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Outline

Maine’s Vulnerability to Natural Disasters Paul Kuehnert, MS, RN Deputy Director Maine Center for Disease Control & Prevention Department of Health & Human Services

We live in challenging  times… Multiple threats to the health of individual people, families, communities Chronic diseases Health disparities Environmental hazards Natural disasters Terrorist threats Emerging infectious diseases

Maine’s vulnerabilities? Environment People Resources

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Definition of Pandemic Influenza Worldwide epidemic involving: Novel influenza virus Highly transmissible between humans Very lethal

Potential Impact: U.S. and Maine In the U.S.:  200 million people will be infected  50 million people will require outpatient care  2 million people will be hospitalized Between 100,000 and 500,000 deaths In Maine: 860,000 people will be infected 165,000 outpatient visits  4,000 hospital admissions  900 deaths

Planning Assumptions for Pandemic Influenza Influenza will spread rapidly Two waves likely… pandemic will extend over months No effective vaccine available early Antiviral agents & other needed pharmaceuticals, supplies & equipment in short supply Health care workers & first responders will be at greater risk of infection Widespread illness in the community … shortages of essential goods & services Health care system stretched beyond capacity quickly Widespread negative psychosocial impact on individuals, families and communities

Are the people of Maine prepared? 6 state-added questions to the Behavioral Risk Factor Surveillance Survey (BRFSS) in Maine in 2004 Comparison of population groups that vary by demographic characteristics Age Race Gender  Income  Education level  Location (rural/suburban/urban)

Are the people prepared? (cont’d) (Initial) Analysis of correlation between social capital (5 questions) and household preparedness: Attended a local community event in past year? Attended a public meeting on a town or school issue? Active member of a local organization or club? Frequency of phone conversations with family/friend in past month? Frequency of visits with family/friend in past month?

Household preparedness: Radio that works if no power?  3-day supply of food? 3-day supply of water?  If exposed to a dangerous disease, where would you first get information? If advised by your health care provider, would you get a free vaccine? If health officials asked, would you stay at home for a week without outside visitors?

Results:  Battery-powered Radio 82% of the overall sample said yes Lower income and uninsured persons were significantly more likely to answer no.

Results:  3 Day Supply Food 92% of the overall sample said yes No significant differences between groups

Results:  3 Day Supply Water 58% of the overall sample said yes No significant differences between groups

Results:  Accept free vaccine 90% of the overall sample said yes No significant differences between groups, but less acceptance among the uninsured

Results:  Voluntary Quarantine 90% of the overall sample said yes No significant differences between groups, but less acceptance among the uninsured

Results:  Post-exposure Health Info MD Offices & Internet most likely sources Women and seniors more likely to use MD office Men more likely to use hospital Low income and lower educational achievement less likely to use internet

Results:  Social Capital & PH Emergency Preparedness Initial analysis show significant correlation between all social capital measures and household preparedness Caution:  small numbers! Need to do further analysis modeling demographics, social capital and household preparedness

Maine Household Survey Conclusions: Majority of Mainers have taken measures to prepare households >90% intend to comply with voluntary public health measures Post-exposure health information: need for partnerships, effective web presence Demonstrated need for planning & targeted risk communication

We live in challenging times Multiple opportunities for partnership to promote and protect the health of individual people, families, communities Chronic diseases Health disparities Environmental hazards Natural disasters Terrorist threats Emerging infectious diseases

Cross-cutting strategies to address disasters: Prevention! Early detection and protective public health measures Communication and outreach Coordinated health care and emergency response Protection and maintenance of essential services

Principles for Preparedness and Response Planning Panic is rare and preventable Enlist the public as a capable partner Think beyond the hospital Provide Information Open communication and decision-making  from “Bioterrorism and the People…”, CID  2002:34 (15 January)

Panic Panic and civil disorder expected outcome Not supported by research and experience Stress, fear and depression Cooperation, adaptiveness, resourcefulness Collective behavior changes over time

Enlist the Public as Partner Not bystanders No such thing as a “general public” “…Interconnected matrix of networks…” 35% of Mainers report giving & doing more in their communities since 9/11

Think Beyond the Hospital Capacity exceeded quickly in disasters Plan for home-based treatment and supportive care Resources & information need to be prepared in advance

Provide Information Must be coordinated, clear, credible and timely Multiple means:  news media, internet, information hotline, meetings, etc.

Open Communication and Decision-Making Open discussions and educational efforts needed in advance Engage local opinion leaders and decision-makers Plan for effective means of both media and personal contact

Principles for Preparedness and Response Planning Panic is rare and preventable Enlist the public as a capable partner Think beyond the hospital Provide Information Open communication and decision-making  from “Bioterrorism and the People…”, CID  2002:34 (15 January)

Contact info: Paul Kuehnert Deputy Director  Center for Disease Control & Prevention Maine Dept. of Health & Human Services 207-287-5179 paul.kuehnert@maine.gov