Category Archives: Disasters
The Center for Public Health Readiness and Communication (CPHRC) at the Drexel University School of Public Health in Philadelphia recently re-launched DiversityPreparedness.org, a clearinghouse of resources and an information exchange portal to facilitate communication, networking and collaboration to improve preparedness, build resilience and eliminate disparities for culturally diverse communities across all phases of an emergency. The site had originally been developed by Dennis Andrulis, now at the Texas Health Institute, and Jonathan Purtle, who co-writes a blog on public health for the Philadelphia Inquirer.
- Read a previous NewPublicHealth interview with Dennis Andrulis
- Read a previous NewPublicHealth interview with Jonathan Purtle
NewPublicHealth recently spoke with Esther Chernak, MD, MPH, the head of CPHRC, about the re-launched site and her work in preparedness.
NewPublicHealth: Tell us a little bit about your background and how you came to lead the Center for Public Health Readiness and Communication.
Esther Chernak: I’m an infectious disease physician by training and pretty much have been working in public health since I finished my infectious disease fellowship in 1991 at the University of Pennsylvania. I started working in the Philadelphia Department of Public Health in its city clinic system doing HIV/AIDS care, and then became the Clinical Director of HIV Clinical Programs for the health centers back in the early ’90s when the epidemic was obviously very different. I then moved to working in infectious disease epidemiology as a staff doctor in the acute communicable disease control program and was involved in infectious disease surveillance and outbreak investigations for a number of years.
Then in 1999, I took a job with the City Health Department in what was then called bioterrorism preparedness. That was the time when major cities in the country were just beginning to be funded to do bioterrorism response plans. Groups that were involved in bioterrorism preparedness recognized relatively quickly that despite the fact that we were dealing with planning for novel strains of influenza and pandemic preparedness and SARS and smallpox, we were also dealing with many, many really significant infectious disease outbreaks, and then ultimately non-infectious disease related issues that had huge impacts on public health, such as earthquakes and hurricanes. Those links helped prepare me for my role at the Center.
The U.S. Food and Drug Administration (FDA) was a partner agency for last week’s Preparedness Summit in Atlanta. NewPublicHealth spoke with Brooke Courtney, Senior Regulatory Counsel in the FDA Office of Counterterrorism and Emerging Threats, about how the agency plans for disasters it hopes never occur. Previously, Courtney was the Preparedness Director at the Baltimore City Health Department and in that role oversaw all of the public health preparedness and response activities for Baltimore City.
NewPublicHealth: What did you speak about at the Summit last week?
Brooke Courtney: FDA views the summit as an unparalleled opportunity each year to engage with stakeholders at the state, local and federal levels—to share with them updates from the federal side and also for us to get feedback from them about challenges and successes. We engage with stakeholders on a regular basis, but this is really the meeting where the largest number of people involved in preparedness come together, and it’s a great opportunity to see people face-to-face.
We feel really fortunate to have been able to take part in the summit for the past few years. For this year’s summit FDA served on the Planning Committee and also participated in the medical countermeasure policy town hall with federal colleagues from the Office of the Assistant Secretary for Preparedness and Response, the U.S. Department of Homeland Security and the national security staff, all of whom we work with closely.
Another thing that we like to do at the summit each year is to give a more in-depth update through a session with the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Department for Health and Human Services (HHS) legal counsel on the authorities that we have that we use related to the emergency use of medical countermeasures during emergencies. This year’s session was especially exciting for us because it was an opportunity for us to discuss with stakeholders some new authorities that were established in 2013 to enhance preparedness and response flexibility.
For example, we can now clearly issue emergency use authorizations in advance of emergencies, which is really a critical medical countermeasure tool for preparedness purposes. Through these flexibilities, for example, we’ve issued three emergency use authorizations in the past year for three different in-vitro diagnostic tests to address the emerging threats of H7 and 9 influenza and MERS-CoV.
NPH: What are the key responsibilities the FDA has in helping to prepare the United States for possible disasters?
Courtney: As an agency of the U.S. Department of Health and Human Services, the FDA, at its core, is a public health agency. FDA’s mission is to protect and promote public health in a number of critical ways. We’re responsible for regulating more than $1 trillion in consumer goods annually, ranging from medical products such as drugs and vaccines to tobacco and food products.
At this year’s Preparedness Summit, which met last week in Atlanta, the American Red Cross was a first-time partner for the annual event which brings together more than 1,000 preparedness experts from around the country.
