Search Results for: preparedness

Nov 11 2014
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Building Back Better: New Jersey as a Case Study for Improving Preparedness

In recent years, the state of New Jersey has found itself at the center of high-profile emergencies and public health scares—from the disaster wrought by Superstorm Sandy in 2012 to a controversial plan in recent weeks to quarantine individuals identified as at risk for contracting Ebola. As the 11th-most populous state—and a major hub of international travel and commerce—New Jersey’s public health leadership serves as a case study for the nation.

NewPublicHealth recently spoke with New Jersey Health Commissioner Mary O’Dowd. She has been sharing New Jersey’s preparedness and recovery lessons nationally as a member of the preparedness policy committee of the Association of State and Territorial Health Officials and implementing them as the state addresses potential exposure to Ebola in returning volunteers.

NewPublicHealth: Looking back, what worked well in the health department’s response before, during and after Sandy?

Mary O’Dowd: I think one of the things that really worked well in that immediate response phase was that we employed our lessons learned from Hurricane Irene the year before, in 2011. For example, we used the Emergency Management Assistance Compact, which is an agreement among states to assist each other in times of crisis or emergency, and we specifically used it to bring additional ambulances into New Jersey for our EMS system to enhance our capability, but we didn’t make the request until after the storm. So for the first day or two, we didn’t have the resources on hand.

We learned from that shortfall. The next year, before Sandy made its way to New Jersey, we had already put out the request via the EMAC system and had ambulances from Indiana on the ground before the storm hit. And that was really critical in our ability to immediately respond in particular with Sandy, because with the flooding we had several areas of the state where ambulances actually were flooded out and were no longer available for us. We were very lucky that we had learned that lesson from the year before. 

Watch a NewPublicHealth video about the public health response to Hurricane Sandy featurining Mary O'Dowd and other public health officials.

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Oct 27 2014
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Public Health News Roundup: October 27

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EBOLA UPDATE: New York State Walks Back New Ebola Quarantine Process—Somewhat—After Heavy Criticism
(NewPublicHealth is monitoring the public health crisis in West Africa.)
The state of New York has partially walked back its new quarantine process for health care workers returning from treating Ebola in West Africa after receiving heavy criticism from the federal government and health officials. New York Gov. Andrew M. Cuomo said health care workers who have been in contact with Ebola patients but show no signs of the virus must still be quarantined and monitored for 21 days, but may do so in their home.

The Obama administration’s criticism of the initial order was strong." We have let the governors of New York, New Jersey, and others states know that we have concerns with the unintended consequences of policies not grounded in science may have on efforts to combat Ebola at its source in West Africa," an Obama administration official said in a statement, according to Reuters. "We have also let these states know that we are working on new guidelines for returning healthcare workers that will protect the American people against imported cases, while, at the same time, enabling us to continue to tackle this epidemic in West Africa.” Read more on Ebola.

Survey: ‘Social Resilience’ More Valuable than Government Assistance in Helping a Community Feel Prepared for Disasters
“Social resilience”—the feeling of trust in a community, with neighbors helping neighbors and looking out for each other—can be more valuable than even government assistance when it comes to how prepared communities feel for disasters, according to a new Associated Press-NORC Center for Public Affairs Research survey. In a survey of more than 1,000 residents in a dozen communities hit by the 2012 hurricane in New York and New Jersey, researchers found that “residents in areas where people say their neighbors actively seek to fix problems in the neighborhood are three times more likely to say their community is extremely or very prepared for a disaster than people in communities without such social resilience.”

Among the rest of the findings:

  • 37 percent of residents in areas reporting high levels of neighbors helping each other are very or extremely confident their neighborhood would recover quickly from a disaster, compared to 22 percent in areas with lower levels of neighborly cooperation
  • 69 percent of respondents said they got help from neighbors in recovering from the storm, while 57 percent said local government assisted them and 55 percent cited federal government agencies as helpful

“Having that level of trust, that preexisting level of trust means you sort of have this reservoir to draw from in times of need,” said the survey’s principal researcher Kathleen Cagney, a University of Chicago sociology professor and director of the Population Research Center at NORC at the University of Chicago. “Money doesn’t buy these informal reservoirs. You need to foster this.” Read more on preparedness.

