Brazil hospital complex installs connected fire alarm system

Brazil’s bustling general practice hospital in São Paulo, the Centro Médico Campinas installed a connected fire alarm system.

Over the past five decades, the hospital campus has undergone significant expansions to add new buildings and specialized healthcare services.

This resulted in installing eleven different, incompatible fire alarm panels across the sprawling campus that required individual monitoring, cleaning, and maintenance.

For seamless, around-the-clock fire safety of the entire premises, clinic operators wanted a unified and future-proof system. The Hospital Centro Médico Campinas chose a system designed by Bosch and implemented by Brazcamp Tecnologia installers in Campinas, Brazil for a completely integrated fire alarm system to provide optimized safety coverage.

The system secures the entire city hospital campus around the clock. All fire detection devices are connected via the Modular Fire Panel 5000 Series from Bosch for improved response times and better maintenance options –including remote maintenance – to the healthcare facility.

The project also required retrofitting of legacy fire prevention equipment and smart connectivity to accommodate the premises’ unique layout. By installing one single, fully customized solution, the hospital:

• Fixed compatibility challenges. Integration and consolidation of all data from connected devices on the fire panel. Thanks to retrofitting of legacy detectors, devices now communicate seamlessly.

• Decentralized access 24/7. Direct access for personnel via remote keypads connected to three desked areas: Main reception, on-site fire department, and operation and control center.

• Entire campus on a single network. Five loop modules cover all areas of Hospital Centro Médico Campinas with panels and detectors, including sensitive environments such as the ICU, operating theater, patient wards, and the hospital laboratory.

• Increased safety response and situational awareness via full integration with gas detection, sprinklers, and access control. As a result, personnel can pinpoint the location of a fire precisely and unlock doors and gates in case of an event for improved evacuation.

As the hospital continues to grow, the flexibility of the new solution allows for future integrations, such as access control and voice alarms.

UK hospital deploys Titan Lite fire barriers

A Plymouth-based hospital in the UK has deployed Titan Lite fire barriers in its facility. The 18-month contract being carried out by a leading UK fire contractor involved installing large quantities of the Titan Lite 120:60, manufactured by TBA Firefly, to create fire barriers above ceiling voids throughout many parts of the hospital.

The hospital has 660 beds and provides medical and surgical care to a third of a million people with the building dating back to before the beginning of the Second World War.   

The refurbishment work, concluded at the end of November 2021, was being carried out by Plymouth based Ventro Ltd. whose operatives have had to work in many areas during the evenings and weekends to avoid disruption to the hospital’s everyday activities, including the treatment of patients.

Following early appraisals of the fire protection requirements within the ageing property and considering the large quantities of different mechanical services to be accommodated into the upgrades, the hospital’s estates department decided to raise the specification for the work from 30 minutes integrity rating to a full two hours.  

The Site Agent for Ventro, John Roberts, commented: “As a specialist fire contractor working across the whole of the UK and beyond, we have employed Firefly products on many projects over the years and expect to continue doing so.  In the early stages of this contract, which began on site in May 2020, it was thought Apollo 30 minutes would be appropriate, but the hospital then switched this to Tian Lite 120:60.  We have been installing the Titan Lite in many parts of the hospital, including most recently in the ceiling voids over the kitchens. This has been done by fixing metal angles across the soffits and then using the special tape and staples to secure the fabric to it. Despite the large number of services making the number of penetrations to be deal with quite challenging, our teams find the Firefly relatively easy to install.”

Global fire alarm and detection market to reach $53.15bn in 2032

The global fire alarm and detection market is expected to be $53.15bn in 2032 expanding at a CAGR of 6% from 2022 through to 2032. The market is currently valued at $29.68bn in 2022.

The increase is forecasted to comes from a demand for developed fire safety systems in mining, automotive, petrochemical, oil and gas exploration, and power and utility sectors.

Rising deployment of fire alarm and detection systems across educational institutes and increasing awareness about its benefits among residents for fire detection systems are key factors propelling market expansion during the forecast period. Furthermore, ongoing technological developments in fire detection and alarming devices is expected to boost the industry’s growth in the coming time.

