Preparing for the worst

Surrounded by binders full of plans and standard operating procedures, Brown County Public Health Emergency Preparedness Coordinator Corey Frost sits in his office.
Surrounded by binders full of plans and standard operating procedures, Brown County Public Health Emergency Preparedness Coordinator Corey Frost sits in his office.

Seven months into his job as Brown County’s public health emergency preparedness coordinator, Corey Frost is loving what he does.

He likes being prepared, he said. “Though, I hope it’s not needed.”

Connected with the federal Centers for Disease Control and Prevention, Frost is the one to make certain his community is ready to deal with both accidental and intentional threats, ranging from infectious epidemics to chemical, nuclear and even radiological threats.

He dedicates almost 10 hours each week just to keeping emergency plans and procedures current with constantly evolving guidance from the state and federal governments.

“I would say that was probably the most surprising thing, was how flexible you had to be,” he said.

In the next few weeks, he will be heading to Indianapolis to discuss plans for a point of dispensing simulation, or PoD.

As a “donut” county, Brown County is part of the CDC’s City Readiness Initiative, designed to coordinate the response to public health emergencies around major population centers.

In the City Readiness Initiative, Brown County is considered an area that could be affected by an emergency such as a bioterrorism attack or major outbreak in Indianapolis.

Typically, a point of dispensing is a location where the health department and volunteers provide lifesaving medication such as antibiotics in response to a large-scale public health threat.

A PoD can be activated to distribute almost anything needed to address a health threat, even fresh water, Frost said.

When to respond

A public health emergency could be any large-scale threat that is treatable from the Strategic National Stockpile. That’s the federal government’s stash of vaccines, antibiotics, chemical antidotes and antitoxins.

Frost’s job is to prepare and to be aware of emerging and existing threats — like a spread of swine flu in other areas of the country and state, or the presence of dangerous chemical agents in the local area.

The most recent PoD exercise, conducted March 15 at the Parkview Church of the Nazarene, simulated an outbreak of tularemia.

Tularemia is a potentially lethal bacterial infection typically passed to humans from rabbits and rodents through skin contact, or through biting insects such as deer flies and ticks.

During the exercise, the participants dealt with a scenario in which tularemia had been turned into an aerosol and used in a bioterrorism attack.

An intentional threat would not have to be a complicated international plot, said Brown County Public Health nurse Toni Warburton.

If a person decided to crop-dust the fairgrounds with toxins when it’s full of people during fair week, a PoD would need to be set up, she said.

Planning for worst

Frost is the kind of person whose mind constantly runs.He has a degree in project management and spent 12 years in the Carmel area working as a geotechnical engineer — a branch of civil engineering dealing with the behavior of earth materials.Though he had grown up as a “military brat,” living in the Panama Canal area and Germany, Frost’s grandparents owned a home in Brown County, and his heart was always there.

About four years ago, he moved here, taking a job with the county maintenance department to make ends meet. It helped lead him to this job.

“It almost feels like a calling at this point,” Frost said. “I feel like the more that I learn, the more trained that I am, the more we’re going to be happy that I’m in this position.

“And I feel like I will be giving back to the community,” Frost said. “As a public servant, I feel like this is probably right where I should be.”

Technically, the job is for 25 hours a week. But tasked with understanding and planning for the worst possible scenarios, he’s often taking home more than just paperwork.

“The best solution for me, to putting stuff out of my head, is when I get home and my 2-year-old wants to play,” he said.

As much as he does not want to ever have to set up a PoD in real life, Frost said he enjoyed the most recent preparedness exercise he oversaw in Brown County, about a tularemia outbreak.

Employees of county offices completely unrelated to public health assisted with the March 15 exercise. In an actual emergency, they would likely be needed to fill non-medical roles.

Frost would like to get more of those county employees familiar with the Incident Command System — a national standard that guides response to large-scale emergencies.

When a real emergency happens, he doesn’t want the people dropped into those jobs to learn that they have questions for the first time.

“If something ever does happen, we need to understand why we’re doing each of these roles and how it affects the other,” he said.

Organizing aid

Though their jobs sprout from separate federal entities — the CDC and the Federal Emergency Management Agency — a large-scale public health threat here will require close communication between Frost and Brown County County Emergency Management Agency Director Sara Vasquez.“If I have to initiate PoD, one of the first people I’m calling is Sara,” Frost said.While volunteers and health workers are implementing Frost’s plan, potentially treating over 100 patients an hour at a PoD, Vasquez could be responsible for calling in additional help for other parts of the emergency response, such as security and cleanup.

Brown County has particular challenges, including a shortage of local health care workers to serve as the county’s medical reserve corps, Frost said.

Maintaining and filling up the volunteer management system — a registry of people available to assist in an emergency — is a daunting task, he said.

When actual PoDs were set up during concerns over swine flu, the health department pulled nurses from Brown County Health and Living and the high school to assist them, Warburton said. Beginning with pregnant women and children, hundreds of people passed through PoDs at the County Office Building and the high school.

Yet, not all volunteers have to have medical training, Warburton said. Others may be called on to help people fill out paperwork or park vehicles.

There’s always a need for more help, Frost said. Anyone interested can call the Brown County Health Department at 812-988-2255 to learn what roles need to be filled.

Ben Kibbey is a Brown County transplant from the cornfields of central Ohio. He covers county government, business, outdoors, sports and general news.