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Mass Distribution and Dispensing of Medical Countermeasures
Topic Collection
January 15, 2020

Topic Collection: Mass Distribution and Dispensing of Medical Countermeasures

This Topic Collection provides links to federal, state, local, and tribal programs and resources, lessons learned, plans, tools, and templates, courses, and guidance that can help planners address the demand to finer distribute and administrate medical countermeasures (MCMs) to a large number of persons in a short period of time, specially through mass dispensing efforts led by public wellness authorities. Various mass dispensing modalities may exist employed, with the aim of preventing individuals exposed to a biological, chemic, or radiological agent from becoming ill through their receipt of post-exposure prophylaxis. This "mass prophylaxis" is most frequently provided to affected individuals through "open", or public points of dispensing (PODs). "Closed" PODs for response partners and vulnerable populations, and straight commitment of prophylaxis to affected individuals may also be used for mass prophylaxis.

MCMs can include vaccines, antiviral drugs, antitoxins, antibiotics, and materials (eastward.thousand., personal protective equipment) that may be used to prevent, mitigate, or treat the adverse wellness effects of an intentional, accidental, or naturally occurring public wellness emergency. The majority of our nation'southward countermeasures stockpile is housed inside the Strategic National Stockpile (SNS) which was managed by the Centers for Affliction Control and Prevention before its movement to ASPR (Office of the Banana Secretary for Preparedness and Response) in October 2018. Other federal agencies, including the Section of Defence force and the Veteran'south Assistants, may also provide countermeasure support after a disaster.

A public health response requiring the distribution and dispensing of MCMs does not occur in isolation, only in the context of a major public health emergency. Few planning and response efforts are every bit circuitous as those for MCMs due to: the need to address varied incident types; possibilities of both very tight time constraints and meaning volumes of MCMs that demand to be moved; risk communication protocols to support public trust and compliance; coincident major epidemiologic and medical surge responses; and the need for coordination beyond all levels of government and amid coalition partners.

Successful MCM planning should begin with an "all-hazards" approach, with more detailed plans developed for specific aspects of distribution and delivery (east.one thousand., warehouse and transportation operations; POD and other dispensing plans) that consider the following:

Specific indications and requirements of the countermeasure (eastward.1000., supply sources/challenges; delivery needs; handling and storage requirements; optimal timing of assistants for greatest efficacy; and adverse effects);
Scope of the required response (plans for distribution and assistants of the MCMs must be scalable); and
Coordination and advice to ensure that the healthcare sector understands the goals, indications, and logistics of the MCM effort and can access the countermeasures in a timely fashion (and that the public understands the reasoning behind and steps for accessing MCMs).

Related information can be found in the following Topic Collections (listed alphabetically): Bioterrorism and High Consequence Biological Threats; Chemic Hazards; Epidemic/Pandemic Influenza; Healthcare-Related Disaster Legal/ Regulatory/ Federal Policy, Infirmary Victim Decontamination; Chemist's shop; Pre-Hospital Victim Decontamination; Radiological and Nuclear; SARS/MERS; VHF/Ebola; Volunteer Direction; and Zika.

Each resource in this Topic Collection is placed into i or more of the post-obit categories (click on the category name to exist taken straight to that ready of resource). Resources marked with an asterisk (*) appear in more than i category.

Must Reads

In the consequence of a public health emergency involving anthrax, state and local jurisdictions will activate their medical countermeasure (MCM) plans, allowing for an initial 10-twenty-four hour period antibiotic distribution. This document can help healthcare authorities plan for the extended post-exposure prophylactic period (in this example, 50-24-hour interval antibiotic supply, three shot vaccine series, and treatment supplies) and includes promising practices in each domain and links to relevant resources.

This comprehensive document provides an overview of the Strategic National Stockpile (SNS) plan, as well as operational and strategic guidance for each operational part required for the distribution and dispensing of medical countermeasures.

These ship-set containers (strategically located across the country) can supply a community with a wide range of pharmaceuticals and medical supplies in the issue of a large-scale public health incident related to an unknown agent, or to help initiate response activities while more targeted countermeasures from the "managed inventory" are being mobilized.

Planners and healthcare providers tin larn more about community-level mass dispensing and the logistics related to standing up points of dispensing from this hour-long course, which is provided through CDC TRAIN.

This program includes updates to the vii domains. Domain 3 is "Medical Countermeasures: Diagnostic Devices, Vaccines, Therapeutics, and Respiratory Devices" and includes seven objectives that can "improve effectiveness, timeliness, availability and accessibility to medical countermeasures."

This guidance document will assistance all Public Health Emergency Preparedness (PHEP) grant recipients and local Cities Readiness Initiative (CRI) planning jurisdictions with conducting the required operational readiness review (ORR). The ORR is a rigorous, bear witness-based assessment that primarily focuses on evaluating a jurisdiction's ability to execute a big response requiring medical countermeasure (MCM) distribution and dispensing.

This webpage includes links to various training and exercises related to the Strategic National Stockpile. Resources are listed in the post-obit categories: online courses, webinars, in-person training, on-site grooming, and exercise back up.

In the event of a public health emergency and so severe that local supplies are taxed, the Strategic National Stockpile (SNS) tin can be activated to ensure medicine and supplies become to those who demand it well-nigh. This website includes data on the history of the SNS; sustaining the SNS; partnerships; products included in the 12-60 minutes push button packs and managed inventory; training and exercises; and examples of the SNS in action.

Johnson County Government, Department of Health and Surroundings. (2017). Dispense Assist.

This online tool may be used to pre-screen individuals that will receive medical countermeasures at Signal of Dispensing (PODs) sites to back up rapid distribution at the PODs. Afterwards answering a few targeted questions, users can print out a completed screening form that indicates the countermeasure they should receive at the POD.