Tips on Warding Off Seasonal Affective Disorder
The shorter, darker days of the fall season also mean the potential to trigger seasonal affective disorder (SAD), a type of depression that can leave some people feeling overly tired and lacking motivation to the point they find it extremely difficult to go about their day. As much as 5 percent of the population is affected by what is believed to be a chemical imbalance linked to reduced exposure to light. Angelos Halaris, MD, PhD, a professor in the department of psychiatry and behavioral neurosciences at Loyola University Chicago Stitch School of Medicine, said there are ways to reduce the likelihood of SAD, which can severely impact an individual’s quality of life:

  • Spend at least 30 minutes a day outside. Avoid wearing sunglasses during this period of time. If weather permits, expose the skin on your arms to the sun.
  • Keep your home well-lit. Open curtain and blinds to allow sunlight in. You can also consider buying a high-intensity light box specially designed for SAD therapy. Sit near the box for 30 to 45 minutes in the morning and at night. Be sure to talk to your doctor before attempting this type of light therapy on your own.
  • Physical activity releases endorphins and other brain chemicals that help you feel better and gain more energy. Exercising for 30 minutes daily can help.
  • When all else fails, there are medications that can help ease the troubling effects of SAD. Halaris recommends visiting a mental health professional if extra sun exposure, indoor lights and exercise are not effective in treating your symptoms.

Read more on prevention.

Oct 24 2014
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Faces of Public Health: Daniel Barnett, MD

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News today that a fourth case of Ebola has been diagnosed in the United States underscores the urgent need to have health workers not just ready, but also willing to treat patients with the illness. Next Wednesday, the National Coordinating Center on Public Health Systems and Services Research (PHSSR) will be hosting a webinar on legal protections to help facilitate health worker willingness. Daniel Barnett, MD, an Associate Professor in the Department of Environmental Health Sciences at the Johns Hopkins Bloomberg School of Public Health, will be the main presenter. Barnett and three Bloomberg colleagues, Leonie Ratko, JD, PhD, MPH, Jon S. Enrick, JD, MPH Carol B. Thompson, MS, MBA received funding from the Robert Wood Johnson Foundation and PHSSR to study the issue. PHSSR's Center is funded by RWJF and based at the University of Kentucky.

NewPublicHealth recently spoke with Barnett.

NewPublicHealth: What are the concerns with respect to health workers being prepared to take some risks in order to protect the public?

Daniel Barnett: There’s been a longstanding tacit dysfunction about preparedness trainings: That if you train someone in knowledge and skills in terms of how to respond, that will necessarily translate into a willingness to do so. But our work has shown that “training to knowledge equals training to willingness” is a false assumption. In other words, I can teach someone how to recognize anthrax or some other infectious disease agent under a microscope, but that in no way ensures that that individual will be willing to come to work to look at anthrax or another infectious disease agent under a microscope, and by analogy, any other type of frontline public health or health care response.

That’s been, frankly, a missing piece in public health preparedness training nationally and internationally, and I think that we need to really rethink paradigms of preparedness training and education to take a more holistic approach. In other words, an approach that recognizes that frontline healthcare workers and public health workers have fears and concerns attached to a whole variety of aspects of the events at hand.

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Oct 24 2014
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Two Important Ebola Conferences Coming Up

Just about every think tank, school of public health and infectious disease association has held a conference on Ebola in the last few weeks, but two coming up are still absolutely worth tracking.

