ASTHO’s Health Security Team Strengthens Preparedness and Response Capabilities Through Partnerships and Collaboration
While it is impossible to predict when a public health crisis may occur, the ability of state and territorial health departments to secure the nation’s health against a variety of threats relies on a capable and equipped public health workforce. ASTHO plays a pivotal role in ensuring that state and territorial health departments can prepare for and respond to all hazards, including chemical, biological, radiological, and nuclear threats; natural disasters; and infectious disease outbreaks.
ASTHO’s health security team specializes in preparedness, environmental health, and infectious disease prevention, and its core mission is to help health officials build capacity and develop the necessary capabilities to deliver essential public health services during an emergency. Over the last decade, ASTHO has figured prominently in emergency response operations across the country, taking steps to aggressively mobilize and support its members by linking them with federal partners like CDC, the HHS Office of the Assistant Secretary for Preparedness and Response, and other national associations, including ASTHO’s 21 affiliates, the National Emergency Management Association, and the National Governors Association’s Homeland Security Advisors Council to tackle complicated planning, response, and recovery issues.
ASTHO’s health security team aptly characterizes its successes across three main areas: (1) helping strengthen the capabilities of state and territorial jurisdictions to prevent and mitigate the consequences of public health threats, (2) building enduring relationships and touchpoints with diverse partners, and (3) forging new multisector collaborations to organize and implement effective preparedness and response activities.
Learning from past incidents is paramount to improving preparedness and response coordination for future events. Homeland security and public health officials, for example, learned during 9/11 and the anthrax attacks in 2001 that state and local health departments lacked the operational readiness and capacity necessary for an effective emergency response.
Since then, major investments in health security have provided critical support to our governmental public health system’s preparedness infrastructure to more rapidly detect, respond to, and prevent public health threats. Congress enacted legislation and appropriated funds for public health to develop and test response plans, deliver timely life-saving medical countermeasures to affected communities, and formalize relationships with emergency medical services, homeland security, healthcare systems, and other partners to help communities prepare for potential threats.
Then, in 2009, the H1N1 influenza pandemic provided the ultimate test of our nation’s preparedness capabilities and, specifically, whether public health departments had the requisite assets to “surge up” and meet the crisis demands of a large-scale public health emergency with immense health consequences. During this time, ASTHO stood up an emergency operations center and detailed preparedness staff to CDC’s Emergency Operations Center in Atlanta to serve as liaison officers. ASTHO, NACCHO, and CDC moderated daily conference calls with state and local public health leadership to maintain real-time situational awareness. ASTHO also facilitated regional calls, shared best practices, and provided a critical interface between state and territorial response partners and federal planning and coordination agencies.
ASTHO’s organizational approach to the H1N1 pandemic was a turning point and, in many ways, the beginning of a culture shift that laid the foundation for working effectively in a crisis environment. ASTHO has used a similar model to enhance situational awareness, technical assistance, and communication during other events, such as the Deepwater Horizon oil spill, the Fukushima Daiichi nuclear disaster, the Ebola outbreak, and—most recently—the spread of Zika virus. Zika is a prime example of how the health security team mobilizes as one unit, then engages many other programs within ASTHO to form a more coordinated response. Zika and other emerging infectious diseases constitute serious threats to public health, requiring an integrated approach involving programs such as maternal and child health, environmental health, infectious disease, and public health law.
Just as state and territorial health departments must establish, maintain, and enhance collaborations with emergency management, homeland security, and other relevant partners, ASTHO has also recognized the value of cultivating meaningful partnerships to better position public health leaders at all levels to respond to rapidly evolving incidents and outbreaks.
ASTHO’s relationship with the Department of Homeland Security’s Office of Health Affairs, for example, has been instrumental in promoting the inclusion of public health in the nation’s fusion centers which bring together the perspectives of law enforcement, criminal intelligence, emergency services, and public health to analyze and share important information, providing a common language and picture across agencies for those involved in emergency response activities and other issues. Other recent public health incidents where ASTHO and its homeland security partners maintain strong working relations include unaccompanied minors crossing the southwest border and acts of violent extremism.
Formalizing an important new partnership, ASTHO, the Environmental Council of States, and the U.S. Environmental Protection Agency this past year signed a memorandum of agreement, recognizing the critical nexus between the environment and public health, and the shared mission and responsibility to work more closely together to achieve the common goal of public health protection. ASTHO will take deliberate steps to work with the leaders of national and state environmental agencies to hone our understanding of how health and the environment are intertwined and point to solutions that will improve environmental public health conditions. Ensuring quality drinking water and mitigating the effects of extreme weather on health and safety are two areas ripe for continued collaboration.
ASTHO’s spirit of and influence in collaboration is evident in other areas, such as radiation and nuclear readiness, and healthcare associated infections/antimicrobial resistance. ASTHO leads the National Alliance for Radiation Readiness (NARR), a coalition of public health, healthcare, and emergency management organizations that works to elevate awareness of the roles, responsibilities, knowledge, and skills of public health agencies in the event of a radiological emergency. ASTHO and the Council of State and Territorial Epidemiologists (CSTE) co-lead the Council for Outbreak Response: Healthcare-Associated Infections and Antibiotic-Resistant Pathogens. The council was created, in part, based on lessons learned from the Ebola outbreak and the recognition that infection prevention and control measures in healthcare settings must be improved. ASTHO is one of several organizations involved in this nascent collaboration to better prevent infections and respond to emerging threats across healthcare settings and communities.
The public health system doesn’t take on just one threat at a time. When an emergency occurs, state and territorial health departments ramp up their day-to-day operations, often for prolonged periods of time, while doing their very best to ensure that other core functions are not disrupted, including conducting restaurant inspections, regulating healthcare facilities, offering cancer screenings, testing newborns to identify congenital disorders, providing immunizations, safeguarding our water supply, and many other services.
All public health emergencies pose unique challenges and expose different vulnerabilities in our states and communities. State and territorial health departments take a lead role to prepare their jurisdictions and mobilize once the “storm”—figuratively and often literally—hits. ASTHO, in its role, serves as a collective, unified voice and trusted partner to ensure that investments in the core public health system equip states and territories with the capacity and capabilities needed to prevent and respond to emerging threats, catastrophic events, and daily emergencies.