  continue to be perceived as a threat to national
  security
• The primary purpose for the CHEMPACK Project is
  to enhance state and local capabilities to save
  lives
• Sustainability of antidote stocks is a critical
  concern for state and local governments
• Provisions of Shelf Life Extension Program (SLEP)
  cannot be waived

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CHEMPACK EQUIPMENT
SENSAPHONE 2050
CHEMPACK STORAGE CONTAINER

• SNS Program supplies CHEMPACK materials, approved
  storage containers, and monitoring equipment
• Sites provide a secure, environmentally
  controlled storage area with phone connectivity

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STANDARD CONTAINERS

• The CHEMPACK Project provides two types of
  containers
• Emergency Medical Service (EMS) Container
  Designed for emergency responders materiel
  packaged mostly in auto-injectors.
• Hospital Container Designed for hospital
  dispensing, with multiuse vials, for precision
  dosing and long term care.
• Pralidoxime increase
• AtroPens

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PILOT PROJECT OBSERVATIONS

• CHEMPACK Pilot demonstrated a national project is
  cost effective and feasible
• Results indicate CHEMPACK Project has the
  potential to deliver significant cost savings
• Procurement advantages
• Shelf-life extension of pharmaceuticals

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SHELF LIFE EXTENSION PROGRAM (SLEP)

• FDA program originally established with DoD to
  extend shelf-life of pharmaceuticals for cost
  efficiency and longevity
• SLEP guidelines provide the quality assurance
  techniques used to determine the condition of
  materiel in storage to ensure a ready-for-issue
  status over the long-term

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Statewide Advisory Committee for
PreparednessOctober 7, 2004

• Michael Huff
• Director
• Bureau of Community Health Systems
• PA Department of Health

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Cities Readiness Initiative (CRI)

• A pilot program to prepare 21 major U.S. cities
  to dispense needed drugs and medical supplies
  within 48 hours
• City of Pittsburgh
• City of Philadelphia
• The best practices, tools and information
  developed during CRI will be shared with all
  American cities and regions
• Executive briefing to key participants
• Planning assessment to be scheduled
• Assessment results will drive funding

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Biohazard Detection System (BDS)

• PCR-based technology
• Samples air continuously above mail-sorting
  machine
• Test run every 60 minutes
• Testing takes 30 minutes
• Limited to Bacillus anthracis
• Positive signal leads to automatic alarm and
  building evacuation

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BDS - Response to Alert

• Confirmatory testing by State Public Health
  Laboratory, Lionville (LRN)
• Decontamination
• Antibiotic post-exposure prophylaxis
• Environmental testing
• Follow-up by public health