Now that New York City has seen is first diagnosis of Ebola, an already scheduled conference next week at Columbia University’s Mailman School of Public Health has taken on added importance. Presenters include ABC News Chief Health and Medical editor and former acting U.S. Centers for Disease Control and Prevention director Richard Besser, MD, as well as Irwin Redlener, MD, director of the National Center for Disaster Preparedness at Columbia University's Earth Institute. While the conversation surrounding the Ebola cases in Dallas focused on the need for health care workers to receive better guidance and training, hours into the first case in New York City the focus is on the challenge of containing the disease in a huge urban setting—a topic the presenters will discuss at length.

And on November 7, the White House Office of Science and Technology Policy will host a simulcast workshop together with Texas A&M, the Worcester Polytechnic Institute and the University of California, Berkeley to discuss proposals to dispatch robots to aid in the care of Ebola patients and people who have succumbed to the disease. The idea is to augment — and not replace — health workers. Robots could spray disinfectant, respond to commands given by health workers in a remote location and even help bury the dead.

The conference will include not just engineers, but also public health officials and health care personnel who can speak to the human needs that need to be considered when design the robots. For example, Texas A&M engineering students are working on a robotic attachment that would pick up a dead body in movements that mimic compassion, rather than in another way that may be efficient but does not show sensitivity for the dead and their families.

>>Bonus Link: Read an interview with the conference conveners.

Oct 21 2014
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The Progress on Ebola: Q&A with Tarik Jasarevic, the World Health Organization

Over the weekend, NewPublicHealth conducted an email interview with Tarik Jasarevic, a spokesperson for the World Health Organization (WHO), on Ebola efforts on the ground in West Africa and the impact on the global effort of the cases recently diagnosed in the United States.

NewPublicHealth: Is there concern among global health leaders that the attention on a handful of cases is taking away attention from the thousands of cases in West Africa? 

Tarik Jasarevic: While countries need to be vigilant and prepared for a possible case of Ebola, we need to focus on getting all possible resources—trained health workers, medical facilities with beds and money—to the affected countries in West Africa. 
 
NPH: Several weeks ago global health leaders had a checklist of things, including money and personnel, needed to stem the outbreaks in the various countries. Where do things stand now, and what is still needed? 

Jasarevic: We need a lot of resources if we’re going to get the virus under control. WHO and partners constructed 12 Ebola Treatment Centers in Liberia, 15 in Sierra Leone and 3 in Guinea—30 out of the 50 that are needed. These facilities contain more than 1,100 beds for patients, out of the more than 4,000 needed. There are more than 2,500 beds becoming available in the next few weeks, but we still need more. We also need international health workers to come work alongside national health workers to manage and run the health facilities. WHO has set up “training academies” in each of the affected countries to train more local health workers, but more are needed.
 
NPH: What is the current fatality rate?

Jasarevic: The fatality rate for this particular outbreak has always been approximately 70 percent. We are seeing higher numbers of cases and deaths because of the geographic spread of the disease, from urban city centers to rural, hard to reach villages. There is also significant under reporting of cases in the three countries, especially Liberia. 

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Oct 17 2014
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Public Health News Roundup: October 17

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EBOLA UPDATE: HHS Accelerates Development of an Ebola Vaccine
(NewPublicHealth is monitoring the public health crisis in West Africa.)
The U.S. Department of Health and Human Services’ Office of the Assistant Secretary for Preparedness and Response (ASPR) is working to accelerate the development of a vaccine to prevent Ebola through a one-year, $5.8 million contract with Profectus BioSciences Inc. ASPR’s Biomedical Advanced Research and Development Authority (BARDA) will also provide subject matter expertise and technical assistance. Plans call for the vaccine to first be tested in animal safety studies. “We are pushing hard to advance the development of multiple products as quickly as possible for clinical evaluation and future use in preventing or treating this deadly disease,” said BARDA Director Robin Robinson, PhD. “Our goal is to close the global gap in vaccines and therapeutics needed to protect the public health from Ebola as highlighted by the epidemic in West Africa.” Read more on Ebola.