This document consists of a ane-page table that summarizes the different factors involved in attaining preparedness for medical countermeasure (MCM) distribution. The authors include considerations for the pre-activation phase; preparing for incoming deliveries; warehouse operations at the Receipt, Store, and Stage (RSS) site; inventory tracking; outgoing deliveries from the RSS site; and readiness of the receiving sites to effectively manage the MCMs when they are delivered.

This webpage includes links to initiatives and helpful data related to medical countermeasures, the Strategic National Stockpile, chemical response, radiations preparedness, pandemic influenza preparedness, and antiviral distribution and dispensing.

NACCHO has published a wide diversity of resources that tin can exist replicated past local emergency planners interested in setting up points of dispensing (POD), exercising their medical countermeasure plans, staffing PODs, and the similar. With a free account, users tin click on the URL, click on "Toolkits," select "Medical Countermeasure (MCM) Toolkit," and review the various tools.

The authors share a gear up of standards that tin can be used to develop mass antibody dispensing plans and focus on points of dispensing (PODs). The standards address "(i) the number and location of PODs, (2) internal POD operations, (3) POD staffing, and (4) POD security."

The authors used 2007 to 2014 land and local data collected from the Centers for Disease Control and Prevention'due south Technical Aid Review to evaluate and describe outcomes of state and local medical countermeasure preparedness planning. They plant that overall preparedness increased during the time period studied, and note that ongoing training, exercising, and incorporation of lessons learned from real events and exercises are all disquisitional to ensuring continued preparedness.

The authors reviewed 33 peer-reviewed studies that assessed advice strategies or information needs using hypothetical CBRN scenarios or in actual CBRN incidents to identify in advance what people would want to know, where they would get information from, and how messages should be presented. These strategies are critical for ensuring that affected individuals go to the correct place at the right time to receive cess and interventions.

This webpage includes links to information on points of dispensing, planning for infectious disease emergencies, and other resource. Also noted is that San Francisco was named as "model practice for helping organizations manipulate antibiotics" and provide a link to the related toolkit.

This guidance document created for the state of Texas includes information, flow diagrams, and organizational charts that may be adjusted by other jurisdictions. The document covers medical countermeasure distribution and dispensing considerations.

This webpage includes links to the text of the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019. This law: authorizes a funding increase for the Hospital Preparedness Program; directs ASPR, the Director of National Intelligence, and the Department of Homeland Security to coordinate regularly on threat assessments; allows states to request temporarily deployment of country personnel whose salaries are funded past HHS in whole or in part nether Public Health Service Act programs; authorizes coalitions to use funds for response activities; authorizes ASPR to found guidelines for the Regional Disaster Health Response System; allows programs to develop medical countermeasures for pandemic influenza and other emerging infectious diseases to receive annual funding from Congress; and authorized appropriations for Project BioShield for 10 years, amongst other provisions. (Access the 2006 Deed here: https://world wide web.congress.gov/beak/109th-congress/senate-bill/3678/text/pl; access the 2013 reauthorization hither: http://world wide web.gpo.gov/fdsys/pkg/PLAW-113publ5/pdf/PLAW-113publ5.pdf).

This fact sheet provides recommendations for responders working at points of dispensing (PODs) during an emergency or disaster. Information technology is broken up into three sections: Assumptions; What to practise; What to say.

The Public Readiness and Emergency Preparedness Human action provides liability immunity related to the development process and administration of medical countermeasures against agents that cause public health emergencies. This webpage provides links to current declarations for nerve agents, Zika, Ebola, pandemic influenza, anthrax, astute radiations syndrome, botulinum toxin, and smallpox.

The FDA works within this framework to ensure that the U.South. legal organisation finer supports public wellness emergency preparedness and response. This webpage includes links to related legislation.

A working grouping that included experts in adventure and crisis communication and medical countermeasures worked together to list "best practices" in this casebook. These practices stem from real-world lessons learned (from the recent Ebola outbreak, the 2011 Fukushima nuclear blow, the 2009-10 H1N1 influenza pandemic, and the 2001 anthrax alphabetic character attacks) and emphasize how solid advice tin can enhance personal and community resilience.

Considerations for Special Populations

On this podcast, local health department preparedness planners discuss partnerships they accept established, the approaches they utilise to engage these partners, and the benefits of such partnerships as they relate to medical countermeasure planning and response.

Speakers share challenges associated with vulnerable populations and open up points of dispensing (PODs) and strategies for using closed PODs to aid protect the wellness of members of vulnerable populations.

The Council shares that many medical countermeasures (MCM) are more likely to be approved for adult use and may not take the unique needs of children into account. They drafted this policy argument to suggest recommendations that address the gaps for the development and use of MCMs in children during public health emergencies or disasters and discuss available options and regulatory problems.

The authors nowadays information regarding vaccine, antimicrobial drug prophylaxis and treatment, clinical considerations, and other factors healthcare practitioners must take into consideration when treating meaning and postpartum women subsequently an anthrax exposure.

This document provides information for public health departments about pursuing Meals on Wheels as an alternate dispensing partner of medical countermeasures.

On this podcast, local health department preparedness planners discuss best practices for defining and identifying at-risk populations in their jurisdictions, and strategies and planning considerations for inclusive medical countermeasure planning. (Note that Babcock, S., Rowell, E., and Scarborough, N. [2015] is cited in this drove and considered Office 2 of this series.)

Pediatric patients may react differently to certain medications, making the development of safety and effective medical countermeasures (MCM) for young patients critical to public health emergency preparedness. This webpage includes links to resources specific to bioterrorism emergencies and radiation emergencies.

Distribution of MCM: Warehouse and MCM Delivery

In the upshot of a public wellness emergency involving anthrax, state and local jurisdictions will actuate their medical countermeasure (MCM) plans, assuasive for an initial ten-twenty-four hours antibiotic distribution. This certificate can assistance healthcare authorities plan for the extended postal service-exposure prophylactic menses (in this instance, l-day antibiotic supply, three shot vaccine series, and handling supplies) and includes promising practices in each domain and links to relevant resources.

