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2010 Report: Public Health Preparedness

Section 1: A National Snapshot of Public Health Preparedness Activities - Continued

Moving Forward

State and local health departments are first responders for public health emergencies and CDC remains committed to strengthening their preparedness. Since 1999, CDC’s Public Health Emergency Preparedness (PHEP) cooperative agreement has helped strengthen state and local public health functions that are critical for preventing, responding to, and recovering from health threats.

Much progress has been made to build and strengthen national public health preparedness and response capabilities. Accomplishments highlighted in this report include the following:

  • Biological laboratory capabilities and capacities in place were strong in most states and localities. Most laboratories in the Laboratory Response Network (LRN) could be reached 24/7, rapidly identified certain disease-causing bacteria and sent reports to CDC, and passed proficiency tests for detecting other biological agents. (See Table 3 on page 26.)
  • A majority of LRN chemical laboratories demonstrated proficiency in core methods for detecting and measuring exposure to chemical agents, and some were proficient in one or more additional methods identified by CDC as important for responding to chemical emergencies. (See Table 3 on page 26.)
  • All states and localities could receive urgent disease reports 24/7, and most states used rapid methods (blast email or fax) to communicate with other laboratories for outbreaks, routine updates, and other needs. (See Table 8 on page 34.)
  • All states and localities received acceptable CDC review scores for their plans to receive, distribute, and dispense medical assets from CDC’s Strategic National Stockpile and other sources. (See Table 8 on page 34.)
  • Most states and localities demonstrated the ability to activate and rapidly staff their emergency operations centers for drills, exercises, or real incidents, and developed after action reports/improvement plans following these activities. (See Table 8 on page 34.)


Preparedness is a continuous cycle of planning, organizing, equipping, training, exercising, evaluating, and taking corrective action to ensure effective coordination during incident response.


CDC has identified the areas listed below for improving state and local preparedness.

Maintain preparedness gains and resolve gaps. Important gains have been made since CDC’s 2008 preparedness report in the areas of laboratory and response readiness. Data presented in this report show improvement in rapid laboratory testing for biological agents; and readiness to receive, distribute, and dispense assets from CDC’s Strategic National Stockpile. CDC will continue to work with state and local health departments to maintain these improvements and to identify and resolve gaps in these and other core capabilities important for preparedness and response. Improvements are needed in continuity of operations plans for state public health laboratories.

Build on the successes and lessons learned from the response to the 2009 H1N1 influenza pandemic. The first influenza pandemic in 40 years provided a real world test of our response capabilities. CDC is working with all levels and sectors of the public health and medical communities toward systematically assessing this response, developing plans to address gaps and challenges, and incorporating needed changes. Assessments will include tools such as after action reports/improvement plans.

Ensure continuous funding to build and maintain a skilled state and local public health workforce. The surge in effort needed to respond to the 2009 H1N1 influenza pandemic placed an increased strain on a system already weakened by workforce shortages and budget shortfalls. The response revealed that the combination of the continued erosion of the general all hazards preparedness capacities, infrastructure, and staffing, along with fiscal issues facing state and local governments proved to be challenging for public health departments. Preparing adequately for future outbreaks – and other public health emergencies that are inevitable and may occur simultaneously – requires predictable and adequate long-term funding to improve infrastructure, staffing, and staff training in the areas of surveillance, epidemiology, laboratories, and response readiness.

Expand performance measurement to assess and monitor preparedness activities and to drive program improvement and accountability. CDC will continue to work with state and local partners to develop new performance measures that are indicators of preparedness and response capabilities and align with the objectives of the National Health Security Strategy45 as well as the Pandemic and All-Hazards Preparedness Act.46 The goal of these efforts is to implement measures that address short-term activities and outcomes that can impact core preparedness functions in the long term.

CDC is working collaboratively to implement the National Health Security Strategy that was established to galvanize efforts to minimize the health consequences associated with significant health incidents. Major gaps exist for measuring preparedness in the areas of surveillance and epidemiology. Draft performance measures in these areas, as well as in laboratory activities are being pilot tested and will be refined based on results obtained and input from partners.

While this report relied on available performance measurement data, future reports will provide information on more robust data generated from planned improvements in the new five-year PHEP program announcement that will go into effect in August 2011. As part of the development and implementation of the new program announcement, CDC is developing a PHEP capabilities model to better define the strategic focus and priorities of the PHEP program and a related planning tool to be used by states, localities, and territories to inform their program planning and priority setting. The PHEP planning tool also will be used to monitor progress in achieving PHEP objectives and capabilities annually and progressively over the course of the five-year cooperative agreement, driving program improvement and accountability.


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