The opinions expressed herein are those of the respective authors and do not necessarily reflect the views of the Pacific NorthWest Border Health Alliance or it ‘s constituent jurisdictions.
August 31, 2010
Emergency Responder Health: What have we Learned from Past Disasters?
As the Deepwater Horizon disaster unfolds in the Gulf of Mexico, public health practitioners are having a sinking déjà vu feeling. Once again, environmental disaster has struck, and tens of thousands of emergency responders—some professionals, but many more volunteers—have swung into action, potentially risking their health as they work to clean up the worst oil spill in U.S. history. Veterans of similar disasters are wondering if historical lessons learned can help keep the damage to a bare minimum. But a paucity of hard data on emergency responder health makes it difficult even to ask the right questions.
http://www.medscape.com/viewarticle/726762
August 26, 2010
Doer: U.S., Canada relations crucial
Canada and the United States have more in common than is different. Same goes for its residents. And surprise: Canada is the largest supplier of oil to the U.S., the largest exporter of hydro energy, and the largest supplier of natural gas to the U.S.
Those commonalities and the value of the trade relationship between the countries was brought to the attention of Borderland Friday by Gary Doer, Canada’s 23rd ambassador to the U.S. “We’re friends, we’re neighbors, we’re working together,” he said. “Bottom line economics: We have more people visiting your country than any other country in the world; we have more people buying your goods than any other country in the world; we have more oil coming from our country than any other country in the world. We want to keep that great friendship and keep working together.”
http://www.ifallsdailyjournal.com/news/national-news/doer-u-s-canada-relations-crucial-laurel-beager-editor-108
President Asks Congress to Reallocate $400M for HHS
President Obama has asked Congress to consider reallocating $400 million in the fiscal year 2011 budget to the Department of Health and Human Services, according to a report by AHA News Now. If approved, the reallocation would provide an addition $250 million for health workforce training enhancements, $55 million for high-risk health insurance pools operated by states, $35 million for domestic HIV/AIDS prevention and research, $30 million for state AIDS drug assistance programs and $30 million for health insurance consumer information, according to the report.
These increases would be offset to decreases in funding to other HHS programs including a $184 million reduction in funding for the Centers for Disease Control and Prevention’s public health emergency preparedness grants, according to the report.
http://www.beckersasc.com/healthcare-reform/president-asks-congress-to-reallocate-400m-for-hhs.html
August 19, 2010
Review calls for new federal approach to medical countermeasures
U.S. Department of Health and Human Services Secretary Kathleen Sebelius today (Aug 19/2010) released an examination of the federal government’s system to produce medications, vaccines, equipment and supplies needed for a health emergency, known as medical countermeasures. The Public Health Emergency Medical Countermeasure Enterprise Review: Transforming the Enterprise to Meet Long Range National Needs reviews the process and makes recommendations for a better approach.
The review placed a special focus on the federal government’s flu response, identifying a need to upgrade flu vaccine manufacturing - from modernizing ways to test a vaccine’s strength, known as potency, to new methods to show that the vaccine is safe, as well as ways to produce the early “seed virus” for vaccines faster.
The review also found that private companies have difficulty attracting investors in countermeasures where there is little or no market for these products outside of that currently needed for government stockpiles.
The HHS Assistant Secretary for Preparedness and Response led the review. All federal agencies working with medical countermeasures participated, including the Department of Homeland Security, Department of Defense, and HHS divisions of ASPR and ASPR’s Biomedical Advanced Research and Development Authority, the National Institutes of Health, the Centers for Disease Control and Prevention, and the Food and Drug Administration. The review also incorporated input from state and local health departments, two federal advisory committees of outside experts, industry groups, venture capital experts, and the Institute of Medicine.
http://www.hhs.gov/news/press/2010pres/08/20100819a.html <http://www.hhs.gov/news/press/2010pres/08/20100819a.html>
Full report at: http://www.phe.gov/Preparedness/mcm/enterprisereview/Pages/default.aspx <http://www.phe.gov/Preparedness/mcm/enterprisereview/Pages/default.aspx>
CDC Antibiotic and Antimicrobial Resistance Web Portal
CDC has launched an enhanced Antibiotic and Antimicrobial Resistance web portal: www.cdc.gov/drugresistance. The new website provides an entry point for all antimicrobial resistance activities for the agency. Topics covered include: general information on drug-resistant pathogens, surveillance systems which track and monitor these infections, educational campaign resources, and laboratory testing and training resources. The site offers insight and information geared toward all readers from the general public to clinicians.
