The National Center for Critical Incident Analysis conducted nine workshops to help state and local officials coordinate with federal officials and prepare for a pandemic or other health crisis. Stephen Prior, the NCCIA Executive Director, coordinated workshops for the National Governors Association. Ford Rowan and Barbara Monseu participated as speakers in the meetings. For an interim report on the workshops, click here..
A preliminary preparedness assessment concluded that there is raised awareness in state government of the problem and potential widespread impact of a pandemic. All states had significant and wideranging awareness of the threat, its origin, and its potential impacts. Additionally, all states were aware of the unique characteristics of a pandemic and the challenge posed for effective planning. But the interim assessment found some shortcomings.
Plans for response and recovery from a pandemic episode continue to have gaps. These shortcomings translate directly into areas in which the states and the federal government should next concentrate their efforts. For example:
- States have not adequately considered how their individual decisions on school closure will impact other states, nor is there consensus among states on how to communicate with the public on this issue. Federal, state, and local authorities must clearly communicate with the public about the purpose and objective of closing schools or dismissing students. They also must recognize the potential impact of those decisions on the availability of workers in both the public and private sectors.
- States do not adequately understand what federal capabilities might be expected at the state level and how federal agencies will engage with them during a pandemic. The presence at some of the regional meetings of the designated Principal Federal Official (PFO) for pandemic response offered the first opportunity for most states to interact with these potentially valuable federal liaisons, but the continued lack of clarity about federal roles and responsibilities—and the triggers for their engagement—contributed to an overall confusion about the federal response.
- Prioritizing the order in which antiviral medications—for either treatment or prevention—are distributed to different groups continues to challenge states. Few clear examples were identified for either prioritization strategies or attendant public communication messages. Although this represents a “moving target” for most states as they continue to stockpile material, it is clearly an area that will generate significant public discussion and should be addressed in advance of any action during a pandemic episode.
- The workshops revealed that informal contacts are in place among officials from states in each region. Those networks have proven effective for most past incidents, but they should be formalized and institutionalized because a pandemic has the potential to overwhelm informal links, particularly if key personnel become sick or are otherwise unavailable.
- State plans rely heavily on the availability of privately held infrastructure, response by volunteer organizations, or actions by other organizations outside their immediate control. Yet the roles and responsibilities of those entities are not clearly defined in most state plans.
- The awareness of potential shortages of critical goods and services was frequently cited as a challenge to the states. However, no solutions were provided for ensuring the availability of goods and services across state and national borders, and there appeared to be little coordination with the private sector in the development of state-based strategies.
- Few states have conducted state-specific economic analyses of their economies under pandemic conditions, and no information was readily available during the workshops about the business of government (e.g., collection of taxes and fees or the potential effect on states’ ability to fund programs, pay vendors, or underwrite special prevention measures).