Date Posted: 
Wed, 2013-05-15

The recent bombings during The Boston Marathon showed the immense value in having a properly prepared community response to tragedy. Strong training and detailed planning led to a swift and effective response from public health organizations in the immediate aftermath of the bombings.

The ability for public health agencies to have such an effective response to emergencies as Boston’s was during the bombings is under attack though. The Hospital Preparedness Program that was part of the Bioterrorism Act of 2002 has seen its budget dramatically shrink from $515 million to $380 million this year, and will drop down to $255 million in 2014 based on President Obama’s budget proposals.

“Preparedness is not a state you get to and just stop. It’s dynamic and the stressors and hazards are constantly changing. These cuts will hurt.”
- Rosalyne Schulman, Director of Policy Development, American Hospital Association

Funding is essential in connecting an entire community of responders. It allows for the hospitals and other public health providers and responders to drill and test their agency’s abilities to respond. Hospitals are currently required to perform two emergency response drills a year, with at least one drill bringing in local agencies (police, EMTs, firefighters) to coordinate the response. Decreased funding has loosened these restrictions though, and allowed for “tabletop” drills instead of real-time physical drills. Less rigorous and thorough drills could lead to an inability to respond to emergencies in the future.

Boston has placed a large investment into being prepared in the case of an emergency. Their responders often meet face-to-face for planning, and in total, the city’s hospitals and community agencies took place in twelve emergency preparedness drills last year (well above the requirement of two). The intense preparation meant the area’s hospitals and staff were completely ready for the influx in patients within just ten minutes of the first bomb going off.

Boston’s public health organizations greatly rely on funding from the Hospital Preparedness Program though, and will be forced to shutter some of its rigorous testing and planning processes to meet the new lowered budgets. Short-term, this may have a negligible impact, but over the long-term less practice and planning could have catastrophic results in the face of an emergency.

In the face of budget cuts, hospitals are getting creative and forming coalitions with neighboring hospitals in the case of emergencies. Right now though, 20% of the nation’s 5,000 hospitals have not done so. Coalitions in St. Louis and Seattle conduct numerous active drills per year and believe they’re ready for emergencies because of the intense planning and pooled resources. The coalition in St. Louis proved it just a couple years ago with their response to the Joplin, MO tornado.

“Sometimes conditions change in a second, and sometimes they arise where you haven’t drilled that particular event. But you have the ability to morph or scale your response because you’ve practiced all the basic stuff. You can pull from those tools and craft a response for an event you’ve never dealt with before.”
- Jerry Glotzer, Director of Environmental Health & Safety, Barnes-Jewish Hospital (St. Louis)

The past year has been marked with events that require strong public health preparedness. Attacks, bombings and explosions, mass shootings, wildfires, and hurricanes have all tested the American public, but we’ve pulled through with damage and casualties minimized. Our public health agencies and people are always going to be more than willing to lend a helping hand to fellow citizens when they need it most, but with public health emergency preparedness funding dropping, it makes it harder for that help to be efficient and effective. When lives are at stake, speedy response is necessary, and cutting funds from preparedness could have a large negative impact if there is another Boston-like attack.

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