Visit the site at: http://www.cdc.gov/drugresistance <http://www.cdc.gov/drugresistance>
August 13, 2010
Lessons from the Frontlines Report on H1N1 Response Released
The Canadian Medical Association (CMA), the College of Family Physicians of Canada (CFPC), and the National Specialty Society of Community Medicine (NSSCM) have just released Lessons from the Frontlines, a collaborative report on H1N1 describing the physician experience on the frontlines of the pandemic.
Superbug did not spread while Alberta man in hospital: Health officials
All that is known is the Alberta resident contracted the illness during a medical emergency in India. He spent an undisclosed amount of time in isolation under medical surveillance. However, the NDM-1 bug did not spread to anyone else when he was admitted to hospital in the spring.
His is one of two cases to be reported in Canada. The other patient was treated in Vancouver. Both recovered. However, doctors have said the NDM-1 strain threatens to take medicine back into the pre-antibiotic era.
Dr. Howard Njoo, of the Public Health Agency of Canada, said the NDM-1 enzyme might be able to attach itself to more serious illnesses. But this doesn’t make these bacteria more infectious, it just makes them more difficult to treat.
“For any bacteria, the actual disease it causes is really no different regardless of whether it’s a drug-resistant strain or not,” said Njoo, who is director general of the agency’s Centre for Communicable Diseases and Infection Control.
http://www.calgaryherald.com/health/Superbug+spread+while+Alberta+hospital+Health+officials/3392680/story.html?cid=megadrop_story <http://www.calgaryherald.com/health/Superbug+spread+while+Alberta+hospital+Health+officials/3392680/story.html?cid=megadrop_story>
August 11, 2010
New Strategy for information sharing
The National Strategy for Information Sharing is but three years old - but changes in technology, culture and conditions necessitated not only an update, but an expansion. “We want to build on the current document, and update it and sketch a target end vision for the Information Sharing Environment and strategies for realizing it,” said Kshemendra Paul, the program manager for the Information Sharing Environment (PM-ISE) . Paul said he will begin working on the document this fall through an interagency process. The White House has instructed him to expand his view to look at the totality of terrorism information sharing across all levels of government, not just focus on sharing with the state, local and tribal communities.
Only a month into his tenure as the PM-ISE, Paul is using his office’s annual report to Congress as a menu of future opportunities. The report details the accomplishments and shortcomings of the ISE in 2009.
http://www.federalnewsradio.com/?nid=35&sid=2024506 <http://www.federalnewsradio.com/?nid=35&sid=2024506>
New superbug gene could spread widely
British scientists have found a new gene that allows any bacteria to become a superbug, and are warning that it is widespread in India and could soon appear worldwide. The gene, which can be swapped between different bacteria to make them resistant to most drugs, has so far been identified in 37 people who returned to the U.K. after undergoing surgery in India or Pakistan. The resistant gene has also been detected in Australia, Canada, the U.S., the Netherlands and Sweden. The researchers say since many Americans and Europeans travel to India and Pakistan for elective procedures like cosmetic surgery, it was likely the superbug gene would spread worldwide.
http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(10)70143-2/fulltext <http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(10)70143-2/fulltext>
August 4, 2010
Canadian Health Interactive website has all the answers
A new website allows Canadians to do one-stop shopping for the latest news about health and safety hazards in their community, province or across the country. HealthandSafetyWatch.com gathers and posts advisories and recalls from the federal, provincial and municipal governments. Launched this week, the idea for the website was conceived in 2007 by Dr. Jeff Aramini after he left the Public Health Agency of Canada, where he had been a food-borne-disease epidemiologist for a decade.
The website gives Canadians access to real-time information about more than 500 products, food and drug recalls. Users can register free to access information based on geographic location and type of recall — consumer product, food, health product and public health issues. More than 200 websites are monitored several times a day.
http://www.healthandsafetywatch.com/Default.aspx <http://www.healthandsafetywatch.com/Default.aspx>
Avian Influenza (H5N1): an overview of the current situation
The global H5N1 avian influenza situation has not improved very much since the virus began spreading widely in 2003, and many human cases have probably gone unreported, French health experts conclude in an assessment published yesterday in Eurosurveillance.
While the deadly virus still has not gained the ability to spread easily from person to person, “The overall worldwide situation of influenza A(H5N1) . . . is not markedly improved since 2003,” says the report by researchers from the French Institute for Public Health Surveillance (Institut de Veille Sanitaire) in Saint-Maurice, a French government agency.
http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19216 <http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19216>
July 30, 2010
What Are the Potential Physical Health Effects From the Gulf Oil Spill?
A Medscape Expert Interview With Vikas Kapil, DO, MPH, From the US Centers for Disease Control and Prevention
A significant growing concern is how the health of coastal residents and response workers involved with the cleanup efforts could be affected over the short and long term.