In addition, the advancement of wireless and remote function fire detection and alarm systems are anticipated to offer significant opportunities for expansion in the evaluation time.  

The Covid-19 pandemic ushered in a change in the demand and consumption pattern of fire alarm and detection systems. With increasing hospitalisation rates and shift towards remote working, the need for residential and healthcare setting oriented fire safety protocols have increased, leading to growing sales of fire alarm and detection systems across these domains.

Key players in the global fire alarm and detection market have adopted various strategies of mergers, acquisitions, and partnerships. In August 2021, ProPharma group acquired iSafety Systems, an Indian pharmacovigilance service provider.

Then in July 2021, ICON plc acquired a CRO, called PRA Health Sciences. The objective of the acquisition was to increase the services portfolio of ICON plc. In October 2020, Honeywell rolled out its first tools from its new suite of Connected Life Safety Services (CLSS), which is its first all-in-one cloud platform for fire safety systems.

Drager partners with the Fire Service College

Dräger, a medical and safety technology company, has partnered with Fire Service College (FSC). Together furthering technical innovation through the optimisation of SCBA product development, firefighter training and communications. 

The FSC, owned by Capita, delivers training to all UK fire and rescue teams, as well as defence, national resilience and critical national infrastructure, and is recognised as an international leader with delegates from across the globe regularly utilising its expertise and facilities. Located on a 320-acre former Royal Air Force airfield, more than 7,000 delegates a year train using every scenario imaginable across domestic and industrial buildings, a ship, aircraft, motorway, train set/station and high-rise buildings – all of which are used for real fire and rescue scenarios on a daily basis. The FSC puts a strong emphasis on interoperability and large-scale exercises.

Dräger’s relationship with the FSC spans more than three decades, and includes the provision of SCBA sets supported by bespoke training. FSC instructors are in an ideal position to provide feedback that supports product development, and to act as product ambassadors to demonstrate the manufacturer’s commitment to firefighter safety.   

As part of the new partnership, Dräger will provide the new PSS AirBoss Connect SCBA kits including telemetry, face masks, communications, and cylinders. And in reinvigorating the relationship there will be further joint activities to ensure delegates are provided with the latest developments and industry insight.

Dominik Wellmann, MD, of the FSC, said the partnership supports the college’s goal to use market leading, technical innovation. He said: “A key part of our responsibilities as a world-leading provider of emergency services training is investing in state-of-the-art kit that delivers optimum safety to all of our delegates. As the global leader in fire safety equipment, we recognise Dräger as the ideal partner to support this goal.”

Matthew Bedford, managing director sales and service added: “We’re very pleased to see the new AirBoss SCBA being utilised at the FSC and look forward to receiving feedback. The partnership enables us to support our industry and learn from it. It’s an invaluable long-standing relationship from which everyone wins.”

Firefighters in Scotland to carry life-saving naloxone

Firefighters in Scotland will set up a network of volunteers to administer naloxone. The Scottish Fire and Rescue Service (SFRS) will administer the medicine, which is given as a nasal spray in the event of an opioid overdose to help save someone’s life.

SFRS staff will be given training in partnership with the Scottish Drugs Forum (SDF) as part of a £90,000 project funded by the Scottish Government, joining the Scottish Ambulance Service and Police Scotland in recognising the role the medication can play in saving lives.

Nicola Sturgeon, First Minister said: “SFRS staff regularly interact with the public during operational incidents, prevention and protection work and community engagement and it is reassuring to know that if they come across a situation involving an opioid overdose that volunteers will be able to administer naloxone while they wait for an ambulance to arrive.“Naloxone is one of a wide range of measures being used to address the public health emergency of drugs deaths, but it plays an important role and allows those administering the kits to connect people who use drugs and their families with appropriate local services.

“Of course, we want to help people long before they get to the point of a life-threatening overdose and we are working hard to increase the number of people in treatment backed by total funding of £250 million over five years.”

Stuart Stevens, assistant chief officer and SFRS director of service delivery said: “We welcome funding from the Scottish Government to provide life-saving medication for some of the most vulnerable people in our communities.

“We will fully support volunteers within SFRS to complete training to safely administer naloxone to help prevent avoidable drug deaths from overdoses. This project highlights our commitment to working with partners to improve the safety and wellbeing of the people of Scotland.”

