Crystal Franco

University of Pittsburgh, Pittsburgh, Pennsylvania, United States

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Publications (35)63.6 Total impact

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    ABSTRACT: This article reviews the history and structure of the National Disaster Medical System (NDMS), with an emphasis on its definitive care component. NDMS's capacity to handle very large mass casualty events, such as those included in the National Planning Scenarios, is examined. Following Hurricane Katrina, Congress called for a reevaluation of NDMS. In that context, we make three key suggestions to improve NDMS's capacity to respond to large mass casualty disasters: (1) increase the level of engagement by the private (i.e., nonfederal) healthcare system in preparedness and response efforts; (2) increase the reliance on regional hospital collaborative networks as part of the backbone of the NDMS system; and (3) develop additional, alternative patient transportation systems, linked to the overall NDMS patient tracking effort, to decrease the sole reliance on DoD long-haul air transport in medical evacuation.
    Biosecurity and Bioterrorism 01/2008; 5(4):319-25. · 1.94 Impact Factor
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    Eric Toner, Richard Waldhorn, Crystal Franco
    Biosecurity and Bioterrorism 10/2007; 5(3):192-3. · 1.94 Impact Factor
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    Biosecurity and Bioterrorism 07/2007; 5(2):180-5. · 1.94 Impact Factor
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    Crystal Franco, Shana Deitch
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    ABSTRACT: Since 2001, the U.S. government has spent substantial resources on preparing the nation against a bioterrorist attack. Earlier articles in this series analyzed civilian biodefense funding by the federal government from fiscal years 2001 through 2007. This article updates those figures with budgeted amounts for fiscal year 2008, specifically analyzing the budgets and allocations for biodefense at the Department of Health and Human Services, the Department of Homeland Security, the Department of Defense, the Department of Agriculture, the Environmental Protection Agency, the Department of State, and the National Science Foundation.
    Biosecurity and Bioterrorism 07/2007; 5(2):117-33. · 1.94 Impact Factor
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    ABSTRACT: This article describes issues related to the engagement of hospitals and other community partners in a coordinated regional healthcare preparedness and response effort. The report is based on interviews with public health and hospital representatives from 13 regions or states across the country. It aims to identify key ingredients for building successful regional partnerships for healthcare preparedness as well as critical challenges and policy and practical recommendations for their development and sustainability.
    Biosecurity and Bioterrorism 04/2007; 5(1):43-53. · 1.94 Impact Factor
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    ABSTRACT: Disasters and epidemics are immense and shocking disturbances that require the judgments and efforts of large numbers of people, not simply those who serve in an official capacity. This article reviews the Working Group on Community Engagement in Health Emergency Planning's recommendations to government decision makers on why and how to catalyze the civic infrastructure for an extreme health event. Community engagement--defined here as structured dialogue, joint problem solving, and collaborative action among formal authorities, citizens at-large, and local opinion leaders around a pressing public matter--can augment officials' abilities to govern in a crisis, improve application of communally held resources in a disaster or epidemic, and mitigate community wide losses. The case of limited medical options in an influenza pandemic serves to demonstrate the civic infrastructure's preparedness, response, and recovery capabilities and to illustrate how community engagement can improve pandemic contingency planning.
    Biosecurity and Bioterrorism 04/2007; 5(1):8-25. · 1.94 Impact Factor
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    ABSTRACT: This article examines the feasibility of allowing private industries such as grocery stores, wholesale clubs, and community immunizers to partner with public health authorities for the mass distribution of vaccines or antibiotics. Retail grocery and wholesale stores already have experience with annual influenza vaccination and may be a resource in a public health emergency, including a bioterrorist attack. This analysis suggests that retail store executives are willing to work with public health authorities to plan for and respond to public health emergencies.
    Biosecurity and Bioterrorism 02/2006; 4(2):176-82. · 1.94 Impact Factor
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    ABSTRACT: This article describes and analyzes key aspects of the medical response to Hurricane Katrina in New Orleans. It is based on interviews with individuals involved in the response and on analysis of published reports and news articles. Findings include: (1) federal, state, and local disaster plans did not include provisions for keeping hospitals functioning during a large-scale emergency; (2) the National Disaster Medical System (NDMS) was ill-prepared for providing medical care to patients who needed it; (3) there was no coordinated system for recruiting, deploying, and managing volunteers; and (4) many Gulf Coast residents were separated from their medical records. The article makes recommendations for improvement.
    Biosecurity and Bioterrorism 02/2006; 4(2):135-46. · 1.94 Impact Factor
  • Crystal Franco, Clarence Lam
    Biosecurity and Bioterrorism 02/2006; 4(2):97-8. · 1.94 Impact Factor
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    Clarence Lam, Crystal Franco, Ari Schuler
