Muttontown Mayor Richard Murcott welcomed Shelly Schecter, APRN, BC of the Nassau County Office of Public Health Preparedness to their Monday, April 10 board meeting. Ms. Schecter came to speak on the need of local villages to prepare for the Cities Readiness Initiative (CRI). She explained that the county has to prepare for a health emergency, be it SARS - the bird flu or an attack using anthrax or any other bio-medical materials. She said the need for planning was to prevent mass mortality and morbidity from diseases for which antibiotics are an appropriate medical countermeasure.

The CRI is a program to aid cities in increasing their capacity to deliver medicines and medical supplies during a large-scale public health emergency such as a bio-terrorism attack. Ms. Schecter said, CRI will help save lives through timely delivery of medicines and medical supplies during a large-scale public health emergency - in 48 hours. "Speed is essential as morbidity increases the longer it takes to deliver the medicines," she said.

They plan to do that through the mass distribution and dispensing of antibiotics provided by the CDC-based Strategic National Stockpile. In that way they are preparing for any potential threat such as from aerosolized bacillus anthracis, she said.

The method of distribution is through creating PODs, a point of dispensing location. "By planning for community based distribution systems, we can ensure that hospitals are able to continue treating their existing patients as well as anyone who gets sick as a result of the emergency," she said.

The county PODs are one of several mechanisms that are being used to distribute medications. Ms. Schecter said they have contacted the First Responders - the local fire battalions who are being trained to deliver medications to themselves and their families. Other methods of distribution include: delivery by US Postal Service; municipal PODs; employer PODs; and by medication kits stored at home.

Ms. Schecter gave an example of how the program will work saying that in two days, Nov. 20 and 21, 2004, Nassau County held a flu vaccination POD. There had been a shortage of the vaccine and planned vaccinations of senior citizens had been cancelled until the county received more of the vaccine. In those two days in November, 7,624 older adults were vaccinated in two-eight hour sessions. That showed that they could get the job done.

They have divided the county into divisions. Division 1 includes Bayville, Centre Island, Matinecock, Lattingtown and Mill Neck; Division 1A includes Muttontown, Upper Brookville, Cove Neck, Laurel Hollow and Oyster Bay Cove. Division 2 is Sea Cliff, Old Brookville, Glen Cove, Old Westbury. Division 2A is Roslyn Harbor, Roslyn, Roslyn Estates, East Hills, Brookville, North Hills. Division 3 is Sands Point, Manorhaven, Port Washington, Port Washington North, Baxter Estates. Division 3A is Plandome, Plandome Manor, Plandome Estates, Munsey Park, Flower Hill. Division 4 is Kings Point, Great Neck, Saddle Rock. Division 4A is Great Neck Estates, Great Neck Plaza, Kensington, Russell Gardens, Lake Success, Thomaston.

Bayville Mayor Victoria Siegel said (in a telephone interview) that a meeting of Division 1 and 1A, will be held on April 25 at the Bayville Village Hall. "Muttontown is part of my emergency division. The Village of Bayville is to be a POD." She said Eileen Scanlon, RN, BC, who works with Ms. Schechter spoke to the Bayville board of trustees. Originally only Bayville and Centre Island were to be partnered but the division now includes Division 1A. Ms. Siegel said, "They are putting municipalities together to work in conjunction whether it be a hurricane or a man-made emergency. If an emergency occurs and medications or inoculations have to be dispensed, people should know where they have to go rather than finding out at the last minute. It is always better to be prepared with the hope that you don't have to use it."

Ms. Siegel said, "My board gave approval for Bayville to act as a POD. I know my residents are not going to leave here and go anywhere else. Last time when Nassau County had a POD when the flu vaccine was available, they didn't go so having learned from that experience, we will volunteer. In this part of the world, we are isolated and it is best we create a condition where things are readily acessible."

