Section III: Medical Care & Countermeasures

PIRA_Section III: Medical Care & Countermeasures_TEST - FINAL
Form Approved
OMB Number: 0920-0879
Expiration Date: 03/31/2018

Introduction
Background
The 2009 H1N1 influenza pandemic underscored the importance of communities
being prepared for potential threats to public health security. Because of its
unique abilities to respond to infectious, occupational, or environmental incidents,
the Centers for Disease Control and Prevention (CDC) plays a pivotal role in
ensuring that state and local public health systems are prepared for these and
other public health incidents.
The identification of the novel influenza A (H7N9) virus illnesses in China in 2013
highlights the importance of influenza pandemic preparedness. To date, the
reported case fatality ratio from human H7N9 infections is more than 30%.
Should the H7N9 virus mutate to allow for sustained human-to-human
transmission, it appears capable of causing severe disease in all ages. To better
prepare for such a scenario, it is important to understand the collective ability of
our nation to prepare for and respond to a pandemic of substantially different
epidemiology than the 2009 H1N1 pandemic.
State and local public health departments are first responders for public health
incidents. To better prepare these agencies to respond, CDC provides funding
and technical assistance for state, local, and territorial public health departments
through the Public Health Emergency Preparedness (PHEP) cooperative
agreement. CDC’s Public Health Preparedness Capabilities: National Standards
for State and Local Planning provide national standards that help state and local
public health departments strengthen their ability to respond to all hazards,
including influenza pandemics, and build more resilient communities. Consistent
with this approach, the following Pandemic Preparedness Readiness
Assessment for State and Local Public Health Planners specifically aligns with 11
public health preparedness capabilities and administrative preparedness
planning goals.
Overview
The Pandemic Preparedness Readiness Assessment for State and Local Public
Health Planners promotes state, local, and territorial public health preparedness
and immunization program collaboration through the administration of a self-

assessment designed to measure jurisdictional readiness to respond to an
influenza pandemic. Although the content of this assessment does not
encompass every contingency or element necessary to effectively respond to an
influenza pandemic, CDC technical experts in differing programs have helped to
arrange content within the following seven priority planning areas:
1.
2.
3.
4.
5.
6.
7.

Vaccination Planning
Epidemiology and laboratory
Medical Care and Countermeasures
Healthcare Systems
Community Mitigation
Public Information and Communication
Public Health and Immunization Workforce

Information collected from the assessment will not be used to score or
competitively rank public health emergency preparedness or immunization
programs. Rather, this assessment is designed to identify preparedness gaps,
as well as promising state, local, and territorial preparedness practices.
Assessment results will be used by the CDC to inform technical assistance and
future program improvement initiatives.
Definitions
Allocation: Amount of pandemic influenza vaccine available for ordering.
Allocating: Process of dividing available vaccine among CDC’s PHEP awardees
or among registered pandemic influenza vaccine providers and facilities within an
awardee’s jurisdiction.
Critical infrastructure personnel (CIP): The full list of CIP is defined in Guidance
on Allocating and Targeting Pandemic Influenza Vaccine; U.S. Department of
Health and Human Services (HHS)/U.S. Department of Homeland Security
(DHS); 2008 Guidance on Allocating and Targeting Pandemic Influenza Vaccine
Distribution: The process of transporting pandemic influenza vaccine from one
location to another.
Enrollment: The process of enabling registered healthcare providers and facilities
to legally provide pandemic influenza vaccine.
Ordering: Process of requesting pandemic influenza vaccine from either the
federal, state, city, or local government. Orders can be placed against an
allocation or independent of allocation.
Non-pharmaceutical interventions (NPIs): Those interventions that can mitigate
transmission of influenza and do not involve medical countermeasures. NPIs