Group Commander Paul Blackwood, pictured giving a demonstration of how the nasal spray works, took part in training from SDF a year ago and is encouraging colleagues to take up this opportunity. He decided to carry naloxone after a personal tragedy.

Paul said: “I grew up in Glasgow and I lost my best friend at the age of 19 from a drugs overdose. This traumatic experience has stayed with me and so it was important for me to volunteer to carry naloxone. I have the kit because I want to be in a position to save someone’s life.”

A naloxone information pack will be available to all SFRS staff. Firefighters who volunteer to undergo training to carry and deploy naloxone will be given guidance on how to identify the signs and symptoms of an opioid overdose and how to use the medication to reverse these effects.

A year of firsts: HSE Chair reflects on the past year

As I complete my first year as Chair of the HSE, I have an overriding feeling of pride in the people and achievements of the whole organisation. Our resilience, flexibility and determination to deliver on our mission, values and business plans during these testing times continues to be an inspiration.

HSE stepped up and continues to contribute to the national response to the global pandemic. At the same time, colleagues are taking on significant new responsibilities and expanding others so that we enable more people to be safe and feel safe in their homes, whether houses , apartments or high-rise buildings as well as protecting people and the environment from harmful exposure to chemicals and explosives.

Behind the scenes colleagues have enabled new ways of working, including the continuity of our helplines and an extraordinary growth in our online advice and information communications reach. Right across the organisation there is much learning that is valuable and will inform our new strategy and future business plans.

Many of our partnerships are deeper and stronger than before. The British Occupational Health Society (BOHS) has recognised HSE’s efforts in putting together a unique team of specialists to assist the Government in their efforts in providing frontline health care workers with life-saving personal protective equipment (PPE), as a part of the pandemic response.

The Peter Isaac award recognises “an outstanding initiative that has contributed to the reduction of ill health at work.” The HSE PPE technical team was assembled to respond to unprecedented global demand for equipment, not only to provide NHS workers with access to high-quality PPE, but also to conduct research, provide expertise, and support policy making and practical guidelines across a whole variety of workplaces.

The celebrated team comprised of experts in occupational hygiene, science, microbiology and infection prevention, as well as policy-making experts and support staff, who combined their skills and knowledge across a wide range of interrelated disciplines.

Working closely with the Department of Health and Social Care (DHSC), Public Health England (PHE), Medicines and Healthcare Regulatory Agency (MHRA), the NHS and other government bodies, the HSE team evaluated materials and specifications against relevant PPE requirements, to rapidly provide agreement that new and novel sources of supply had been properly assessed and could be deployed to frontline workers without unnecessary delay.

At the same time, colleagues developed the new Spot Check service that has enabled HSE to support local authorities across GB to support workplaces to be to as Covid secure as possible. Colleagues have completed some complex and significant prosecutions including an NHS Trust, National Gas Grid and an Adventure Theme Park operator. While we remain focused on prevention, it is also essential that we also hold people to account and secure justice.

I am one of many colleagues who joined HSE during the pandemic and while I have valued participating in our virtual events, I am very much looking forward to meeting as many colleagues as possible during the forthcoming ‘One HSE’ events this autumn. These events will provide us all with a good opportunity to appreciate the breadth and depth of our work and think about our shared purpose, values and direction of travel. I am confident and positive about the year ahead and the contribution that HSE will make during these challenging times.

This article was originally featured on the HSE website.

Hochiki Europe roundtable: How can we improve life safety in care homes?

Over the last 12 months, the country has watched COVID-19 tear through care homes and leave devastation in its wake. With the sector experiencing the first major escalation in fatalities due to the close knit and closed off nature of homes, the importance of protecting society’s most vulnerable has been thrust firmly to the top of the nation’s agenda.

As well as the threat of the virus though, care home residents still face the risks they did pre-pandemic from a variety of other factors, including fire. And when it comes to making, installing, maintaining and supplying life safety technology, the care home environment presents a range of unique challenges.

In April 2021, Hochiki Europe hosted a roundtable made up of industry experts focused on the requirements and opportunities around life safety in care homes. The virtual conversation explored how the people responsible for keeping residents and care givers safe can work together, sharing knowledge and ideas to improve standards and best practice.