This comprehensive document provides an overview of the Strategic National Stockpile (SNS) programme, besides as operational and strategic guidance for each operational role required for the distribution and dispensing of medical countermeasures.

This document describes the functions, tasks, performance measures, and resources elements required to achieve Capability 9 (Medical Materiel Management and Distribution) of the Public Health Preparedness Capabilities issued in 2011.

The Countermeasure Tracking System (CTS) consists of multiple interoperating components that may be used by federal, state, and local public health agencies to rail and manage medical and non-medical inventory and usage during both daily operations and all-hazards events. It includes the Inventory Management Tracking System (IMATs); the Countermeasure and Response Administration (CRA) system; and the Countermeasure Inventory Tracking (CIT) Dashboard.

This guidance can help healthcare planners found coordinated efforts regarding the receipt, distribution, and dispensing of medical countermeasures during an anthrax response.

This certificate consists of a one-page table that summarizes the different factors involved in attaining preparedness for medical countermeasure (MCM) distribution. The authors include considerations for the pre-activation stage; preparing for incoming deliveries; warehouse operations at the Receipt, Store, and Stage (RSS) site; inventory tracking; approachable deliveries from the RSS site; and readiness of the receiving sites to effectively manage the MCMs when they are delivered.

This guidance document created for the state of Texas includes information, flow diagrams, and organizational charts that may be adapted by other jurisdictions. The document covers medical countermeasure distribution and dispensing considerations.

Education, Preparation, and Exercises

While free registration is necessary to view this instructional video, other materials are available on this webpage and include slides for clerks, nurses, pharmacists, and social workers. Users tin as well access a short video on the role of the social worker at points of dispensing.

This 25-infinitesimal online course provides a basic overview of CHEMPACK. Because the MCM that protects exposed persons from harmful effects of chemical exposure must often be administered within two hours of exposure, the CDC uses the CHEMPACK program to forward place significant caches of these assets within communities, at locations such as hospitals and fire stations.

Participants will learn more about logistics and maintenance issues associated with CHEMPACK containers in this (Vermont-specific) 20-minute, on-line course. Other topics covered include dissimilar CHEMPACK configurations, storage requirements, and mobilization timing.

CDC Train. (2018). CDC Railroad train. (Complimentary registration required.)

The Centers for Disease Control and Prevention offer numerous on-line courses on medical countermeasures, the Strategic National Stockpile, and points of dispensing. ASPR TRACIE has listed several individual courses under the Education and Preparation category; users should search by keyword to locate courses specific to their needs.

This in-person course covers the coordination of planning, preparation and responding to a Medical Countermeasure (MCM) response for a public health incident.

This class provides state and local agencies with information to manage closed signal of dispensing (POD) sites during a public health emergency.

This webinar, which is provided through CDC Train, volition familiarize participants with disquisitional SNS concepts, and help them to amend sympathize the importance of shelf life and its impact on medical countermeasure (MCM) preparedness planning.

This grade, which is provided through CDC Railroad train, provides state and local agencies with basic information regarding the deployment of assets from the SNS into a jurisdiction during a public health emergency and how those assets should be managed.

Planners and healthcare providers tin larn more about community-level mass dispensing and the logistics related to continuing upwardly points of dispensing from this hour-long course, which is provided through CDC TRAIN.

This webpage includes links to various training and exercises related to the Strategic National Stockpile. Resources are listed in the following categories: online courses, webinars, in-person grooming, on-site training, and practice support.

The CDC's Partitioning of Land and Local Readiness (DSLR) Preparation Team identified a prepare of vi common responsibilities and associated skills of Medical Countermeasure (MCM) Coordinators to aid in supporting the training needs of MCM Coordinators across the country. These responsibilities and skills were developed with input from CDC MCM subject matter experts, the National Association of County & Urban center Health Officials (NACCHO), and the Association of Land and Territorial Health Officers (ASTHO).

The Primary Response Incident Scene Direction (PRISM) series is comprised of three volumes that can assist ensure that patients exposed to potentially hazardous chemicals receive the most constructive handling possible during the initial stages of an incident (after prompt decontamination). Updated in 2019, PRISM incorporates new scientific prove on emergency self-decontamination, pilus decontamination, the interactions of chemicals with hair, and the effects of a combined decontamination strategy referred to as the "triple protocol." The clinical inquiry showed that these three steps, taken together, remove 99.9 percent of chemical contagion.

This webpage includes links to HSEEP-compliant exercise documents that were adult by the Los Angeles Canton Department of Public Health. This series of exercises concluded with full-scale exercises (FSE) of Medical Countermeasure Distribution and Dispensing (MCMDD) in November 2015. Documents will exist added every bit the section develops another set of HSEEP-compliant practice documents for the entire series that will pb up to the next FSE of MCMDD in November 2020.

This 3-page guide includes data on both a two-year professional development programme for new MCM Coordinators and a number of recommended resources that the members of NACCHO'due south MCM Workgroup identified as of import to this position.

This webpage links to several trainings that will assist planners with preparing for medical countermeasure dispensing.

This online, self-paced training can help healthcare providers and coalitions learn more well-nigh and prepare to stand up up a closed betoken of dispensing.

This course (online and self-paced) was designed to supplement just-in-time preparation and provides a general overview of points of dispensing (PODs) and the roles that staff and volunteers tin can play to ensure PODs run smoothly.

This resources is the after-action study (AAR) from a regional do in Ohio that tested public health bureau capabilities to carry out mass prophylaxis operations through Points of Dispensing during a Pandemic Influenza A (H7N9) outbreak. It may be referenced by other health departments to develop their ain corresponding AARs, as well every bit to develop scenarios and objectives for similar exercises.

Legal and Regulatory Resources

This fact canvass summarizes how the telescopic of exercise for diverse practitioners (e.1000., pharmacists, emergency medical services responders, physicians, and nurses) was contradistinct in several states to allow for increased numbers of vaccinators.

