Keystone Health Preparedness Digest
August 1, 2024
Volume 13, Issue 15
How Hospitals Respond to the ‘Unthinkable’
A commitment to planning and preparation helps hospitals keep their communities safe
The recent news from Butler County, Pennsylvania, was shocking and scary. Many of the residents interviewed after the attempted assassination of former president Donald Trump mentioned they could not believe that something like that could happen in their community. For emergency managers, this scenario reflects an adage we have always understood: you need to expect anything to happen at any time, anywhere. We know that an “it can’t happen here” mentality is a recipe to fall short when a crisis emerges.
Read the new blog post by Chris Chamberlain, MS, RN, CHEP, HAP's vice president, emergency management.?
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HAP’s Emergency Management team helps Pennsylvania's hospitals and health systems prepare for public health emergencies and serves as a national model for best practices. Learn more about HAPevolve's Emergency Preparedness Solutions .?
HOT TOPICS
Experts consider H5N1 avian flu unknowns as state fairs loom , CIDRAP: So far, humans who have been infected with H5N1 via contact with infected cows have also exhibited mild illness.
Experts choose target pathogens for Olympic wastewater monitoring , CIDRAP: The team arrived at six target pathogens: the viruses that cause polio, influenza A, influenza B, mpox, COVID-19, and measles.?
Hurricane Beryl is a Historic Storm. Here's Why , CBS News: Hurricane Beryl, which has been lashing the southeastern Caribbean with life-threatening winds and flooding the week of Tuesday, July 2, made history before it even made landfall. When Beryl strengthened into a Category 3 hurricane, it become the first major hurricane east of the Lesser Antilles on record for June, according to Philip Klotzbach, Colorado State University hurricane researcher. It took Beryl only 42 hours to strengthen from a tropical depression to a major hurricane —a feat accomplished only six other times in Atlantic hurricane history, and with September 1 as the previous earliest date, hurricane expert Sam Lillo said. Beryl then gained more power, becoming the earliest Category 4 Atlantic hurricane on record and then, on July 1, the earliest to reach Category 5. "Beryl is an extremely dangerous and rare hurricane for this time of year in this area," hurricane specialist and storm surge expert Michael Lowry said in a phone interview.
Data: COVID shaved 2.6 years from life expectancy Much more in some groups—in India , CIDRAP: The death rate was 17 percent higher in 2020 than in 2019 in India, implying an estimated 1.19 million excess deaths.
World Trade Center Responders Exposed to More Dust Saw Higher Risk of Early Dementia , STAT; Nearly a quarter of a century after the 9/11 attacks in New York City, first responders continue to face steep health consequences for their exposure to particulate matter in the aftermath of the World Trade Center’s collapse. More than 10,000 people who were in the area have been diagnosed with cancer, with an incidence 30 percent higher than in the general population, and more first responders have died from long-term health issues associated with the collapse than during the attack. The toll continues to grow. A new study published in JAMA Network Open found a significant increase in early-onset dementia among 9/11 first responders compared to the general population. The study enrolled about 5,000 9/11 responders who were younger than 60 at the start of the study, and who did not have dementia symptoms or other neurological or cardiovascular conditions. Researchers followed them for an average of five years between 2014 and 2023—and in that time, 228 responders were diagnosed with dementia.
National Preparedness News and Updates
COVID-19
COVID activity continues at brisk pace across much of U.S. , CIDRAP: The West has had the highest wastewater detections for most of the summer, but levels have now declined a bit according to the CDC's latest update.
HHS announces pharmacy-based clinical trial under Project NextGen , CIDRAP: The trial to identify correlates of protection for COVID vaccines will take place at about 20 Walgreens sites, ranging from urban to rural.?
No increase in birth defects found following COVID vaccination in pregnancy , CIDRAP: In the entire cohort, 17,704 infants (5.2%) had a major congenital anomaly.
COVID-19 lockdowns, quarantines linked to mental distress in teens , CIDRAP: The effects were especially apparent among 16-year-olds, those with parents with lower educational attainment, and those with lower genetic susceptibility to depression.
INFECTIOUS DISEASES?
H5N1 Avian Flu
China reports fatal H5N6 avian flu case , CIDRAP: The woman, from Anhui province in eastern China, had recently visited a live poultry market.
