Given its population size (nearly 1.6 million residents), geographic location, and historical significance, Philadelphia is at risk for a variety of potential disasters, both naturally occurring and manmade. As the current COVID-19 pandemic has demonstrated, emerging infectious diseases can rapidly deplete public health and healthcare resources and stress response capabilities. While the Philadelphia Department of Public Health (PDPH) had engaged in robust pandemic planning prior to COVID-19, the early months of the COVID-19 pandemic highlighted the challenges and gaps that are likely to occur during any response to an emerging infectious disease with a high attack rate. As challenging as the previous two years have been, they have also been highly instructive and present a realistic scenario on which to model future pandemic plans. Perhaps most notably, the racial and ethic disparities observed during COVID-19 have demonstrated the importance of conducting all public health emergency planning using an equity lens.
PDPH’s application for the Cooperative Agreement for Emergency Response: Public Health Crisis Response describes baseline capacity, anticipated response gaps, such as staffing deficits, and describes how PDPH will use this funding stream to address those gaps during an emergency. Specifically, this Cooperative Agreement would allow PDPH to hire additional personnel to conduct response-specific functions, which would augment departmental capacity to both respond to the emergency and maintain essential public health services throughout its duration. In addition, this funding would also enable PDPH to procure critical supplies, such as personal protective equipment (PPE) for public health responders, as well as leverage existing contracts to procure clinical staff and biohazard disposal services to support the large-scale distribution of medical countermeasures. As documented in this application, PDPH has the administrative capacity to expedite hiring and procurement during an emergency to rapidly scale up and sustain response efforts.
In summary, the activities and strategies proposed in the application, support achievement of the following outcomes:
• Prioritized public health services and resources sustained throughout all phases of emergencies and incidents, including testing, vaccination, medical countermeasure distribution, isolation and quarantine services, and other services as appropriate
• Earliest possible activation and management of emergency operations, including rapid activation of incident command and management protocols upon notification of a public health emergency or observation of an unusual cluster of cases signifying a severe disease outbreak
• Timely communication of risk and essential elements of information through mass media, the PDPH website, social media, listservs, community-based organizations and service provider agencies, and a public call center
• Timely implementation of intervention and control measures, such as:
o Rapid identification of persons under investigation (PUIs) and facilitation of early lab testing, diagnosis, treatment, contact tracing, and isolation and quarantine
o Operation of testing/triage centers for patient screening and referral; and/or Points of Dispensing (PODs) to administer medical countermeasures
o Non-pharmaceutical interventions, such as masking and social distancing requirements
• Timely coordination and support of response activities with partners
• Earliest possible identification and investigation of an incident
• Continuous learning and improvements that are inclusive of a real-time feedback loop