“It was important for us to partner with the American Red Cross because they have a major role and responsibility in disasters,” said Jack Herrmann, the Summit chair and Chief of Public Health Preparedness at the National Association of County and City Health Officials (NACCHO), the lead partner for the Summit. “We felt that it was important that the public health and health care communities understand the Red Cross’ role and authority during a disaster and look for ways to foster and build partnerships [among] local health departments, state health departments and American Red Cross chapters across the country.”
Just prior to the Summit, NewPublicHealth conducted an interview by email with Russ Paulsen, Executive Director, Community Preparedness and Resilience Services of the American Red Cross.
NewPublicHealth: What are the key issues that communities should focus on now to get themselves better prepared for a disaster should it occur?
Russ Paulsen: Everyone has a role to play in getting communities better prepared for disasters.
As a first step, individuals, organizations and communities should understand the problem: What hazards are in their area? How likely are any of these hazards to become actual disasters? What have people already put in place to deal with them? Local Red Cross chapters can help with this assessment.
Once people understand the problem, the next step is to make a plan. Plan what to do in case you are separated from your family or household members during an emergency, and plan what to do if you must evacuate your home. Coordinate your household plan with your household members’ schools, daycare facilities, workplaces and with your community’s emergency plans.
Disaster experts at this week’s Preparedness Summit underscored the importance of meeting the specific needs of children and young adults in a disaster, who often react not only to their own response to a crisis but also to how adults around them are responding and dealing with the situation.
The Federal Emergency Management Agency (FEMA) has a program called Teen CERT (Community Emergency Response Team) which teaches readiness and response skills and includes practice and exercises. A California fourteen-year-old Teen CERT member, for example, has 17,000 Twitter followers for a weekly feed she updates with disaster preparedness tips.
Teen CERT Training takes 20-30 hours; more if teens are also certified in CPR, First Aid and the use of automatic defibrillators. Training includes:
- Keeping the teen volunteer safe while helping others
- Identifying and anticipate hazards
- Reducing fire hazards in the home and workplace
- Using fire extinguishers to put out small fires
- Assisting emergency responders
- Conducting light search and rescue
- Setting up medical treatment areas
- Applying basic first aid techniques and helping reduce survivor stress
Teen CERT members are also eligible for community credits which many high schools require for graduation.
And Columbia University’s National Center for Disaster Preparedness spearheads a program called SHOREline, which has a pilot program at five high schools in the Gulf Coast. Students work on organizational and leadership skills; meet and practice preparedness drills with local and national experts; and attend youth preparedness summits, said David Abramson, PHD, MPH, the deputy director of the Center who spoke about the SHOREline program at the Preparedness Summit this morning.
Abramson told attendees about the work of one group of SHOREline members at a Gulf Coast high school who took the lead on a disaster recently when a student at the school was killed by in a shooting. Seeing that the school had not planned a memorial service, the students raised $500 and bought all the helium balloons they could find for a service they planned and carried out that Abramson said was very critical for community recovery.
At the start of the 2014 Preparedness Summit meeting this week in Atlanta, Summit chair Jack Herrmann took a moment to remember the lives lost in the mudslide in Washington State last week and took note of the many public health workers who left their communities to help in the rescue and recovery. Since then, two more major disasters have occurred—the earthquake and tsunami waves in Chile and the shooting yesterday at Fort Hood. Conversations about those events, and other events back home that need the attention of public health staff even while they are on travel at a preparedness conference, can be heard in the hallways during breaks in the sessions as people who train for such disasters mourn the losses and offer their assistance.
Tom Hipper, Public Health Planner at the Center for Public Health Readiness and Communication at Drexel University in Philadelphia, had some advice for communications by public health departments not involved in a disaster earlier this week. Hipper advises delaying planned, non-urgent communication and sending out empathetic messages about the disasters which can help build community and resilience and give people a chance to become involved by expressing and sharing their sentiments. Hipper says empathetic communication can be a bonding experience and lets people know that others will be thinking about and trying to help them in the event of an emergency in their community.
In addition, says Hipper, while previously people outside a disaster area could often only help by donating money, they can now also be “digital volunteers” by posting and retweeting accurate information from credible sources about a disaster to let people impacted by an emergency know they’re not alone.
The Center maintains and updates a list of important preparedness resources.