Colorado reports 2 more avian flu infections in poultry cullers , CIDRAP: The CDC said the latest patients have mild illness and have been offered antiviral treatment.
Colorado orders weekly bulk tank avian flu testing for dairy farms , CIDRAP: The state has now reported 49 outbreaks in dairy cows, nearly half of its licensed dairy farms.
Study suggests earlier US-licensed H5N1 vaccines prompt antibodies to current strain , CIDRAP: Scientists said until the newer more closely matched vaccine is approved, earlier licensed vaccines might be a useful bridge, if needed.?
Emerging Disease
Salmonella Outbreak from Backyard Poultry Expands to 38 States , CIDRAP: In a new update on a multistate Salmonella outbreak linked to backyard poultry—first announced in May—the CDC reported 86 more illnesses and nine more affected states, raising the national total to 195 cases from 38 states. Initially, outbreak involved five Salmonella serotypes: Altona, Indiana, Infantis, Mbandaka, and Typhimurium. The CDC said two more have been implicated in the illnesses—Cerro and Johannesburg. Of information based on 136 patients, 50 were hospitalized. No deaths have been reported. Just over 40 percent of patients are younger than 5 years old. The latest illness onset is May 30. The CDC warned that the outbreak total is likely much higher and that illnesses probably aren't limited to the states with known cases, given that most people aren't tested and recover without medical care. Of 45 people with information available, 36 had bought or obtained poultry before they became ill. People got the birds from multiple retail stores and directly from hatcheries.
Measles in Minnesota, new polio cases, liverwurst recall due to potential Listeria , CIDRAP: All measles cases occurred in unvaccinated children.
PAHO warns of uptick in whooping cough cases , CIDRAP: Through the first half of 2024, the United States, Mexico, Brazil, and Peru are seeing increases in pertussis cases.
Multistate Listeria outbreak tied to meats sliced at delis sickens 28, kills 2 , CIDRAP: Sixteen of 18 people sickened (89%) reported eating meats sliced at deli counters (not packaged meats).
Chagas Disease more prevalent than anticipated , MedPage Today: Researchers from one Washington, DC, center confirmed that there was a high prevalence of Chagas disease in a sample of Latin American immigrants hospitalized with cardiac conditions.
?India reports fatal Nipah virus infection , CIDRAP: State officials said the boy had eaten plum fruit from the neighborhood before his symptoms began.
Poliovirus found in Gaza wastewater , CIDRAP: GPEI said the viruses are closely related to each other and to a variant that circulated in Egypt in the last half of 2023.
CYBERSECURITY AND PHYSICAL SECURITY
Cybersecurity?
Watch on Demand: CISA Live! Presents: Cybersecurity for Healthcare and Public Health, CISA , Cybersecurity and Infrastructure Security Agency: Recap of CISA Live! event discussing cybersecurity for the healthcare and public health sector, featuring special guests Nitin Natarajan, CISA’s Deputy Director; Brian Mazanec, Deputy Director of the Office of Preparedness within the Administration for Strategic Preparedness and Response (ASPR) at the U.S. Department of Health and Human Services (HHS); and CDR Thomas Christl, Director of the Office of Critical Infrastructure Protection (CIP) within HHS ASPR.?
CISA released two Industrial Control Systems (ICS) advisories on July 25, 2024. These advisories provide timely information about current security issues, vulnerabilities, and exploits surrounding ICS.
领英推荐
The latest CISA Vulnerability Bulletin provides a summary of new vulnerabilities that have been recorded by the NIST National Vulnerability Database (NVD) in the past week. In some cases, the vulnerabilities in the bulletin may not yet have been assigned CVSS scores. Please visit NVD for updated vulnerability entries, which include CVSS scores once they are available.
Free Cybersecurity Services and Tools : As part of the Department of Homeland Security's Cybersecurity and Infrastructure Security Agency's (CISA) continuing mission to reduce cybersecurity risk across U.S. critical infrastructure partners and state, local, tribal, and territorial governments, CISA has compiled a list of free cybersecurity tools and services to help organizations further advance their security capabilities. This living repository includes cybersecurity services provided by CISA, widely used open-source tools, and free tools and services offered by private and public sector organizations across the cybersecurity community. Any reference to specific commercial products, processes, or services by service mark, trademark, manufacturer, or otherwise, does not constitute or imply their endorsement, recommendation, or favoring by CISA.
