Mass Dispensing and the Importance of Improvisation

For those of us familiar with West Texas we all know that the population has been booming with the recent economy. While the low unemployment rates and the amazing positives of this economy are not to be overlooked this does also present challenges. There are a great many challenges to public health that could be highlighted, but for our purposes here it is important that we address the challenges that we see with Strategic National Stockpile (SNS) and Points of Dispensing Sites (PODS) planning.

There has been a high focus in Ector County (Odessa area) on getting PUBLIC PODS established. There is something to be said for the importance of these PODS and they are certainly necessary. Our greatest challenge has been finding appropriate sites that can effectively service our population in the event of a public health emergency. However, up until fairly recently the Odessa-Midland area did not have the population that we are seeing now. As such the area is seeing problems with housing shortages and overcrowding. Attempt to go grocery shopping mid-day on a Saturday in the Odessa-Midland area and one quickly realizes exactly what “overcrowding” really looks like. These problems arise, quite simply, because the city and county infrastructure cannot build fast enough to manage the surge in population. This problem really has affected Ector County PODS planning because there simply are not enough ideal structures that can manage throughput for our population. This is where we have quickly discovered that attempting to adhere too tightly to the recommendations from State and Federal levels with regard to PODS planning is unrealistic and, quite frankly, more of a hindrance than a help. That is why they are guidelines and both the state and the federal government do encourage local health departments to “think outside of the box” when they need to. The guidelines for planning can be widely applied to the statistical majority of the nation and it simplifies planning, but for statistical outliers like Odessa-Midland, that isn’t always easy.

The Midland-Odessa area is the perfect example of the importance of improvisation in public health emergency preparedness planning for all of the aforementioned reasons and many others. Since that is the case we need to get creative and find a way to utilize the infrastructure and systems that we already have for our purposes even if they are not ideally fit to the guidelines we have handed down to us. We cannot expect--as a statistical minority--that the higher echelons of government are going to tailor make plans for emergency preparedness with us in mind. If it was a one-way fits all planning possibility, then let’s be honest with ourselves, there wouldn’t be a need for local health departments at all. We have to make those considerations ourselves. That said, the federal government and state governments are aware that these planning guidelines will not always work for every locality and they make points of saying that explicitly.

So, for Ector County our means of thinking outside of the box is to shift from a focus on PUBLIC PODS to a focus on Push Sites. We will still work on establishment of PUBLIC PODS, but not as a primary focus. What this means is that we are going to begin working with local businesses/local partners fitting specific descriptions that will be given an allotment of SNS materials by the health department in the event of an SNS deployment scenario. Those supplies would be used by these businesses/local partners in their own PRIVATE PODS in order to give prophylaxis to their employees and their families.
This will ideally allow for several things: 1) It will decrease the burden on public health and decrease the number of PUBLIC PODS that we need to establish. 2) People in the community will be able to receive their medications/supplies/etc. in a place where they feel more safe and secure. 3) It would allow for local businesses/local partners involved to operate as normal and diminish the negative effect on our local economy.

These plans are new and in their infancy so it will be some time before we see any real results, but hopefully in the next few months we will have some more strong foundations in place with community partners that we have yet to speak with and begin making headway so that in the event of an emergency we are able to help those in need rather than being the ones in need.

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, Odessa Epidemiology Examiner

I have been working in Public Health and Epidemiology since 2009.

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