EBOLA UPDATE: Looted Quarantine Center Raises Fears of Ebola’s Spread
(NewPublicHealth is monitoring the public health crisis in West Africa.)
The raid by residents of an Ebola quarantine center in Liberia this weekend sent potentially infected patients fleeing and has raised very serious concerns over spreading the outbreak throughout West Point, Monrovia. Looters—apparently angry that patients were brought to the holding center from other parts of Monrovia—were seen taking items that were visibly stained with blood, vomit and excrement, all of which can spread the Ebola virus. The Washington Post reports that there have been talks about quarantining the entire township if needed. Read more on Ebola.
Study: Mothers in Poorer Health Less Likely to Breastfeed
Mothers who are in poorer health are also less likely to breastfeed their infant children, according to a new study in the journal PLOS ONE. Researchers from the School of Public Health at the University of Minnesota determined that women who are obese, have diabetes or have hypertension were 30 percent less likely to intend to breastfeed than were mothers without health complications. “Statistically we’re seeing an increase in breastfeeding in the U.S., which is great news. Unfortunately, at the same time, rates of obesity and other health problems are increasing. More than a million women each year enter pregnancy with a health problem, and our study shows that these mothers were less likely to plan to breastfeed,” said Katy Kozhimannil, PhD, lead author of the study and assistant professor at the university, in a release. “This is troubling because the families with social and medical risk factors are often those who stand to gain the most benefits from breastfeeding.” Read more on maternal and infant health.
Study: HPV Vaccine Still Effective After Eight Years
The human papillomavirus (HPV) vaccine appears to remain effective at protecting against the sexually transmitted virus for at least eight years, according to a new study in the journal Pediatrics. Researchers randomly assigned 1,781 sexually inactive boys and girls ages 9-15 to either the HPV vaccine or placebo shots, finding that those who received the vaccine still had antibodies against HPV after eight years. “The body's response against HPV by making antibodies looks very good at eight years, and it seems like no booster doses will be necessary," said lead researcher Daron Ferris, MD, director of the HPV epidemiology and prevention program at Georgia Regents University in Atlanta, according to HealthDay. "These are all indications that the vaccine is safe, and it looks like it's effective in preventing genital warts and other diseases caused by HPV.” Read more on vaccines.
The worst Ebola outbreak in history has now claimed 1,145 lives, according to the World Health Organization (WHO). In the two days to August 13, 76 people died and there were 152 confirmed, probable and suspected new cases in Guinea, Liberia, Nigeria and Sierra Leone. NewPublicHealth has been following the outbreak in West Africa closely. You can read our ongoing coverage of the Ebola epidemic here. Below is a look at the latest news on the outbreak:
- While stating its belief that the magnitude of the outbreak has been “vastly” underestimated, WHO continues to partner with individual countries, disease control agencies, agencies within the United Nations system and other organizations to combat the Ebola epidemic. “Practical on-the-ground intelligence is the backbone of a coordinated response,” the global health organization said in an update, noting that the U.S. Centers for Disease Control and Prevention (CDC) is providing computer hardware and software that should enable real-time reporting and analysis. The World Food Programme is also delivering food to the more than one million people living in quarantine zones; the food shortage has been compared to a “wartime” situation.
- The medical charity Médecins Sans Frontières (MSF) estimates that it will take public health officials at least six months to bring the Ebola outbreak under control. "In terms of timeline, we're not talking in terms of weeks, we're talking in terms of months,” said MSF President Joanne Lui, according to the BBC. “We need a commitment for months, at least I would say six months, and I'm being, I would say, very optimistic."
- Kent Brantly, MD, one of two U.S. aid workers infected in Liberia who received an experimental Ebola treatment, continues to improve and hopes to be “released sometime in the near future.” He is being treated at Emory University Hospital in Atlanta, Ga. The family of Nancy Writebol, a missionary from Charlotte, N.C., said she also continues to improve and doctors remain optimistic.
- The U.S. Department of State has ordered family members of staff members at the U.S. embassy in Freetown, Sierra Leone, to evacuate the country, announcing the order as part of reconfiguring of resources to better respond to the Ebola outbreak. The order stated: “We remain deeply committed to supporting Sierra Leone and regional and international efforts to strengthen the capacity of the country’s health care infrastructure and system—specifically, the capacity to contain and control the transmission of the Ebola virus, and deliver health care.”
HHS: $250M to Expand Access to High-Quality Preschools
The U.S. Department of Health and Human Services (HHS) has announced that applications are now available for the $250 million Preschool Development Grants competition, which was established to build, develop and expand voluntary, high-quality preschool programs in high-need communities for children from low- and moderate-income families. “When we invest in early education, the benefits can last a lifetime,” said HHS Secretary Sylvia M. Burwell, in a release. “Children who attend high-quality early learning and preschool programs are more likely to do well in school and secure good jobs down the road. We all gain when our country has a stronger, more productive workforce, lower crime rates, and less need for public assistance. These Preschool Development Grants will help put more children on the path to opportunity.” Read more on education.