At the request of the US Department of Health & Human Services, the Institute of Medicine (IOM) quickly convened a workshop, “Assessing the Human Health Effects of the Gulf of Mexico Oil Spill,” on June 22 and 23 in New Orleans, Louisiana. Experts there agreed that existing research that evaluated the adverse health effects for humans from previous oil spills is surprisingly lacking; many of these studies were small, used poor methodology, or focused on short-term health outcomes only.
Vikas Kapil, DO, MPH, is the Associate Director for Science for the Deepwater Horizon Oil Spill Response at the CDC in Atlanta, Georgia. Dr. Kapil spoke with Medscape about the potential physical health effects in humans who are exposed to an oil disaster and what clinicians can do in response to such situations.
http://www.medscape.com/viewarticle/725593?src=mp&spon=42&uac=98401ST <http://www.medscape.com/viewarticle/725593?src=mp&spon=42&uac=98401ST>
July 28, 2010
HHS unveils draft plan to implement national health security strategy
The U.S. Department of Health and Human Services has issued its first-ever “Biennial Implementation Plan” to implement the National Health Security Strategy the department unveiled last year, which is a comprehensive blueprint for dealing with the health consequences of a major man-made or natural disaster or a devastating terrorist attack. The biennial implementation plan, or BIP, focuses on key outcomes that should be realized during the next four years to meet the objectives spelled out in the over-arching National Health Security Strategy. The National Health Security Strategy can be found at: http://www.phe.gov/Preparedness/planning/authority/nhss/Pages/default.aspx. <http://www.phe.gov/Preparedness/planning/authority/nhss/Pages/default.aspx.>
Pdf document at: http://www.phe.gov/Preparedness/planning/authority/nhss/comments/Documents/nhssbip-draft-100719.pdf <http://www.phe.gov/Preparedness/planning/authority/nhss/comments/Documents/nhssbip-draft-100719.pdf>
Review of Disaster Medical Preparedness: Improving Coordination and Collaboration in the Delivery of Medical Assistance during Disasters
Ad Hoc Subcommittee on State, Local, and Private Sector Preparedness and Integration
This hearing will assess how federal efforts and programs coordinate with the private sector to ensure individuals affected by disasters have access to medical care. This hearing will use the activation of hospitals under the National Disaster Medical System (NDMS) during Hurricane Katrina, Hurricane Gustav and the Haiti earthquake as a case study of federal medical preparedness and response efforts. Specifically, the Subcommittee will review the challenges faced by activated hospitals in Little Rock, Arkansas, in response to Hurricane Gustav. These hospitals experienced issues with patient transportation, medical surge capacity and coordination of medical reimbursement between Federal programs and agencies. Reviewing the lessons learned will provide the Subcommittee with a better understanding of the challenges in responding to the medical needs of those affected by disasters and ways to improve Federal response efforts. HHS ASPR’s Dr. Kevin Yeskey testifying at the Senate hearing on July 22nd, 2010. It can be viewed at:
http://hsgac.senate.gov/public/index.cfm?FuseAction=Hearings.Hearing&Hearing_ID=67b0888e-2101-4a44-bfa7-03202adae119 <http://hsgac.senate.gov/public/index.cfm?FuseAction=Hearings.Hearing&Hearing_ID=67b0888e-2101-4a44-bfa7-03202adae119>
July 22, 2010
US starting to work collaboratively on the border, instead of alone
Last week, Public Safety Minister Vic Toews and United States Homeland Security Secretary Janet Napolitano announced a plan to establish a first-ever cross-border approach to critical infrastructure. It would see the two nations sharing information and managing risks in an effort to better prepare and respond to natural disasters. The two countries also announced the possibility of sharing information to combat money-laundering and terrorist financing. But the history of close collaboration has not been that long, experts say. In the aftermath of 9/11, Canada has been mostly reacting to unilaterally-proposed security measures by the US, as opposed to truly working together. It is the language of this latest announcement and the last few months, however, that make experts optimistic about the move towards true collaboration.
http://www.embassymag.ca/page/view/border-07-21-2010<http://www.embassymag.ca/page/view/border-07-21-2010>
Continued tight security on Canada-U.S. border vital: Ambassador
The Canada-U.S. border should be the last line of defence in the battle against terrorism, United States Ambassador David Jacobson told an audience of government and business leaders from both countries this morning in Calgary. A “layered” approach to security that has governments and federal agencies from both Canada and the U.S. working together more regularly on the “perimeter” will ensure the border is both secure and efficient in allowing people and goods to swiftly pass through, he said.
http://www.edmontonjournal.com/business/Continued+tight+security+Canada
July 13, 2010
Public Safety Minister Toews and Secretary Napolitano announce new cooperative initiatives to combat threats and expedite travel and trade
Today, Canada’s Public Safety Minister, Vic Toews and U.S. Department of Homeland Security Secretary, Janet Napolitano, met to advance a strategic dialogue on developing a shared vision for border security for Canada and the United States-one that will enhance security and resilience against common threats, while bolstering competitiveness and job creation.