Mayor Siegel said East Norwich, an unincorporated area, would not be included in her division plans. The same was said at the Muttontown meeting as they considered they have 3,000 residents who would need to be treated at their village hall off Route 106.

Matthew Meng, president of the East Norwich Civic Association said, "Yet another reason to be incorporated." Mr. Meng has had a meeting of the ENCA devoted to the Community Emergency Response Team program (CERT). "It is part of the FEMA (Federal Emergency Management Agency). Emergency responses are all very difficult to plan and nothing will work as smoothly as people think. CERT is a second tier response to help and assist the First Responders. CERT people would load trucks with water and man the welcoming tables getting people to sign in and write down their names and saying 'no pets allowed'.

"If you have to move everyone from south of the Southern State, everyone in emergency management knows you can't move people out fast enough. Just think of what happened during Hurricane Katrina. Actually Charles Wang may have to consider when he is building his stadium, that it might be used in an emergency like the one in New Orleans.

"I have my CERT certification. I have my training, helmet, backpack and emergency preparedness material. It's a wonderful course to take. Schools should give them. It makes young people aware of what to do in emergencies and of how fragile life is," Mr. Meng said.

An article in the April 15 issue of The New York Times on a report by FEMA Inspector General Richard L. Skinner on the department's response to Hurricane Katrina last year said they must train their employees better. It also said that the September 11 attack focused official thinking on terrorism, "Even though natural disasters are more frequent and cannot be prevented." The New York Times article said the report made 38 recommendations for improving FEMA's performance including "communicating better with state and local officials."

Nassau County has been speaking to all the local villages through an evolving process at the Nassau County Village Officials Association (VOA). Warren Tackenburg VOA executive director said the Nassau County Department of Health has also talked to them about the opportunity to set up PODs. He said, "We are asking Nassau County to help us preplan to set up what can be done. Not everyone can run to the 11 hospitals in Nassau County so it has to be done locally."

He said some villages are talking about creating smaller PODs. "The Plandomes and Roslyns may band together since it is in their best interests to do that. In Port Washington, they are talking about linking up with Baxter Estates and Sands Point."

"Centre Island has 444 people and they are talking about joining up with Bayville's 9,000 residents. That should give them enough volunteers to make a successful POD. Also it is a good decision for them geographically since they are separated only by a small bridge of land."

Mr. Tackenburg continued, "What happens will be decided on what is practical and makes sense. It is incumbent on all village officials to take an active part in the preparations since their residents will want to know what their villages are doing."

Ms. Schecter said at the Muttontown meeting that perhaps their local villages of Brookville and Upper Brookville could get together with Muttontown and cooperate. Trustee Russell Corker, their liaison on emergency management said that could be a problem but the village decided they would contact the North Shore-LIJ Center for Emergency Medical Services to come and help them with emergency planning.

Ms. Schecter said there are 1.3 million people in Nassau County that would need to be served in an emergency. "We can't do it without partners," she said, "probably partners nationwide," she added.

Nassau County's plan is decentralization and local control. They see the First Responders as the first layer of involvement followed by municipal PODs, employer PODs and then Health Department/County PODs. Each POD design is modular, using about 50 people to operate a POD that can optimally move 1,000 people an hour. They foresee that PODs will be slowed down due to traffic, parking and uninformed citizens.

The plan began in 2002-2004 as the Department of Health developed Memorandums of Understanding (MOU) for county operated PODS. (The county wants the villages to sign MOUs to eliminate lawsuits in case a resident has an accident at a POD.)

In November 2004, the county held a flu vaccine POD for seniors at the NCC field house and gave 8,000 vaccinations in two 10-hour days. In the spring of 2005, there was a Health Commissioner Strategy briefing.

Next the DOH worked with Fire Department Battalions on a First Responder POD plan.

The DOH identified part of their CRI funding to contact locations on the north shore to assist in planning and training municipals in POD operations.

The county is working with the First Responders and the county attorney and VOA and are developing a template MOU for village PODs.

