25 states and Washington D.C. top performers on public health emergency preparedness measures

Twenty-five states and the District of Columbia were high-performers on a three-tier measure of states' preparedness to protect the public's health during an emergency, according to a new report released today by Trust for America's Health.

The annual report, Ready or Not 2020: Protecting the Public's Health from Diseases, Disasters, and Bioterrorism, found year-over-year improvement among 10 emergency readiness measures, but also notes areas in need of improvement. Last year, 17 states ranked in the report's top tier.

For 2020, 12 states placed in the middle performance tier, down from 20 states and the District of Columbia in the middle tier last year, and 13 placed in the low performance tier, the same number as last year.

States' level of preparedness has improved in key areas, including public health funding, participation in healthcare coalitions and compacts, hospital safety, and seasonal flu vaccination. But other key health security measures, including ensuring a safe water supply and access to paid time off, stalled or lost ground.

WHAT'S THE IMPACT

The results are encouraging in light of the public health threat that has weighed heavily on the minds of many: the spreading coronavirus which has reportedly killed 490 people

While the coronavirus' epicenter is in China, where the number of cases is now 24,000, 11 cases have been reported in the U.S., mostly in the Pacific Northwest, prompting Health and Human Services Secretary Aex Azar to declare a public health emergency last week.

Beginning Sunday, the U.S began implementing temporary measures to try to contain the virus. Any U.S. citizen returning to the country who has been in Hubei Province in China during the previous 14 days will be subject to up 14 days of mandatory quarantine; and any citizen returning from other regions of China within the previous 14 days will undergo health screenings at select ports of entry and be subject to up to 14 days of monitored self quarantine.

President Trump has also signed a proclamation temporarily suspending entry into the U.S. by any foreign national who poses a risk of transmitting the virus. As a result, foreign nationals other than immediate family of U.S. citizens or permanent citizens, who have traveled in China in the last 14 days, will be denied entry.

Buttressing national coronavirus containment efforts is the improving performance of several states when it comes to emergency preparedness, as outlined in the TFHA report.

The report measures states' performance on an annual basis using 10 indicators that, taken together, provide a checklist of a jurisdiction's level of preparedness to prevent and respond to threats to its residents' health during an emergency.

Four states (Delaware, Pennsylvania, Tennessee and Utah) moved from the low performance tier in last year's report to the high tier in this year's report. Six states (Illinois, Iowa, Maine, New Mexico, Oklahoma and Vermont) and the District of Columbia moved up from the middle tier to the high tier. No state fell from the high to the low tier but six moved from the middle to the low tier: Hawaii, Montana, Nevada, New Hampshire, South Carolina and West Virginia.

WHAT ELSE YOU SHOULD KNOW

The TFAH analysis also found that a majority of states have plans in place to expand healthcare capacity in an emergency through programs such as the Nurse Licensure Compact or other healthcare coalitions. Thirty-two states participated in the Nurse Licensure Compact, which allows licensed nurses to practice in multiple jurisdictions during an emergency. Plus, 89% of hospitals nationally participated in a healthcare coalition, and 17 states and the District of Columbia have universal participation, meaning every hospital in the state participated in a coalition. In addition, 48 states and D.C. had a plan to surge public health laboratory capacity during an emergency.

Most states are accredited in the areas of public health, emergency management, or both. Such accreditation helps ensure that necessary emergency prevention and response systems are in place and staffed by qualified personnel.

Meanwhile, seasonal flu vaccination rates improved but are still too low. The seasonal flu vaccination rate among Americans ages 6 months and older rose from 42% during the 2017-2018 flu season to 49% during the 2018-2019 season, but vaccination rates are still well below the 70% target established by Healthy People 2020.

Only 30% of hospitals, on average, earned top patient safety grades, up slightly from 28% in 2018. Hospital safety scores measure performance on such issues as healthcare associated infection rates, intensive-care capacity and an overall culture of error prevention. Such measures are critical to patient safety during infectious disease outbreaks and are also a measure of a hospital's ability to perform well during an emergency.

THE LARGER TREND

Six days ago, the World Health Organization declared the coronavirus a Public Health Emergency of International Concern.

The numbers of those infected keeps growing. As of last week, there were close to 9,700 cases in China, with more than 200 deaths. Another 23 countries had 132 confirmed cases. This includes 12 people in six countries who did not travel to China.
 

Twitter: @JELagasse

Email the writer: jeff.lagasse@himssmedia.com