A Planned Exercise Supports a Real-World Event in Oklahoma

CDC’s Public Health Emergency Preparedness (PHEP) cooperative agreement program is a critical source of funding, guidance, and technical assistance for state, local, tribal, and territorial public health departments to strengthen their public health preparedness capabilities.  Since 9/11, the PHEP program has saved lives by building and maintaining a nationwide public health emergency management system that enables communities to rapidly respond to public health threats. 

In late September of 2016, the Oklahoma Strategic National Stockpile (SNS) team, part of the Oklahoma State Department of Health, was prepared to conduct a full-scale exercise of their ability to distribute medical countermeasures (MCM) – medications and other products used to prevent and treat conditions that may arise during a public health emergency.  In this exercise, state and local partners would test their ability to apportion quantities of placebo “pills” from the stockpile for local health departments across the state.

In another department, one that is generally unrelated to the SNS team, the state communication services team was sending information about an influenza immunization campaign. However, two days before the scheduled MCM exercise, the state health department realized that a manufacturing delay would prevent the distribution of the influenza vaccines across the state in time for the campaign. Acting with flexibility and ingenuity, the SNS team decided to incorporate the distribution of the vaccines into their exercise, and sustain a system capable of rapidly distributing lifesaving medication and emergency medical supplies to the public.

Incorporating influenza vaccine distribution into the regular MCM exercise meant that the team completed all original requirements of the exercise, apportioning 20 percent of the stored “pills,” while simultaneously transporting 11,960 vaccine doses to eight local health departments. The vaccine distribution presented a unique challenge, as the SNS team had to ensure cold chain integrity – that is, keeping the vaccines below a specified temperature. The state health department experienced a similar scenario during a previous H1N1 influenza outbreak and quickly learned that better plans and infrastructure for cold chain were needed. The lessons learned from this event ensured that complete cold chain was kept for the distribution of the influenza vaccines during the 2016 exercise.

The exercise was completed flawlessly. The vaccines, which arrived to the state health department in bulk, was broken down and distributed across the state in time for the campaign, and all original objectives of the MCM exercise were completed with proficiency. Additionally, the state highway patrol, which was interested in testing a new GIS/GPS system, used the exercise to track the vehicles delivering the vaccine in real time and offered to provide this service anytime the SNS is activated in the future.

The entire exercise, including the vaccine distribution, which necessitated waiting for each local health department to respond to the request for delivery, took, from start to finish, 24 hours. SNS Coordinator Mark Schultz attributes his team’s ability to be flexible and successful to the quarterly, PHEP-funded drills that the volunteer SNS team undergoes. Oklahoma’s ability to change plans on a moment’s notice, and incorporate complex logistics such as cold chain in an efficient and effective way, is a testament to the broad application of preparedness measures in communities across the country.