Study: Three Common Respiratory Illnesses Linked to Higher Risk of Lung Cancer
Chronic bronchitis, emphysema and pneumonia are all tied to an increased risk of lung cancer, according to a new study in the American Journal of Respiratory and Critical Care Medicine. Researchers analyzed data on more than 250,000 people, concluding that the reason for the increased risk could relate to underlying disease mechanisms. They also said that a better understanding of the respiratory diseases could affect how doctors monitor and help patients. Read more on prevention.
FDA: More Data Needed on Painkiller’s Abuse-Deterrent Capability
The U.S. Food and Drug Administration (FDA) has requested additional study and information to determine the effectiveness of an abuse-deterrent capability in an experimental painkiller. Acura Pharmaceuticals states that its drug, which contains the common painkillers hydrocodone bitartrate and acetaminophen, cannot be abused by snorting. The drug is designed to cause a burning sensation when snorted or form a gelatinous mixture when prepared for injection. However, the drug failed in a mid-stage trial to show a statistically significant likelihood of reducing abuse. Read more on substance abuse.
If you’re reading this, then YOU can prevent wildfires. Also forest fires.
Both are indelible messages from Smokey Bear—an icon of public health and a friendly face from everyone’s childhood—who is celebrating his 70th birthday. Born August 9, 1944, the creation of the U.S. Forest Service and the Ad Council has over the decades become the center of the longest-running PSA campaign in U.S. history.
As part of the birthday celebration, the U.S. Forest Service and the National Association of State Foresters have launched a new round of PSAs featuring outdoor enthusiasts thanking Smokey for his years of work.
Since the campaign’s launch in 1944, the average number of acres burned by wildfires has decreased from 22 million to 6.7 million. However, they still remain one of the country’s most critical environmental issues—as well as one of its most misunderstood. While many people believe that lightning is the cause of most wildfires, the reality is the vast majority—9 out of 10—are manmade. The causes range from unattended campfires and burning debris on a windy day to improperly discarded smoking materials and operating equipment without spark arrestors.
EBOLA UPDATE: 55 CDC Workers Now on the Ground in West Africa
(NewPublicHealth is monitoring the public health crisis in West Africa.)
There are now 55 disease detectives and other experts from the U.S. Centers for Disease Control and Prevention (CDC) on the ground in West Africa in response to the ongoing Ebola outbreak. All told, more than 350 CDC U.S. staff are working around the clock on logistics, communications, analytics, management and other support functions. “We are fulfilling our promise to the people of West Africa, Americans, and the world, that CDC would quickly ramp up its efforts to help bring the worst Ebola outbreak in history under control,” said CDC Director Tom Frieden, MD, MPH. “We know how to stop Ebola. It won’t be easy or fast, but working together with our U.S. and international partners and country leadership, together we are doing it.” Read more on Ebola.
Three Studies Offer Differing Takes on Extremely-Low Salt Diets
Two new studies in the New England Journal of Medicine are calling into question the conventional wisdom that as little sodium as possible is always the ideal. The first study found that extremely low-salt diets may not be as beneficial as believed—and may even be dangerous—and the second found that people with moderate salt intake don’t benefit from reductions as much as people who consume higher amounts of salt. "Previously it was believed that the lower you go the better. What these studies show collectively is that there is an optimal level, and lower is not necessarily better," Andrew Mente, MD, of McMaster University in Hamilton, Ontario, chief author of the blood pressure study, according to Reuters. However, a third study also published in the journal found a direct link between less salt and better health, and no evidence to indicate that extremely-low sodium levels were dangerous. Read more on nutrition.
SAMHSA: States Meeting Goals for Reducing Tobacco Sales to Minors
All states and the District of Columbia continue to meet their goals of preventing tobacco sales to people under the age of 18, according to a new report from the Substance Abuse and Mental Health Services Administration (SAMHSA). The report found that only 9.6 percent of inspected retail outlets illegally sold tobacco products to minors in 2013, below the goal of 20 percent set by the Synar Amendment program. The rate was as high as 72.7 percent only 16 years ago. “Tobacco use is still the nation’s leading cause of preventable death. We must do everything we can to deter minors from buying tobacco products,” said Frances Harding, director of SAMHSA’s Center for Substance Abuse Prevention. “For the past 17 years, the Synar program has made a real difference in lowering the levels of illegal tobacco sales to minors across the nation. However, everyone in the community must continue to work together in eliminating these illegal sales.” Read more on tobacco.
This week, David Fleming, MD, MPH, stepped down as public health director of Seattle and King County in Washington State after seven years leading the public health agency. Over that period, among many other accomplishments, he led the department’s efforts to sign up more than 165,000 residents under the Affordable Care Act and oversaw a 17 percent drop in obesity rates in partnering schools.