The authors discuss federal legal tools that are critical to enhancing medical countermeasure legal preparedness for public health emergencies. They focus on the Public Readiness and Emergency Preparedness (PREP) Act and Emergency Utilise Say-so (EUA) authority to facilitate the emergency employ of countermeasures.

The development of government and public health liability protection for emergency use of medical countermeasures, associated with the Pandemic and All-Hazards Preparedness Reauthorization Act, is analyzed to advance emergency preparedness and response activities and protection of personnel.

This Executive Club was developed to "(1) mitigate disease and prevent death; (ii) sustain critical infrastructure; and (3) complement and supplement State, local, territorial, and tribal authorities medical countermeasure distribution capacity." Information technology is comprised of five sections: policy development in the event of a biological attack; United States Postal Service delivery of medical countermeasures; federal response; continuity of operations; and general provisions.

This Human activity allows the Secretarial assistant of Wellness and Human Services to event a declaration providing immunity from state and federal liability to persons and entities involved in the manufacture, testing, distribution, administration, and use of covered pandemic/ epidemic medical countermeasures, and provides a compensation plan to sure individuals who receive covered countermeasures.

This webpage includes links to the text of the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019. This police force: authorizes a funding increase for the Hospital Preparedness Program; directs ASPR, the Director of National Intelligence, and the Department of Homeland Security to coordinate regularly on threat assessments; allows states to asking temporarily deployment of state personnel whose salaries are funded by HHS in whole or in part nether Public Health Service Act programs; authorizes coalitions to utilize funds for response activities; authorizes ASPR to establish guidelines for the Regional Disaster Health Response System; allows programs to develop medical countermeasures for pandemic flu and other emerging infectious diseases to receive almanac funding from Congress; and authorized appropriations for Project BioShield for ten years, amid other provisions. (Access the 2006 Act here: https://www.congress.gov/bill/109th-congress/senate-bill/3678/text/pl; admission the 2013 reauthorization here: http://world wide web.gpo.gov/fdsys/pkg/PLAW-113publ5/pdf/PLAW-113publ5.pdf).

This amendment includes an updated "description of covered countermeasures and the disease threat; extend[south] the effective time menstruum of the declaration;" and clarifies the terms of the proclamation.

This draft guidance certificate includes data regarding the implementation of section 3086 of the 21st Century Cures Human activity (Cures Act) (Public Law 114-255), which added section 565A of the Federal Food, Drug, and Cosmetic Deed (FD&C Act) (21 The statesC. 360bbb-4a). Section 565A requires the Food and Drug Administration "to accolade a priority review voucher (PRV) to sponsors of certain medical countermeasure (MCM) applications that meet the criteria specified in that section."

The Public Readiness and Emergency Preparedness Act provides liability amnesty related to the development process and assistants of medical countermeasures against agents that cause public health emergencies. This webpage provides links to current declarations for nerve agents, Zika, Ebola, pandemic influenza, anthrax, acute radiation syndrome, botulinum toxin, and smallpox.

This page describes the legal authority possessed past the Secretary of Health and Human Services with and without a formal proclamation of a public wellness emergency.

This order allows public health emergency stakeholders to execute plans for "emergency dispensing of eligible ciprofloxacin products without individual prescriptions in the time to come if they reasonably believe there is a need to do and then because of their constituents' known, suspected, or likely imminent exposure to B. anthracis."

This social club allows public health emergency stakeholders to permit emergency dispensing of FDA-approved oral dosage forms of doxycycline products without prescription for the post-exposure treatment of "inhalational anthrax during an emergency involving Bacillus anthracis (B. anthracis), the biological agent that causes anthrax disease."

This webpage includes data and links to resources specific to facilitating the development of medical products (including MCMs) and MCM-specific Cures provisions (e.g., Emergency Use Authority and the MCM priority review voucher program).

This potency allows the Food and Drug Administration to facilitate the availability and use of medical countermeasures to help during public wellness emergencies. Links to information on current authorizations (east.g., anthrax, Ebola, and nervus agent) are provided on this page.

The FDA works within this framework to ensure that the U.S. legal system effectively supports public wellness emergency preparedness and response. This webpage includes links to related legislation.

Lessons Learned

This fact canvas summarizes how the scope of exercise for various practitioners (due east.1000., pharmacists, emergency medical services responders, physicians, and nurses) was contradistinct in several states to allow for increased numbers of vaccinators.

On this podcast, local health section preparedness planners discuss partnerships they take established, the approaches they apply to appoint these partners, and the benefits of such partnerships as they relate to medical countermeasure planning and response.

Speakers share challenges associated with vulnerable populations and open points of dispensing (PODs) and strategies for using closed PODs to help protect the wellness of members of vulnerable populations.

This webpage includes lessons learned, planning documents, and sample templates from planners across the state to back up preparedness for medical countermeasure dispensing.

This webinar includes lessons learned from Erie County, New York's Hepatitis A outbreak response in 2008, and compares walk-in and drive-thru POD models and experiences.

The Philadelphia Department of Public Health tested the readiness of a nonmedical closed indicate-of-dispensing (POD) site to run into how rapidly and accurately it could provide medication to its internal population. Hateful throughput and accuracy rates were compared to a previous public POD exercise staffed by wellness section personnel and medical volunteers. Overall accurateness, and pediatric dosing accuracy, were found to be significantly lower during the closed POD vs. the public POD.

This report lists the lessons learned past the U.S. Department of Health and Homo Services during the 2009 H1N1 pandemic, including those related to communications and the Strategic National Stockpile. Comments from several federal agencies are included equally appendices.

This document consists of a one-folio table that summarizes the dissimilar factors involved in attaining preparedness for medical countermeasure (MCM) distribution. The authors include considerations for the pre-activation phase; preparing for incoming deliveries; warehouse operations at the Receipt, Store, and Stage (RSS) site; inventory tracking; approachable deliveries from the RSS site; and readiness of the receiving sites to effectively manage the MCMs when they are delivered.

