Using Closed PODs to Protect Critical Infrastructure

Download the full Closed POD Infographic

Download the full Closed POD Infographic

Sara Dinga, Public Health Emergency Response Coordinator at the Washoe County Health District (NV), is working to better prepare Washoe County for a pandemic through the use of closed Points of Dispensing (PODs) which target vital services employees. Closed PODs are defined as public and private locations that have agreed to dispense medications, generally during a public health emergency, to the people that work or reside there.

Aiming to establish closed POD Memorandums of Understanding (MOUs) with community providers, Dinga narrowed down from a long list of potential partners. She first identified those partners that fell within the critical infrastructure sectors as defined by the 2013 National Infrastructure Protection Plan. That group of providers was then divided into two groups: providers who could dispense medication in a public health emergency and those who could both dispense medication and administer vaccine. Washoe County Health District ultimately partnered with three local hospitals, one skilled nursing facility, three regional fire agencies, one Emergency Medical Services provider, and other large employers.

MOUs in place, Washoe County Health District turned its focus to its non-healthcare vital systems. The Health District collaborated with the skilled nursing facility to extend vaccination and medical countermeasures coverage to vital systems employees. In the case of a POD deployment, the skilled nursing facility has agreed to deploy nurse strike teams to local power and water companies. While the utility companies would be responsible for prioritizing their employees for vaccination, strike teams will also provide vaccine to employees’ families, if enough is available.

Additionally, each Washoe County fire agency has put plans in place to extend vaccination and medical countermeasures to local law enforcement and emergency management staff critical to emergency operations. To increase the effectiveness of these plans, the Health District has provided training to 280 intermediate and advanced EMT firefighters in POD operations and the provision of influenza vaccine.

As to the benefits of partnering with critical infrastructure facilities, Dinga says, “In any emergency, our first priority is to prevent loss of life, and by protecting the health and safety of our critical infrastructure employees, continuity of operations is more likely to occur, resulting in less social disruption and [more] lives saved.”

Washoe County Health District faced minimal hurdles in establishing closed POD MOUs. Dinga attributes this to a “triple-win” situation for all involved. Dinga estimates that, during a pandemic, closed PODS will divert up to 70,000 people from the limited number of public PODs opened by the Health District, benefiting the healthcare system and the community, while closed POD partners will receive POD planning training and technical assistance. During a pandemic, POD partners will also be able to prioritize their employees, decreasing employee time to treatment.

Dinga outlined several best practices for successful partnerships with both healthcare providers and critical infrastructure facilities:

  • Work to incorporate common goals and articulate goals and objectives clearly.
  • Listen actively to individual partner needs, and address those needs. For example, the Health District understands that each partner may be at a different stage of the planning process, thereby tailoring training and other technical assistance needs to each agency.
  • Ask for input from partners on a regular basis. While the Health District may lead the POD planning process, it is understood that our community partners equally contribute to this process. This assists in creating buy-in from all partners.
  • Develop high levels of trust and respect. Health District employees understand they will need to rely on community partners in the event of a public health emergency. We cannot effectively respond to a public health emergency alone – and our partners cannot either. We understand the importance of collaboration.

Sharing best practices for closed POD implementation is important, as so many local health departments have incorporated closed PODs into their preparedness planning: NACCHO and the Association of State and Territorial Health Offi­cials (ASTHO) recently surveyed 358 entities, including states, directly-funded cities, territorial health agencies, and local emergency medical countermeasure planners, to examine planning efforts for closed PODs — specifically partnership outreach and implementation challenges. The survey found that 86 percent of surveyed health agencies have closed POD agreements. Download the full report from NACCHO’s Bookstore.

For more resources on closed PODs, check out:

We are interested to learn about your health departments’ efforts to implement closed PODs. Let us know your thoughts in the comment box below.

Special thanks to Sara Dinga, Public Health Emergency Response Coordinator, Washoe County Health District for contributing to this article.

About Erin Roberts

Erin Roberts, MPH, is a Program Analyst on the Environmental Health, Pandemic Preparedness, and Catastrophic Response team at NACCHO. Her work includes broadening the public's access to medical countermeasures during a severe pandemic, fostering collaboration between public health and pharmacy, and contributing to NACCHO's food safety initiatives.

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