The Panel

  • Paul Adams, Marketing Manager, Hochiki Europe (Chair)
  • Martin Green, Regional Sales Manager, Hochiki Europe
  • Ian Hill, Emergency Lighting Manager, Hochiki Europe
  • Andy Hollingshead, Health and Safety Manager, Barchester Healthcare & Vice Chair NASHiCS
  • Simon Titley, National Account Manager – Healthcare, Churches Fire & Security
  • Ian Watts, Business Development Manager, Llumarlite Lighting Solutions

How has the pandemic affected the provision of fire safety in the care environment?

The discussion began with a reflection of the last year and how COVID-19 has impacted the delivery of fire safety services within care homes – taking into consideration the battle of controlling infection and reducing visitors, while observing stringent safety standards and maintenance requirements.

“It’s obviously been a very difficult time within the industry, particularly in March and early April last year when people were being discharged from hospital without a test, as testing wasn’t the norm at that time,’ stated Andy Hollingshead – who is part of the H&S Team for one of the country’s largest independent care providers. Like any other business, he stressed that those within the care sector had faced no choice but to adapt almost overnight.

“Fire and evacuation drills are a vital part of any fire safety strategy, but they encourage people to gather together, which is a challenge in the current climate. To combat this, we turned drills into desktop training where scenarios were given and staff had to describe the actions they’d take. This has been extremely well received and we’ll be continuing to run these exercises even after restrictions are lifted.

“We also had a number of fire and rescue crews that were concerned about how they’d know which residents had tested positive/suspected if they arrived to support with an emergency. We overcame this by putting red letter Cs on PEEPS to identify who was high risk, which made things immediately clear to fire fighters.”

On the topic of maintenance, all parties agreed that the legal requirement to inspect and test systems over the last 12 months has been challenging. Simon Titley shared his experience: “By law, risk assessment and method statements (RAMs) must be updated regularly, so we had no choice but to continue. We altered our approach to offer more virtual appointments via WhatsApp video calls to maintenance staff or care home managers to ascertain whether or not a site visit was necessary.

“When they are, all appointments are pre booked and technicians are instructed not to enter a care home until they’ve called from the vehicle to ensure it’s still appropriate to visit. We have put certain protocol in place where contractors can’t enter bedrooms and with smaller properties, we’ve prearranged for the carer to take the patient out into the garden while we are on site. We’ve also produced a letter for staff which states that they provide an essential service to support them with accessing the vaccine as a priority.”

Everyone agreed that new processes are key and looking to how life safety technology itself can support, Hochiki’s Martin Green expanded – “hybrid wireless systems are a great fit as they are designed to reduce installation time, which minimises the time installers need to spend in people’s rooms. The wireless technology that’s on offer now is so much more robust than it was a few years ago – it’s ideal for the care environment.”

Working alongside vulnerable individuals

Albeit obvious, one of the most challenging considerations of providing life safety systems to the care sector is the fact that many residents have poor sight, mobility issues, are hard of hearing or living with dementia – all adding to the complexity of ensuring systems are appropriately designed.

Hollingshead explained that protecting those with bariatric care requirements and reduced mental capacity causes the most issues and in response, Green went on to offer his insight into the technology designed specifically with vulnerable individuals in mind. He said, “In the event of a fire alarm being activated, visual alarm devices – or VADs – complying to BS EN54-23 are required in locations where they are considered to be the primary source of warning to building occupants.

“Within care homes, this is extremely common so we offer devices which flash brightly to serve as a primary indicator of a fire occurrence for those with impairments. More innovative control panels which enable a programmed phased evacuation are also perfectly suited to care environments, as they help to control the evacuation process and minimise confusion and chaos – a must when dealing with people who may not have any comprehension of the danger they’re facing.”

Hollingshead agreed – “People believe the concept of fire evacuation is total evacuation but in the care industry, it’s progressive horizontal evacuation (PHE). Getting people away from the point of a fire and moving them into a point of safety (minimum 2 fires doors away) is the best approach.”