Workshop participants discussed the need for shared terminologies; data needs, sources, and collection methodologies; considerations for conducting rapid clinical inquiry on medical countermeasures (MCM) during a public health emergency; and the federal perspective on MCM. Lessons from a 2012 fungal infection outbreak, anthrax, and H1N1 are shared in sidebars throughout the proceedings.

This webpage includes links to an infographic and report on a survey which found 86 percent of surveyed healthcare-related entities accept airtight POD agreements.

The authors used a real seasonal influenza vaccination clinic to assess throughput and accuracy, and to evaluate the resources needed to operationalize a Point of Dispensing (POD) model to distribute the boosted l-24-hour interval grade of antibiotics and administer the 3-dose vaccine serial required after the initial response to an aerosolized anthrax release is completed.

The authors used 2007 to 2014 state and local data nerveless from the Centers for Affliction Control and Prevention's Technical Assistance Review to evaluate and describe outcomes of state and local medical countermeasure preparedness planning. They found that overall preparedness increased during the time period studied, and annotation that ongoing preparation, exercising, and incorporation of lessons learned from existent events and exercises are all disquisitional to ensuring continued preparedness.

The authors discuss lessons learned by the New York Section of Wellness and Mental Hygiene, which set upward and operated 58 points of dispensing (PODs) over 5 weekends during the 2009 H1N1 outbreak.

The Los Angeles County Section of Public Health used points of dispensing (PODs) to vaccinate residents during the H1N1 outbreak. This commodity highlights vaccination rates past demographic, average altitude traveled to PODs, and other factors that should exist considered by emergency planners.

On this podcast, local wellness department preparedness planners discuss all-time practices for defining and identifying at-risk populations in their jurisdictions, and strategies and planning considerations for inclusive medical countermeasure planning. (Note that Babcock, S., Rowell, Due east., and Scarborough, N. [2015] is cited in this collection and considered Part 2 of this serial.)

A working group that included experts in risk and crisis communication and medical countermeasures worked together to list "all-time practices" in this casebook. These practices stalk from real-world lessons learned (from the recent Ebola outbreak, the 2011 Fukushima nuclear blow, the 2009-10 H1N1 influenza pandemic, and the 2001 anthrax letter attacks) and emphasize how solid communication tin enhance personal and community resilience.

The author describes the airplane pilot testing of a program designed to dispense medical countermeasures via a Costco warehouse in Virginia.

Mass Prophylaxis Planning: Full general

The authors summarize the various modes of medical countermeasure dispensing under two models: medical and non-medical. They likewise emphasize how critical partnerships, volunteers, and personal responsibilities are to ensuring a successful response to a public health emergency.

This document describes the functions, tasks, performance measures, and resources elements required to accomplish Capability 8 of the Public Health Preparedness Capabilities issued in 2011.

This document describes the functions, tasks, functioning measures, and resource elements required to accomplish Adequacy ix (Medical Materiel Direction and Distribution) of the Public Health Preparedness Capabilities issued in 2011.

This webpage provides links to factsheets for healthcare providers and others on the use of doxycycline and ciprofloxacin in the event of a mass prey incident involving anthrax.

These transport-set containers (strategically located across the state) can supply a community with a broad range of pharmaceuticals and medical supplies in the event of a big-calibration public health incident related to an unknown agent, or to help initiate response activities while more than targeted countermeasures from the "managed inventory" are beingness mobilized.

The goal of community-broad mass vaccination is to inoculate all willing and eligible people in an area. This smallpox-specific webpage defines points of dispensing and provides links to Maxi-Vac Version 1.0 and Maxi-Vac Alternative, a modeling program that tin help planners allocate homo resources to vaccinate the greatest number of people equally chop-chop equally possible.

This webpage includes data on medical countermeasure readiness and the Cities Readiness Initiative (CRI), a federal initiative designed to enhance preparedness in the nation's largest population centers, where nearly lx% of the population resides, to effectively respond to big-calibration public wellness emergencies needing life-saving medications and medical supplies.

This guidance document will aid all Public Health Emergency Preparedness (PHEP) grant recipients and local Cities Readiness Initiative (CRI) planning jurisdictions with conducting the required operational readiness review (ORR). The ORR is a rigorous, evidence-based assessment that primarily focuses on evaluating a jurisdiction's ability to execute a large response requiring medical countermeasure (MCM) distribution and dispensing.

This guidance can assist healthcare planners establish coordinated efforts regarding the receipt, distribution, and dispensing of medical countermeasures during an anthrax response.

In the event of a public health emergency and then severe that local supplies are taxed, the Strategic National Stockpile (SNS) can be activated to ensure medicine and supplies get to those who demand it almost. This website includes data on the history of the SNS; sustaining the SNS; partnerships; products included in the 12-60 minutes push packs and managed inventory; training and exercises; and examples of the SNS in action.

This article discusses findings from a series of 8 focus groups conducted by the New York City Department of Health and Mental Hygiene to determine what improvements could exist made to public advice and education plans to ensure that the public would adhere to instructions issued during an emergency that required mass antibody distribution.

The authors reviewed 33 peer-reviewed studies that assessed communication strategies or information needs using hypothetical CBRN scenarios or in actual CBRN incidents to place in accelerate what people would want to know, where they would get information from, and how messages should be presented. These strategies are disquisitional for ensuring that affected individuals become to the right place at the right time to receive assessment and interventions.

This article discusses findings from a poll conducted to examine the public'southward response to a mass prophylaxis program conducted nether a "worst-case scenario" in which cases of inhalation anthrax are discovered without an identified source and the entire population of a city or town is asked to receive antibiotic prophylaxis inside a 48-60 minutes menstruum. Findings provide indicators of public willingness to comply with public health recommendations for obtaining antibiotics from a dispensing site, although they likewise indicate that public health officials may confront several challenges to compliance.