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    ABSTRACT: Since 2001, the United States government has spent substantial resources on preparing the nation against a bioterrorist attack. Earlier articles in this series analyzed the civilian biodefense funding by the federal government from fiscal years 2001 through 2006. This article updates those figures with budgeted amounts for fiscal year 2007, specifically analyzing the budgets and allocations for biodefense at the Department of Health and Human Services, the Department of Homeland Security, the Department of Agriculture, the Environmental Protection Agency, the Department of State, and the National Science Foundation.
    Biosecurity and Bioterrorism 02/2006; 4(2):113-27. · 1.94 Impact Factor
  • Biosecurity and Bioterrorism 02/2006; 4(2):207-17. · 1.94 Impact Factor
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    Biosecurity and Bioterrorism 02/2006; 4(3):313-9. · 1.94 Impact Factor
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    ABSTRACT: Atlantic Storm was a tabletop exercise simulating a series of bioterrorism attacks on the transatlantic community. The exercise occurred on January 14, 2005, in Washington, DC, and was organized and convened by the Center for Biosecurity of UPMC, the Center for Transatlantic Relations of Johns Hopkins University, and the Transatlantic Biosecurity Network. Atlantic Storm portrayed a summit meeting of presidents, prime ministers, and other international leaders from both sides of the Atlantic Ocean in which they responded to a campaign of bioterrorist attacks in several countries. The summit principals, who were all current or former senior government leaders, were challenged to address issues such as attaining situational awareness in the wake of a bioattack, coping with scarcity of critical medical resources such as vaccine, deciding how to manage the movement of people across borders, and communicating with their publics. Atlantic Storm illustrated that much might be done in advance to minimize the illness and death, as well as the social, economic, and political disruption, that could be caused by an international epidemic, be it natural or the result of a bioterrorist attack. These lessons are especially timely given the growing concerns over the possibility of an avian influenza pandemic that would require an international response. However, international leaders cannot create the necessary response systems in the midst of a crisis. Medical, public health, and diplomatic response systems and critical medical resources (e.g., medicines and vaccines) must be in place before a bioattack occurs or a pandemic emerges.
    Biosecurity and Bioterrorism 02/2005; 3(3):256-67. · 1.94 Impact Factor
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    ABSTRACT: 2006, the Center for Biosecurity of the University of Pittsburgh Medical Center convened a meeting of senior government officials, hospital leaders, clinicians, and public health officials on Hospital Pre-paredness for Pandemic Influenza in Baltimore, Mary-land. A list of meeting participants is provided in Appen-dix 1. Individual comments were not for attribution so as to foster a frank and open discussion. The purpose of the meeting was to examine ways the U.S. healthcare community, and especially hospitals, can prepare to care for the large number of patients that would be expected during an influenza pandemic. At the meeting, the group was asked to discuss the serious chal-lenges hospitals and communities will confront, to try to reach accord on what high-level solutions should be pur-sued, and to examine actions and next steps that the group or others might take to bring about such changes. To structure the meeting conversation, the staff of the Center for Biosecurity presented its initial assessment of the issues. The assessment was informed by analyzing pre-meeting discussions with the group and other gov-ernment and clinical leaders and by reviewing informa-tion from a broad range of government and industry re-ports and peer-reviewed literature. This meeting report synopsizes the presentations given at the meeting and the group's discussions. Initially, a vision of success in hospital preparedness was proposed: U.S. hospitals, individually and jointly, will be able to provide medical care for flu victims while maintaining other essential medical services in the community during and after a pandemic.
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    [Show abstract] [Hide abstract]
    ABSTRACT: Atlantic Storm was a tabletop exercise simulating a series of bioterrorism attacks on the transatlantic community. The exercise occurred on January 14, 2005, in Washington, DC, and was organized and convened by the Center for Biosecurity of UPMC, the Center for Transatlantic Relations of Johns Hopkins University, and the Transatlantic Biosecurity Network. Atlantic Storm portrayed a summit meeting of presidents, prime ministers, and other international leaders from both sides of the At- lantic Ocean in which they responded to a campaign of bioterrorist attacks in several countries. The summit principals, who were all current or former senior government leaders, were challenged to address issues such as attaining situational awareness in the wake of a bioattack, coping with scarcity of critical medical resources such as vaccine, deciding how to manage the movement of people across borders, and communicating with their publics. Atlantic Storm illustrated that much might be done in advance to minimize the illness and death, as well as the social, economic, and political disruption, that could be caused by an international epidemic, be it natural or the result of a bioterrorist attack. These lessons are especially timely given the growing concerns over the possibility of an avian in- fluenza pandemic that would require an international response. However, international leaders can- not create the necessary response systems in the midst of a crisis. Medical, public health, and diplo- matic response systems and critical medical resources (e.g., medicines and vaccines) must be in place before a bioattack occurs or a pandemic emerges.