May 28, 2003
Good morning, Mr. Chairman and Members of the Committee. I am Joseph Henderson, Associate Director for Terrorism Preparedness and Emergency Response at the Centers for Disease Control and Prevention (CDC) of the Department of Health and Human Services. Thank you for the opportunity to testify today about the terrorism preparedness and emergency response program at CDC. The United States continues to experience threats to its national security that require ongoing preparedness for terrorism and other public health emergencies. Helping lead this effort is the Centers for Disease Control and Prevention. CDC is committed to helping prevent, prepare for, respond to, and recover from acts of terrorism and other public health emergencies. As the current response to Severe Acute Respiratory Syndrome (SARS) shows, we must be prepared for all types of public health emergencies. CDC, in recent years, committed to building preparedness and response capacities across the nation and we will continue to build the capacity of the public health system to prepare for and respond to all hazards, including chemical, biological, radiological, and nuclear.
CDC has set a strategic course to ready our nation for any potential public health threat including terrorism. CDC's preparedness vision statement, "People Protected – Public Health Prepared," and the mission statement, "Prevent death, disability, disease and injury associated with urgent health threats by improving preparedness of the public health system and the public through excellence in science and services," are wide reaching concepts which convey our sense of purpose and commitment. To realize this vision and achieve this mission, CDC has identified 11 strategic imperatives, to include: timely, effective and integrated detection and investigation; sustained prevention and consequence management programs; coordinated public health emergency preparedness and response; qualified, equipped and integrated laboratories; competent and sustainable workforce; protected workers and workplaces; innovative, relevant and applied research and evaluation; and timely, accurate and coordinated communications. Fully addressing these imperatives is critical to our overall success.
Upgrading State and Local Capacity
Terrorism, outbreaks of naturally occurring infectious diseases, and other disasters or emergencies have significant public health implications that may quickly threaten the health of thousands of people and overwhelm local and state capacities to respond. Within 90 days of the FY 2002 appropriation, CDC provided $918 million to states and selected cities-- New York State received $29.4 million and New York City received $19.9 million. In FY 2002, CDC:
In FY 2003, CDC is providing almost $1 billion to continue to upgrade state and local capacity to prepare for terrorism and other urgent public health threats and emergencies. New York State will receive $27.8 million and New York City will receive $20.9 million. These funds support critical public health capacities that are vitally important to national security, such as: preparedness planning and readiness assessment; surveillance and investigation capacity; biological and chemical laboratory capacity; communications systems and information technology; health information dissemination; and education and training.
With support from CDC, states conducted mock exercises to prepare for terrorism events involving numerous state, county and local agencies; implemented near real-time syndromic surveillance systems; trained large numbers of staff from public health agencies, health care facilities, emergency management organizations, police and fire departments and other key institutions; created and tested communication systems linking local public health staff and first responders with senior staff from state public health departments, emergency management agencies and other critical decision-makers.
Upgrading CDC Capacity
Emergency Preparedness and Response
CDC has strengthened its internal Emergency Preparedness and Response infrastructure to provide enhanced technical and programmatic assistance to state and local health agencies. Some examples include: improved rapid identification and characterization of potential biologic agents; expanded the Epidemic Intelligence Service to assure that well-trained, first-line responders are available to respond to public health emergencies; and developed a secure infrastructure to provide enhanced Geographic Information System (GIS) capability at the federal, state and local levels.
Emergency Communication System
CDC moved quickly to assure that its Emergency Communication System can comprehensively, efficiently, and rapidly respond to communication needs associated with terrorism. This system, currently used to respond to SARS and adverse events related to smallpox vaccinations, can: develop critical information; arrange for immediate direct communication with key stakeholders around the world; provide real-time updates to the media; make sure essential information is available to the public through the CDC Web site; maintain a public health response hotline; develop training for clinicians; and develop public service announcements. A central component of this system is the state-of-the art Marcus Emergency Operations Center located in Atlanta. This facility is currently the nerve center for CDC's efforts to respond to SARS and West Nile virus. CDC also has 20 teams of ten individuals who can immediately be deployed to support State and local emergency response efforts.