Health Industry Cybersecurity Tactical Crisis Response Guide : This document is constructed by industry and government experts to help guide response activities.?
Cybersecurity updates: Subscribe to the weekly Healthcare and Public Health Sector Cybersecurity Bulletin .
AI IN HEALTH CARE
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Elusive quadruple aim revisited for the generative AI era, AI in Healthcare: Is U.S. health care capable of achieving its own quadruple aim? Or is that ideal destined to remain a perpetual pursuit, always chased but never really caught?
However you answer, injecting AI into the health care system changes the math producing your conclusion. The report’s authors recommended the following to avoid AI related negatives:
How to Mitigate institutional inequities involving AI , AI in Healthcare: When it comes to adopting health care AI, large, well-off hospitals are likely to frequently homer while smaller, struggling institutions go down looking. (Baseball analogy in honor of tonight’s Midsummer Classic.) As a result, some patients will benefit by AI while many others go wanting. This won’t serve the whole of U.S. health care well. The authors posit that to develop and experiment with AI technologies, equitable access to these technologies is crucial to prevent a widening divide in health care quality.” They suggest that concerted efforts will be need in the following areas:
HEALTH SYSTEM PREPAREDNESS
Shortage of BD blood culture tubes forcing some hospitals to make tough decisions , CIDRAP: A Becton Dickinson (BD) exec said supplier manufacturing problems are behind the disruption and that more supplies should become available in September.
Strengthening the U.S. Public Health Lab System: Summary of Coronavirus Disease (COVID-19) After Action Review Workshop , Rand: Workshop identifies priority areas, recommendations to clarify public health labs’ roles in outbreak responses, address challenges in capacity, agility, and collaboration.?
ASPR Awards $240 Million for Health Care System Readiness Across the Nation , ASPR News Release: The Administration for Strategic Preparedness and Response (ASPR), an agency within the U.S. Department of Health and Human Services, is awarding $240 million through the Hospital Preparedness Program (HPP) cooperative agreement.
“When disaster strikes, HPP supports the health care delivery system to save lives,” said Assistant Secretary for Preparedness and Response Dawn O’Connell. “ASPR is preparing our health care systems for whatever emergency comes next through HPP’s focus on key priorities, such as supporting the health care workforce, preparing for cybersecurity incidents, and providing patient care during a disaster.”?
This award is distributed to 62 recipients representing the governments of all U.S. states, territories, freely associated states, Washington, D.C., Chicago, New York City, and Los Angeles County. Through HPP, ASPR provides funding and guidance to health care coalitions that prepare the health care delivery system to save lives, meet community needs, and provide equitable access to care during disasters and emergencies. By executing these awards, HPP recipients and health care coalitions will begin work on a new set of activities to increase the nation’s readiness for disasters and emergencies, as well as continue essential HPP preparedness activities and exercises, such as those that prepare for medical surge.
Rural Emergency Medical Communications Demonstration Project (REMCDP) , CISA: On June 18, 2024, the Cybersecurity and Infrastructure Security Agency (CISA) released the Fiscal Year 2024 Rural Emergency Medical Communications Demonstration Project (REMCDP) Notice of Funding Opportunity. This opportunity will fund a demonstration project that addresses the National Emergency Communications Plan implementation gaps and enhances existing emergency communications infrastructure to improve the delivery of rural medical care.?
REMCDP provides funding for public institutions of higher education, states, U.S. territories, local governments (e.g., county, city, township), or Indian/Native American Tribal Governments (federally recognized) to work with a public health or medical facility to address barriers and challenges in rural emergency medical communications. Specifically, applicants must demonstrate their ability to leverage existing technologies and engage non-medical professionals to help enhance statewide or regional medical communications systems and improve the delivery of rural medical care. Eligible applicants may apply for $1,000,000 for a two-year period of performance, anticipated to begin on September 30, 2024. REMCDP funding will be awarded to one recipient following a competitive review process.
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Education?
On Demand Webinar: Update on Highly Pathogenic Avian Influenza A(H5N1) Virus for Clinicians and Healthcare Centers , The Centers for Medicare & Medicaid Services?
