Mr. Chairman, ladies and gentlemen, thank you for the opportunity to bring the issues of importance to those of us in the field of public safety to the attention of the incoming administration of Governor-Elect Deval Patrick. 

Mr. Chairman, the town of Acushnet, the city of Brockton, the island of Nantucket and every one of the 351 communities in the Commonwealth as well as every state in the nation is confronting the very real possibility of pandemic influenza.  The H5N1 virus that has infected humans in ten countries is slowing shifting to the point of becoming a clear and present danger.

I am by profession a Fire Chief.  My primary responsibility is to extinguish fires that occur in my community.  Inherent in my job description – and a responsibility every fire chief in the Commonwealth takes very seriously – is the safety and well-being of the men and women under our command.  The issue of a pandemic influenza is obviously a public health concern, but the reality is that those who will be called to render care to the ill as well as confront the virus while carrying out their daily functions are the Commonwealth’s public safety first responders.

How serious is this threat?  Last summer the United States Secretary of Health and Human Services traveled the nation informing state leaders not to look toward the federal government to save the day.  Some argued that the administration was attempting to lower expectations of federal involvement in this crisis given their abysmal response to Hurricane Katrina.  Others stated that the breadth and scope of a pandemic would be too large for the federal government to address.  Fair enough.  We thank them for their honesty and accept the challenge of developing state, regional and local plans to effectively respond to the challenges of pandemic influenza.

And what will those challenges be?

The Massachusetts Department of Public Health projects that of the 6.4 million citizens of the Commonwealth, 2 million of our citizens will become ill with the influenza, an attack rate of 30%.  DPH further projects that 80,000 residents will be hospitalized with flu related illnesses and that 20,000 will die within the first wave of the pandemic.

That figure represents influenza deaths that are twice the number of residents in the community I serve.

Finally, DPH further projects that a pandemic will result in a workplace absentee rate of up to 40%.  That means up to 40% of the people who pump our gas, sell our food and build our homes will not be at work during the peak of the pandemic.  That also means up to 40% less police officers, firefighters, EMT’s, corrections officers and every other job title under the banner of public safety. 

So, at a time when we at the local level can anticipate an unprecedented number of calls for treatment and transport due to the large number of sick residents in each of our communities, our public safety services will be understaffed in addition to being overwhelmed.

To its credit, the Commonwealth’s Department of Public Health has taken the lead in certain areas.  By DPH directive each community in the Commonwealth is required to identify a site and develop a plan to open an Emergency Dispensing Site commonly referred to as an EDS.  An EDS would be opened to provide medication to local citizens in response to local health emergencies such as a biological incident or to vaccinate its population during a smallpox outbreak.  Each community is required to have a plan ready to distribute medication to their entire population on 24 hours notice and complete this daunting task within seventy-two hours.  The number of EDS locations is determined by the community’s population, so while my town is required to have one site our neighbors in New Bedford are required to operate nine sites.  Many communities are beginning to exercise their EDS plans.  I recently participated in an annual flu clinic held in New Bedford at the site of one of their EDS locations.  This clinic operated according to state EDS guidelines and in real time.  The lessons learned were many, the challenges numerous.

Anticipating a surge in residents seeking medical assistance during a pandemic, DPH has asked the state’s acute care hospitals to develop plans to operate Influenza Specialty Care Units – or ISCU’s --  at locations separate from the main hospital.  The plan is to treat all non critical influenza patients at one licensed satellite location while the main facility handles those who are in critical condition as well as the other medical needs hospitals face on a daily basis.  The ISCU’s would operate under the direction and control of the main hospital but – as we were told by our local acute care facility – will depend on a very large number of volunteers and support staff.

DPH has also conducted an inventory of all appropriate hospital space that could be used during such a large scale crisis.  Based on that study it has been determined that the southeast portion of the state (Emergency Preparedness Region 5) has approximately 1,000 less beds then the expected need.  The solution will be to transport our excessive patients to other regions with available bed space.  Keep in mind that we would be doing this important task with up to 40% less staff at a time when our 911 system is bogged down with local residents requesting treatment or transport.

