By Mary Beth Sheridan
Washington Post Staff Writer
Wednesday, December 13, 2006
Maryland is one of the lowest-ranked states in the country in terms of preparedness for health emergencies such as bioterrorism or pandemic flu, but Virginia is among the 14 best-prepared states, according to a report issued by a health advocacy group yesterday.
The study by the Trust for America's Health, a nonpartisan group, also gave poor marks to the District's level of preparedness.
The group's fourth annual report found that the country is not nearly as ready as it should be for bioterrorism, bird flu and other health crises.
"We continue to make progress each year, but it is limited," said the group's director, Jeff Levi, a former deputy director of the White House Office of National AIDS Policy. "As a whole, Americans face unnecessary and unacceptable levels of risk."
District health officials took issue with the report, saying that it is unfair to compare a city with concentrated poverty to entire states. In addition, the report did not measure the D.C. Health Department's experience in dealing with anthrax and major events such as presidential inaugurations, officials said.
"It gives a misleading picture," said Gregg A. Pane, director of the D.C. Health Department.
Matthew Minson, a senior official in the Maryland Health Department, said he did not want to comment on the report's findings without more access to the data it used. But, he said, Maryland has made "substantial improvement" on preparing for health disasters. He also said he was "pleased" with confidential evaluations that Maryland had received from the Centers for Disease Control and Prevention.
This year's report puts greater emphasis on pandemic flu, which occurs when an influenza virus mutates into a potentially deadly version that can be transmitted between humans. Concerns about a possible pandemic have grown as avian flu has spread from Asia, with some cases of transmission to people.
The report found that half of all states -- including Maryland and Virginia -- would run out of hospital beds within two weeks of a moderately severe pandemic flu outbreak. The District is in better shape: About two-thirds of its hospital beds would be filled in that period, according to the study.
But the District fared more poorly in another key area -- flu shots. They are viewed as an indicator of how well a state is prepared for an emergency that would require distribution of vaccines.
Only 58 percent of D.C. residents 65 or older got the annual shots in the 2003-2005 period, the second-lowest percentage in the nation after Nevada, the report said. In Virginia, 68 percent got the shots; 64 percent in Maryland got them.
"The vaccination rate is a reflection of underlying problems in the health-care system," Levi said. "Why are we not reaching people in the way we ought to be?"
Another troubling sign, he said, was the number of states that hadn't achieved a top grade for their plans to distribute vaccines and supplies from the federal government's Strategic National Stockpile. Only 15 states, including Virginia, are at the highest level, according to the report, which uses data from the CDC. Neither Maryland nor the District scored at that level.
"Most states . . . are still not able to deliver medications or medical supplies in a rapid enough way to respond to an emergency," Levi said.
Pane, the D.C. health director, said the District had obtained the CDC's highest rating -- "green" -- but subsequently lost it because it didn't keep up with some of the requirements.
"We have the capability and the experience" to distribute medication during an emergency, he said.
As for the vaccination rate, he noted that the District had inoculated nearly all schoolchildren. The elderly "can be an under-served and hard-to-reach population," he said.
Virginia got passing grades on eight of the 10 indicators in the study; the District had five; and Maryland had four, ranking it at the bottom with California, Iowa and New Jersey. The indicators also measured whether states and the District had enough nurses and lab capacity and were maintaining levels of public health spending.
Three years ago, Maryland was ranked among the best prepared states by the Trust for America's Health, which at that time focused more on readiness to confront a bioterrorism attack. Maryland got a lower score this time, in part because of its vaccination rates and nursing shortage.
The report's authors said they compared the District to a state because that's the way U.S. health authorities treat it for grants and for rating its preparedness to distribute emergency medicine.
Lisa Kaplowitz, a top official in Virginia's Health Department, said the state government is working on the two indicators that Virginia missed: having enough nurses and hospital beds for a crisis.
"I certainly don't want people to think we have resolved all the issues . . . but we're much, much better off than we were in 2002 and 2003," she said.
Note: The report is online athttp://healthyamericans.org
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