BEGINNING as early as 1999, the Lee County Health Department (LCHD) began engaging in a wide range of measures designed to respond to and to mitigate the possible effects of a terrorist event.  These efforts have dramatically intensified since 9/11.

 

In February of this year, Congress approved a multi-billion allocation in response to these events.  The bulk of this money is earmarked for the individual states for the enhancement of terrorist planning and response capabilities.  Florida is in the process of receiving approximately fifty million dollars of these funds.

 

A month after the tragic events, Florida created a Florida Regional Domestic Security Task Force (RDSTF), designed to strengthen the state’s capability to prepare and to respond to terrorist activities. The Florida Department of Law Enforcement (FDLE) is overseeing this effort.  This action divided the state into seven geographic regions, roughly corresponding to the present FDLE regions.  Southwest Florida is part of Region 6, encompassing Lee, Charlotte, Collier, DeSoto, Glades, Hendry, Highlands, Okeechobee and Sarasota counties. 

 

Each regional task force is composed of five subcommittees - Health/Medical, Emergency Medical Services (EMS), Law Enforcement, Fire Services and Public Information.

 

Under the directorship of Judith Hartner, M.D., M.P.H., the Lee County Health Department is the lead public health agency for the region.  Dr. Hartner also serves as the Regional Chairperson of the Health/Medical Subcommittee.

 

region 6:
DSTF Region 6 has twenty-three hospitals. There are no state or mobile laboratory facilities, and no Metropolitan Medical Response System. Health and medical services available and accessible are somewhat uneven from county to county within the region, and EMS response times can vary significantly based on the geographic area served. This is also true of the response capabilities of each county to infectious disease outbreaks and other public health threats and emergencies, including a Weapons of Mass Destruction (WMD) event.

The region is served by twenty-four licensed emergency medical services operations. However, four of the region’s counties are served by only one EMS operation each, and of the remaining counties, two are served by only two EMS operations each.

A considerable portion of the region is rural, with a growing metropolitan concentration in some of the counties bordering the Gulf of Mexico. In some counties there is limited access to a centralized water and sewage treatment infrastructure and as a result, septic tanks and private wells serve many residences. In some communities, less than 50 percent of the dwellings are connected to a municipal or county water and sewage system.

There are no major military facilities in the region. However, the area has two major airports, Southwest Florida International Airport in Fort Myers and Sarasota International Airport in Sarasota. Amtrak and CSX both utilize the regions railroad tracks, with the latter often transporting hazardous materials - which could pose a threat in the event of a derailment.

The region has a significant amount of coastline when the Gulf of Mexico and inland waterways are taken into account. There are no seaports in the region.

There are fifteen rural health clinics in the region that are not operated by the respective county health departments. Health resources in rural areas available to identify and treat victims of a bioterrorism event are limited. Without additional resources, assistance, and cooperation with urban providers, rural communities will continue to be ill prepared and equipped to deal with an event.

 

lchd activities:

LCHD and Region 6 are continuing to develop plans and strategies aimed at responding to and mitigating the effects of terrorism caused by weapons of mass destruction.  Our activities cover five major areas:

1.    Planning and Policies

2.    Workforce/Personnel

3.    Equipment

4.    Training

5.    Mental Health

Recent collaborations have included:

• An exercise simulating a smallpox outbreak, theoretically occurring at the Collier County Sheriff’s Office.  Dr. Hartner, as the health/medical head of the Incident Command Team, oversaw medical response operations throughout the exercise, which included all the players on the Region 6 DSTF – fire, law enforcement, EMS and public information services. It should be noted that this was the first such event of its kind to be staged in Florida, bringing together over two hundred participants and observers from throughout the state.

• The Forty Fourth Civil Support Unit of the Florida National Guard was in town recently to demonstrate the Army’s equipment, capabilities and ability to assist in the event of a major chemical or biological attack in Lee County. In an all day, very realistic operation held at the Fort Myers Fire Department training facility off Dr. Martin Luther King, Jr. Boulevard, a simulated bioterrorism event was staged, involving a secret laboratory, a potential bomb situation and planned assassinations. The LCHD has a Rapid Response Team formed specifically to respond to public health emergencies, and Dr. Robert South, our epidemiologist and Biological Terrorism Coordinator, served as the health department authority for biological agents.

Both of these exercises demonstrated the need for further training among the agencies - but on the other hand, they clearly demonstrated the degree of cooperation and integration that has been achieved in a relatively short period.

Should there be an actual bioterrorist attack, plans are being developed to put into effect the National Pharmaceutical Stockpile Plan (NPS), designed to bring Centers for disease Control and Prevention (CDC) medications and supplies directly into the affected area. Each of the region’s eight county health departments are developing local plans, which will be incorporated into one regional response plan.

Combined, the regional plan and the NPS, individual health department response and mitigation plans, along with training and education, will bring us significantly closer to our goal of effectively detecting and responding to public health threats and emergencies.

Mental Health:

One of the glaring gaps identified in the regional bio-terrorism plan is our current capability to adequately address mental health interventions in the event of a bio-terrorist attack or other large-scale natural disasters.  In order to alleviate this unsatisfactory situation, DSTF Region 6 is proposing to institute a comprehensive mental health component consisting of training and of plan development.

 

The mental health training component will be a multi-pronged effort designed to aid different categories of recipient.  The first prong will be aimed at “first responders” and their families.  The second prong will be directed towards “victims” their families and those who perceive themselves to be victims.  Depending on the nature and the scope of the event, interventions and required numbers of qualified mental health professionals will vary.  Based on conversations with mental health professionals and with research gleaned from reports of the 9-11 tragedy, it is anticipated that the major portion of the mental health intervention will be directed at preventing and/or mitigating Acute Stress Disorder and potential Post-Traumatic Stress Disorder (PTSD).  Additionally, efforts will also be directed towards other mental health interventions including grief counseling and on-going crisis counseling.