Creative Use of Emergency Communications Tool Saves Clark County Time and Money
Eighteen months ago, a Vancouver-area family was returning home from a visit to India. During the middle of the long, overseas flight to Portland International Airport, the baby in the family broke out in measles. The child’s exhausted parents realized the baby was sick, but had no idea of the severity of the illness. They drove from the airport to their home in the Vancouver area. The next morning, alarmed by the redness around their child’s eyes and splotchy red spots appearing on her face, they rushed to the emergency room at a Clark County hospital. By the time the baby had seen a doctor, gone for some lab tests, and been carried through the hospital pharmacy, 496 people in Clark County, Washington had been unwittingly exposed to this highly contagious disease.
When this scenario actually occurred in Vancouver in 2011, Clark County Public Health sprang into action. Once alerted to the danger, these professionals knew they had 36 hours to prevent a major measles outbreak. Their task: contact 496 potentially infected persons and identify all those who were not yet protected by two doses of combined measles, mumps, and rubella (MMR) vaccine that most of us received as children. If the unprotected received vaccinations promptly, the danger would be averted.
Public Health immediately set up a phone center with 20–25 staff working on logging calls, tracking down the 496 exposed to infection, and recording critical information about their vaccination history. Staff worked for two straight 15-hour days to ensure that everyone possible had been contacted. The makeshift paperwork recording contacts, no answers, and immunization history was a nightmare to track. The county spent close to $10,000 in mobilization and staff costs. After working close to 48 hours straight, Lianne Martinez, the Emergency Preparedness Coordinator for Clark County Public Health, finally dragged herself home and tried to get some sleep. She had the satisfaction of knowing that the Public Health Department had confirmed that 54 of the 496 people exposed needed an additional dose of the MMR vaccine. But that night, she lay wide awake for a long time, thinking there had to be a better way.
That’s when she hit upon the idea of using the county’s Emergency Community Notification System to collect information important to a public health disease investigation. Local governments typically use community notification or reverse 911 telephone calls to notify residents within a certain radius of a danger or problem, such as a power outage or missing person. Working with Clark County’s Emergency Management Department, Lianne Martinez found that the county’s call system could also conduct short telephone surveys of up to five questions. That short survey would give the Public Health Department enough information to help jump start important disease investigations.
Recently, Clark County Public Health used the Emergency Community Notification System (reverse 911) to assist with a disease investigation at a school that had experienced high absentee rates for two straight days. Within five minutes of the calls going out, Clark County Public Health had a 74% response rate and had identified a clear pattern of the types of symptoms the sick students were experiencing. Public Health officials determined that the outbreak of illness was likely a viral infection and not a serious public health problem. The system was able to quickly generate follow-up phone calls to parents with updated health information based on the survey.
The savings in time and money are significant. Staffing a call center, recording and tracking information in the measles exposure case cost close to $10,000. With the Emergency Community Notification System, the marginal cost of making the calls and tracking the data would have been less than $100. And the customer response has been very positive, with respondents appreciative of the ease of use and receipt of timely follow up information.
Can your emergency community notification system collect data as well? There may be other uses beyond public health for this versatile resource.
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