More training, better understanding key to management of biological outbreak

As the director for the Center for Disaster Medical Preparedness at the University of California, Irvine (UCI) and an emergency physician, Dr. Kristi Koenig has experience in emergency medicine and reacting quickly in a public health emergency.

“Although (UCI's) resources are stretched, I think we are prepared [for a biological outbreak like Ebola or an attack, like anthrax,]” Koenig said in a recent interview with 

In a public health emergency, response comes in multiple stages. First, there’s the need for a comprehensive emergency management plan; mitigation of potential risks; preparation; and when the public health threat occurs, there’s the response and recovery.

There are several components that would help immensely in improving responses to public health and emergency response situations, Koenig said. They include increasing the understanding of different areas of emergency response, establishment of clear preparation and response protocols, and training on how to make difficult decisions in public health emergencies such as an outbreak of Ebola.

“It’s important to remember that these events are global in nature,” Koenig said. “The big threats are emerging infectious diseases and these diseases are changing.”

Koenig is also a member of the American College of Emergency Physicians (ACEP) Ebola Expert Panel, and a guest editor of the Disaster Medical and Public Health Preparedness Journal’s Ebola issue.

To manage the unknowns, Koenig said it’s important to define strict incident management protocols and coordination efforts. It is also important to create better understanding between policymakers and those responding to public health threats.

“The people on the front lines don’t understand how policymaking works, and the policymakers don’t understand what is happening on the ground,” Koenig said. “We also need training for decision-makers, to make sure that those people are comfortable making these decisions.”

Koenig said there are things that the public health and medical communities can do to improve their response, though. The medical community could use more education about public health situations, where it is important to look at a population and how things are occurring, instead of one patient at a time; the government could provide more education and training opportunities for the public health and medical communities, as well as more funding for training, Koenig said.

“People are so busy with the day-to-day that their time isn’t allocated to allow for preparation training,” Koenig said.