SPCI 512
Emergency Systems, Public Health, and Disease Control

Course Introduction

Welcome to SPCI 512! This course will build on some of your learning in previous courses to fine-tune your understanding of how the private and public health-care systems of the United States intersect in dealing with critical situations. Both of these systems are in place all the time; and, to some extent, their vigor determines our ability to respond to critical events. In this course you will use much of the knowledge, techniques, and reference materials you have used in previous courses in the SPCI program. We will examine the strengths and weaknesses of health care in the U.S. (including private and public health care) and how it interacts with emergency health-care services. We'll look at the distinct "cultures" of private health-care, public-health, and emergency services providers to prepare you to interact with each of these sectors. We'll discuss strategic stockpiling and its place in public health and emergency situations. We will emphasize the interrelation of all these systems and their existing communication channels and coordination activities in times of emergencies. We will also discuss government's funding role and issues of balancing ongoing public-health needs against emergency preparedness. Finally, we'll look at various communications issues (such as communication among first responders, with government officials, or with the general public) as well as pyschological recovery from major traumatic events.

Learning Objectives

This course should enable you to describe the intersection of the private and public health systems that are most pertinent to coping with critical events.

When you have finished this course, you will be able to

• describe the major strengths and weaknesses of the private and public health systems and the underlying causes of those strengths and weaknesses;
• describe the history, components, organization, and operation of the health care and public health systems;
• provide a systems analysis of the health care and emergency systems in your local community;
• describe how the formal elements of the health care system interact with emergency services; and
• organize an inter-agency response to a biological or chemical threat.

The Online Environment

Your online course offers several advantages to the traditional classroom, including the comprehensive Online Student Handbook, the ability to communicate electronically with students and with your instructor, and links to a rich array of online resources.

Online Student Handbook

This handbook answers questions about your online learning course, such as how to purchase your text, schedule an exam, obtain a transcript, and get technical help if you need it. The handbook also provides additional resources, such as how to order books or journals from the library and how to study for an online course.

Communication with Your Instructor and Student Peers

• Online Discussion Forums, designed by the University of Washington award winning Catalyst team, allow you to communicate with other currently enrolled students and with your instructor. We encourage you to use the discussion forum to exchange ideas, resources, and comments about your course work with other students in this course. This unstructured forum is monitored by your instructor.
• You can use e-mail to ask me a question or preferably post your question on the discussion forum. I will reply to all discussion forum questions on the forum, and to e-mail questions via e-mail.

Online Resources

As an online student, you have access to a wealth of Web resources compiled to provide fast, easy access to information that supports your online learning experience. Organized by subjects, Online Resources link you to sites with help for writing and research, study skills, language learning, and library reference materials. All links have been assessed for credibility and reliability, and they are regularly monitored to ensure their usability.

About This Course

Course Prerequisites

There are no prerequisites for this course, although you are strongly encouraged to have completed SPCI 500 (Strategic Planning and Systems Analysis), SPCI 501 (Introduction to Comprehensive Emergency Management), and SPCI 507 (Epidemiology II).

Required Materials

Textbooks

Institute of Medicine of the National Academies, The Future of the Public's Health in the 21st Century. Washington, D.C.: The National Academies Press, 2003. ISBN: 0-309-50655-7.
Note that you can either purchase this book in print, or read it online (or print it) at http://www.nap.edu/books/030908704X/html/.

Journal Articles

Journal articles and other readings will be provided through Internet links. If you have concerns about the availability of the Internet from where you are located, we suggest you access and print these articles as soon as possible.  

Technology Requirements and Skills

See the Online Student Handbook for the technology requirements and skills necessary for this course.

Course Organization

This course is organized into two modules: the first contains four lessons followed by a summation project (Project I). The second module includes two lessons followed by a final project (Project II).

• The first module introduces and describes the domain for four critical systems in health care: public health, private health care, emergency systems, and strategic stockpiling. In the first major project, we'll examine the ways these systems interact with one another.
• The second module consists of lessons dedicated to the role of government agencies and funding, followed by a lesson on risk communication and the psychological aspects of responding to and recovering from crisis situations. The second major project will integrate both modules and stimulate you to think through the role in which you you may soon find yourself.