include voluntary home isolation, school closures, respiratory etiquette, hand
hygiene, and routine cleaning of frequently touched surfaces and objects.
Peak vaccine administration capacity: The highest rate at which a jurisdiction is
able to provide pandemic influenza vaccine to its population; CDC recommends a
peak vaccine administration capacity of at least 10% of the population per week.
Point of dispensing (POD) / mass vaccination clinic: Location for dispensing
medical countermeasures, specifically for vaccine, during an influenza pandemic
response. Located in a public or private space, this clinic is designed to
vaccinate a large group of persons over a short time period. The POD or clinic
might target the entire population or people in specific priority or high-risk groups.
Public and/or private entities can manage a POD or clinic.
Closed POD: Point of dispensing/vaccination clinic closed to the general public
and open only to a specific group (e.g., staff of a participating business or
healthcare personnel in a specific hospital).
Open POD: Point of dispensing/vaccination clinic open to the general public,
specifically to provide vaccine, during an influenza pandemic response.
Recruitment: The process of soliciting healthcare providers and facilities
interested in and willing to provide pandemic influenza vaccine.
Registration: The submission of required information, similar to an application, by
healthcare providers or facilities interested in providing pandemic influenza
vaccinations.
Retail-based clinics: Non-pharmacy businesses that sell retail products (e.g.,
Walmart, Target) and serve as PODs/mass vaccination clinics.
School-located vaccination clinics: Vaccination clinics that target students and
are typically held on school grounds.
Public reporting burden of this collection of information is estimated to average 30 minutes per
response, including time for reviewing instructions, searching existing data sources, gathering
and maintaining the data needed, and completing and reviewing information. An agency may not
conduct or sponsor, and a person is not required to respond to a collection of information unless it
displays a currently valid Office of Management and Budget control number. Send comments
regarding this burden estimate, or any other aspect of this information collection, including
suggestions for reducing this burden to CDC/Agency for Toxic Substance and Disease Registry
Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333;
Attention: PRA (0920-0879).

(End of Page 1)

Section III: Medical Care and Countermeasures
Goal: Each awardee will distribute medical countermeasures (MCM) during an
influenza pandemic in collaboration with hospitals, healthcare coalitions, and
pharmacies to assure that these MCMs reach the affected population(s) in an
efficient, equitable, and timely manner.
Planning Assumptions:
• Awardees are working collaboratively with hospitals, healthcare coalitions, and
pharmacies to optimize MCM distribution during an influenza pandemic.
• Jurisdictions that have mechanical ventilators and respiratory protective devices
stockpiled in advance of a severe influenza pandemic will use these to offset
commercial shortages of these devices.
• During a severe influenza pandemic, the number of commercially available and
stockpiled ventilators and respiratory protective devices (RPDs) within the
jurisdiction may not be able to meet the entire need.
Information gathered will help to inform the development of tools to assist
awardees to improve planning for state-level allocation, distribution, and use of
MCMs during an influenza pandemic.
(End of Page 2)

Section III: Medical Care and Countermeasures
Please select your jurisdiction:

mAlabama
mAlaska
mAmerican Samoa
mArizona
mArkansas
mCalifornia
mChicago
mColorado
mCommonwealth of the Northern Mariana Islands
mConnecticut
mDelaware
mFederated States of Micronesia
mFlorida
mGeorgia
mGuam
mHawaii
mIdaho
mIllinois
mIndiana
mIowa
mKansas

mKentucky
mLos Angeles County
mLouisiana
mMaine
mMaryland
mMassachusetts
mMichigan
mMinnesota
mMississippi
mMissouri
mMontana
mNebraska
mNevada
mNew Hampshire
mNew Jersey
mNew Mexico
mNew York
mNew York City
mNorth Carolina
mNorth Dakota
mOhio
mOklahoma
mOregon

mPennsylvania
mPuerto Rico
mRepublic of Palau
mRepublic of the Marshall Islands
mRhode Island
mSouth Carolina
mSouth Dakota
mTennessee
mTexas
mU.S. Virgin Islands
mUtah
mVermont
mVirginia
mWashington
mWashington, DC
mWest Virginia
mWisconsin
mWyoming

Please select your position:
mPHEP Director
mStrategic National Stockpile Coordinator
mHealthcare Preparedness Program Director

mOther (please specify) ____________________

(End of Page 3)

Section III: Medical Care and Countermeasures
1. Does your agency manage a stockpile of mechanical ventilators for distribution
to hospitals in your jurisdiction during an influenza pandemic?
(Please do not include any additional stockpiles that might be available for use
but are not directly managed by your agency.)
mYes
mNo >>>> Skip to Page 6: 3. Does your jurisdiction plan to distribute
ventilators during an influenza pandemic?

(End of Page 4)

Section III: Medical Care and Countermeasures
2. Please describe the make, model, and number of mechanical ventilators that
you currently have stockpiled:

Make
Ventilator
1:

_________
_________
__

Ventilator
2:

_________
_________
__

Ventilator
3:

_________
_________
__

Ventilator
4:

_________
_________
__

Model
Ventilator
1:

_________
_________
__

Ventilator
2:

_________
_________

__

Ventilator
3:

_________
_________
__

Ventilator
4:

_________
_________
__

Number Stockpiled
Ventilator
1:

_________
_________
__

Ventilator
2:

_________
_________
__

Ventilator
3:

_________
_________
__

Ventilator
4:

_________
_________
__

(End of Page 5)

