STRATEGIC NATIONAL STOCKPILE

1. STRATEGIC NATIONAL STOCKPILE Presented to: California Indian Health Centers Presented by: Brian Tisdale

2. Goals Discuss the role of the Strategic National Stockpile, how it is deployed and methods in which it is distributed throughout the population.

3. Strategic National Stockpile (SNS) • The SNS is “a national repository of antibiotics, chemical antidotes, vaccines, antitoxins, antivirals, life-support medications, IV and IV administration supplies, airway maintenance supplies and other medical/surgical items used to augment federal, state and local supplies in the event of a terrorist attack or other emergency”.

4. 12-hour Push Packages

5. Specific Item Support • Managed Inventory • Vaccines • Buying Power/Surge Capacity

6. Based on Category A Threat Agents Smallpox Anthrax Botulism Viral Hemorrhagic Fevers Plague Tularemia Chemical nerve agent antidotes Formulary Development

7. Pharmaceuticals: Antibiotics (Oral and Intravenous) Vaccines, Antivirals and Antitoxins Other Emergency Medications IV Administration Supplies Airway Management Supplies: Pediatric and Adult Items for Radiation, Burns and Blast Wound Care Supplies Formulary Content

8. SNS Commitment SNS will: • Arrive in 12 hours or less with pharmaceuticals and other medical materiel and equipment • Continue to provide pharmaceutical support for as long as it is needed • Constantly update what is kept in stock to ensure it supports the needs of the County/State • Buy what is needed from the private sector if it is not stocked • Assistance in planning for and using the materiel the SNS provides

9. Technical Advisory Response Unit (TARU) TARU members respond with the Push Pack • Designed to be self-sufficient • Communications/IT • Security • Reference material • Medical Supplies

10. Is getting from here… The Challenge

11. To here.

12. Cities Readiness Initiative(CRI)

13. Cities Readiness Initiative Started in 2004, CRI is a U.S federally funded program to aid major U.S. cities in increasing their capacity to respond during a large-scale public health emergency, such as a bioterrorism attack. CRI’s primary objective is to avert mass casualties by dispensing needed drugs and medical supplies to the cities’ entire population within 48 hours.

14. CRI Project Areas

15. CRI Planning Assumptions • Response to an outdoor anthrax release drives planning • Must offer prophylaxis to the “population at risk” within 48 hours to avert mass casualties • In early hours of response, uncertainty in Epi & modeling likely to compel decision to offer broadly • The County or City Department of Public Health has the lead role in any CRI event

16. 1 3 2 No Warning At All We are, in fact days behind Witnessed Release Potentially Up to 48 Hours to prophylax Bio Watch System Potentially Up to 24 Hours to prophylax PLAUSIBLE SCENARIOS Methods of Detection

17. DELAYin Initiation DURATION of Campaign Immed. 2 Days 3 Days 4 Days 5 Days 6 Days 7 Days 1 Day 10Days 84% 78% 71% 62% 54% 45% 36% 28% 7 Days 95% 91% 85% 78% 69% 59% 49% 39% 6 Days 97% 94% 89% 83% 75% 65% 54% 43% 5 Days 98% 96% 92% 87% 80% 71% 60% 49% 4Days 99% 98% 95% 91% 85% 76% 66% 54% 3Days 100% 99% 97% 94% 89% 81% 72% 60% 2Days 100% 99% 98% 96 92% 86% 77% 66% 1Day 100% 100% 99% 97% 94% 89% 82% 72% AnthraxExposure: ProportionofPopulationSaved

18. SNS Planning • Written plans • Names with job assignments • Maps and traffic flow plans • Security plans • Annual Assessments

19. How does it work? • Pull Method • POD • Push Method • Prisons, jails, juvenile detention facilities, nursing homes, assisted living facilities • Universities, large corporations, other with the ability to distribute • Postal Plan

20. Local Challenges • Large Populations • Locating PODS • Staff/Volunteers • Equipment • Security

21. Summary We discuss the role of the Strategic National Stockpile, how it is deployed and methods in which its contents can be distributed throughout the population.

22. QUESTIONS?

23. CONTACT INFORMATION… Brian Tisdale, MS 951-440-7495 btisdale@co.riverside.ca.us