When questioned on the recommended two and a half minute evacuation time, Hollingshead shared some interesting trivia – “the story goes that this originates over 100 years ago from theatres playing the national anthem in the event of a fire, as it typically signalled the end of a performance and encouraged audiences to leave. Whether this is true or not, it makes very little sense to a care worker in an emergency who’s trying to assist a resident that requires a hoist to get out of bed, for example. That’s why we take the simple approach of ‘you do whatever it takes to save a life.’”

Minimising false alarms

Next, the panel discussed the importance of reducing occurrences of false alarms – due to the reoccurring issue of the frailty of care home residents. Simon Titley reminded the group that this can be supported by regular, planned preventative maintenance programmes which extend the life expectancy of equipment, in particular sensors. In addition, visual checks of electrical equipment that come into a premises are vital to monitor for scorched plugs or broken cables.

Andy Hollingshead commented – “Toasters are a huge issue – they usually cause smoke rather than fires, which cause activation of alarms. Halogen floor lights have recently cause problems too, so we only use LED bulbs across our homes now. It’s so important to be smart in order to avoid bad relationships with local fire brigade, as the work they do is incredible and it’s vital to keep them on side.”

Turning to how technology can help avoid false alarms, Hochiki’s Martin Green said: “Investigation delays can be set to give staff a few minutes to respond before the fire brigade is alerted and cause and effect programming in multi-sensors can also help, particularly with common causes such as toasters. For example, you can program the multi-sensor to provide an initial alert at the fire control panel to inform a manager that there is smoke present and then, while also monitoring for the presence of heat, begin to determine whether it’s a real fire and whether a full alarm condition should be initiated.”

When asked what companies can do to improve system design and engineering, Simon Titley stressed that every design should be built around a fire risk assessment (FRA) provided by the owner of the care home – “creating a robust fire safety strategy relies on a partnership between contractor and operator”, he said.

Picking up on a potential design flaw, Hollingshead explained that people living with dementia often set off call points. “We do everything we can to try and stop this with covers and howlers and it still happens. Within BS 5839-1, there’s a proviso that all manual call points are fitted with covers to reduce false alarms but when you’re dealing with people living with dementia, it’s almost impossible to avoid them completely,” he said.

The group were in agreement and FIA trainer, Ian Watts, advised that it’s possible to write something into the care home’s risk assessment to override this issue. He commented – “There’s so much ability to create variations to the BS and this is something that I’m always keen to stress during training courses. Of late, there has been a real uplift in the take-up for training, which is wonderful to see. People are taking their knowledge and applying it to individual buildings successfully – it’s a lovely movement.”

The role of regular risk assessments

Expanding on the subject of risk assessments, all parties agreed that they don’t just offer an understanding of fire safety, but also the people that use a home and the unique difficulties of each care home. “This isn’t often appreciated within the industry. An ex-fire officer isn’t necessarily a risk assessor,” said Hollingshead. “We have a full survey every three years and an additional review annually that looks at the people and the environment, not just the system.”

Under the Regulatory Reform (Fire Safety) Order 2005, the responsible person is required to – following a risk assessment – implement appropriate fire safety measures to minimise the risk to life from fire, and to keep the assessment up to date. However, within the industry, there is often confusion around how a responsible person is defined. Andy continued: “Under legislation, it’s officially the CEO but typically it’s down to managers to make sure remedial work from assessments are carried out.”

Energy efficiency

While it’s clear that fire safety must not be disregarded in the quest for energy efficiency, there is a clear link between the two. The panel discussed ways that new build homes are more energy efficient and fire safe by design – through the use of products such as LED bulbs and USB charger ports. However, when it comes to older buildings it can be more challenging, as it’s hard to put demands on people regarding their own belongings.

Hollingshead said: “We wouldn’t like people to come into our bedrooms and start altering things, so it can be tricky! There are ways to overcome this though, for example, we’ll quite often replace the halogen bulbs in residents’ reading lamps for cooler running LEDs, so you’re not taking someone’s belongings away, just changing them to make them safer and more efficient.”

The benefits of wayfinding technology

At this point, Hochiki’s emergency lighting manager, Ian Hill, raised the topic of wayfinding technology and emergency lighting, which is also now designed to use LED – not only more efficient but also long-lasting, meaning products are much more reliable, reducing the chance of failure and simplifying maintenance.

