Category Archives: Preparedness
U.S. public health officials have continually said that it is highly unlikely that the Ebola virus will spread in the United States, even if infected travelers land here. Officials at the U.S. Centers for Disease Control and Prevention (CDC) say that the disease is most contagious when people come into contact with the bodily fluids of someone who is ill—and someone that ill would be very likely be identified by border and airline personnel quickly. If hospital admission became necessary, U.S. infection control procedures could stem an outbreak, according to Tom Frieden, MD, the CDC’s director and the point person for the U.S. government on the current Ebola outbreak. Frieden has discussed the issue repeatedly during several news conferences in the last few weeks.
Of course, that changes if the virus becomes transmissible through the air, rather than just via bodily fluids, as Michael T. Osterholm, PhD, MPH, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, suggested in the New York Times last week. While Osterholm often addresses the direst potential outcomes of infectious disease outbreaks, it’s prudent to at least know what to do, which is why agencies such as the CDC and the Network for Public Health Law say what’s needed is information and procedures...but not panic.
Last month, the Network held an online webinar on preparedness measures and Ebola which was watched by more than 1,200 public health officials. Following the webinar, Network experts posted answers to follow-up questions, including one about the right of public health or hospital workers to refuse to care for/help with someone suspected of having Ebola.
The Network also recently created an online primer on preparedness and legal issues surrounding the Ebola outbreak, both for public health officials engaged in the response overseas and for those with current or future responsibility for handling Ebola-related issues in the United States.
>>Bonus Link: Richard Besser, MD, now the chief health editor for ABC News, was formerly the CDC’s head of disaster response and led the early response to the H1N1 outbreak in the United States several years ago. In a recent opinion piece for the Washington Post, Besser laid out what’s being accomplished and what still needs to be done to stem the Ebola outbreak in West Africa.
EBOLA UPDATE: Death Toll to at Least 2,622
(NewPublicHealth is monitoring the public health crisis in West Africa.)
The World Health Organization announced today that the Ebola outbreak in West Africa has now claimed at least 2,622 lives and infected at least 5,335 people. "The upward epidemic trend continues in the three countries that have widespread and intense transmission—Guinea, Liberia and Sierra Leone," the global health agency said in a statement, adding that the disease’s spread through Liberia is in large part due to an increasing number of cases in the capital of Monrovia. Read more on Ebola.
HHS to Sponsor the Development of a Portable Ventilator for Use in Public Health Emergencies
The U.S. Department of Health and Human Services (HHS) is sponsoring the development of a next-generation portable ventilator for use in pandemics and other public health emergencies. The low-cost, user-friendly device will be developed with Philips Respironics under a $13.8 million contract; the project will be overseen by the Biomedical Advanced Research and Development Authority (BARDA) within the HHS Office of the Assistant Secretary for Preparedness and Response. “In pandemics and other emergencies, doctors must have medicines, vaccines, diagnostics, and critical equipment such as mechanical ventilators at the ready in order to save lives,” said BARDA Director Robin Robinson, PhD, in a release. Read more on preparedness.
HUD Launches $1B National Disaster Resilience Competition
The U.S. Department of Housing and Urban Development (HUD) is launching a $1 billion National Disaster Resilience Competition to help state, local and tribal leaders prepare their communities for the impacts of climate change and other factors using federal funds. “The National Disaster Resilience Competition is going to help communities that have been devastated by natural disasters build back stronger and better prepared for the future,” said HUD Secretary Julián Castro, in a release. “This competition will help spur innovation, creatively distribute limited federal resources, and help communities across the country cope with the reality of severe weather that is being made worse by climate change.” Read more on disasters.
NewPublicHealth continues a new series to highlight some of the best public health education and outreach campaigns every month. Submit your ideas for Public Health Campaign of the Month to email@example.com.
The Federal Emergency Management Agency (FEMA) is starting off National Preparedness Month with a series of stark, dark and attention-getting public service advertisements (PSAs) developed in cooperation with the Ad Council. They are set in what looks to be a dark, crowded school auditorium and showcase an intact family sheltering from the storm, and another family unable to locate their son. The obvious focus is on making a plan to know where all family members are when disaster strikes, but the auditorium—with too few chairs, no apparent cots and little room to move or stretch—gives a rare glimpse into what a public shelter looks like during an emergency and adds to the urgency of making that plan.
“The first step to preparing for disasters is simple and it’s free—talk to your family and make a plan,” said Craig Fugate, FEMA administrator. “Do you know how you’ll reunite and communicate with your family during an emergency? Through our continued partnership with the Ad Council, this year’s campaign illustrates how making a plan can keep families together and safe during a disaster.”
