December 11, 2002

Dear Colleagues:

Many of you joined the standing-room-only crowd at Tuesday's Town Meeting in Hurd Hall to hear the latest information on the planned pre-emptive vaccination of health care workers who volunteer to form first-response teams to handle possible bioterrorism-related outbreaks of smallpox. For those of you unable to attend, a brief summary and links to additional information are below. Over the next weeks, you'll receive more information via the Hopkins On Alert newsletter, broadcast e-mails and meetings for your employee groups, as appropriate.

As you may recall, the Hopkins Office of Critical Event Preparedness and Response (CEPAR) was created last summer to serve as the command center and clearinghouse for Hopkins' enterprise-wide planning for and reaction to any extensive-impact catastrophe, particularly one involving a terrorist attack.

Although each component of the Johns Hopkins Health System and University maintains its own disaster plan, CEPAR combines experts and resources from both the Health System and University and will serve as the "official and unified voice" for Hopkins in disaster planning and response. CEPAR will set priorities for the entire enterprise if a disaster overwhelms one entity, or involves two or more of them. It has the authority to tap every asset of the Hopkins enterprise in the event of such a disaster.

At the Town Meeting, the audience heard that the federal Centers for Disease Control (CDC) is the key source of the latest information on smallpox and smallpox vaccinations. I urged those interested to check the CDC Web site for the most current advisories on the potential threat from smallpox and on federal plans to combat it: www.cdc.gov/smallpox.

The goals of CEPAR are to protect the institution, our health care workers, all of our employees, and our patients in the event of a bioterrorism attack. As CEPAR's administrator, Jim Scheulen, told the Town Meeting, CEPAR is focused on implementing an impending federal mandate to prepare health care workers to respond to a bioterrorism attack employing smallpox as the weapon. As the "umbrella organization" for such crisis management, CEPAR is working to ensure that an enterprise-wide plan is in place and well-integrated; that this plan is integrated with city, state and federal plans; and that Hopkins "creates a model for others" to adopt.

Trish Perl, Hopkins Hospital's epidemiology and infection control director, reminded the audience that facts about the federal pre-emptive vaccination program for health care workers remain fluid, and it is not known exactly when it will be launched, although it is likely to begin in late January. A minimum of 500,000 health care workers nationwide will receive smallpox vaccinations to prepare them to form first-response teams to care for a sudden surge in smallpox or suspected smallpox cases.

The Johns Hopkins Hospital is allocated 250 vaccines for volunteers for pre-emptive vaccination to be administered by the local health department; the Johns Hopkins Bayview Medical Center 175; and Howard County General Hospital 100. Those vaccinated will serve as the first response team in the event of a smallpox outbreak.

The categories of employees from whose ranks the volunteers will be sought include nurses; physicians; respiratory therapists; radiology technicians; laboratory workers in virology and surgical pathology; triage personnel who meet, greet and enter patient data; support services personnel, including environmental services, facilities, security and occupational health.

Principal services to be covered by these volunteers include dermatology, both adult and pediatric; infectious diseases; ophthalmology; critical and intensive care; general medicine; general pediatrics; emergency medicine; obstetrics and gynecology; and dialysis nurses or technicians.

CEPAR's deputy director, Christina Catlett, discussed the Hospital's existing Disaster Plan with its four levels, Administrative Alert, Operation Yellow, Operation Red, and Operation Orange. To handle new threats, we have added Operation Red Chemical Addendum, designed for handling treatment of victims of a chemical attack or accident, and Operation Red Radiation Addendum, a still-evolving plan to address a radiation or nuclear threat. Both of these involve decontamination procedures. More details will be provided later.

Hopkins Hospital's vice president for general services, Ken Grant, not only described the stockpiling of supplies and pharmaceuticals and plans for their distribution at different levels of alert, but brought along a "show and tell." His enormous, bright orange duffel bag was a sample of the emergency kits packed with such basic emergency equipment as flashlights, masks, gloves and gowns for first-response health care workers.

I join with Judy Reitz, Hopkins Hospital's executive v.p. and COO and the Health System's v.p. for operations integration, in her assurance that additional educational sessions will be held at multiple locations. And as Hopkins Medicine Dean and CEO Ed Miller reminded the large gathering at the Town Meeting, CEPAR and its efforts remain "a work in progress." We intend to keep you fully informed of that work as it advances and hope we can address any questions you have.

In the meantime, we will place the audiotape and videotape of the Town Meeting on the Hopkins Medicine Intranet in the next few days. Departments that wish to obtain copies of the Town Meeting videotape should contact the JHM Office of Communications and Public Affairs about the number of tapes needed (410-614-6652 or eelder1@jhmi.edu ).

Sincerely,
Gabor D. Kelen, M.D.
Director, Department of Emergency Medicine
Director, CEPAR