High-Fat Meals Could Be More Harmful to Men than to Women
High-fat meals could be more harmful to men than they are to women, according to a new study in the journal Cell Reports. Researchers at the Cedars-Sinai Diabetes and Obesity Research Institute and funded by the National Institutes of Health determined that male mice who received high-fat diets experienced greater health complications than did female mice who received the same. "For the first time, we have identified remarkable differences in the sexes when it comes to how the body responds to high-fat diets," said Deborah Clegg, PhD. "In the study, the mice were given the equivalent of a steady diet of hamburgers and soda. The brains of the male mice became inflamed and their hearts were damaged. But the female mice showed no brain inflammation and had normal hearts during the diet." Richard Bergman, PhD, director of the Diabetes and Obesity Research Institute, said the findings suggest that physicians must “reconsider whether the diets and drugs we recommend for managing obesity may need to be sex-specific to be more effective.” Read more on obesity.

Study Links Metal-Contaminated Well Water to Birth Defects, Other Detrimental Health Outcomes
Increased levels of metals in private well water may be linked to birth defects and other detrimental health outcomes, according to a new study in the journal BiodMed Central Public Health. Researchers at the UNC Gillings School of Global Public Health utilized well water data from between 11,000 and 47,000 wells provided by the North Carolina Department of Health and Human Services. They determined that metals such as cadmium, arsenic, lead and manganese in drinking water can lead to spontaneous abortion, stillbirth, low birth weight and impaired neural development in infants. Read more on water and air quality.

Oct 16 2014
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Faces of Public Health: Jim Blumenstock, ASTHO

People tuning into news coverage of the Dallas Ebola cases have come to recognize David Lakey, the Texas state health officer. Every state has a similar position and those officials are charged with improving population health—from holding immunization clinics to responding to potentially fatal illnesses. The Association of State and Territorial Health Officers (ASTHO) is the professional association of the 50 state health officers. Jim Blumenstock is the chief program officer of ASTHO’s public health practice division. NewPublicHealth spoke to Blumenstock this week about state and federal coordination on Ebola detection and case treatment.

NewPublicHealth: What is ASTHO’s role in dealing with preparedness for Ebola in the United States and with the current cases?

Jim Blumenstock: In a crisis or a public health emergency like we’re experiencing with Ebola, ASTHO’s role principally is to do two things. Number one is to sort of be the glue or the hub that helps pull together the 50 states, the nine territories and the District of Columbia as an integrated, harmonious component of our public health infrastructure. The second feature is to provide a solid interface between federal efforts and state efforts. So, that’s our role with any significant public health issue.

During the H1N1 outbreak several years ago, both ASTHO and the National Association of County and City Health Officials (NACCHO) had key staff embedded in the U.S. Centers for Disease Control and Prevention’s (CDC) Emergency Operation Center because it was recognized that the value of the insight of a national organization that represents all the states and locals was so critical to the federal planning and response process. That was the first time it was done.

We’re on standby to do it and we’re sort of functioning in that capacity right now, but sort of in a virtual or remote area. For example, I’m not today embedded in CDC’s Emergency Operation Center. However, I would say I’m on the phone with them at least six to eight times a day—including last evening—and have had email exchanges already this morning, not only to get information, but also to be part of some planning and problem solving efforts they’ve requested our help on, or a request for our help on state consensus around a strategy or a tactic or an approach on a particular matter.

And our other critical roles are to help our members; to talk to federal public health officials; and to educate and inform the public. 

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Oct 2 2014
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Public Health News Roundup: October 2

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EBOLA UPDATE: Texas Ebola Patient Came into Contact with at Least 80 People; Second Man Being Monitored
The known number of people who came into contact with the Ebola patient being treated in Texas—now identified as Thomas Eric Duncan of Liberia—has climbed from 18 to at least 80, according to Dallas Health Director Zack Thompson. Duncan, who is in isolation at Texas Health Presbyterian Hospital Dallas, is the first person to be diagnosed with the disease in the United States. Several members of his family are under a “control order” to stay inside their homes. Texas health authorities are also monitoring a second potential Ebola patient. Read more on Ebola.