As part of that dialogue, Secretary Napolitano and Minister Toews announced a first-ever plan to establish a comprehensive cross-border approach to critical infrastructure resilience-focused on the need for a strong partnership to share information and assess and manage risks to enhance both nations’ ability to prepare for and respond to disasters.
“Our mutual security extends beyond our borders and we must work together to mitigate threats before they reach either Canada or the U.S. while facilitating the legitimate mobility of people and goods between us” said Minister Toews. “Crystallizing a shared vision of border security that facilitates trade is a priority if we are to mitigate threats to our joint security and promote economic competitiveness.”
Included in the joint initiatives that will play a critical role in the national and economic security of both nations is an enhanced common understanding of shared threats through the Joint Border Threat and Risk Assessment, which outlines areas of concern along the U.S.-Canada border where there is the potential of terrorism and transnational organized crime. The assessment, which will be released later this summer, jointly addresses drug trafficking and illegal immigration, the illicit movement of prohibited or controlled goods, agricultural hazards, and the spread of infectious disease.
http://www.publicsafety.gc.ca/media/nr/2010/nr20100713-eng.aspx?rss=true
http://www.securitepublique.gc.ca/media/nr/2010/nr20100713-fra.aspx?rss=true
Preparing for the Next Public Health Crisis
An American Progress report suggests establishing a public health response plan to address threats such as the gulf oil disaster. American Progress proposes that a single, high-ranking HHS official be designated to launch and oversee the coordinated response plan implemented whenever a situation arises that can threaten public health. They recommend this leadership role go to the assistant secretary for health, or ASH. The ASH should have responsibility for determining when and how the response to a public health threat moves into the initial emergency phase and when it transitions to a long-term monitoring and management phase. In this proposal the ASH would have responsibility for ensuring-in conjunction with other federal, state, and local agencies, academics, and the private sector-that needed services are delivered and information is collected, and that data, information, and resources are transferred to the responsible HHS agency or agencies.
http://www.americanprogress.org/issues/2010/07/public_health_plan.html
http://www.americanprogress.org/issues/2010/07/pdf/public_health_emergencies
July 9, 2010
Canadian health care—Follow the leader
As American debated health-care reform last year, many advocates of universal coverage looked approvingly at Canada, which spends less per head on medical care than the United States does and has a longer life expectancy. Yet this pillar of Canada’s national identity is now creaking under the burden of cost. Health spending, which is administered by the provinces, has increased from nearly 35% of their total budgets in 1999 to 46% today. The Economist reports that the biggest culprit is prescription drugs, which have seen their share of public-health spending triple since 1980.
Canada is renowned as a source of cheap drugs on the internet. But whereas branded medicines cost less in Canada, because provinces making giant orders can negotiate lower prices with manufacturers, generic-drug costs in Canada are among the world’s highest. Although provinces cap the amount they pay for generic drugs at a fixed fraction of the branded price, they have set the bar too high. That has allowed manufacturers to pay pharmacists legal kickbacks-worth C$750m ($717m) a year in Ontario alone-for stocking their products, while still earning large profits.
In March Ontario said it would slash the ratio of generic to branded prices from 50% to 25%, saving over C$500m a year. The province offered to replace some of pharmacists’ lost income by increasing dispensing fees and paying them for patient counselling. But the industry was not mollified. Shoppers Drug Mart, Canada’s biggest pharmacy chain, threatened lay-offs and store closures, and asked customers to sign protest cards. It also made the fight personal, cutting hours at seven stores in the provincial health minister’s district. The official leading the reform, who had received death threats in a previous round of cost-cutting, now has police protection.
Future battles over health costs will probably not be so easily won. One time bomb is set for 2013, the expiry date of a deal between the federal government and the provinces to transfer C$25 billion a year into provincial health coffers. Seeking to shore up its finances in advance, Quebec added a health tax to its 2010 budget, requiring individuals to share a burden directly that was previously paid out of general public revenues or withheld from wages. And like most rich countries, Canada’s population is ageing, and the demands on its health system will soar when the baby-boom generation retires. America has already had its dose of health-care debate; Canada’s may just be starting.
http://www.economist.com/node/16542808?story_id=16542808&fsrc=rss
July 8, 2010
What BP Can Learn from Healthcare Emergency Preparedness
As oil continues to gush into the Gulf of Mexico and news reports pour out details of BP’s ill-prepared incident management plan and capabilities, healthcare emergency management professionals suggest that BP could have been better prepared.