About the Lessons

Module 1: Three Historically Independent Systems

• Lesson One: What is public health? History of public health and the current system in the United States.
• Lesson Two: Delivery of private health services and population access issues.
• Lesson Three: Emergency health services and other emergency response systems.
• Lesson Four: Strategic national stockpiling of critical medicines
• Project I: Revisiting the sarin gas subway case from SPCI 507 (Epidemiology 2).

Module 2: The Challenge of Response

• Lesson Five: Financing and its effects on operations. Government's role in the health system, and new challenges in the post 9/11 era: Federal, state, and local powers and challenges.
• Lesson Six: Risk Communication and Psychological Responses to Emergency Situations.
• Project II. TOPOFF2 Case Study.

About the Assignments

There are three kinds of assignments in this course:

• Written Assignments (6)
• Discussion Forums (6)
• Major Projects (2)

These three types of assignments count toward your course grade as shown in Table i.1:

Table i.1—Course Components

Components	Percentage
Written Assignments (6)	30% (5% each)
Discussion Forums (6)	30% (5% each)
Project I	20%
Project II	20%
Total	100%

Written Assignments

Each lesson is accompanied by an assignment consisting of one or more questions. Where there is more than one question, you will select one question to answer; that is, you need not answer all questions in the assignment. You will have one week to submit a short response (150–200 words).You must complete at least 80 percent of the written assignments satisfactorily to pass this course.

Please note the assignment due dates on the Course Calendar. Late assignments will not be accepted without prior arrangement with the instructors. Turnaround on assignments will be seven to ten days.

Discussion Forums

Each lesson also includes one or more discussion questions. You are required to post your response and at least one comment about another student's response each week.

Major Projects

The two major projects include several questions to which you will respond in writing; you will submit your responses to your instructors. You will have one week to complete each project.

• In Project I, you will revisit the sarin gas release in the Tokyo subway, from SPCI 507, Epidemiology 2 (note Tokyo was called Daidai-shi in that lesson). This time, however, you will be looking at the incident from a public-health standpoint; you'll use what you've learned in the first four lessons about public health, personal health care, emergency systems, and strategic stockpiling, and the ways these systems interact with one another. You will also be focusing, not on Tokyo, but on a major American metropolitan area of your choice.
• In Project II, you will critically examine a recent, comprehensive, international bioterrorism training exercise that was designed to determine if the concepts you have learned in this course really work under real-life, full-scale conditions. You will methodically follow the events as they develop and analyze what you would do, what was actually done, and lessons learned from the field. This final project will help you synthesize material from the course; it will also help you transition into the next course by giving you an understanding of the key elements of conducting a field or table-top training exercise

Grading and Assessment Criteria

You will receive a numeric grade for this course. The numeric grading system used by the University of Washington relies on a decimal scale between 1.7 (low) and 4.0 (high). The grade scale for graduate courses applies to all graded courses offered by the Department of Urban Design and Planning.

For graduate courses, grades below 1.7 are recorded as 0.0 and no credit is earned.  A minimum of 2.7 is required in each course that is counted toward a graduate degree. A 3.0 cumulative average in graduate work is required to receive a graduate degree.

Grading Criteria

This course (and this program) is intended to prepare you to work with high-level public health officials and other professionals. Therefore, your communication skills should reflect that level of professionalism. Your work in this course will be graded according to the criteria shown in Table i.3, below:

Table i.3—Grading Criteria for This Course

Component	Percentage	Criteria
Content	75%	For written assignments and discussion forum assignments, where there is more than one part to a question, all parts of the question are answered completely and thoroughly. You demonstrate engagement with the material. Although there may not be a "right" answer, your process for arriving at your answer is transparent and methodical—that is, the reader can follow your argument.
Style	15%	Spelling, punctuation, grammar and so on are of professional quality, with at most one or two errors.
Timeliness	10%	Your assignment or discussion contribution is submitted on time and in the approved format (see "About Your Instructor" for submission instructions). Any late submissions have been pre-approved by your instructors. Note: repeated unapproved late assignments may result in your failing the course.

Study Tips

Keep up with the material: set a course of study that allows you to comfortably finish the lessons and readings with time to review before starting the major projects.