Section III: Medical Care and Countermeasures
3. Does your jurisdiction plan to distribute ventilators during an influenza
pandemic?
mYes, directly from the U.S. Strategic National Stockpile
mYes, through allocations from the state health department from the U.S.
Strategic National Stockpile
mYes, from state stockpiles
mNo
mNot sure

(End of Page 6)

Section III: Medical Care and Countermeasures
The following set of questions asks possible ways your jurisdiction may choose to
allocate ventilators during a severe influenza pandemic; assuming uniform
demand across hospitals:
4. Please state which of the following considerations below will your jurisdiction
allocate ventilators for. Please respond with an N/A if the consideration is not
applicable to your jurisdiction.

Yes

No

N/A

Size of
m
jurisdictional
population

m

m

Size of
population
served by
a hospital

m

m

m

Number of
ICU beds
in a
hospital

m

m

m

First
m
come/first
served
basis (e.g.,
provide
ventilators
based on
the order in
which
requests
are
received
until
stockpiled
supply is

m

m

depleted)
Availability
of trained
and
qualified
staff to
operate
additional
ventilators
and care
for patients
with
complex
illnesses

m

m

m

Sufficient
m
space to
accomodat
e additional
ventilated
patients

m

m

Equipment
needed to
support
additional
ventilaged
patients

m

m

m

Other
factors

m

m

m

5. Did your jurisdiction conduct a hospital-based assessment between June 30,
2010 and June 30, 2014 to determine their mechanical ventilation capabilities?
Please indicate which of the following considerations were included in the
assessment (please check all that apply)?
qNo assessment conducted
qNumber of ventilators in normal conditions
qAvailability of "surge" ventilators

qTypes of populations to be served during an influenza pandemic (e.g.,
underserved or vulnerable populations)
qAvailability of trained and qualified staff to operate additional ventilators and
care for patients with complex illnesses
qSufficient space to accomodate additional ventilated patients
qAdequeate equipment needed to support additional ventilated patients
qFamiliarity of hospitals with portable ventilators used in the U.S. Strategic
National Stockpile (SNS)

6. Please enter the percentage of the hospitals within your jurisdiction that were
included in your assessment.
(Please enter a percentage) ____________________

7. How will your jurisdiction coordinate hospital requests for ventilators during an
influenza pandemic (please check all that apply)?
qThrough ESF-8 lead
qThrough state, regional, or local hospital associations
qThrough state, regional, or local healthcare coalitions
qOther (please specify) ____________________

(End of Page 7)

Section III: Medical Care and Countermeasures
8. Has your jurisdiction determined when and how it will train healthcare systems
to operate federally stockpiled ventilators that are distributed to hospitals?
mYes
mNo, but in development
mNo >>>> Skip to Page 9: 9. Has your jurisdiction collaborated with hospitals
and/or healthcare coalitions to stockpile fit-tested respiratory protective devices
for their healthcare workforce that could be used during an influenza pandemic?
mDon't know

(End of Page 8)

Respiratory Protective Devices
9. Has your jurisdiction collaborated with hospitals and/or healthcare coalitions to
stockpile fit-tested respiratory protective devices for their healthcare workforce
that could be used during an influenza pandemic?
mYes
mNo

(End of Page 9)

Respiratory Protective Devices
10. Since June 2010, has your jurisdiction issued recommendations or guidance
to hospitals and/or healthcare coalitions about stockpiling fit-tested respiratory
protective devices for their healthcare workforce?
mYes
mNo

>>>> Skip to End Page: Survey Submitted

(End of Page 10)

Respiratory Protective Devices
11. If yes, which of the following items were included in your jurisdiction’s
guidelines?
qNumber of respiratory protective devices to stockplie based on the projected
duration of the pandemic
qRecommendations about who should wear respiratory protective devices
qRecommendations about circumstances in which respiratory protective
devices should be worn
qRecommendations about fit-testing for respiratory protective devices
qOther (please specify) ____________________

(End of Page 11)

Medical Countermeasures Distribution and Dispensing
12. Which of the following partnerships has your jurisdiction established to
enhance antiviral distribution/ dispensing during a pandemic (please check all
that apply)?
qWe have not established partnerships to enhance antiviral distribution /
dispensing during a pandemic
qCommunity pharmacies
qPharmaceutical distributors
qState Board of Pharmacy
qPharmacy training programs
qOther (Please specify) ____________________

13. Please describe the role of these partners in your jurisdiction’s antiviral
distribution/dispensing plans.
______________________________________________________________
______________________________________________________________
______________________________________________________________

(End of Page 12)