This report summarizes findings from a conference held with geographically representative residents from the Seattle and King County regions. In general, participants indicated they preferred multiple options regarding medical countermeasure (MCM) development and dispensing; prophylactic and equal access to MCM was of the utmost importance; MCM should exist gratis; clear and timely communication is disquisitional; and most residents will follow directions given regarding collecting MCM.

Mass Prophylaxis Planning: Points of Dispensing (PODs)

Head-of-household points of dispensing (PODs) were tested in a simulation anthrax do with the Philadelphia Section of Public Health. The authors note that this method tin achieve large populations quickly during a public health emergency.

While written for the State of Alabama, the guidance in this document can help emergency healthcare planners across the U.Due south. understand the benefits of developing airtight points of dispensing (POD). The certificate includes steps and guidance for functioning before and during a public wellness emergency.

In the result of a public health emergency involving anthrax, state and local jurisdictions will activate their medical countermeasure (MCM) plans, allowing for an initial 10-day antibody distribution. This document tin aid healthcare government programme for the extended post-exposure prophylactic period (in this case, l-day antibiotic supply, three shot vaccine series, and treatment supplies) and includes promising practices in each domain and links to relevant resources.

The authors examined traffic-related challenges associated with points of dispensing (PODs) and found that planners should consider using physical barriers, traffic control officers, and signage to help guide vehicular and pedestrian traffic. They also found that due to long lines of people waiting to access the PODs, staff would probable be used nearly xc% of the fourth dimension and encouraged planners to consider burnout in their strategies.

The authors summarize the diverse modes of medical countermeasure dispensing under two models: medical and non-medical. They likewise emphasize how critical partnerships, volunteers, and personal responsibilities are to ensuring a successful response to a public health emergency.

This webpage includes lessons learned, planning documents, and sample templates from planners across the country to support preparedness for medical countermeasure dispensing.

This document describes the functions, tasks, performance measures, and resources elements required to achieve Capability 8 of the Public Health Preparedness Capabilities issued in 2011.

This webpage includes guidance for staffing, location, layout, administration, and vaccine tracking related to large-scale influenza vaccination clinics.

The goal of community-wide mass vaccination is to inoculate all willing and eligible people in an area. This smallpox-specific webpage defines points of dispensing and provides links to Maxi-Vac Version ane.0 and Maxi-Vac Alternative, a modeling program that can help planners allocate homo resources to vaccinate the greatest number of people as speedily as possible.

The authors describe the simulation modeling work completed for a mass vaccination drive-through dispensary in 2009, where more than than 19,000 patients were served (more than two-thirds via ten drive-through lanes). Using this model can assistance public health emergency planners determine "the required number of Points of Dispense (POD) lanes, number and length of the lanes for consent hand outs and fill in, staff needed at the consent handout stations and PODs, and average user waiting time in the organization."

* Johnson Canton Authorities, Section of Health and Environment. (2017). Dispense Aid.

This online tool may be used to pre-screen individuals that will receive medical countermeasures at Point of Dispensing (PODs) sites to support rapid distribution at the PODs. After answering a few targeted questions, users can print out a completed screening course that indicates the countermeasure they should receive at the POD.

The authors examine Points of Dispensing and alternatives to dispensing oral prophylaxis in the upshot of a biological attack, from the perspective of a local health department located in a large metropolitan area.

This plan document covers Signal of Dispensing (POD) operations, logistics, and staffing. It too reviews POD alternatives. It may be referenced and/or adapted by other jurisdictions and includes tables showing throughput vs. population / fourth dimension, forms, and layouts.

This software can aid public health officials rapidly develop a model that provides immediate planning assistance specific to disseminating vaccinations and/or dispensing clinic. It tin can exist used either before or during an incident. While slightly dated, this tool may yet be useful for those new to the field, new to their role, and/or communities in need of a solid plan.

The authors share a set of standards that tin can be used to develop mass antibody dispensing plans and focus on points of dispensing (PODs). The standards address "(ane) the number and location of PODs, (2) internal POD operations, (3) POD staffing, and (4) POD security."

This Point of Dispensing (POD) Field Operations Guide (FOG) was created for the state of Oregon, but may be used as a model for other jurisdictions to develop detailed operational plans for both mass dispensing of safe antibiotics (medical and not-medical models) and mass vaccination of a given population.

A well-nigh-equal number of Cities Readiness Initiative (CRI) and non-CRI sites were surveyed to mensurate open Points of Dispensing (POD) readiness. The authors institute that well-nigh all open PODS had plans/layouts for each sites. Shut to one-half had plans for an alternative dispensing modality and 42.6% reported acceptable staffing. While most respondents had conducted a full scale exercise and a staff notification drill, simply forty% had conducted a vaccination dispensary practise.

This webpage includes links to information on points of dispensing, planning for infectious disease emergencies, and other resources. Also noted is that San Francisco was named equally "model practise for helping organizations dispense antibiotics" and provide a link to the related toolkit.

This fact sheet provides recommendations for responders working at points of dispensing (PODs) during an emergency or disaster. It is broken upward into three sections: Assumptions; What to practise; What to say.

Mass Prophylaxis Planning: POD Alternatives

The authors summarize the various modes of medical countermeasure dispensing nether ii models: medical and non-medical. They also emphasize how disquisitional partnerships, volunteers, and personal responsibilities are to ensuring a successful response to a public health emergency.

Speakers share challenges associated with vulnerable populations and open points of dispensing (PODs) and strategies for using closed PODs to assistance protect the health of members of vulnerable populations.

The author evaluates four models for delivering post-exposure prophylaxis (PEP) following an aerosolized anthrax effect: local stockpiling; partner storage/rotation agreements; pre-effect distribution of PEP to commencement responders; and the Strategic National Stockpile for the provision of PEP. Evaluation criteria include: timeliness of response; price; logistics; stakeholder acceptance; and comprehensiveness.