Chemical Terrorism Preparedness and Response
In the event of a major chemical terrorism attack, CDC's chemical laboratory capacity faces many challenges. To prepare for this possibility, five state environmental health laboratories were funded in FY 2002 to provide surge capacity to the chemical laboratories at CDC, to include the Wadsworth Public Health Laboratory in Albany. These state laboratories measure chemical warfare agents or their metabolites in human specimens, and help CDC quickly and accurately determine the chemical agent used in a terrorist attack. We are expanding this collaboration in FY 2003 to ensure all state public health labs can manage and submit human specimens for chemical analysis. Three states have also begun a project known as ChemPac which pre-deploys chemical antidotes, such as atropine (a nerve agent antidote), to local emergency response agencies. In addition, CDC has improved its laboratory capacity to rapidly screen for 150 chemicals in blood or urine which might identify a chemical terrorism incident.
CDC has taken a number of other important steps to ensure readiness in the event of a terrorist attack involving chemicals. Our EOC includes staff from the Agency for Toxic Substances and Disease Registry (ATSDR) with expertise in chemical and medical toxicology, GIS, epidemiology, emergency response and other areas that would be important in responding to a chemical terrorism event. CDC and ATSDR are also preparing toxicological information on industrial chemicals and chemical warfare agents for dissemination to a range of audiences including the general public, emergency responders, health care providers and laboratories. CDC/ATSDR is working to identify the next level of priority toxic substances to address and to fill gaps in research concerning those substances.
CDC's Select Agent Program: Ensuring the Safety and Security of Laboratory Facilities
Through the Select Agent program, CDC is responsible for registering and inspecting laboratories that transfer microorganisms and toxins that pose a significant health risk to humans. This program has inspected more than 100 laboratories across the United States, and is continuing to inspect new labs with a goal of 200 total laboratories inspected by the end of FY 2003.
Guidelines for Worker Safety in Terrorist Events Issued
CDC has issued new guidelines for protecting emergency responders and for safeguarding building ventilation systems from attack, addressing two of the most pressing terrorism-related worker safety issues. These guidelines give employers and emergency systems practical steps towards increasing safety. CDC is also conducting research to investigate uses of personal protective equipment (such as respirators) for emergency responders.
Strategic National Stockpile
CDC continues to be responsible for managing the Strategic National Stockpile (SNS). The mission of SNS is to ensure the availability of life-saving pharmaceuticals, antidotes and other medical supplies and equipment necessary to counter the effects of nerve agents, biological pathogens and chemical agents. The SNS Program stands ready for immediate deployment to any U.S. location in the event of a terrorist attack using a biological, toxin or chemical agent directed against a civilian population. It is comprised of pharmaceuticals (such as vaccines and antibiotics), medical supplies, and medical equipment that exist to augment depleted state and local resources for responding to terrorist attacks and other emergencies. These packages are stored in strategic locations around the U.S. to ensure rapid delivery anywhere in the country within 12 hours of activation. Recently, the SNS has prepared specific guidance, and provided technical assistance to states to help them effectively manage the deployment of the SNS within their jurisdictions.
Smallpox Vaccination Program
In FY 2002, CDC moved swiftly to assure the availability of smallpox vaccine for every person in the United States. In addition, CDC quickly moved to implement the President's smallpox response plan to make sure the United States is prepared to respond to a potential smallpox release. In the event of a smallpox attack, advance vaccination of Smallpox Response Teams will allow them to immediately administer the vaccine to others and care for victims. Major progress has been achieved and states may use terrorism response funds to implement the President's plan. Continued focus is needed now for post-smallpox attack preparedness by: preparing and protecting the frontline workforce; developing plans and systems to detect, identify and confirm smallpox disease; and protecting the population through mass vaccination strategies.
The implementation of the pre-attack vaccination program will continue to focus on training and education, distributing vaccine to states, and preventing, diagnosing, treating, and monitoring adverse events. To date, over 289,000 vaccine doses have been released to States, and over 36,000 front line workers have been vaccinated. CDC has implemented an adverse reactions monitoring system that has responded to potential adverse reactions to the vaccine.
As you can see, CDC has been busy assuring public health readiness at all levels of government. We are committed to our vision of "People Protected – Public Health Prepared."
Thank you for this opportunity to provide the CDC perspective on this very important Homeland Security Effort. I would be happy to answer any questions.
Last Revised: May 30, 2003