NewPublicHealth spoke with Fleming about his views on the mission of public health.
NPH: How has public health changed since you began your career?
David Fleming: The mission of public health has not changed—and that's to prevent unnecessary illness and death—but what has been changing is what the nature of that prevention is. Increasingly, it is in chronic diseases, injuries and, importantly, the driving force of underlying social determinants of health. So public health has changed from being more of a direct service agency where we have frontline public health workers who are out there providing treatment to people and preventing infectious diseases, to really more of a collaborative kind of agency where we need to be working with a wide range of partners outside of the traditional domains of public health to help them implement the changes that need to happen. It's a fundamental shift, I think, in the business model of public health that we're in the process of witnessing today.
NPH: When you point to some of the achievements that you've had, whether they're specific changes in the state or specific models of examples that you've given to other states, what would you point to?
Fleming: First off, I think it's important to say that public health is a team sport, and so when I talk about accomplishments, I'm talking about accomplishments of the department in which I work on this and the staff that work here. I think that we have been successful at pivoting to that future that we were talking about a moment ago, at looking at how health departments can attack the underlying social determinants of health.
Increasingly, it is health disparities that are driving poor health in this country. We have been successful here in beginning to figure out how to partner with other sectors—the education sector to reduce obesity in our poorest school districts, for example. We’ve also worked with the community development sector to begin making investments in our poorest neighborhoods to increase the healthiness of our communities, so that people who live in them can be healthy, as well. At the end of the day, I think that we have been trying to lead this new path where public health is a partner in communities with all of the other entities that are capable of influencing health and figuring out how to make that happen.
EBOLA UPDATE: Canada to Donate Experimental Drug for Ebola Treatment
(NewPublicHealth is monitoring the public health crisis in West Africa.)
Canada announced late yesterday that it will donate 800 to 1,000 doses of its experimental Ebola vaccine for the World Health Organization (WHO) to use in West Africa. WHO declared yesterday that it was ethical to use untested drugs to combat the Ebola outbreak. "We see this as a global resource, something we need to put on the global table to say...how can we make best use of this asset? We're looking to do that as fast as we can,” said Greg Taylor, MD, deputy chief public health officer of the Public Health Agency of Canada, according to Reuters. Read more on Ebola.
CDC: 40 Percent of Americans Will Develop Diabetes
An estimated 40 percent of Americans will develop diabetes at some point in their lives, according to a new study in The Lancet Diabetes & Endocrinology. Researchers from the U.S. Centers for Disease Control and Prevention analyzed data on 598,216 adults from 1985 to 2011, finding that the increase in the diagnosis of diabetes and overall declining mortality means that people are also living longer with diabetes; years spent with diabetes increased by 156 percent in men and 70 percent in women. Researchers said the findings demonstrate a need for effective interventions to reduce the incidence of diabetes. Read more on diabetes.
FDA Approves Device that Could Increase the Number of Transplantable Lungs
The U.S. Food and Drug Administration (FDA) has approved a new device to preserve donated lungs that do not initially meet the standards for transplantation, but that might be transplantable given more time to evaluate their viability. Only approximately one in five donated lungs meet transplantation criteria. There were 1,754 lung transplants in the United States in 2012, with 1,616 potential patients remaining on the recipient list at the end of the year. “This innovative device addresses a critical public health need,” said Christy Foreman, director of the Office of Device Evaluation at the FDA’s Center for Devices and Radiological Health. “With this approval, there may be more lungs available for transplant, which could allow more people with end stage lung disease who have exhausted all other treatment options to be able to receive a lung transplant.” Read more on technology.
Better communication means better patient engagement, and better patient engagement means better health outcomes. Understanding this, Sense Health has developed an app to promote interactive, text-message-based communications between health care professionals and high-needs patients. Stan Berkow, CEO of the New York City-based company, said in a recent interview with AlleyWatch that the focus thus far has been on Medicaid patients with chronic conditions because they represent “an underserved population with a huge unmet need both considering the human element as well as the cost-burden.”
The app allows providers to create message-based conversations tailored to the particular needs of their patients. In a two-month randomized control trial with Montefiore Medical Center, which included 67 high-needs patients and 15 care managers, providers saw a 40 percent increase in self-reported patient adherence to appointments, a 12 percent increase in adherence to medications and a 7 percent increase in adherence to care plan goals.
“Our business is built on our belief that it is not only possible, but essential to personalize healthcare through the use of technology,” said Berkow. “The prevention and management of chronic health conditions requires behavior change, something that technology alone cannot provide. Sense Health is amongst those who realize that technology in health works best when there is a human touch behind the system and patients feel supported by their providers.”
