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So how would New Haven respond today in the event of an outbreak? Rubano’s staff would begin by contacting the state and other regional health departments, as well as the CDC. In the case of an identifi able pathogen or biological agent, the CDC would send a vendor managed inventory (VMI) within thirty-six hours. Threatspecifi c VMIs contain the antibiotics, antidotes, antitoxins, vaccines, or other medical supplies needed to contain that particular threat. Such supplies are stored in a Strategic National Stockpile (SNS) in Washington D.C. If New Haven offi cials did not know what had hit them, the CDC would send an all-purpose “Push Package” within twelve hours. At its discretion, the CDC might deploy Technical Advisory Response Units (TARUs) to aid state and local health offi cials in distributing pharmaceuticals.
In the event of a particularly widespread or virulent outbreak, more extreme measures might be taken. Under the CT Public Health Emergency Response Plan, the governor can confer additional emergency powers to the state Commissioner of Health, who may in turn convey these powers to city or state level offi cials. Offi cials might quarantine select groups of people, including passengers on a bus, people in a neighborhood, or even entire cities. The health commissioner might also order individuals to be vaccinated or to receive treatment during an epidemic. By law, an individual may then legally refuse such care, but then the commissioner reserves the right to force that individual into quarantine. The individual may legally appeal for release from isolation. These expanded powers, of course, apply only during declared public health emergencies.
So is New Haven ready? The answer depends on the outbreak itself. While a handful E. coli cases might prove easy to manage, an outbreak of smallpox or drug-resistant fl u could devastate an entire city population or nation. Public health plans are by no means a hard science; a protocol that seems infallible on paper can prove an absolute disaster in practice. Health offi cials can only continue to revise and update plans based on what does and doesn’t work in trial scenarios and real experiences.
In reality, neither New Haven nor the United States will ever be totally prepared for a full-blown catastrophe. Instead the focus must be on preventing such an epidemic in the first place. As Rubano told P.H., “After 9/11, we’re just waiting for the final shoe to drop.”
Emily Bucholz is a junior Molecular, Cellular, and Developmental Biology major at Yale University.