Ian explained: “The majority of fire risks in care homes are at night, when there’s substantially less staff than during the day and it’s dark, which highlights the importance of designing a fire system with emergency lighting in mind.

“Design is vital here. It’s extremely important to communicate an exit plan right the first time to minimise confusion – especially when dealing with people with dementia. In care homes, there tends to be corridors with lighting signs at each end, so blocking off exits to take choice away makes evacuations safer and quicker. With some intelligent life safety systems that combine emergency lighting and fire detection, at the first instance of a fire, the nearby exit signs will change from a green running man to a red cross to show the exit is compromised. In these instances, there’s no room for ambiguity and it must be totally clear to residents and staff alike.”

Closing the discussion, Paul Adams asked the group for any final advise they’d offer those within the care industry, as well as where they can access support or technical guidance.

Ian Watts suggested the FIA, while Andy Hollingshead praised the HSE and NASHiCS websites. He also urged them to always consider the ‘three c’s’ – communicate, command and control. “We use this motto to train care sector staff and believe that if all these are in place, nobody will lose their life.” Watts echoed this sentiment – “in a similar vein, we use ‘review, refresh, replace’ when referring to the importance of maintaining risk assessments.”

In conclusion, Ian Hill stressed that reading the guidance and keeping abreast of evolving standards and requirement is important, a robust life safety strategy comes down to a successful initial design and the quality of products installed. By working with industry experts, those within the care sector can rest assured that every possible measure is in place to protect residents and staff.

For more information about Hochiki Europe and its range of intelligent life safety devices suitable for the care sector, visit www.hochikieurope.com. To watch the panel discussion, head to www.youtube.com/hochikieurope

NIOSH offers coal miners free health screenings

In September 2021, the National Institute for Occupational Safety and Health (NIOSH) will offer a series of free, confidential health screenings to coal miners as part of the Coal Workers’ Health Surveillance Program (CWHSP). The screenings are intended to provide early detection of coal workers’ pneumoconiosis (CWP), also known as black lung, a serious but preventable occupational lung disease in coal miners caused by breathing respirable coal mine dust.

The health screenings are provided through the state-of-the-art NIOSH mobile testing units at convenient community and mine locations. This year’s screenings will be held from September 9 through September 24 in areas throughout southern West Virginia.

“Black lung disease can occur in miners who work in mines of all sizes,” said NIOSH Director John Howard, M.D. “Early detection of black lung disease allows underground, surface and contract miners to take the steps needed to keep it from progressing to severe lung disease.”

Screenings include a work history questionnaire, an x-ray, a respiratory assessment questionnaire, and blood pressure screening. The screenings typically take about 15 minutes and each individual miner is provided with their results. By law, each miner’s results are confidential. Individual medical information and test results are protected health information and not publicly disclosed. Spirometry, a common breathing test, will not be conducted during this year’s survey.

Participation in this program provides the coal miner:

  • An easy way of checking on their health
  • A confidential report regarding whether or not they have x-ray evidence of CWP

The NIOSH mobile health unit is considered a “healthcare setting” so COVID-19 prevention strategies will be followed.
Please watch for health screening locations, dates, and additional announcements on the CWHSP web pageCWHSP Facebook, and @NIOSHBreathe on Twitter.  Local and individual outreach will be done in all specific locations.  All coal miners – current, former, underground, surface, and those under contract – are welcome to participate.

New report finds gaps in preparedness for public health emergencies

The COVID-19 pandemic has starkly demonstrated that underinvestment in preparedness to respond to public health emergencies can cost hundreds of thousands of lives and wreak havoc on the economy. A new report released today by Trust for America’s Health (TFAH) measured states’ performance on 10 key emergency preparedness indicators and found room for improvement in every jurisdiction.

The report, Ready or Not 2021: Protecting the Public’s Health from Diseases, Disasters and Bioterrorism measured states’ readiness for health emergencies of any kind (not just the COVID-19 crisis). It placed 20 states and the District of Columbia in a high level of preparedness category, 15 states in a middle preparation tier and 15 states in a low degree of preparation tier. 