Test out your access to the course Web site, discussion forums, and E-submit site during the first week of the course to be sure your electronic tools will work for you.

About the Course Developers

This course was developed by a team of three experts in public health at the University of Washington.

Ann Marie Kimball MD, MPH, FACPM

Dr. Kimball is Professor of Epidemiology and Health Services at the University of Washington School of Public Health and Community Medicine. She is an adjunct professor in Biomedical and Health Informatics and Medicine with the School of Medicine. She serves as Director of the Asia Pacific Emerging Infections Network and as an attending physician at the STD (Sexually Transmitted Diseases) Clinic at Harborview Medical Center in Seattle. Her research interests include emerging infections and global epidemics, as well as prevention, surveillance, investigation, and control of infectious diseases. Specifically, she has worked extensively in the areas of trade policy and disease control; telecommunications and disease surveillance; and alert systems. Formerly, Dr. Kimball served as Regional Advisor for HIV/AIDS with the Pan American Health Organization (part of the World Health Organization). She has also served as Director of the Washington State HIV/AIDS/STD Program with the state Department of Health and as Chair of the National Alliance of State and Territorial AIDS Directors in the United States.

She has served on numerous editorial, scientific, and technical committees. She serves on the editorial board of the Control of Communicable Diseases Manual (American Public Health Association, 2000) and as a member of the Institute of Medicine Expert Committee to review the Global Emerging Infections Surveillance program. Dr. Kimball is a fellow in the American College of Preventive Medicine, Chair of the University of Washington Hogness Symposium, and a member of the International Faculty Council of the University of Washington.

Jason Allen, ND, MPH (2006)

Dr. Allen is a naturopathic physician and adjunct associate professor at Bastyr University. He has a decade of experience as an urban and wilderness Emergency Medical Technician (EMT). He has taught first aid and emergency medicine for the American Red Cross, the American Heart Association, and many fire departments throughout the U.S.

Before academia, Dr. Allen spent several years as a wilderness guide and was actively involved in search and rescue in Colorado, Arizona, and Australia. He has contributed to and edited a popular medical nutrition textbook. He has worked as an institutional and independent researcher in the area of environmental medicine, and is currently pursuing a Master of Public Health (MPH) in occupational and environmental medicine at the University of Washington. Dr. Allen is focusing in the areas of preventive toxicology, air-pollution epidemiology, and biochemical responses to environmental toxicants.

Andy Stergachis, Ph.D., R.Ph.

Andy Stergachis is a Professor of Epidemiology with the Northwest Center for Public Health Practice and Affiliate Professor with the Program in Pharmaceutical Outcomes Research and Policy, University of Washington. Previously, Doctor Stergachis was Vice President and Chief Pharmacist at drugstore.com. Before that, he was Chairman of the Department of Pharmacy, founding Director of the Program in Pharmaceutical Outcomes Research and Policy, and Professor of Pharmacy and Epidemiology at the University of Washington. Dr. Stergachis earned his pharmacy degree from Washington State University and an M.S. and Ph.D. from the University of Minnesota. He was the 1990 Burroughs Wellcome Scholar in Pharmacoepidemiology. The American Association of Pharmaceutical Research Scientists awarded Dr. Stergachis the 1994 Research Achievement Award in Economic, Marketing and Management Sciences. In 1999, American Druggist selected him as one of the most influential pharmacists in the U.S. He was awarded the 2002 Pinnacle Award by the American Pharmaceutical Association Foundation for career contributions towards improving quality of care through the medication use process. Dr. Stergachis served as a member of the Institute of Medicine Committee to Study the Interactions of Drugs, Biologics, and Chemicals in Deployed U.S. Military Forces and advised the U.S. State Department on assembling the U.S.-Switzerland Joint Economic Commission Panel on Bioterrorism held in conjunction with the World Economic Forum in 2002. He serves as a member of NCQA's Asthma Measurement Advisory Panel, the Agency for HealthCare Research and Quality Health Systems Research Study Section, and the Institute of Medicine Committee on Poison Prevention and Control. He has published over 100 articles and book chapters, including work in drug safety, and he has published in journals such as the New England Journal of Medicine, JAMA, and Medical Care.

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