A blog posting on LiveProcess’s website, blog.liveprocess.com, offers up lessons BP can learn from healthcare emergency preparedness, an industry responsible daily for millions of lives, a business under constant scrutiny and regulation:
Assess all risks, even low-probability ones. Healthcare emergency preparedness usually begins with an assessment of hazards that could impact a facility. Then plans are crafted to address the high-risk threats. High-impact, low-probability events are almost always included in their plans. Simply ask anyone that lives in a tornado, hurricane or earthquake area and it’s very likely they have well-tested plans in place.
Assume that any event could become a long-term event. Healthcare conducts business impact analysis (BIA) to identify critical business functions that could be impacted by any hazard and subsequently develops continuity of operations plans (COOP) or business continuity plans (BCP) that ensure these functions continue in order to maintain patient care services.
Work closely with your community partners. Healthcare emergency coordinators work closely with their communities for planning and testing of plans. This transparency makes the plans more realistic and helps all agencies work together with greater accountability and clear expectations.
Adhere to regulatory guidelines. Healthcare is highly scrutinized by regulators and standards organizations. There are numerous local, state and federal requirements that continuously review and challenge healthcare’s planning efforts. While having so many different organizations and agencies is often tedious, it also helps prevent any planning gaps.
June 30, 2010
The end of North American trilaterism
Harmonization was once all the rage, but under Obama the initiative appears dead Established in August 2007 by Canada, the US and Mexico, the Security and Prosperity Partnership (SPP), was 20 working groups of bureaucrats, hammering away on issues from harmonizing regulations to developing pandemic preparedness plans. A means to to continue North American economic integration where NAFTA had left off. The SPP had withstood the transition from Canada’s Paul Martin to Stephen Harper and from Mexico’s Vicente Fox to Felipe Calderón. But at the first trilateral summit attended by Obama last summer in Guadalajara, Mexico, the leaders shut it down. The 20 working groups were disbanded; Obama declared the process should be left to individual cabinet secretaries and ministers, and opened to the public and other interest groups such as his allies in the labour unions. Although the leaders identified 10 priority areas, the results of the ad hoc process, if it can be called a process at all, have been negligible, according to Chris Sands, a senior fellow at the Hudson Institute, a Washington think tank, and Greg Anderson, a political scientist at the University of Alberta in Edmonton, who have concluded that little headway has been made on any of the 10 agenda items.
http://www2.macleans.ca/2010/06/29/the-end-of-the-trilateral-dream/
June 23, 2010
B.C.’s Response to the H1N1 Pandemic: A Summary Report June 2010
Under the signature of Dr. Perry Kendall, B.C. Provincial Health Officer, this report oulines key events, tactics and lessons learned from B.C.’s response to the 2009 H1N1 pandemic. Of note on the lesson’s learned, Dr. Kendall states “We have learned that mass immunization clinics can’t be “first-come, first-served,” and that they could be better organized by allowing appointment-style bookings. We have learned that using schools or community centres as bases for immunization clinics would probably make good sense for future mass vaccination efforts. We have learned that further engagement and leveraging of B.C.’s primary care physicians would be beneficial to a smoother and more streamlined and effective immunization effort.” http://www.hls.gov.bc.ca/pho/pdf/PHO_Report_BC_Response_to_the_H1N1_Pandemic_June2010.pdf
How the Performance of the U.S. Health Care System Compares Internationally, 2010 Update
Despite having the most costly health system in the world, the United States consistently underperforms on most dimensions of performance, relative to other countries. Previous reports by the nonprofit Fund, which conducts research into healthcare performance and which promotes changes in the U.S. system, have been heavily used by policymakers and politicians pressing for healthcare reform. This report—an update to three earlier editions—includes data from seven countries and incorporates patients’ and physicians’ survey results on care experiences and ratings on dimensions of care. Compared with six other nations—Australia, Canada, Germany, the Netherlands, New Zealand, and the United Kingdom—the U.S. health care system ranks last or next-to-last on five dimensions of a high performance health system: quality, access, efficiency, equity, and healthy lives. Newly enacted health reform legislation in the U.S. will start to address these problems by extending coverage to those without and helping to close gaps in coverage—leading to improved disease management, care coordination, and better outcomes over time.
Note: Overall ranking chart (below) shows Canada at position number 6. Netherlands is number one, UK number two.
http://www.commonwealthfund.org/Content/Publications/Fund-Reports/2010/Jun/Mirror-Mirror-Update.aspx
June 22, 2010
HHS Assistant Secretary for Preparedness and Response (ASPR) Launches new Public Health Emergency Portal
The new PHE.gov acts as a cross-governmental portal for residents in the U.S. and worldwide to obtain information from all U.S. federal agencies and their state and local partners involved in a public health emergency, medical disaster or public health aspects of a natural or man-made disaster.