According to a recently released FEMA survey, 50 percent of Americans have not discussed or developed an emergency plan for family members about where to go and what to do in the event of a local disaster.
EBOLA UPDATE: Nigeria Confirms Second Ebola Case
(NewPublicHealth is monitoring the public health crisis in West Africa.)
Nigeria today confirmed its second case of Ebola amidst an epidemic that has so far killed more than 700 people in West Africa. Liberia has also ordered the cremation of all bodies of people who die from Ebola, in response to communities concerned over having the bodies buried nearby. However, even as the virus continues to spread in West Africa, Anthony S. Fauci, MD, Director of the National Institute of Allergy and Infectious Diseases, has told NBC that the risk posed by the return of the Ebola-infected health workers to the United States is "infinitesimally small.” The second U.S. patient is scheduled to arrive for treatment tomorrow. Read more on infectious disease.
HHS: New Committee to Advise on Children’s Health During Disasters
The U.S. Department of Health and Human Services (HHS) has announced the formation of a new federal committee to advise on children’s health issues during natural and manmade disasters. The National Advisory Committee on Children and Disasters’ contributions will include comprehensive planning and policies to meet kids’ health needs before, during and after disasters and other public health emergencies. The committee, formed under the Pandemic and All-Hazards Preparedness Reauthorization Act of 2013, includes 15 members selected from 82 nominations. Seven are from outside the federal government and 8 are from within (the full list is available here). "Ensuring the safety and well-being of our nation's children in the wake of disasters is vital to building resilience in every community,” said HHS Secretary Sylvia M. Burwell, in a release. “We look forward to working with the committee toward this common goal." Read more on disasters.
Toledo Lifts Ban on Drinking Water; 400,000 Residents Affected Over the Weekend
The town of Toledo, Ohio, has lifted the ban on drinking water implemented over the weekend after dangerously high levels of algae were found in Lake Erie. The Great Lake provides much of the area’s drinking water. Approximately 400,000 residents were affected by the ban. Read more on water and air quality.
Study: New Requirements Needed for Hand Hygiene for Anesthesia Providers
Anesthesia providers frequently miss identified opportunities to clean their hands during surgical procedures, with the points immediately before patient contact and immediately after contact with the patient’s environment the times when they are least likely to practice proper hand hygiene, according to a new study in the American Journal of Infection Control. However, the findings also point to a larger problem: Complete compliance with all hand hygiene guidelines would take so much time that there would be no time to actually perform any procedures. The findings indicate “a need to create more practical—but still effective—methods of controlling bacterial transmission in anesthesia work environments.” Read more on prevention.
HHS: $840M to Help State, Local Agencies Improve Disaster Preparedness
The U.S. Department of Health and Human Services (HHS) has awarded approximately $840 million in grants to help state and local public health and health care systems improve their emergency response preparedness. Distributed through the Hospital Preparedness Program (HPP) and the Public Health Emergency Preparedness (PHEP) program, the funds will ensure that communities are prepared to respond to an array of emergencies, including infectious disease outbreaks, natural disasters, or chemical, biological, or radiological nuclear events. “Community and state preparedness is essential to the health security of all Americans,” said Nicole Lurie, MD, assistant secretary for preparedness and response (ASPR), in a release. “Events in the last few years have demonstrated how critical it is for health systems across the country to be ready and able to respond quickly and effectively.” Read more on disasters.
ACP: Annual Pelvic Exams Not Needed for Asymptomatic Women
Annual pelvic exams for women do more harm than good and should not be a routine part of health care for women who are not pregnant or who show no other signs of pelvic problems, according to new guidelines from the American College of Physicians (ACP). In a review, researchers found no studies on the effectiveness of pelvic exams in identifying cancers, infections and other health issues that they are commonly used to find. Researchers stressed that their findings only apply to pelvic exams and that women should still undergo recommended cervical cancer screening. Read more on prevention.
During Hurricane Katrina, volunteers at American Red Cross shelters in the Gulf region noticed a pattern among some of the young children settling in as the storm began: They had brought pillowcases from home filled with some of their most precious items, such as a favorite book or a devoted stuffed animal. Other volunteers learned that evacuating college students also carried their belongings in pillowcases.
Following the storm, chapters along the Gulf launched a pilot called the “Pillowcase Project” that earlier this year became a national program of the American Red Cross, sponsored by the Walt Disney Company. Chapters across the country and in several pilot countries are now adapting the project to teach preparedness to children in grades 3 to 5 at school, after school and in camp settings.