The author shares data on alternate modes of dispensing (eastward.g., via door-to-door, pharmacy, civil service, and Kaiser Permanente) and methods for evaluating their effectiveness in Los Angeles County.

The authors examine Points of Dispensing and alternatives to dispensing oral prophylaxis in the event of a biological attack, from the perspective of a local health department located in a big metropolitan area.

This document provides information for public health departments about pursuing Meals on Wheels as an alternate dispensing partner of medical countermeasures.

In a public health emergency, the Us Mail could deliver self-administrable medical countermeasures to affected communities inside one 24-hour interval, assuasive healthcare agencies the time to activate their longer-term response and recovery plans. This webpage explains the model and includes links to related resource.

Plans, Tools, and Templates

This resource contains several downloadable documents related to closed PODs, including a grooming checklist, plan template, field operations guide, and other attachments.

This webpage includes lessons learned, planning documents, and sample templates from planners across the country to support preparedness for medical countermeasure dispensing.

This comprehensive certificate provides an overview of the Strategic National Stockpile (SNS) program, every bit well as operational and strategic guidance for each operational function required for the distribution and dispensing of medical countermeasures.

This document describes the functions, tasks, functioning measures, and resource elements required to achieve Adequacy viii of the Public Health Preparedness Capabilities issued in 2011.

This document describes the functions, tasks, performance measures, and resource elements required to attain Capability 9 (Medical Materiel Direction and Distribution) of the Public Health Preparedness Capabilities issued in 2011.

The Countermeasure Tracking System (CTS) consists of multiple interoperating components that may be used by federal, country, and local public health agencies to track and manage medical and non-medical inventory and usage during both daily operations and all-hazards events. It includes the Inventory Management Tracking System (IMATs); the Countermeasure and Response Assistants (CRA) organization; and the Countermeasure Inventory Tracking (CIT) Dashboard.

This plan includes updates to the 7 domains. Domain iii is "Medical Countermeasures: Diagnostic Devices, Vaccines, Therapeutics, and Respiratory Devices" and includes seven objectives that tin can "meliorate effectiveness, timeliness, availability and accessibility to medical countermeasures."

This guide is designed for squad leaders who will be delivering Just-in-Time training to personnel involved in mass prophylaxis/POD operations.

Los Angeles County shares their policy related to the release of local pharmaceutical caches in the consequence of a major incident.

* Johnson County Government, Department of Health and Surroundings. (2017). Manipulate Aid.

This online tool may be used to pre-screen individuals that will receive medical countermeasures at Point of Dispensing (PODs) sites to support rapid distribution at the PODs. Later on answering a few targeted questions, users tin print out a completed screening form that indicates the countermeasure they should receive at the POD.

This plan template may exist used past hospitals to develop closed Point of Dispensing (POD) plans to distribute oral antibiotics after an aerosolized anthrax release.

This toolkit provides information on how to become a airtight POD. It includes materials such as a closed POD dispensing plan template, sample POD checklists, sample Incident Command Organization structure and task action sheets, and a supply listing for airtight PODs.

This plan certificate covers Point of Dispensing (POD) operations, logistics, and staffing. Information technology also reviews POD alternatives. It may be referenced and/or adapted by other jurisdictions and includes tables showing throughput vs. population / fourth dimension, forms, and layouts.

This webpage includes links to initiatives and helpful information related to medical countermeasures, the Strategic National Stockpile, chemic response, radiation preparedness, pandemic influenza preparedness, and antiviral distribution and dispensing.

This webpage includes data on tools and technologies for capturing patient data during vaccination clinics (barcode scanners, digital pens, magnetic card swipers, mobile applications, scanning, and web-based applied science), and a link to search examples in the NACCHO Toolbox.

NACCHO has published a broad variety of resources that can exist replicated by local emergency planners interested in setting upwards points of dispensing (POD), exercising their medical countermeasure plans, staffing PODs, and the like. With a complimentary business relationship, users tin can click on the URL, click on "Toolkits," select "Medical Countermeasure (MCM) Toolkit," and review the diverse tools.

This program includes operational considerations related to Points of Dispensing, and may be referenced and/or adapted past other jurisdictions in the development of their corresponding countermeasure dispensing plans.

This document provides data for public health departments about pursuing Meals on Wheels as an alternate dispensing partner of medical countermeasures.

This webpage contains a closed POD toolkit that can exist used past healthcare partners. It also provides a Strategic National Stockpile (SNS) airtight POD plan template, quick "how-to guide, FAQ sheet, and other attachments. Notation: Materials can be plant in the dropdown choice at the bottom of the webpage titled, "Closed POD Planning for Businesses and Organizations."

This Point of Dispensing (POD) Field Operations Guide (FOG) was created for the country of Oregon, but may be used as a model for other jurisdictions to develop detailed operational plans for both mass dispensing of prophylactic antibiotics (medical and not-medical models) and mass vaccination of a given population.

This is a state-level plan that discusses coordination, and roles and responsibilities amid partners, to manipulate medical countermeasures in the country of Ohio. It may be adapted for other jurisdictions. This plan is not particularly detailed but does outline better than many the country-level coordination and the number and roles of the many stakeholders.

This guidance certificate created for the land of Texas includes information, menstruum diagrams, and organizational charts that may be adjusted by other jurisdictions. The document covers medical countermeasure distribution and dispensing considerations.

U.S. Section of Health and Man Services, Office of the Assistant Secretarial assistant for Preparedness and Response. (2021). National Health Security Strategy. U.Southward. Section of Health and Human being Services.

The goal of the National Wellness Security Strategy (NHSS) is to strengthen and sustain communities' abilities to preclude, protect against, mitigate the effects of, respond to, and recover from disasters and emergencies. This webpage includes links to the full text of the strategy, an overview, the NHSS Implementation Plan, the NHSS Evaluation of Progress, and an NHSS Archive.