The site was created by the HHS Office of the Assistant Secretary for Preparedness and Response (ASPR) in conjunction with cross-governmental partners to meet public information requirements of the Pandemic and All Hazards Preparedness Act of 2006, Public Law No. 109-417 and National Health Security Strategy (NHSS) objectives.
Using this portal, visitors can find the current status and actions taken by the federal government in preparing for and responding to public health emergencies and medical disasters. Links to report potential public health threats, and information about medical response, emergency support functions and medical services are also available along with public health actions taken by the federal government during domestic and international emergencies. In addition, visitors can learn about U.S. efforts to provide basic and advanced research and development of medical countermeasures and how these countermeasures will be used in response to public health emergencies.
The portal also provides specific information for federal, state, and local emergency planners to aid in preparing for, responding to, and recovery from public health emergencies. Information on legal authorities and guidance, preparedness and planning tools, and specific preparedness programs are also provided for emergency planners. Information for responders includes information on physical safety and mental health, and guidance for dealing with specific public health emergencies.
http://www.phe.gov/Preparedness/pages/default.aspx
Experts warn bioterror could be future of war
The continued proliferation of chemical, biological, nuclear and radiological weapons is a major concern for U.S. military officials and could end up changing the battleground for troops according to experts. Commanders under U.S. Central Command recently expressed such concerns during a Special Operations Forces Industry Conference, nationaldefensemagazine.org reports. While the panelists agreed that they did not know where the next wars will be fought, they agreed troops should be prepared for a number of possibilities, including chemical and biological attacks.
One concern expressed by Air Force Major General Charles Cleveland is that the Defense Department has not invested enough in next-generation protective gear to protect troops from a combination of different terrorist attacks, including biological or chemical weapons.
http://www.bioprepwatch.com/news/213457-experts-warn-bioterror-could-be-future-of-war
June 19, 2010
A framework for research ethics review during public emergencies
New strategies are needed for emergency review to help research ethics boards and institutions expedite research while respecting ethics review procedures, according to an article reported online June 7 in the Canadian Medical Association Journal. Lead author Catherine M. Tansey is quoted in Medscape Medical News stating “We have no strategy for research ethics review during public emergencies now, and we found that the normal research ethics review didn’t work during the [severe acute respiratory syndrome (SARS)] outbreak,” ….. “Because the current system is so bogged down with paperwork, it could take weeks or months for research ethics review, and there just isn’t time for that during public emergencies. Also, there are special circumstances during public emergencies — for example, some research subjects may have already had their privacy breached because of media attention, and that could make them more vulnerable or at risk.”
Medscape: http://www.medscape.com/viewarticle/723711
CMAJ online: http://www.cmaj.ca/cgi/rapidpdf/cmaj.090976v1?maxtoshow=&hits=10&RESULTFORMAT=&fulltext=Tansey&searchid=1&FIRSTINDEX=0&sortspec=date&resourcetype=HWCIT&eaf
June 17, 2010
Experts Approve of Information-sharing Boost in House WMD Bill
Federal efforts to facilitate information sharing and interagency collaboration to address bioterrorism threats generally have faltered to date, experts on biological agents told a House panel last Tuesday. But legislation due to be marked up next week could help reverse that trend.
The Weapons of Mass Destruction (WMD) Prevention and Preparedness Act of 2010 (HR 5498), introduced last week by Reps. Bill Pascrell (D-NJ) and Peter King (R-NY), would direct the director of national intelligence to produce and administer a National Intelligence Strategy for Countering the Threat from WMD in consultation with the homeland security secretary and other relevant agencies.
http://www.hstoday.us/content/view/13640/149/
June 7, 2010
BMJ: European group criticize WHO pandemic actions
An article published by the British Medical Journal says three scientists who helped frame World Health Organization (WHO) guidance on pandemic influenza preparedness had consulted for pharmaceutical companies that stood to profit from the WHO guidance and that the WHO did not disclose the scientists’ industry ties. The lengthy report, published online yesterday, says the scientists had declared their industry connections in other publications, but the WHO did not reveal them in its guidance document, WHO Guidelines on the Use of Antivirals and Vaccines During an Influenza Pandemic, issued in 2004.
* “Key scientists advising the World Health Organization on planning for an influenza pandemic had done paid work for pharmaceutical firms that stood to gain from the guidance they were preparing. These conflicts of interest have never been publicly disclosed by WHO, and WHO has dismissed inquiries into its handling of the A/H1N1 pandemic as “conspiracy theories.”