State performance, by scoring tier, 2020

Performance TierStatesNumber of States
High TierCO, CT, DC, DE, GA, ID,
KS, MA, MD, ME, MS, NC,
NE, NM, OK, RI, UT, VA,
VT, WA, WI
20 states and DC
Middle TierAL, CA, FL, IA, IL, KY, LA,
MI, MN, MT, ND, NJ, OR,
TN, TX
15 states
Low TierAK, AR, AZ, HI, IN, MO,
NH, NV, NY, OH, PA, SC,
SD, WV, WY
15 states

For nearly two decades, TFAH has examined the nation’s public health emergency preparedness in this annual report. During that time, all states have made improvements in their emergency preparedness, but all continue to have room for additional strengthening of their public health preparedness and emergency response.

“The importance of this report is that it gives states actionable data to adopt policies that save lives. The COVID-19 crisis shows that we have much more work to do to protect Americans from health threats, particularly in the ways in which structural racism create and exacerbate health risks within communities of color,” said John Auerbach, President and CEO of Trust for America’s Health. “States need to take aggressive steps to shore up their preparedness for all types of public health emergencies.”

While the report’s findings are not a measure of any state’s COVID-19 response, they demonstrate that while states’ readiness is important, national health emergencies on the scale of a pandemic require strong federal leadership and coordination, and long-term investment in public health infrastructure and workforce. States alone, even those that rank high in this report, are not sufficiently equipped to respond to a pandemic without federal help, say the report’s authors.

The report found:

A majority of states have made preparations to expand healthcare and public health capabilities in an emergency, often through collaboration. Thirty-four states participated in the Nurse Licensure Compact, up from 26 in 2017. The compact allows registered nurses and licensed practical or vocational nurses to practice in multiple jurisdictions with a single license.

In an emergency, this enables health officials to quickly increase their staffing levels. In addition, hospitals in most states have a high degree of participation in healthcare coalitions. On average, 89 percent of hospitals were in a coalition and 17 states and the District of Columbia had universal participation, meaning every hospital in the jurisdiction was part of a coalition. Such coalitions bring hospitals and other healthcare facilities together with emergency management and public health officials to plan for and respond to incidents. Every state and the District of Columbia had public health laboratories that had plans for a large influx of testing needs. This ability to surge laboratory testing capacity during the COVID-19 crisis was extremely critical.

Most states are accredited in the areas of public health, emergency management, or both. As of December 2020, the Public Health Accreditation Board (PHAB) or the Emergency Management Accreditation Program (EMAP) accredited 42 states and the District of Columbia; 29 states and the District of Columbia were accredited by both groups, a net increase of one since November 2019. Both programs help ensure that necessary emergency preparation and response systems are in place and staffed by qualified personnel.

Seasonal flu vaccination rates, while still too low, have risen significantly. The seasonal flu vaccination rate among Americans ages 6 months or older rose from 42 percent during the 2017–2018 season to 52 percent during the 2019–2020 season but is still below the 70 percent target vaccination rate set by Healthy People 2030.  

In 2019, only 55 percent of employed state residents, on average, used paid time off, the same percentage as in 2018. Those without paid leave are more likely to work when they are sick and risk spreading infection. This became particularly relevant during the COVID-19 pandemic, as isolation and quarantine are important tools for controlling the outbreak.

Most residents who got their household water through a community water system had access to safe water. On average, just 5 percent of state residents used a community water system in 2019 that did not meet all applicable health-based standards.

The report includes recommendations for actions by federal and state policymakers to improve the nation’s public health emergency preparedness in seven priority areas:

  • Provide stable, sufficient funding for domestic and global public health security.
  • Strengthen policies and systems to prevent and respond to outbreaks and pandemics.
  • Build resilient communities and promote health equity generally and in preparedness.
  • Ensure effective public health leadership, coordination, and workforce.
  • Accelerate development and distribution, including last mile distribution, of medical countermeasures.
  • Strengthen the healthcare system’s ability to respond and recover during and from health emergencies.
  • Prepare for environmental threats and extreme weather.

The Ready or Not report series is funded by the Robert Wood Johnson Foundation with additional support from The California Endowment, W.K. Kellogg Foundation and The Kresge Foundation.