1. PIHOA’s Career Epidemiology Field Officer Supporting Epidemiology Preparedness in the Pacific Islands
Thane Hancock MD MPH
Field Services Branch
Division of State and Local Readiness
Office of Public Health and Preparedness and Response
PIHOA Board Meeting
March 11, 2015
Office of Public Health Preparedness and Response
Division of State and Local Readiness

2. Thane Hancock: Background
Grew-up on the Big Island of Hawaii
Older adopted brother from neighboring islands of Yap (Ulithi)
Spent first summer on Ulithi at 14 years old
Education: Amherst College (BA Anthropology); University of Hawaii (MPH, MD. & Family Med)
Work: Yap ( ), CDC ( ), Yap ( )
Family: Married to a Yapese, one 2 year old son
February 2015, new USAPI Career Epidemiology Field Officer

3. Chief, Field Services Branch Division of State and Local Readiness
Career Epidemiology Field Officer Supporting Epidemiology Preparedness in the Pacific Islands
Randolph Daley, DVM, MPH
Captain, USPHS
Chief, Field Services Branch
Division of State and Local Readiness
PIHOA Board Meeting
August 12, 2014
Office of Public Health Preparedness and Response
Division of State and Local Readiness

4. Public Health Concerns in the Pacific
Diseases
Infectious — Measles, Chikungunya, Dengue, Leptospirosis, Hansen’s Disease, TB, Influenza
Chronic — Heart disease, Diabetes, Obesity, Cancer
Environmental Health
Natural disasters — Typhoons, Tsunamis
Food and water safety
Surveillance System Development
Population Movement
Human resources for health
Recent outbreaks: Measles, Chikungunya
Atypical diseases (US): Malaria, Dengue, Hansen’s Disease
Pandemic potential: influenza
Travelers from Asia can move freely into USPI; USPI residents can move freely into the US

5. Career Epidemiology Field Officer (CEFO) Program
Created in 2002 in response to attacks of 9/11
Mission — strengthen epidemiologic capability for public health preparedness and response
Assigns CDC epidemiologist to health departments
Funded through CDC’s Public Health Emergency Preparedness (PHEP) cooperative agreement
CDC created the Career Epidemiology Field Officer (CEFO) Program in 2002 in response to the attacks of September 11th and the subsequent anthrax incidents. The mission of the CEFO program is to strengthen state, local, tribal, and territorial epidemiologic capability for public health preparedness and response. The CEFO Program is dedicated to facilitating epidemiologic and scientific support of preparedness activities in state and local programs. To achieve this mission the program assigns a CEFO, a CDC staff epidemiologist, to a health department to strengthen epidemiologic capacity. CEFOs are funded through CDC’s Public Health Emergency Preparedness Cooperative Agreement to assist states in meeting PHEP Capability 13 (Public Health Surveillance and Epidemiologic Investigation)

6. CEFO Activities Strengthen local surveillance systems
Conduct outbreak investigations/response
Provide expertise on epidemiologic studies and community assessments
Support workforce development in epidemiology
Build partnerships for emergency preparedness
Serve on emergency response teams: including planning, exercises, and response activities
Examples of CEFO activities include
•• Strengthening state and local surveillance systems
•• Conducting outbreak investigations
•• Developing response plans for major public health emergencies
•• Building partnerships with government agencies and other organizations for emergency preparedness
•• Serving as liaisons to CDC and U.S. Department of Health and Human Services response teams
•• Leading portions of a state’s planning and response activities for pandemic influenza
•• Leading or participating in federal, state or local emergency response exercises
•• Providing expertise on the design, implementation, and analysis of epidemiologic studies

7. CEFO for the Pacific Islands Concept
Pacific Island Health Officers Association (PIHOA)
Regional approach
Concentration of CDC staff
Direct CDC funding
Pilot of alternative funding model
National health security
Collaborative direction

8. CEFO for the Pacific Islands Challenges
Multiple Jurisdictions
Assessment of risk and needs
Collaborative prioritization from PIHOA Board
Regional projects
Planned activities in all jurisdictions
Enhancement of jurisdictional staff
Travel
Dedicated funding
Collaboration with other CDC programs
Examples of CEFO activities include
•• Strengthening state and local surveillance systems
•• Conducting outbreak investigations
•• Developing response plans for major public health emergencies
•• Building partnerships with government agencies and other organizations for emergency preparedness
•• Serving as liaisons to CDC and U.S. Department of Health and Human Services response teams
•• Leading portions of a state’s planning and response activities for pandemic influenza
•• Leading or participating in federal, state or local emergency response exercises
•• Providing expertise on the design, implementation, and analysis of epidemiologic studies

9. CEFO for the Pacific Islands Opportunities
Experienced epidemiologist dedicated to the Pacific Islands
Crosscutting approach across multiple disease areas
Strengthen regional collaboration
Attract additional resources
Collaboration with regional partners
Enhanced communication with CDC
CDC fellowship programs
Build regional capacity in epidemiology
Examples of CEFO activities include
•• Strengthening state and local surveillance systems
•• Conducting outbreak investigations
•• Developing response plans for major public health emergencies
•• Building partnerships with government agencies and other organizations for emergency preparedness
•• Serving as liaisons to CDC and U.S. Department of Health and Human Services response teams
•• Leading portions of a state’s planning and response activities for pandemic influenza
•• Leading or participating in federal, state or local emergency response exercises
•• Providing expertise on the design, implementation, and analysis of epidemiologic studies

10. CEFO for the Pacific Islands Work Done in First Three Weeks
Supported an Environmental Health Team’s epidemiologic investigation into outbreak of foodborne illness
Facilitator for the upcoming epidemiology regional training workshop (DDM) in Guam
Connected health department with CDC subject matter experts to assist in an outbreak response
Linked CDC with members of Micronesian community to inform/improve outbreak response in the US
Heaps of Admin, including travel clearance…

11. CEFO for the Pacific Islands Work Plan Prioritization
Based on PIHOA board recommendations
Tailored for jurisdictional needs
Emphasis on building capability in epidemiology:
Systems improvement
Work force development
“Work yourself out of a job.”