The report also raises other questions about the WHO’s transparency and its management of potential conflicts of interest. In particular, it is critical of the WHO’s refusal to reveal the names of the members of its Emergency Committee, which was set up to help guide the WHO response to the H1N1 pandemic, including when to change pandemic alert phases. The secrecy fuels conspiracy theories about issues such as the triggering of vaccine contracts, the article says.
http://www.cidrap.umn.edu/cidrap/content/influenza/swineflu/news/jun0410conflict.html
Conflicts of interest: WHO and the pandemic flu “conspiracies.” BMJ 2010;340 (published online Jun 3): http://www.bmj.com/cgi/content/full/340/jun03_4/c2912
Caltech Biologists Provide Molecular Explanation for the Evolution of H1N1 Flu Virus Resistance to Tamiflu
Biologists at the California Institute of Technology (Caltech) have pinpointed molecular changes that helped allow the global spread of resistance to the antiviral medication Tamiflu (oseltamivir) among strains of the seasonal H1N1 flu virus. The study-led by David Baltimore, Caltech’s Robert Andrews Millikan Professor of Biology and recipient of the 1975 Nobel Prize in Physiology or Medicine, and postdoctoral scholar Jesse D. Bloom-appears in the June 4 issue of the journal Science.
http://www.sciencemag.org/cgi/content/abstract/328/5983/1272
May 23, 2010
Canada needs to step up to prevent human infections: experts
Up to three-quarters of all emerging infectious diseases in humans come from animals, but Canada doesn’t have an early-warning system to detect or prevent those illnesses. Instead, public-health officials respond as outbreaks occur, which is neither smart nor economically sound with a resurgence in new viruses, experts say.
“Part of the problem that I think has been recognized with this pandemic (H1N1) is the major gaps and lack of surveillance that’s been done in animals,” says Dr. Donald Low, who is medical director of Ontario’s public-health laboratories.
Some experts blame the rise of zoonotic outbreaks on factory farms. Others argue the proximity of people, pigs and poultry, especially in the backyards and markets of Asia, is a breeding ground for new animal-to-human viruses. Meanwhile, global travel and trade have made it easier for people and live animals to spread viruses rapidly, making surveillance a necessity, experts say.
According to Dr. Danuta Skowronski, an epidemiologist at the British Columbia Centre for Disease Control, the obvious place to build a first line of defence is on pig and chicken farms, where evolving animal viruses are most likely to infect humans. “We should have better systems in place for routine monitoring of influenza-like illness in workers with swine and with poultry,” says Skowronski.
http://www.montrealgazette.com/health/Canada+needs+step+prevent+human+infections+experts/3062136/story.html
May 21, 2010
China prevented several bioattack during 2008 Olympics
Reuters reports that thorough planning by Chinese officials led to a bioterrorism-free 2008 Beijing Olympic experience. During the 2008 Games, security dealt with several threats of possible biological, chemical and explosive attacks, according to the report. Reuters reports that five unidentified embassies in Beijing received packages containing unidentified white powder. The powder was later tested and found to be harmless, according to a Beijing Health Bureau official, Reuters reports. Other threats that were uncovered and never materialized during the games included plans to target Olympic venues, load a plane at the Beijing airport with explosives and set off an explosion on the metro train, Reuters reports.
Reuters further states that Chinese officials released a wanted list of eight people after the games who they said had threatened terror attacks on the Olympics. The report states that all eight wanted people were of China’s mostly Muslim minority group, Uighur, and were connected to the East Turkestan Islamic Movement, which the United Nations has said is tied to al Qaeda.
While Beijing went unharmed during the 2008 Summer Olympics, Xinjiang was hit by three attacks before and during the games, according to Reuters. The attacks - involving bombings and stabbings - resulted in 30 total deaths.
http://www.bioprepwatch.com/news/213115-china-prevented-several-bioattack-during-2008-olympics
http://ca.reuters.com/article/sportsNews/idCATRE64I3UA20100519
“Google Flu Trends” Found to Be Nearly on Par with CDC Surveillance Data
By comparing the popularity of the 50 million most common Google search queries in the U.S. with flu-like illness rates measured by the U.S. Centers for Disease Control and Prevention’s (CDC) national surveillance program, the Flu Trends team narrowed down the pool to 45 search terms (relating to symptoms, complications and remedies) that correlated with the agency’s data on the prevalence of flu symptoms.
