BALTIMORE – Maryland counties lack the emergency management planning and resources to respond to a massive outbreak of avian flu, according to a study by researchers at the University of Maryland, Baltimore County.
During a large-scale epidemic, droves of influenza victims would fill hospitals, people stricken by the virus would have no place to turn, and ambulances would have nowhere to take sick passengers, according to Richard Bissell, the lead researcher of the study funded by the Maryland Department of Health and Mental Hygiene.
In addition, a surge of calls would tie up the lines of 911 call centers and medical supplies would be exhausted.
“We will run out of personnel very quickly,” said Bissell. “Emergency management services and the system that supports them are not prepared to respond to a massive outbreak of an infectious disease.”
Bissell presented his findings yesterday at a symposium on avian flu hosted by the University of Maryland School of Law in Baltimore and attended by leading experts on the spread, prevention and response to infectious diseases.
In separate interview, Robert Bass, the executive director of the Maryland Institute for Emergency Medical Services, the agency that oversees and coordinates all components of statewide emergency medical services, agreed that a catastrophic influenza epidemic would probably hamstring the local emergency response services.
“People don’t like to hear this, but we’re not going to be able to get to everyone immediately,” Bass said. “The reality in a pandemic is jurisdictions are not going to be able to help other jurisdictions. We are not going to be able to go to other states.”
But the state is working on plans for responding to a massive outbreak, he said. His agency is working with the counties to develop alternative medical shelters where patients could be taken when hospitals fill up, and on holding mock outbreak exercises with other state agencies to better prepare.
In preparing his study, Bissell and his colleagues reviewed the written outbreak response plans of Maryland counties and cities and interviewed county health officials and managers of emergency medical services such as fire and police departments and ambulance services.
The researchers found that most emergency response agencies have plans for dealing with an infectious disease outbreak, but that the plans were inadequate for dealing with the extraordinary circumstances resulting from a pandemic influenza outbreak like the one that killed 20 million people worldwide in 1918.
Many of the local agencies plan to rely on support from neighboring counties or state agencies if hospitals fill with flu victims.
This is a problem, said Bissell, since the state cannot manufacture hospital beds or produce hospital staff on short notice and other counties will probably have their own problems to deal with and be unable to spare people or supplies.
He said hospitals already strain to cope with influenza.
“When the flu season hits every year, ambulances struggle because hospitals fill up. They take a patient on board, but there is no place to take them,” Bissell said. “And that’s just a normal flu season.”
The emergency personnel interviewed during the research worried that they would run out of basic supplies, that non-infected patients would become infected by riding in ambulances, and that they themselves would become infected unable to perform their duties.
Emergency personnel in Maryland’s rural western and southern counties are already particularly short-handed, based on the interviews in Bissell’s report.
Richard Alcorta, the medical director for Maryland’s Emergency Medical Services, said state officials have been preparing for a massive outbreak for years and have a plan in place to coordinate the county agencies.
He said the state has stockpiled equipment that would protect key personnel from getting infected and are working closely with localities to develop response plans.
But he cautions it is important to weigh the costs and benefits of preparing for a large-scale disaster like an avian flu pandemic.
“We could spend billions of dollars on this and still not be prepared,” he said. “If it’s truly a catastrophic, we are going to have a problem no matter what.”
Based on his research, Bissell provided several suggestions on improving local capacity to respond to an outbreak.
These include training volunteers to assisted emergency personnel, prioritizing certain patients based on the severity of their illness to decide who should go to hospitals and who should go to shelters, and develop response plans based what local supplies and personnel are available.
He said it is important for localities to plan on fending for themselves and not relying to much on the federal government for help. “We know from the Katrina experience that the Federal Emergency Management Agency is not going to come to the rescue,” he said.