Realizing that a pandemic could quickly overwhelm an individual municipality’s ability to respond, eight communities in Southeastern Massachusetts – along with the University of Massachusetts at Dartmouth – have formed an organization we call the Southcoast Emergency Planning Partnership (SEPP).  Municipal leaders from public health, public safety, the executive level of government and school administrators comprise our membership.  In addition we have reached out for the participation of the local faith based community, the local Chamber of Commerce and other civic groups and organizations.  We have met monthly since April to discuss pandemic planning and have been successful in creating the Greater New Bedford Medical Reserve Corps – the entity we hope will begin to address the need for a pool of qualified, pre-credentialed and trained volunteers.

In addition, we have joined the Fire Chiefs Association of Massachusetts in requesting a change in policy relative to the distribution of influenza vaccine by classifying all public safety personnel in the top tier along with their EMT counterparts.  We have received a response indicating that DPH is actively considering our request and we will continue to monitor this in order to insure that the policy is changed prior to a crisis beginning.

That, Mr. Chairman, is the focus of my testimony.  If I were to inform you that your house is guaranteed to burn – we just weren’t sure when -- or that your car would absolutely be stolen – but we couldn’t tell you the day, month or year -- I trust that you would take the necessary actions to prevent these events from happening.  While we are not able to prevent a pandemic from hitting our state we can take the steps necessary to prepare now.

In the fall of 1918, this country and the world were devastated by the Spanish Flu.  Approximately 20-40 million people died worldwide with 500,000 deaths in the United States.   Local history tells us that The Mayor of New Bedford was completely unaware of the crisis until he received a call from the Mayor of Brockton requesting doctors, nurses and beds.  Within a few days the flu traveled south to New Bedford and resulted in over 1,400 deaths, including a member of my family.

By comparison, today you can log onto the World Health Organization’s website and follow the course of the H5N1 virus on a daily basis.  Prominent health officials warn that once this virus makes the final step to being easily transmitted from person to person it will be in our communities within three months.  That final step may occur next week, next month or next year.   It is important that we ramp up our preparedness for this crisis now.

My concern is for all our residents who will be made ill and possibly die due to this virus.  My primary concern today is for the first responders who will once again be on the front lines of an emergency.  There is much to do:

• we need to begin a coordinated training program for those public safety personnel who will enter the homes and transport the sick

• we need to stockpile the masks necessary for respiratory protection that is recommended by OSHA and insure easy access to those masks by our public safety employees

• we need to move forward on reworking regulations necessary for EMT’s and Paramedics to work outside their scope of practice during pandemic emergencies

• we need for the state to begin the process of purchasing the equipment and supplies necessary for hospitals to implement the state required plan of operating ISCU’s

• we need increased and sustained funding for local Medical Reserve Corps so that communities can build a pool of trained volunteers necessary to operate the state required Emergency Dispensing Sites and Influenza Specialty Care Units.

• We need to address the issues of liability that often proves to be an impediment for health care professionals to volunteer their services at the local level

And most importantly – in my opinion – we need executive level leadership on this most important issue.

A few weeks ago the Southcoast Emergency Planning Partnership hosted a meeting with our local state legislative delegation.  After discussing with them the issues just raised, I asked our State Senator how important an issue pandemic planning was during the current legislative session.  We were stunned to learn that the first person to mention the issue to him was a member of our group a few weeks earlier.  There had been no legislative briefing by the Department of Public health to which he had been invited.  There had been no telephone calls from appropriate administration staff explaining pandemic funding requests.  Most importantly, there had been no contact by the Governor indicating that pandemic planning and response was a top priority.

Each passing day brings us closer to what the experts predict will be a worldwide crisis.    While the public may become exhausted by yet another doom and gloom scenario, we can ill afford for the state to do the same.

I respectfully request that this group advise the incoming Governor of the very real work being done at the local level and the very real need for leadership at the executive level of our state government.

Thank you for your time.

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