>> Bonus Content: Read a previous NewPublicHealth Q&A with Jonathan Woodson on the U.S. Department of Defense’s overall approach to wellness and prevention for military, veterans and their families as part of our National Prevention Strategy series.
SAMHSA Disaster Distress Helpline Open 24/7 to Help People Impacted by the Severe Weather
The Substance Abuse and Mental Health Administration (SAMHSA) issued a bulletin yesterday to remind public health officials and the community that its Disaster Distress Helpline (1-800-985-5990) can provide immediate counseling to anyone who needs help in dealing with the damage caused by the winter storms in the Mid-Atlantic and Southern states. The helpline is a 24 hours-a-day, seven-days-a-week resource that responds to people who need crisis counseling after experiencing a natural or man-made disaster or tragedy. The helpline immediately connects callers to trained professionals from the closest crisis counseling center; helpline staff provide confidential counseling, referrals and other needed support services. Assistance is available in several languages. The helpline can also be accessed by texting TalkWithUs to 66746, by going here and by TTY for deaf and hearing impaired at 1-800-846-8517. Read more on disasters.
Well-Child Visits Linked to More than 700,000 Cases of Flu-Like Illness
A recent study in Infection Control and Hospital Epidemiology links well-child doctor appointments for annual exams and vaccinations with an increased risk of flu-like illnesses in children and family members within two weeks of the visit. This risk translates to more than 700,000 potentially avoidable illnesses each year, costing more than $490 million annually, according to the researchers.
"Well child visits are critically important. However, our results demonstrate that healthcare professionals should devote more attention to reducing the risk of spreading infections in waiting rooms and clinics [and] more attention should be paid to these guidelines by healthcare professionals, patients, and their families," said Phil Polgreen, MD, MPH, lead author of the study.
The researchers used data from the Agency for Healthcare Research and Quality's (AHRQ) Medical Expenditure Panel Survey to examine the health care trends of 84,595 families collected from 1996-2008. After controlling for factors including the presence of other children, insurance and demographics, the authors found that well-child visits for children younger than six years old increased the probability of a flu-like illness in these children or their families during the subsequent two weeks by 3.2 percentage points. A commentary in the journal on the study also pointed out the likelihood of some unnecessary antibiotics being prescribed for some of the illnesses.
"Even with interventions, such as the restricted use of communal toys or separate sick and well-child waiting areas, if hand-hygiene compliance is poor and potentially infectious patients are not wearing masks, preventable infections will continue to occur," said Polgreen. Read more on infectious disease.
NIH Study Seeks to Improve Asthma Therapy for African-Americans
A new study by researchers at the National Heart Lung and Blood Institute, a division of the U.S. National Institutes of Health, is enrolling about 500 African-American children and adults with asthma in a multi-center clinical trial to assess how they react to therapies and to explore the role of genetics in determining the response to asthma treatment. The study will be conducted at 30 sites in 14 states, and its goal is to determine the best approach for asthma management in African-Americans, who suffer much higher rates of serious asthma attacks, hospitalizations and asthma-related deaths than whites. “While national asthma guidelines provide recommendations for all patients with asthma, it is possible that, compared with other groups, African-Americans respond differently to asthma medications,” said Michael Wechsler, MD, principal investigator for the study and professor of medicine at National Jewish Health in Denver. “Our study is designed to specifically address how asthma should be managed in African-American asthma patients, both adults and children.” Read more on health disparities.
The fallout from this week’s snowstorm in Atlanta was a hot topic among many of the county officials attending the National Association of Counties (NACo) Health Initiative Forum in San Diego. Many have had to make tough decisions on crises in their communities—from flu to flooding to snow to shootings—and the consensus was that the snarled traffic, kids left to stay overnight in schools and thousands of cars abandoned marked a failure not of adequate preparation, but of communication and preparedness.
“You can’t know what disaster might hit, so you have to be prepared for everything,” said Linda Langston, NACo’s president and the supervisor of Linn County, Iowa, who has chosen resilient counties as her President’s initiative.
Langston said several steps can help reduce the trauma from disasters, including designating someone in each community to coordinate response, to stay up to date on dealing with emergencies, to building relationships among intersecting communities so that people trust each other in a disaster and to convening meetings with all sectors at the table. Langston pointed out that while schools and businesses don’t typically plan together, in the case of Atlanta’s snow storm most students and workers left the city for the suburbs at the same time of day, increasing traffic at the height of icy conditions. That might have been avoided by having a large pool of participants at the planning table.
