STRATEGIC NATIONAL STOCKPILE (SNS)

Introduction

An act of terrorism or large scale natural disaster impacting a U.S. civilian population requires rapid access to large supplies of pharmaceuticals and other medical materials. Such quantities may not be readily available today and special caches may not have been created to hold these necessary medical supplies. No one can accurately predict where or when an attack will occur and therefore, states and local governments must be prepared to respond. Due to the fact that state resourcing to establish sufficient medical caches is not typically available, the Strategic National Stockpile was established.

What It Is...

The Strategic National Stockpile (SNS), a product of the Centers for Disease Control and Prevention (CDC), was developed in 1999 to provide an inventory of pharmaceuticals and of special interest, antibiotics, along with other medical supplies. These materials are available for rapid shipment to a specific location in the event of a large infectious disease outbreak or public health emergency, a bioterrorist attack included. Once federal, state, local officials as well as the CDC agree that the SNS should be deployed, pharmaceuticals and medical supplies can be delivered to any state in the U.S. within 12 hours utilizing push packages. These packages, consisting of 50-ton containers of drugs and supplies, are pre-positioned in undisclosed warehouse locations around the country to ensure materials can be expeditiously shipped if the need should quickly arise. States are expected to conduct periodic exercises and test plans to receive and distribute the SNS at the local community level.

SNS Functions...

Having a well tested plan and trained personnel identified prior to the arrival of the materials directly affects the speed and efficiency at which the distribution process functions. To effectively receive, distribute, and dispense the SNS once it arrives, a trained SNS team must be established to integrate within the following areas:

• Command and Control - Calls the SNS team to activate distribution functions, identifies locations of dispensing sites and treatment centers, and coordinates overall aspects of the SNS.
• Receipt, Storage, and Staging (RSS) - Works with the CDC to determine the best location for receiving and staging the SNS, identifies and activates the location of the warehouse, monitors the arrival of the SNS, and establishes transportation and security measures for moving the SNS to dispensing sites.
• Inventory Control - Identifies items and quantities of material that will arrive in the SNS, sets up the inventory management system to monitor usage, and requests additional medical materials as necessary.
• Distribution - Determines allocation of SNS materials to appropriate locations and coordinates the movement of material from the RSS warehouse to the dispensing sites and treatment centers.
• Dispensing Sites - Deliver mass prophylactic treatment regimens to large asymptomatic populations to prevent the development of disease in individuals exposed to biological agents during such an event.
• Treatment Centers - Focus on the treatment of symptomatic individuals whom may have been referred from dispensing sites are self-presented. Have the capability to prophylax asymptomatic individuals as well.
• Repackaging - Becomes crucial to operations when regimens of prepackaged units of issue have been exhausted and there is a need to repackage bulk pharmaceuticals, primarily antibiotics, into units of issue for continued dispensing.
• Communications - Provides the critical communications systems support to interconnect the SNS team, the command and control, the SNS functional areas, and the state and local Emergency Operations Center (EOC) integration.
• Security - Provides protection of SNS materials, dispensing site and treatment center staffs, and the general public reporting for prophylaxis or treatment while managing traffic and crowd control issues.

Dispensing Sites…

Dispensing sites or Points of Distribution (POD) sites, as they are more commonly known, are established at various locations throughout the community to distribute pharmaceuticals (primarily antibiotics) and other medical supplies as may be necessary. A concerted effort to coordinate health care activities is critical in effectively managing a large scale bioterrorism event when mass prophylaxis is indicated. Large numbers to asymptomatic individuals may be at risk of falling ill after possible exposure to such a bio release, therefore expeditious distribution of antibiotics will be required. By establishing POD sites throughout a community, healthy individuals can efficiently access preventive treatment while freeing treatment centers, hospitals primarily, to treat the symptomatic and injured. Potential POD sites include schools, community centers, churches and malls among other appropriate settings that can provide electricity, heat and air conditioning, water, and adequate toilets, parking and an area suitable for receiving supplies. When scouting for potential POD sites, planners should also consider accessibility for people with impaired mobility.

-- MikeLawrence - 30 Nov 2005