“We’re working hard to get kids involved in preparedness,” said Jim Judge, a member of the American Red Cross Scientific Advisory Council. Judge said getting kids involved helps dispel some of the fear they may face as they evacuate to avoid a disaster, “but we’ve also found that if you get the kids involved, often times they go home and get the parents involved [as well].”
But why a pillowcase? “Just about every home has a pillowcase, it’s inexpensive, you can decorate it and it’s a simplified way of getting kids involved,” he said.
In the pilot programs, kids get the pillowcases and supplies such as a mini first-aid kit, a glow stick, an activity book and crayons, all of which they use to start their own personalized disaster kit and preparedness plan. As part of the program, they learn about the types of emergencies that can impact their community and then they do a physical activity—such as leaving the building—to reinforce what they’ve learned. Afterward they talk about the lessons in small discussion groups.
“The hands-on activities will also help to build confidence so that kids are prepared to take action during an emergency,” said Francisco Ianni, who oversees Red Cross youth readiness programs throughout Oregon and Southwest Washington State.
>>Bonus Link: Watch a pillowcase presentation to a group of young students
One of the key lessons of Hurricane Sandy—which caused massive destruction in New York and New Jersey, two states that don’t usually see that kind of weather devastation—is that disasters can strike anywhere. That’s the thinking behind a new exhibit at the National Building Museum in Washington, D.C., Designing for Disaster, which brings together objects, video, photos and interactive components to show that policies, plans and designs can result in safer, more disaster-resilient communities.
A key goal of the exhibit is to share ideas for building and rebuilding. In a recent interview posted on the museum’s website, the exhibit’s curator, Chrysanthe Broikos, asks “as we face an increasing number of destructive and deadly natural disasters...should we have the right to build exactly what we want, where we want, no matter the risks? Should we give more thought to the long-term viability and protection of the structures and communities we build?”
Those are policy discussions underway right now, and some suggestions are being shared in a “disaster mitigation” blog launched to complement the exhibit. The blog invites building and disaster experts to post their ideas and thoughts on how to make us all more disaster-resilient.
The exhibit highlights current work by planners, engineers, designers, emergency managers, scientists, environmentalists, business leaders and community leaders, some viewable in a short video on the exhibit. For example, constructed just for the exhibit is a Federal Emergency Management Agency (FEMA) “safe room” that would be highly protective if a tornado struck. But the exhibit asks the necessary questions, as well. For example: What if requiring safer construction makes housing unaffordable for many?
While many of the exhibit designs are experimental, the museum’s website also offers resources to learn about steps individuals can take in their own homes and communities to prepare for disasters, remain safe and prevent damage. FloodSmart, for example, is a FEMA resource which lets users see how much damage flooding can cause, assess flood risk and learn about flood insurance.
>>Bonus Link: On June 24, the National Building Museum will hold a competition, Rebuild by Design, that challenges contestants to envision rebuilding designs for communities devastated by Hurricane Sandy.
Recovery after a disaster can take years or even decades—but what most people don’t realize is that recovery starts even before the disaster occurs. Resilience is about how quickly a community bounces back to where they were before a public health emergency—and only a healthy community can do that effectively.
NewPublicHealth recently spoke with Alonzo Plough, PhD, MPH, Vice President, Research-Evaluation-Learning and Chief Science Officer at the Robert Wood Johnson Foundation, about taking steps toward recovery even before a disaster occurs.
NewPublicHealth: What are some important aspects of preparedness that help prepare responders and the community for recovery from a disaster?
Alonzo Plough: Connectivity between organizations, between neighbors, between communities and formal responder organizations is absolutely critical to building community disaster resilience. This allows recovery to go more smoothly because the partners who have to work together in recovery have been working together and connecting to communities prior to a disaster event. Managing the long tail of recovery is easier if there has been recovery thinking in the preparedness phase.
NPH: One of the issues for the panel at the recent Preparedness Summit is the impact of the news spotlight when a disaster occurs, and then the impact of that spotlight turning off. How does that focus impact recovery?
Plough: Often the initial media frames are to wonder why there weren’t preventive mechanisms. In the case of the mudslides in Washington State, for example, why weren’t there zoning restrictions or regulatory restrictions? That initial media frame often will point a finger to ask why houses were allowed to be built in an at-risk location. Why were building permits given at all?
But none of that really addresses the long-term issues of communities working toward recovery, regardless of the specific event. There is a disruption of life as people know it in a disaster that goes on for a long, long period of time. The media doesn’t really capture the complexity of that while they’re focused on the short-term outcomes. When the media focus goes away, the appropriate agencies and organizations who need to be engaged continue their engagement.