“By inviting a member of the chamber of commerce, for example, to preparedness meetings and exercises, decisions can be made on traffic flow and other crowd control issues in the event of an emergency,” she said.
Langston, whose community saw devastating flooding in 2008, said recent preparations for possible flooding (that thankfully never happened) made city managers and the sheriff’s department—which controls the jail—realize they needed to coordinate on evacuation plans in the event of an emergency.
“And if the emergency never occurs, all those planning exercises create a more cohesive community, able to deal with run of the mill disasters like budget cuts, “ said Langston.
HHS to Form Committee to Address Children’s Needs in Disasters
The U.S. Department of Health and Human Services (HHS) is forming a new advisory committee to help meet the particular needs of children before, during and after a disaster or other public health emergency. The committee will seek to bring together experts from the scientific, public health and medical fields. HHS’s Office of the Assistant Secretary for Preparedness and Response (ASPR) also created the Children’s HHS Interagency Leadership on Disasters (CHILD) working group in 2010, which has so far increased interagency coordination and recommendations to improve lifesaving care for children in disasters; developed ways to mitigate the behavioral and psychological needs of children in disasters; and identification of medications and vaccines for children in emergencies. The deadline for nominations for committee membership is Feb. 14. Read more on disasters.
Study: Cold Weather May Help People Lose Weight
There’s at least one benefit to the frigid air currently blanketing much of the country—regular exposure to mild cold may help people lose weight and sustain healthier weights, according to a new study in the journal Trends in Endocrinology & Metabolism. However, that also means that the during the winter, when most buildings keep their temperature warmer, our body is working less to stay warm, so using less energy. "Since most of us are exposed to indoor conditions 90 percent of the time, it is worth exploring health aspects of ambient temperatures," said first author of the article Wouter van Marken Lichtenbelt of Maastricht University Medical Center in The Netherlands. "What would it mean if we let our bodies work again to control body temperature? We hypothesize that the thermal environment affects human health and more specifically that frequent mild cold exposure can significantly affect our energy expenditure over sustained time periods." Read more on obesity.
AHA, NFL App to Encourage Kids’ Physical Activity
The American Heart Association and the National Football League have released a new app, NFL Play 60, to encourage kids to get the full 60 minutes of daily recommended physical activity. In the interactive running experience, players dropped into a virtual world full of obstacles, and have to run, jump, pivot and turn in place to make their app character do the same and navigate the world. “One-third of U.S. children and adolescents are overweight or obese and at a higher risk for heart disease and stroke. Engaging young people in physical activity is one of the best ways to decrease their risk for heart disease,” said Mariell Jessup, MD, President of the American Heart Association. “We’re proud to partner with the NFL in developing an innovative way to reach adolescents, through their schools and now via their smartphones, in an effort to impact their lives earlier to make their lives longer.” The app is available for free download in the iTunes store starting today and will be available for Android on Feb. Read more on physical activity.
The pop culture craze of zombie apocalypse films, televisions shows and books penetrated deeper than many might have expected—even the U.S. Center for Disease Control and Prevention (CDC) weighed in on the cultural phenomenon, with a 2011 blog post on preparing for a real zombie apocalypse. The post covers everything from the history of zombie outbreaks to how to assemble an emergency supply kit should one of these possible apocalyptic zombie scenarios play out in your community.
At the time, NewPublicHealth spoke with the CDC’s Dave Daigle, who dreamed up the zombie post. The CDC campaign was crafted to help spread information on emergency preparedness for the upcoming hurricane season, while the zombie cover was designed both to attract a younger demographic and to offer an off-kilter slant that would make people pay attention. The post contains strong recommendations to help people prepare for many types of emergencies, from natural disasters to disease outbreaks—for example, your supply kit should include water, food, medications, important documents, and so on. The CDC was able to reach an even larger audience by packaging this valuable information in a playful nod to the fantastical fears that a zombie outbreak could actually happen.
Among the tips from the CDC’s Preparedness 101: Zombie Apocalypse: "Plan your evacuation route. When zombies are hungry they won’t stop until they get food (i.e., brains), which means you need to get out of town fast!"