HHS: Two Contracts to Improve Earlier, More Accurate Flu Diagnosis
The U.S. Department of Health and Human Services’ (HHS) Office of the Assistant Secretary for Preparedness and Response (ASPR) has issued two contracts to help improve doctors’ abilities to diagnose influenza cases sooner and more accurately. One contract is for 3.5 years and worth $12.9 million, while the other is a two-year, $7.9 million contract that could expand to a $14.7-million contract over four years. “Administering fast and inexpensive tests at the point of care has tangible benefits to personal and public health, particularly in helping doctors prescribe the right therapy immediately,” said Robin Robinson, PhD, director of ASPR’s Biomedical Advanced Research and Development Authority, in a release. “Prescribing medication or other therapies in a more targeted way is good stewardship and will be critical to reducing the risk of antimicrobial resistance.” Read more on influenza.

Health Officials: 500 Confirmed Cases of Enterovirus D68 in 42 States and the District of Columbia
There have now been more than 500 confirmed cases of Enterovirus D68 in forty-two states and the District of Columbia since the severe respiratory illness first began infecting children during the summer. While four patients have died in the past several weeks, health officials are still unsure whether the virus is linked to the deaths. They are also working to determine whether 10 cases of children with muscle weakness and even paralysis are due to the virus. Read more on infectious disease.

Oct 1 2014
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Public Health News Roundup: October 1

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EBOLA UPDATE: First U.S. Case of Ebola Diagnosed in Dallas
(NewPublicHealth is monitoring the public health crisis in West Africa.)
The U.S. Centers for Disease Control and Prevention (CDC) has confirmed the first Ebola case to be diagnosed in the United States. The patient flew from Liberia—at the time not showing symptoms—and fell ill several days later, seeking treatment at Texas Health Presbyterian Hospital of Dallas. He was admitted on Sept. 28. The CDC is monitoring people he came in contact with and feels confident that the disease will not spread further. “Ebola can be scary. But there’s all the difference in the world between the U.S. and parts of Africa where Ebola is spreading. The United States has a strong health care system and public health professionals who will make sure this case does not threaten our communities,” said CDC Director, Tom Frieden, MD, MPH. “While it is not impossible that there could be additional cases associated with this patient in the coming weeks, I have no doubt that we will contain this.” Read more on Ebola.

FDA: New Recommendation to Protect Patients from Cybersecurity Risks
The U.S. Food and Drug Administration (FDA) is taking steps to ensure patient safety and security with the finalization of recommendations to medical device manufacturers for managing cybersecurity risks. Potential risks include malware infections on network-connected medical devices or computers, smartphones, and tablets used to access patient data; unsecured or uncontrolled distribution of passwords; failure to provide timely security software updates and patches to medical devices and networks; and security vulnerabilities in off-the-shelf software designed to prevent unauthorized access to the device or network. “There is no such thing as a threat-proof medical device,” said Suzanne Schwartz, MD, MBA, director of emergency preparedness/operations and medical countermeasures at the FDA’s Center for Devices and Radiological Health. “It is important for medical device manufacturers to remain vigilant about cybersecurity and to appropriately protect patients from those risks.” Read more on technology.

HUD: $112M in Grants to Protect Kids, Families from Lead-Based Paint and Other Housing Dangers
The U.S. Department of Health and Human Services (HHS) has awarded more than $112 million in grants to help protect children and families from the dangers of lead-based paint and other home health and safety hazards. The grants will go to 39 local and state government agencies and research institutions, helping almost 7,000 low-income homes while also supporting research to improve safety efforts. "Millions of families and children are seeing their hope for the future threatened by poor health simply because of where they live," noted Matthew E. Ammon, Acting Director of HUD's Office of Lead Hazard Control and Healthy Homes.  "Every child deserves to grow up in a healthy home and yet far too many continue to be exposed to potentially dangerous lead and other health hazards in the home." Read more on housing.

Sep 25 2014
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Preparing for Ebola in the U.S. Makes Good Public Health Sense

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.