Strategic Planning/Inquiry and Development

Users can click on diverse tabs to learn more than about BARDA'due south work to develop diagnostics, antitoxins, antivirals, vaccines, and treatments for threats such as thermal burns, anthrax, smallpox, botulinum toxin, and Ebola.

This webpage includes information on medical countermeasure readiness and the Cities Readiness Initiative (CRI), a federal initiative designed to enhance preparedness in the nation's largest population centers, where almost lx% of the population resides, to effectively respond to large-calibration public health emergencies needing life-saving medications and medical supplies.

This certificate summarized presentations and discussions that focused on the Strategic National Stockpile and: an overview of the plans to distribute medical countermeasures during a disaster or public health emergency; individual industry practices geared towards distributing medical products and supplies (daily and during emergencies); gaps in current planning; opportunities for collaboration; and opportunities for economical sustainability as missions and countermeasures evolve.

The section on Capabilities 8 and 9 includes links to pinnacle- and 2d-tier resources chosen by the authors as helpful to medical countermeasure planning, preparation, and exercises.

This conference summary provides findings from breakout and plenary sessions. Topics related to medical countermeasures included stop-user considerations, federal initiatives and programs, industry partnerships, and emerging infectious diseases and pandemic influenza.

This program is the annual blueprint to protect national wellness security via the procurement and use of medical countermeasures. Department 1 highlights progress made in medical countermeasures, using the response to Zika and Ebola as examples. Section 2 summarizes updates fabricated since the terminal plan was published.

This webpage provides links to the work the Biomedical Advanced Inquiry and Development Authority (BARDA) does to develop and field countermeasures under v categories: core services, CBRN programs, pandemic influenza, innovation, and stockpile building. Links to programs and helpful resource are also included.

U.S. Department of Wellness and Human Services, Office of the Assistant Secretarial assistant for Preparedness and Response. (2018). MedicalCountermeasures.gov.

This webpage highlights announcements, publications, and events regarding medical countermeasures. Users can register to asking TechWatch meetings (on vaccines, diagnostics, therapeutic strategies, and other topics). Links to other federal initiatives, Biomedical Avant-garde Research and Evolution Authority (BARDA), and Public Health Emergency Medical Countermeasures Enterprise partners are also provided.

This webpage provides an overview of how PHEMCE coordinates federal preparedness efforts between ASPR and internal and external bureau partners. The Enterprise's focus is to provide medical countermeasures to combat chemic, biological, radiological, nuclear, and emerging infectious disease threats. The page also includes a link to 2017-2018 Public Health Emergency Medical Countermeasures Enterprise (PHEMCE) Strategy and Implementation Plan (also referenced in this section).

This webpage is focused on the need to build and maintain a national capability to monitor and assess medical countermeasures (MCMs) afterwards they are dispensed or administered in response to a chemical, biological, radiological, or nuclear threat or an emerging infectious disease. Links to "FDA Information almost Past and Electric current MCM Monitoring and Assessment Projects" are included.

The FDA coordinates medical countermeasure development under this initiative, and links to various initiatives and resources are provided on this webpage.

Threat-Specific Countermeasures

This webpage explains how the smallpox vaccine tin help forbid infection (prior to or inside days of exposure) and lists three antiviral drugs that have been shown constructive against smallpox: Tecovirimat, Cidofovir, and Brincidofovir.

This affiliate includes a review of current plans and existing infrastructure for the distribution and dispensing of medical countermeasures necessary in the event of a terrorist set on involving Bacillus anthracis (anthrax). Concerns nigh the current system and legal and regulatory issues are besides presented.

This certificate includes guidance for x specific agents and has 1 chapter on "other infectious diseases" and another on agents for which no treatment can be recommended (e.g., ricin and viral encephalitis).

The authors discuss the benefits of creating and pre-deploying "MedKits" to households that may be affected by a mass anthrax set on. Cost and logistical may limit the applicability of this strategy.

The Constitute of Medicine convened a committee to written report the part of diverse prepositioning strategies in the overall medical countermeasures dispensing strategy. The committee found that while prepositioning strategies can save time, it also provides less flexibility (e.g., should an attack take identify at a different location or uses a strain of anthrax that is resistant to the pre-positioned handling).

Workshop attendees were asked to develop consensus recommendations for mail exposure handling against melioidosis and glanders (acquired by Burkholderia pseudomallei and B. mallei infections). Recommended prophylaxes includes trimethoprim/sulfamethoxazole or co-amoxiclav. The authors also emphasized the need for standardized animal models and farther research and training.

U.Southward. Section of Health and Human Services. Chemical Hazards Emergency Medical Management (CHEMM). (2021). CHEMPACK.

CHEMPACKs comprise nerve agent antidotes and are stored in secure locations beyond the state. More than xc percent of the U.S. population is inside 1 60 minutes of a CHEMPACK location; nigh locations are in hospitals or burn down stations.

Doxycycline monohydrate and doxycycline hyclate tablets and capsules (50 mg) and 100 mg of doxycycline are indicated (and stockpiled) for post-exposure prophylaxis or handling of inhalational anthrax; this guidance document explains how stakeholders can extend the shelf life of these medications.

This webpage provides information on and links to resources specific to products approved to treat anthrax and maintained in the Strategic National Stockpile (SNS).

This webpage includes links to information and guidance on products approved for utilise during bioterrorism emergencies, specifically for botulism, Ebola virus disease, plague, smallpox, tularemia, and Zika virus disease.

This webpage provides information on and links to resources specific to products approved to treat the effects of radiations exposure. These products are contained in the Strategic National Stockpile (SNS).

Agencies and Organizations

This free resource provides wellness departments with a secure, user-friendly platform for requesting technical aid from CDC subject field matter experts on public health preparedness. On-TRAC too offers admission to new and existing tools and resource that support the public health preparedness capabilities.

This webpage includes links to initiatives and helpful data related to medical countermeasures, the Strategic National Stockpile, chemical response, radiation preparedness, pandemic flu preparedness, and antiviral distribution and dispensing.