The company recently joined the New York Digital Health Accelerator, which offers up to $100,000 in funding to companies engaged in developing digital health solutions. The accelerator is run by the Partnership Fund for New York City and the New York eHealth Collaborative.
Read the full interview at AlleyWatch.
EBOLA UPDATE: Death Toll at 1,013 as Two More Doctors are Set to Receive an Experimental Treatment
(NewPublicHealth is monitoring the public health crisis in West Africa.)
Two more Ebola-infected doctors are set to receive the experimental ZMapp drug that was given to two American health workers and a Spanish priest. The Americans continue to receive treatment in an Atlanta hospital, while the 75-year-old missionary died early this morning. The death toll of the West African outbreak—the largest Ebola outbreak in history—now stands at 1,013, according to the World Health Organization. Read more on Ebola.
FDA Approves New Colorectal Screening Test
The U.S. Food and Drug Administration (FDA) has approved the first stool-based colorectal screening test to identify cancers such as colon cancer or precursors to cancer. The test can detect red blood cells and DNA mutations that can indicate certain types of abnormal growths. Colorectal cancer is the third most common cancer among those that affect both men and women, and regular screening tests for all people ages 50 and older could reduce related deaths by at least 60 percent, according to the U.S. Centers for Disease Control and Prevention. “This approval offers patients and physicians another option to screen for colorectal cancer,” said Alberto Gutierrez, PhD, director of the Office of In Vitro Diagnostics and Radiological Health at the FDA’s Center for Devices and Radiological Health, in a release. “Fecal blood testing is a well-established screening tool and the clinical data showed that the test detected more cancers than a commonly used fecal occult test.” Read more on cancer.
Study: Women, Blacks Affected Most by Heart Disease and Stroke
Women and African-Americans are affected the most by chronic diseases linked to increased risk of heart attack or stroke, according to a new population-based study in the journal Circulation. Researchers analyzed the five major risk factors for heart disease—high cholesterol, smoking, high blood pressure, obesity and diabetes—in more than 13,500 Americans from 1987 to 1998, finding that while the combined risk for women dropped from 68 percent to 58 percent, it was still higher than the risk for men, which dropped from 51 percent to 48 percent. The study also found that diabetes more than doubled the risk of heart disease for African-Americans when compared to whites—28 percent versus 13 percent. Researchers said the difference could be because heart disease has been traditionally viewed as a disease of white men, affecting how it is treated. Read more on health disparities.
Vital Healthcare Capital (V-Cap) and the Robert Wood Johnson Foundation (RWJF) have announced a $10 million investment in Commonwealth Care Alliance (CCA), based in Boston, Mass., to help fund the organization as it rapidly expands its model of care for patients who are dually eligible for Medicare and Medicaid.
The non-profit care delivery system provides integrated health care and related social support services for people with complex health care needs covered under Medicaid and for those eligible for both Medicaid and Medicare. CCA’s expansion comes as Massachusetts continues to pioneer integrated, patient-centered care for people who are eligible for both Medicare and Medicaid though the newly created “One Care: MassHealth plus Medicare” program, one of several financial alignment initiatives for people with dual eligibility established by the Affordable Care Act (ACA) that are launching nationwide.
The loan—the first to be made by Vital Healthcare Capital, a new social impact fund based in Boston, through support from RWJF—provides funds needed by CCA for financial reserves required by the Commonwealth of Massachusetts as the agency expands the number of beneficiaries in its programs.
According to CCA Director Robert Master, the social impact goals are to:
- Scale a person-centered integrated care model for high-needs populations.
- Demonstrate what are known in public health as “triple aim” outcomes in health status, care metrics and cost effectiveness.
- Train, develop and create frontline health care workforce jobs, including health aides, drivers and translators.
- Create innovations in health care workforce engagement in coordinated care plans to better integrate into the care plan the staff members who most directly touch the lives of its members.
Over the next five years, Vital Healthcare Capital plans to establish a $100 million revolving loan fund, leveraging $500 million of total project capital for organizations working on health care reform for patients in low-income communities.
NewPublicHealth recently spoke with Steven Weingarten, CEO of Vital Healthcare Capital, about the inaugural loan and the firm’s expansion plans going forward.
NewPublicHealth: How did Vital Healthcare Capital get started and what are its overarching goals and investment criteria?
Steven Weingarten: Vital Healthcare Capital has been formed as a new non-profit financing organization to invest in quality health care and good health care jobs in low-income communities. The organization came about after a couple of years of research and development with funding from the Robert Wood Johnson Foundation, as well as from the Ford and Rockefeller Foundations and support from SEIU, the health care union. Healthcare reform is really part of a broader restructuring of health care that has enormous implications for low-income communities, and for the health care providers and plans that have been focused on these communities. Having financial capital to be able to transform health care to a better delivery model will be a critical challenge in upcoming years. So we are coming in to serve that need.