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On Sept. 11, 2001, “Effective decision-making in New York was hampered by problems in command-and-control and in internal communications. … [We propose to] Make homeland security funding contingent on the adoption of an incident command system to strengthen teamwork in a crisis, including a regional approach.”
—The 9/11 Commission Report, July 2004
“No one’s in charge, the plan’s incomplete, and resources aren’t sufficient if we suffer mass casualties in an overwhelming disaster.”
—Reporter Justin Rood,
Government Executive magazine, Nov. 1, 2005
“In virtually every major city and county in the United States, no interoperable communications system exists to support police, fire departments, and county, state, regional, and federal response personnel during a major emergency.”
—“America—Still Unprepared, Still in Danger,” sponsored
by the Council on Foreign Relations, 2002
“Emerging information technologies could help to strengthen … the nation’s ability to prepare for and respond to bioterrorism and other public health emergencies.”
—U.S. General Accounting Office, May 2003
“An interoperable public health surveillance system is needed that will allow exchange of information … to better protect against disease.”
—“Report of the National Coordinator for
Health Information Technology,” U.S. Department
of Health and Human Services, July 2004
“For public health emergencies in particular, the ability to quickly exchange data from provider to public health agency — or from provider to provider — is crucial in detecting and responding to naturally occurring or intentional disease outbreaks. … Health care providers have traditionally used paper- or telephone-based systems to report disease outbreaks to approximately 3,000 public health agencies. This is a labor-intensive, burdensome process for local health care providers and public health officials, often resulting in incomplete and untimely data.”
—U.S. General Accounting Office, July 2004
As of February 2004, “all states reported progress in developing the capacities that the Centers for Disease Control and Prevention (CDC) considers critical for public health preparedness, but no state had completed all program requirements,” and only about half the states had developed systems to receive and evaluate urgent disease reports at all times, and to provide critical health information to all parties involved in health emergency response.
—U.S. General Accounting Office, July 2004
In the most comprehensive terrorism response exercise ever conducted in the United States, TOPOFF 2, officials played out a scenario involving the release of pneumonic plague in several Chicago-area locations. According to the final government report on the exercise, “TOPOFF 2 represented a significant experiment in communications and coordination for the public health and medical communities. In particular, the massive amounts of communication required to track resource status (beds, specialized spaces, medical equipment), and the cumbersome procedures and insufficient electronic means to do so in many cases, taxed hospital staff.”
—“TOPOFF 2: After Action Summary Report,”
U.S.
Department
of Homeland Security, December 2003
“Sept. 11, 2001 was the first time that Illinois activated its State Medical Disaster Plan statewide, and it took two and a half hours to find out from hospitals across the state how many beds were available, how many ventilators we had, how much blood we had, and where those resources were. Today, using better information technology, it takes just minutes to get that information, and that is a huge gain for preparedness.”
—Leslee Stein-Spencer, Director of the Illinois Dept. of
Public Health's EMS and Highway Safety Division,
in a presentation to the American Medical Association
Conference on Bioterrorism Preparedness, July 21, 2004
“A comprehensive, real-time electronic reportable disease surveillance system is vital to the country’s ability to detect and respond to clusters of disease or syndromes in various areas of the nation simultaneously. The capability to rapidly detect, identify, and respond to these events can make the difference in the ultimate morbidity and mortality of disease outbreaks, whether natural or terrorist-initiated.”
—“Public Health Preparedness: A Progress
Report—The First Six Months,” Association of
State and Territorial Health Officials, July 2003
“The history of public health is a recurring sequence of alarm, followed by preventive measures in response to the most recent crisis, followed by neglect. Failure to seize the current opportunity to do much more will increase the likelihood that another such cycle will occur.”
—“Public Health Preparedness at a Price: Illinois,”
Dr. Bernard J. Turnock, The Century Foundation, January 2004
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