The plot could have been taken from a Stephen King novel or an X Files script: a pandemic contagion strikes across the country. Or a terrorist lets loose a biological weapon to infect the public.
Officials from Stearns, Benton, and Sherburne counties have been working for a year and a half to plan in the case of such a public health disaster.
"You know that these (disasters) do happen, and could happen, so you try to take your experience from the past and plan," explained Marvin Klug, director of Stearns County Emergency Services, after a public meeting about the plan at the city hall in Paynesville on Thursday.
"If you anticipate the worst and you have a plan, you can scale it back," added Renee Frauendienst, of the public health division of Stearns County Human Services.
The public health annex is one of 13 annexes that the county is developing as part of its all-hazard disaster plan. Other annexes include plans for a natural disaster, like the tornado that ravaged Granite Falls recently, or just how to coordinate all the volunteer assistance in an emergency situation.
The public health annex is designed for an emergency where public health is at risk, and the public health departments head the emergency services. "This is a new kind of disaster that could occur that we've never had a plan for," said Frauendienst.
A considerable amount of the plan is devoted to maintaining communication. "Communication is key," said Klug. "Not only from public health to the local providers but from the local providers to public health."
A public health disaster could either originate in the area, or sweep the into the region. In the first scenario, the public health personnel would have to investigate with the aid of ambulance crews, first responders, doctors, and clinic and hospital staff to determine the cause of the illness.
This, unfortunately, could take time, as case histories, test results, and treatment results would need to be studied. Input from the Minnesota Department of Health (MDH) and the Center for Disease Control (CDC) in Atlanta might be needed, too.
The other scenario would involve some sort of contagion sweeping into central Minnesota. In this case, information - warning signs, treatments, immunizations, et cetera - would be available from the MDH or the CDC. The county agencies would then need to pass that information to providers, who could check for cases in the area and provide treatment.
The plan establishes a Disaster Response Action Team, with the appropriate abbreviation of DRAT. This team would have a core of county and state officials, but specialists could be added as needed.
The list of occupations that may be needed to assist DRAT in an emergency include law enforcement personnel, school officials, pharmacists, health care professionals, ministers, community organizations, and the media.
Treatment options in a public health disaster range from immunizations to quarantines. "Unfortunately, this is one of those sort of plans that deals with something that no one can plan for," said Klug.
What the public health and emergency service officials did when they drafted a plan, with the help of representatives from hospitals, community services, and other health departments, was take experiences from the past and project them onto a future disaster.
From an outbreak of meningitis in Mankato, for instance, a lesson was learned about traffic control. In that case, the treatment was a mass immunization, but when 8,000 people descended upon the armory, traffic became a problem.
From the gas explosion by the court house in St. Cloud, Klug recalled learning that it became impossible to communicate with cellular phones, because the accident prompted a flood of calls. Since then, emergency personnel have gone back to carrying radios. "Communication is the first thing that falls apart in a major event," Klug said.
One hopeful note, Klug said, is the development of new technologies. E-mail, for instance, can be used to communicate now, and probably will be more useful in the future. This, and other developments, provide options to using the fax machine and phone.
In addition to the relatively new threat of bioterrorism, the public health disaster annex is considered a priority because outbreaks of contagious diseases do occur occasionally. Smallpox was eradicated in the United States through immunizations but still exists in pockets of the world. At the public meeting, it was noted that there is not enough vaccine currently available in the country to immunize the population of the United States against the disease.
The public hearings were held so the county officials could get feedback from citizens, medical personnel, and related officials before finalizing the annex. The small crowd in Paynesville on Thursday consisted of representatives from police departments, civil defense, and the local health care system.
Revisions to the annex are expected to be made by the end of the month. The annex could be ready for consideration by the three county boards in September. Each board has already given preliminary approval of the annex.