Panhandle Health pulls off disaster drill

An Arkansas woman and her California grandson spent part of their family vacation Saturday pretending to get vaccinated for smallpox.

Judy Allen and Cory Campbell were among 500 people who participated in an emergency disaster drill put on by Panhandle Health District and law enforcement agencies at Sandpoint High School. About 350 people from throughout North Idaho and Eastern Washington volunteered to be patients. Another 150 health workers ran the clinic and evaluated it. And police officers provided security and traffic control.

“Even though it’s not my community, it’s my country, and if it started here, it would get everywhere,” said Allen, who is vacationing in Hope, Idaho. Also, she said of her grandson, “He wants to be a doctor, so I thought it would be good for him.”

Alertness to public health is heightened in this post-9/11 world, following bioterrorism threats related to anthrax and smallpox. Government money is flowing into communities nationwide to ensure their preparedness for any possible disaster.

Last year, Panhandle agencies received $500,000 from the federal Centers for Disease Control and $750,000 from the Homeland Security department, and they expect to receive $335,000 from the Health Resources Services Administration, said Dale Peck, the health district’s program manager.

“Public health is now in the forefront of protection and defense,” said Jeanne Bock, director of the health district, which serves Idaho’s five northern counties. “I don’t see any hope of it being lessened. Our job is to step up and look at this duty as a way of life.”

Saturday’s exercise was the culmination of two years of preparation, said Peck, who came on as program manager in July 2002 and began developing plans to address various public health threats. In March, leaders in the five northern counties did an exercise to set up the guidelines for Saturday’s clinic.

The scenario assumed that 47 cases of smallpox had been confirmed in several major U.S. cities. The federal government had declared a state of emergency and ordered health districts to implement a mass vaccination plan.

Smallpox, which was eradicated from this country through vaccination in the 1970s, can cover the body with blisters and attack the internal organs, Peck said. Historically, it was fatal in 30 percent of cases. Smallpox was chosen for the disaster training because it is considered the most challenging bioterrorism threat, Peck said.

“So if you can prepare for it,” he said, “you can prepare for anything.”

The clinic was only a quarter-model of real life. The health district’s goal in a real outbreak would be to vaccinate everyone in the five northern counties – about 180,000 people – in four days, working 24 hours a day, Peck said. Eight clinics would be set up in North Idaho, with two each in Kootenai, Benewah and Bonner counties and one apiece in Shoshone and Boundary. Smallpox has a 14-day incubation period, followed by a four-day period when a person is most contagious but before symptoms show up, Peck said.

Clinic workers were sensitive to public concern about side effects of the vaccine, which is a small amount of the virus itself. The vaccine can cause the skin to blister and could kill a person with a compromised immune system, such as someone with HIV or AIDS, Peck said. They counseled patients about the risks and left each decision up to each person. Police stationed at the high school entrance repelled one person protesting the vaccinations.

Most of the volunteers, however, appeared to be saying yes to the mock vaccination. They talked about their decisions while enjoying a barbecue lunch outside – their reward for participation.

“The possibility of (side effects) are so rare,” said Cindy Rust, a Hauser Lake woman who received the pretend vaccination, along with her 1-year-old daughter, Morgan, and friend, Rusti Madsen of Coeur d’Alene. “To run around and be a host for smallpox, it seems so selfish.”

Joanne Cottrell of Sandpoint participated Saturday because her son, Andrew, 18, just decided to join the Army.

“He’s going to put his life on the line,” she said, with emotion. “I wanted to come today because … anything I can do to help.”

Peggy Sala, a nurse from Spokane, said if the outbreak were real, she would accept the vaccination. However, as a volunteer, she claimed to have had contact with a smallpox patient, and thus was sent away. Volunteers who said they had the disease also were sent away as the exercise was only for those eligible for vaccination. In a real outbreak, those people would be sent to clinics for treatment or additional monitoring. Those who had the disease would be isolated, Peck said.

In a debriefing following the exercise, health district volunteers raised concerns about patient traffic flow, managing stress and panic in a real outbreak and handling people with special needs. They talked about the importance of keeping supplies stocked, providing more bathroom breaks for emergency workers and making sure documentation was provided in other languages.

Sandpoint Police Chief Mark Lockwood said his staff was significantly reduced protecting just one entrance to the high school. Guarding the entire perimeter would be challenging, he said. And setting up a clinic during Sandpoint’s snowy winter would create additional problems, he said.

“If this happens in January, it would be pretty ugly,” Lockwood said.

All of the information will be used to hone the health district’s plan, Peck said. “I am confident today that if we had a major medical emergency in North Idaho, that we would be successful.”