8 May 2006

Department of Defense (DOD) Health Care Actions and Expectations in the New US Pandemic Flu Plan

Chapter 6 “Protecting Human Health” in the new US Pandemic Flu “Implementation Plan” released May 3, 2006 lists multiple actions and expectations, to be completed within specific time frames, for both the Department of Defense (DOD) and Veterans Administration (VA). Some of the most notable ones include:

1. “DOD shall establish stockpiles of vaccine against H5N1 and other influenza subtypes determined to represent a pandemic threat adequate to immunize approximately 1.35 million persons for military use within 18 months of availability” (page 120).

2. “DOD shall procure 2.4 million treatment courses of antiviral medications and position them at locations worldwide within 18 months” (page 121).

3. “DOD shall enhance influenza surveillance efforts within 6 months by: (1) ensuring that medical treatment facilities (MTFs) monitor the Electronic Surveillance System for Early Notification of Community-based Epidemics (ESSENCE)…(2) ensuring that Public Health Emergency Officers (PHEOs) report all suspected or actual cases through appropriate DOD reporting channels, as well as to CDC, State public health authorities, and host nations; and (3) posting results of aggregated surveillance on the DOD Pandemic Influenza Watchboard; all within 18 months…”(page 128).

4. “As appropriate, DOD, in consultation with its Combat Commanders (COCOM), shall implement movement restrictions and individual protection and social distancing strategies (including unit shielding, ship sortie, cancellation of public gatherings…DOD personnel and beneficiaries living off-base should comply with local community containment guidance with respect to activities not directly related to the installation. DOD shall be prepared to initiate within 18 months.” (page 131).

5. “DOD shall enhance its public health response capabilities by: (1): continuing to assign epidemiologists and preventive medicine physicians within key operational settings; (2) expanding ongoing DOD participation in CDC’s EIS Program; and (3) within 18 months fielding specific training programs for PHEOs that address their roles and responsibilities during a public health emergency.” (page 133).

6. “DOD and VA assets and capabilities shall be postured to provide care for military personnel and eligible civilians, contractors, dependants, other beneficiaries, and veterans and shall be prepared to augment the medical response of State, territorial, tribal, or local governments and other Federal agencies consistent with their ESF # 8 support roles, within 3 months. (page 134).

7. “VA shall develop, test, and implement protocols and policies allowing VA personnel and resources to be used for the treatment of non-veteran patients during health emergencies, within 3 months. (page 134).

8. “VA shall develop draft emergency policies and directives allowing VA personnel and resources to be used for the treatment of non-veteran patients with pandemic influenza within 3 months (page 134).

9. “DOD shall develop and implement guidelines defining conditions under which Reserve Component medical personnel providing health care in non-military health care facilities should be mobilized and deployed, within 18 months” (page 135).

10. “DOD and VA, in coordination with HHS, shall develop and disseminate educational materials, coordinated with and complementary to messages developed by HHS but tailored for their respective departments, within 6 months”.(page 135).

Implementation of these timed actions as part of the integration of civilian, military (DOD), and VA health care resources and personnel into pandemic influenza preparedness is a welcome advance in US and international planning.

Daniel R. Lucey, MD, MPH

Director, Center for Biologic Counterterrorism and Emerging Diseases

EROne Institutes, Washington Hospital Center

Co-Director, Master of Science Program

Biohazardous Threat Agents and Emerging Infectious Diseases

Georgetown University School of Medicine

Washington, DC website: www.BePast.org

e-mail: Daniel.R.Lucey@Medstar.net