Millions of people have now seen their phone shake and heard it wail with news of an impending tornado or other disaster. Two years ago the wireless industry rolled out a free service known as wireless emergency alerts, and wireless carriers representing more than 98 percent of subscribers agreed to participate.
People with older phones, however, may not be able to access the alerts. Brian Josef, general counsel for the CTIA—The Wireless Association in Washington, D.C., recommends checking for the capability when buying a new phone and. For your current phone you can check with your carrier’s customer service office to see whether you automatically get the alerts.
People who can’t receive the texts, or who want a double layer of information, can sign up with local emergency management offices and get alerts via phone, text, email and in some cases Twitter—although sessions at the recent Preparedness Summit in Atlanta indicated that while Twitter is growing, it is still not used by many local and state health departments. Check the bottom of your health department home page to find the Twitter handle, if there is one.
Josef also points out that you may find that a neighbor got an alert and you didn’t—but that’s because the alerts are geo-targeted. If you and your neighbor were a few miles away from each other when an alert went out, only the one in harm’s way would get pinged.
But the apps won’t do you much good if your phone loses its charge. Preparedness experts recommend keeping a charged extra battery and portable charger on hand, and some emergency radios also include phone/device chargers.
Other tips to conserve your smartphone battery, according to Mary Clark, Chief Marketing Officer of the mobile technology company Syniverse, include:
- Reduce the brightness of your screen
- Close unnecessary apps
- Use text messages to communicate with friends and family
- Send an initial text to those most important detailing your plans
- Turn off unneeded options such as Wi-fi and Bluetooth
HUD Awards $40 Million in Housing Counseling Grants
The U.S. Department of Housing and Urban Development (HUD) has awarded more than $40 million in grants to hundreds of national, regional and local organizations to help families and individuals with their housing needs and to prevent future foreclosures.
“HUD-approved counseling agencies use this funding to support a wide range of services from assisting lower income persons to locate an affordable apartment to helping first-time homebuyers avoid unsustainable mortgages,” said Secretary of Housing Shaun Donovan.
More than $38 million will directly support the housing counseling services provided by 29 national and regional organizations, seven multi-state organizations, 22 state housing finance agencies and 232 local housing counseling agencies. In addition, HUD is awarding $2 million to three national organizations to train housing counselors with the instruction and certification necessary to effectively assist families with their housing needs.
In 2012, HUD released two reports on the impact of HUD-approved housing counseling for families who purchase their first homes and those struggling to prevent foreclosure. In both studies, HUD found housing counseling significantly improved the likelihood homeowners remained in their homes.
Read more on housing
Chest Pain Incidence Drops for Whites, But not for Blacks
The percentage of people reporting angina (chest pain) dropped in the last two decades among Americans 65 and older and white people 40 and older — but not among black Americans, according to a study in the American Heart Association journal Circulation: Cardiovascular Quality and Outcomes.
Angina is chest pain or discomfort that occurs when the heart isn’t getting enough oxygen-rich blood.
Researchers analyzed national health survey data starting in 1988 to find how many patients reported that a health care professional had told them they have the condition and how many people report angina symptoms.
- The rates for whites 40 and older reporting a history of angina dropped by about one-third, from the 2001-04 survey to the 2009-12 survey.
- The rates for whites 40 and older reporting angina symptoms declined by half from the 1988-94 survey to 2009-12 survey.
- For blacks, the rates were essentially unchanged.
- The rates for American women 65 and older reporting a history of angina dropped nearly in half from the 2001-04 survey to the 2009-12 survey.
- The rates for women 65 and older reporting angina symptoms declined by almost 60 percent from the 1988-94 survey to 2009-12 survey; the rates for men in this age group declined by more than 40 percent during this same time period
Read more on heart health
United States, Canada and Mexico Set Guidelines to Strengthen Information Sharing in Health Emergencies
The United States, Canada and Mexico have adopted a set of principles and guidelines on how the three countries’ governments will share advance public information and communications during health emergencies impacting the countries.
The Declaration of Intent calls on the three countries to:
- Share public communications plans, statements and other communications products related to health emergencies with each other prior to their public release;
- Apprise other appropriate authorities, depending on the type of health emergency, within their respective governments when the declaration is invoked;
- Conduct an annual short communications exercise to improve joint coordination; and
- Hold recurrent meetings to review and propose amendments to the Declaration of Intent.
Read more on preparedness