Once the post went live, the staff sat back while it was tweeted, retweeted, Facebooked, commented on and reported on by a growing list of mainstream print and online publications. The result was an overwhelming success:
- The initial tweet received 70,426 clicks
- “CDC” and “Zombie Apocalypse” trended worldwide on Twitter
- The CDC Emergency Facebook page gained more than 7,000 fans within the first month of its launch
- There were more than 3,000 articles, broadcasts and other media coverage of the blog
- The messages received an estimated 3.6 billion impressions with a marketing worth of $3.4 million—and all for a campaign that cost $87.00
Six Killed, Dozens Injured as Tornados Sweep Across the U.S. Midwest
At least six people were killed and dozens left injured after a flurry of tornados swept through the American Midwest yesterday. Tornado watches were announced for Illinois, Indiana, Iowa, Michigan, Missouri, Ohio and Wisconsin; by the end of the day, an estimated 77 had touched down, mostly in Illinois, according to the National Weather Service. The severe weather left thousands without power (approximately 89,000 in Northern Illinois alone) and leveled entire neighborhoods. “I went over there immediately after the tornado, walking through the neighborhoods, and I couldn’t even tell what street I was on,” said Tyler Gee, an alderman on the Chicago City Council, to radio station WBBM in Chicago. “It just completely flattened some of the neighborhoods here in town, hundreds of homes.” Read more on disasters.
NHTSA: 2012 Highway Fatalities Up for the First Time Since 2005
While highway traffic fatalities continue to hover around historic lows, the total number of deaths increased by 1,082 from 2011 to 2012, to a total of 33,561, the first increase since 2005. The findings are part of the U.S. Department of Transportation's National Highway Traffic Safety Administration’s (NHTSA) 2012 Fatality Analysis Reporting System (FARS) data. "Highway deaths claim more than 30,000 lives each year and while we've made substantial progress over the past 50 years, it's clear that we have much more work to do," said U.S. Transportation Secretary Anthony Foxx. "As we look to the future, we must focus our efforts to tackle persistent and emerging issues that threaten the safety of motorists, cyclists and pedestrians across the nation." Read more on safety.
Heart Groups’ New Risk Guidelines, Calculator Apparently Flawed
The risk guidelines and calculator released last week by the American Heart Association and the American College of Cardiology, meant to improve the assessment of potential cardiovascular disease, could possibly instead greatly overestimate the risk and as built could lead to millions of unnecessary statin prescriptions. The potential problems, first identified by two Harvard Medical School professors, will be published today in The Lancet. One possible explanation for the problem is that the system relies on old data, while populations and their behaviors have changed. Steven Nissen, MD, chief of cardiovascular medicine at the Cleveland Clinic and a past president of the American College of Cardiology, called the findings “stunning,” adding “We need a pause to further evaluate this approach before it is implemented on a widespread basis.” However, after emergency meetings at the American Heart Association’s annual meeting this weekend in Dallas, both organizations said despite the apparent flaws the guidelines are still a major step forward, noting that patients are also advised to speak with their doctors, and not simply follow the results of the calculator. Read more on heart health.
CDC: Emerging Tobacco Products Gaining Popularity among Middle and High School Students
A new report from the U.S. Centers for Disease Control and Prevention (CDC) finds that emerging tobacco products such as e-cigarettes and hookahs are quickly gaining popularity among middle- and high-school students, but with no significant decline in students’ cigarette smoking or overall tobacco use. The new report was culled from data in the 2012 National Youth Tobacco Survey, which shows that electronic cigarette use rose among middle school students from 0.6 percent in 2011 to 1.1 percent in 2012 and among high school students from 1.5 percent to 2.8 percent. Hookah use among high school students rose from 4.1 percent to 5.4 percent from 2011 to 2012.
The study authors say the increase in the use of electronic cigarettes and hookahs could be due to an increase in marketing, availability and visibility of the products, as well as the perception that they may be safer alternatives to cigarettes. While electronic cigarettes, hookahs, cigars and certain other new types of tobacco products are not currently subject to regulation by the U.S. Food and Drug Administration, the agency has said recently that it plans to issue a proposed rule that would deem products meeting the statutory definition of a "tobacco product" to be subject to the Federal Food, Drug, and Cosmetic Act—as cigarettes are.
The researchers say cigar use in young adults is of particular concern. During 2011-2012, cigar use increased dramatically among non-Hispanic black high school students from 11.7 percent to 16.7 percent, and has more than doubled since 2009, and similar to the rate of cigarette use among high school males (16.3 percent). Read more on tobacco.