Highly Pathogenic Avian Influenza (HPAI) (H5N1) virus is widespread among wild birds and continues to cause outbreaks in poultry and spillover to mammals. In March 2024, HPAI A(H5N1) virus was detected in dairy cattle. To date, there have been three human cases of HPAI A(H5N1) virus infection identified in dairy farm workers in the United States. The risk to the public from HPAI A(H5N1) viruses is low; however, people who have job-related or recreational exposure to infected birds or animals, including dairy cattle, are at greater risk of HPAI A(H5N1) virus infection.?
During this Clinician Outreach and Communication Activity (COCA) Call, presenters will give an update on the current outbreak in the United States and current CDC surveillance and monitoring efforts. They will also provide information for clinicians on testing, using antivirals, and infection prevention and control recommendations.?
At the conclusion of the session, the participant will be able to accomplish the following:
Extreme Weather and Healthcare—Lessons Learned and Considerations for the Future , ASPR TRACIE The Exchange, Issue 19?
The articles in this issue of the Exchange can help stakeholders plan for summertime’s extreme weather hazards to include heat stress, burns, and other injuries related to extreme heat; and flooding, utility outages, and other infrastructure failures associated with severe precipitation events (e.g., hurricanes).
Webinar: Healthcare Facility Extreme Weather Resilience and Mitigation , ASPR TRACIE
Speakers from the Office of Climate Change and Health Equity, New York University Langone Medicine, and Mass General Brigham discuss strategies for incorporating lessons from past disasters in the design/retrofitting of climate resilient health care facilities.
Workplace Violence Speaker Series , ASPR TRACIE,
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ITEMS OF INTEREST
New/Updated Resources from ASPR TRACIE
The latest issue of The ASPR Express highlights the following new and updated resources:
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Risk Identification and Site Criticality (RISC) Toolkit is an objective, data-driven all-hazards risk assessment that can be used by public and private organizations within the Healthcare and Public Health Sector to inform emergency preparedness planning, risk management activities, and resource investments. The RISC Toolkit provides owners/operators in the HPH Sector with nationally recognized standards-based evaluation criteria in an easy-to-follow, guided format. It can be utilized by a wide variety of HPH stakeholders including but not limited to hospitals, long-term care facilities, community health centers, health care coalitions, and public health agencies. The RISC Toolkit contains three self-assessment modules. These allow users to identify external threats and internal hazards specific to their site by using objective national-level data; assess the vulnerability of their site based on industry standards and guidance; and evaluate the criticality of and consequences to their site in the event of an incident. The RISC Toolkit compares multiple facilities across systems, coalitions, and regions to identify dependencies and interdependencies in a consistent and repeatable method to help create a more resilient healthcare system.?
Partnering with the Healthcare Supply Chain to Improve Disaster Response and Healthcare Coalition Supply Chain Integrity Self-Assessment Checklist : The health care supply chain is complex, supporting patient care on a daily basis by producing and delivering medications as well as products ranging from gloves and gowns, to diagnostics, to pharmaceuticals and biomedical equipment, to surgical supplies. During disasters or catastrophic events, the health care supply chain can experience distinct strains depending on the nature of the event and the impact on surrounding infrastructure. These resources provide an overview of the emergency planning and response considerations of health care supply chain owners, operators, and end users, as well as insights for health care coalitions working with health care supply chain partners on preparedness, response, and recovery. Checklist
EMTALA and Disasters: This fact sheet addresses several frequently asked questions regarding the Emergency Medical Treatment and Labor Act (EMTALA) and disasters, and provides links to more resources. Note: This document is not intended to be used as regulatory guidance or in place of communications with or guidance from the Centers for Medicare & Medicaid Services (CMS) who oversees EMTALA compliance. Fact sheet
HHS emPOWER Map NEW GIS REST Service Link—Partners must connect to the newly named REST service to consume the layer in their GIS System: Connect to the new link and GIS end points . In doing so, partners will be able to continue to gain population-level situational awareness of electricity-dependent populations in their own GIS applications. Please send any questions you may have to [email protected] and [email protected] .
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Fantastic blog post by Christopher Chamberlain, MS RN CHEP!