The CDC’s national surveillance program is based on weekly reports from 3,000 health clinics that count the number of patients with a fever and a cough or a sore throat. But it takes up to two weeks for these numbers to be compiled into meaningful and publicly available information about flu trends, Yood says. Google Flu Trends is updated daily, and according to data from the 2007-2008 flu season, it can bridge the CDC’s two-week lag, potentially buying officials critical extra time to devise a public health response and curtail the virus’s spread.
http://www.scientificamerican.com/article.cfm?id=google-flu-trends-on-par-with-cdc-data
Canadians healthier, outliving Americans: Universal health care seen as important factor in higher quality of life
Canadians tend to lead longer, healthier lives than Americans on average, say researchers who point to lack of universal health care in the U.S. as one reason. The study in Thursday’s online issue in BioMed Central’s journal Population Health Metrics was based on data from the 2002-03 Joint Canada/United States Survey of Health, which offered comparable data on the health of the population in both countries. David Feeny, a dual Canadian/U.S. citizen and investigator at the Center for Health Research at Kaiser Permanente Northwest in Portland, Ore., and his U.S. colleagues calculated health-adjusted life expectancy, which takes into account not only mortality risk but also the health-related quality of life, such as being free of disability. The study’s authors found a 19-year-old in Canada could expect to enjoy 2.7 more years of perfect health than a 19-year-old in the U.S. In this case, someone in perfect health would have a top score of 1.00 on the Health Utilities Index Mark 3. The index lowers an individual’s score depending on their level of disability in eight areas: vision, hearing, speech, ambulation dexterity or ability to move, emotion, cognition, pain and discomfort. The lowest score is 0.00 for death. About two-thirds of the gap was because mortality rates in Canada are lower and the remaining one-third was thanks to lower rates of morbidity or disease in Canada -differences Feeny called “quite substantial” with policy implications on both sides of the border.
http://www.cbc.ca/health/story/2010/04/28/health-life-expectancy-canada-us.html
Link to journal report: http://www.pophealthmetrics.com/content/5/1/10
April 26 2010
A year later, 5 lessons from swine flu outbreak
USA Today reports that since 9/11, governments at all levels have spent billions to prepare for pandemics, and most experts say the swine flu outbreak showed that the planning paid off. In some ways the nation got lucky that this past year’s H1N1 was not more severe. It suggests that swine flu’s most potent legacy is five valuable lessons it can teach:
*Use warnings wisely..
*It’s better to overreact than underreact.
*It’s better to underpromise and overdeliver.
*Replace those chickens.
*The feds can’t do it all.
Full story: http://www.usatoday.com/news/opinion/editorials/2010-04-26-editorial26_ST_N.htm
Airborne Fungus Expected to Spread in U.S.
A potentially deadly airborne fungus, widely dubbed the killer fungus, has infected more than 50 people in the U.S., according to the CDC, and is expected to spread from the Pacific Northwest where it first surfaced. Even so, public health officials say, there is cause only for concern and awareness, but not for alarm. The killer fungus, which first surfaced in Canada in 1999, appeared in the U.S. in Washington in early 2006. Since then, reports of cases have occurred in Oregon and Northern California.
http://www.webmd.com/lung/news/20100423/airborne-fungus-expected-to-spread-in-u-s
http://www.aerzteblatt.de/nachrichten/40956/C_gattii_Tropische_Pilzsporen_in_Vancouver.htm
April 21 2010
IT disaster recovery planning and earthquake emergency response: Lessons learned from Haiti
The 2010 Haiti earthquake killed more than 210,000 people, and approximately 1 million people were evacuated from their homes. That disaster was followed about a month later by the 2010 Chilean earthquake, which scientists said shifted the earth’s axis, and generated a blackout that affected 93% of the country and lasted for several days in some areas. And more recently, the death toll from China’s recent earthquake is nearing 2,400 according to reports. In the aftermath of Katrina and other hurricanes a few years back, IT personnel in certain geographic areas made hurricane preparation a top priority in IT disaster recovery planning.
These earthquakes in Haiti and Chile should prompt IT organizations to look at how they’re prepared to survive earthquakes, just as Katrina and other hurricanes a few years back made hurricane preparation a top priority in IT disaster recovery planning in certain geographic areas. http://searchdisasterrecovery.techtarget.com/news/article/0,289142,sid190_gci1510356,00.html
April 19 2010
Capacity of Public Health Surveillance to Comply with Revised International Health Regulations, USA
US Centers for Disease Control and Prevention, Council of State and Territorial Epidemiologists and US Department of Health and Human Services report on capacities and compliance with IHR of all 50 states and Washington, DC. Overall reporting capacity was high. Eighty-one percent of respondents reported being able to transmit notifications about unknown or unexpected events to the Centers for Disease Control and Prevention (CDC) daily. Additionally, 80% of respondents reported use of a risk assessment tool to determine whether CDC should be notified of possible public health emergencies. These findings suggest that most US states have systems in place to ensure compliance with IHR. However, full state-level compliance will require additional efforts.
