Despite six years of funding and planning, health systems in 10 localities in five sampled states still aren’t ready for a pandemic flu, and levels of readiness vary, according to a pair of reports issued yesterday by the Office of Inspector General.
The first report, based on documents and interviews provided by the selected areas, looked at how well systems can gear up to add beds, medical equipment, trained volunteers, find alternate sites, and triage patient care.
It found that all 10 localities had committees to plan for a pandemic and had coalitions to coordinate care. But "the degree to which coordination occurred varied."
Fewer than half the selected localities had started to recruit medical volunteers and none of the states had implemented an electronic system to manage them. All four of the localities that had started to recruit, register, and train medical volunteers had concerns about using them. States were required by the assistant secretary for preparedness and response to have electronic systems to register medical volunteers by August 2009.
All localities had acquired limited medical equipment for a pandemic, but only three of the states had electronic systems to track beds. Though all 10 had limited caches of medical equipment, many experienced difficulties managing it.
Most localities were in the early stages of planning for alternate care sites, such as schools or convention centers, and few had signed formal agreements. None of the localities that were planning to use alternate care sites had plans that included scope of care, or how these sites would be managed, staffed, and supplied.
Most localities had no guidelines for altering triage, admission, and patient care. Seven localities noted that providers in their areas were concerned they would be legally at risk if they were to alter their standards for triage, admission or patient care.
All localities conducted medical surge exercises, but none consistently documented lessons learned. And most exercises were discussions rather than operations-based.
In neither report did the agency identify the states or localities reviewed.
The second report looked at eight planning areas and 89 preparedness items for vaccine and antiviral drug distribution in the event of a pandemic.
None of the 10 localities had started planning for distribution or dispensing. "Localities plans generally were not actionable. For example, localities did not generally have valid and detailed formal agreements, such as a Memorandum of Understanding, with partnering agencies."
Between September 2006 and July 2008, the localities conducted 63 exercises related to distribution and dispensation of vaccines and antivirals. But most did not create action reports and improvement plans after these exercises.
All localities collaborated with community partners to develop and exercise plans.
The agency recommended that the Centers for Disease Control and Prevention step in to determine the cause of any delays in preparedness and provide assistance. The CDC also should emphasize the importance of localities developing actionable vaccine and antiviral drug distribution and dispensing plans, according to OIG.