In early 2006 the VOA developed the District Village POD concept. In June 2006 the Nassau and Suffolk Health Departments are planning a community forum for businesses and schools. They have identified the largest employers on Long Island using figures from Newsday June 13, 2005. They include: North Shore-LIJ Health Systems - 26,896; state government - 24,900; federal government - 18,208; Catholic health services - 14,000; Suffolk County government - 10,445; Stop & Shop - 7,000; Long Island Rail Road - 6,318; Winthrop-South Nassau University Health System - 6,300; Waldbaums - 6,250; Verizon - 5,034; Diocese of Rockville Centre - 5,000; King Kullen - 4,800; Adecco - 4,633; Pathmark - 4,500; Federated Department Stores - 4,493; KeySpan - 4,337; Long Island University - 4,257.

The CW Post Campus of Long Island University in Brookville is already becoming involved in learning how to handle a large scale emergency. C.W. Post, along with law enforcement departments, fire departments and other emergency management agencies, will conduct a disaster drill to practice the response procedures that may need to be deployed in a campus emergency.

The exercise will take place on Friday, April 21 and will provide an opportunity to train staff in disaster preparedness, evacuation methods, rescue techniques and coordination with outside agencies -- as outlined by the National Incident Management System of the US Department of Homeland Security.

The exercise is underwritten with a grant secured by New York State Senator Michael Balboni, who chairs the Senate Committee on Veterans, Homeland Security and Military Affairs, which oversees and approves legislation relating to all aspects of homeland security. He is a member of the board of advisors of the Long Island University's Homeland Security Management Institute.

Also involved in emergency planning issues is New York Institute of Technology's (NYIT) School of Health Professions, Behavioral and Life Sciences and the Long Island Chapter of the Contingency Planning Exchange which will present, "Long Island's Business Approach to Pandemic Preparedness," on Friday, April 28 from 8 a.m. to noon on NYIT's Old Westbury campus. Nassau County Department of Health Commissioner Dr. David Ackerman will discuss how Long Island businesses should prepare for a possible widespread outbreak of disease.

Brendan Horton, director of operations for Arrow Electronics, will moderate a panel discussion about the importance of business pandemic preparation. Members of the panel will include Thomas C. Gillett, manager of emergency preparedness and nuclear affairs, KeySpan Corporation; Charles Bauer, assistant vice president of business continuity and special projects, Teachers Federal Credit Union; John Hayes, vice president, New York Life Insurance Company; and Roseann McSorley, managing director, Deutsche Bank Americas.

The seminar will take place at Rockefeller Auditorium on NYIT's Old Westbury campus, located at Northern Boulevard, one mile east of Glen Cove Road. To R.S.V.P. or for more information, please call 212.344.4003 or e-mail headquarters@cpeworld.org.

"The Town of Oyster Bay has been approached about becoming a Point of Distribution (POD) and we are looking forward to working with the county on this project," said a town spokesperson. The town is just beginning their planning as they address the issue.

Currently there are Strategic National Stockpiles (SNS) of antibiotics, chemical antidotes, antitoxins, life-support medications, IV adminstration, med/surgical and airway supplies. There are 12 strategically located, 12-hour push packages: 50,000 lbs. each of 130 pallets; that can be delivered by eight tractor trailers and one wide body DC10, 747. The medications should arrive in 4 to 12 hours by surface or air transportation through a Tailored Advisory and Response Unit (TARU) that can be deployed within 24 to 36 hours.

Kathy Wilson, NYS Senator Carl Marcellino's director of communications said that in an emergency you have to rely on the locals first. "We are an Island and so for help to come to us is another issue. We have to hunker down and take care of ourselves. The first line of defense is always local government in any kind of emergency."

She said, "In that moment that you first know there is an emergency you have to be prepared to act - in that moment - so you have to prepare beforehand. It's wonderful that these plans are beginning to come together so we can do the research and coordinate our efforts."