Information Sharing and Collaboration Applications to Integrated Biosurveillance: Workshop Summary (2012) / Chapter Skim
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5 Discussion of a Scenario
5 Discussion of a Scenario
Pages 41-56
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From page 41... ...
In a number of cases, particularly among those patients requiring hospitalization, stool cultures are performed. Across the affected cities, these cases of illness come to the attention of local or state health departments in a variety of ways and in varying time frames.
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From page 42... ...
Simultaneously, local media in some communities are alerted to the situation by parents of ill children, and reporters who contact local hospitals learn of additional cases of similar illness. A wire service editor notes the occurrence of similar reports in multiple local or regional newspapers and publishes a national report, speculating about the possibility of a common cause.
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From page 43... ...
Laboratory information can detect just a few common cases spread through a collection of states, whereas just a few cases would not trigger a syndromic surveillance system. Collecting exposure information quickly is important, said Braden, in addition to detecting aberrations above a background level of disease.
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From page 44... ...
Tan emphasized the importance of the local and state health departments. Using this information, USDA's compliance investigation division would work closely with the applied epidemiology division and with state and local officials to find, as quickly as possible, such information as lot codes, sell-by dates, production dates, and establishments that are involved.
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From page 45... ...
It would seek information from CDC about ongoing actions and from the FBI about its investigations of responsibility. Based on this information, NBIC would determine, in consultation with the involved federal agencies, whether to activate the National Biosurveillance Integration System protocol, which is focused on information sharing, coordination, and collaboration.
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From page 46... ...
CDC also has conference calls involving lots of people, said Braden. All of the investigators and partners are on the calls, so "information sharing occurs early and often and on the phone." Kautter added that 50state conference calls may occur two, three, or more times per week.
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From page 47... ...
"What is critical for the investigation is what's happening on the ground at the local and state health departments, what information they're getting, and what hypotheses they're generating.
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From page 48... ...
DOD's involvement, said Russell, would not yet be determined at this point in the scenario, but it would be providing information to CDC and ensuring that communication occurs within DOD. "We feel strongly a responsibility to our own service members, and that would not be neglected at the expense of handing it over to the CDC." A questioner asked specifically about the curation of information that extends beyond public health to the national security arena, and several panelists pointed to a tension that exists in this area.
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From page 49... ...
Audience members offered some insight regarding their expertise and local context. Joel Ackelsberg of the New York City Department of Health said that in a scenario such as the one described, state and local public health departments would be "ramping up their resources." These kinds of cases would catch people's attention.
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From page 50... ...
"Sometimes the incident commander is spending half the time in the studios in front of the cameras." Joint press conferences with all of the involved agencies on the phone, along with as many as 150 reporters, also take up time. Tan reiterated that the epidemiological information starts with state and local health departments.
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From page 51... ...
Kautter said that if a positive sample were taken of the sprouts either in a restaurant or at someone's home, FDA would work with its federal, state, and local officials to try to determine whether it was one brand or numerous brands, one distributor or numerous distributors, or perhaps a single lot. Trace backs would investigate the sprouting facilities, the source of the seeds, and the companies involved.
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From page 52... ...
We have to triage that and determine where our public messaging is." In response to a question about how quickly information would be delivered to the public, Quitugua said that in significant events, DHS personnel may have just 60 minutes to prepare the Secretary to talk with the press, and that "all efforts" are made to ensure interagency coordination. Spaeth emphasized the importance, in the current media environment, of making immediate public contact to establish that the situation is being managed.
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From page 53... ...
I have a feeling it would go a very secure route that would take a long time and maybe completely bypass the center and a number of NBIC partners." People may say that they are going to share information, but they do not exercise those communications routes in each event. Jamison agreed, though he also described the Interagency Policy Committee through which intelligence information would be communicated to agency representatives.
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From page 54... ...
Rather, department secretaries or even the President will be on the news. A good protocol is available for more routine episodes, but this episode is dramatically different "if CNN is running this 24/7 that terrorists have contaminated the American food supply." On this point, Jamison noted, the terrorist claim would certainly create the public perception that the FBI is leading the investigation.
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From page 55... ...
Gibson observed that county public health directors have remarkable amounts of authority in cases where there is a threat to public health. If experts indicate that something needs to be done, "there is huge power at the county health director level," he said.
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From page 56... ...
Public messaging would be a major focus with a disease like this that is contagious and can cause secondary infections. State and local public health departments would be working with their partners to find the source of the outbreak and stem its spread as quickly as possible.
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