Infectious Diseases: Gaps Remain in Surveillance Capabilities of State and Local Agencies, Testimony of Janet Heinrich, Director, Health Care -- Public Health Issues before the Subcommittee on Emergency Preparedness and Response   [open pdf - 469KB]

In order to be adequately prepared for such a major public health threat such as a large-scale infectious disease outbreak or bioterrorism event, state and local public health agencies need to have several basic capabilities, including disease surveillance systems, laboratory facilities, communication systems and a sufficient workforce. GAO examined the capacity of state and local public health agencies and hospitals to detect and report illnesses or conditions that may result from such an event. This testimony is based largely on recent work, including a report on state and local preparedness for a bioterrorist attack; preliminary findings from current work on updates of bioterrorism preparedness at the state and local levels; and findings from a survey GAO conducted on hospital emergency department capacity and emergency preparedness. The efforts of public health agencies and health care organizations to increase their preparedness bioterrorism have improved the nation's ability to recognize such events. However, gaps remain in state and local disease surveillance and communication systems. Other essential elements of preparedness include laboratory facilities, workforce, and communication systems. GAO also found that while contingency plans are being developed at the state and local levels, planning for regional coordination for disease outbreaks or bioterrorist events was lacking between states. The disease surveillance capacities of many state and local public health systems depend, in part, on the surveillance capabilities of hospitals. Although most hospitals reported training their staff on biological agents and planning coordination efforts with public health entities, many hospitals still lack the capacity to respond to large-scale infectious disease outbreaks and are already experiencing some degree of overcrowding.

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