Category Archives: Disasters
Study: New Requirements Needed for Hand Hygiene for Anesthesia Providers
Anesthesia providers frequently miss identified opportunities to clean their hands during surgical procedures, with the points immediately before patient contact and immediately after contact with the patient’s environment the times when they are least likely to practice proper hand hygiene, according to a new study in the American Journal of Infection Control. However, the findings also point to a larger problem: Complete compliance with all hand hygiene guidelines would take so much time that there would be no time to actually perform any procedures. The findings indicate “a need to create more practical—but still effective—methods of controlling bacterial transmission in anesthesia work environments.” Read more on prevention.
HHS: $840M to Help State, Local Agencies Improve Disaster Preparedness
The U.S. Department of Health and Human Services (HHS) has awarded approximately $840 million in grants to help state and local public health and health care systems improve their emergency response preparedness. Distributed through the Hospital Preparedness Program (HPP) and the Public Health Emergency Preparedness (PHEP) program, the funds will ensure that communities are prepared to respond to an array of emergencies, including infectious disease outbreaks, natural disasters, or chemical, biological, or radiological nuclear events. “Community and state preparedness is essential to the health security of all Americans,” said Nicole Lurie, MD, assistant secretary for preparedness and response (ASPR), in a release. “Events in the last few years have demonstrated how critical it is for health systems across the country to be ready and able to respond quickly and effectively.” Read more on disasters.
ACP: Annual Pelvic Exams Not Needed for Asymptomatic Women
Annual pelvic exams for women do more harm than good and should not be a routine part of health care for women who are not pregnant or who show no other signs of pelvic problems, according to new guidelines from the American College of Physicians (ACP). In a review, researchers found no studies on the effectiveness of pelvic exams in identifying cancers, infections and other health issues that they are commonly used to find. Researchers stressed that their findings only apply to pelvic exams and that women should still undergo recommended cervical cancer screening. Read more on prevention.
During Hurricane Katrina, volunteers at American Red Cross shelters in the Gulf region noticed a pattern among some of the young children settling in as the storm began: They had brought pillowcases from home filled with some of their most precious items, such as a favorite book or a devoted stuffed animal. Other volunteers learned that evacuating college students also carried their belongings in pillowcases.
Following the storm, chapters along the Gulf launched a pilot called the “Pillowcase Project” that earlier this year became a national program of the American Red Cross, sponsored by the Walt Disney Company. Chapters across the country and in several pilot countries are now adapting the project to teach preparedness to children in grades 3 to 5 at school, after school and in camp settings.
“We’re working hard to get kids involved in preparedness,” said Jim Judge, a member of the American Red Cross Scientific Advisory Council. Judge said getting kids involved helps dispel some of the fear they may face as they evacuate to avoid a disaster, “but we’ve also found that if you get the kids involved, often times they go home and get the parents involved [as well].”
But why a pillowcase? “Just about every home has a pillowcase, it’s inexpensive, you can decorate it and it’s a simplified way of getting kids involved,” he said.
In the pilot programs, kids get the pillowcases and supplies such as a mini first-aid kit, a glow stick, an activity book and crayons, all of which they use to start their own personalized disaster kit and preparedness plan. As part of the program, they learn about the types of emergencies that can impact their community and then they do a physical activity—such as leaving the building—to reinforce what they’ve learned. Afterward they talk about the lessons in small discussion groups.
“The hands-on activities will also help to build confidence so that kids are prepared to take action during an emergency,” said Francisco Ianni, who oversees Red Cross youth readiness programs throughout Oregon and Southwest Washington State.
>>Bonus Link: Watch a pillowcase presentation to a group of young students
One of the key lessons of Hurricane Sandy—which caused massive destruction in New York and New Jersey, two states that don’t usually see that kind of weather devastation—is that disasters can strike anywhere. That’s the thinking behind a new exhibit at the National Building Museum in Washington, D.C., Designing for Disaster, which brings together objects, video, photos and interactive components to show that policies, plans and designs can result in safer, more disaster-resilient communities.
A key goal of the exhibit is to share ideas for building and rebuilding. In a recent interview posted on the museum’s website, the exhibit’s curator, Chrysanthe Broikos, asks “as we face an increasing number of destructive and deadly natural disasters...should we have the right to build exactly what we want, where we want, no matter the risks? Should we give more thought to the long-term viability and protection of the structures and communities we build?”
Those are policy discussions underway right now, and some suggestions are being shared in a “disaster mitigation” blog launched to complement the exhibit. The blog invites building and disaster experts to post their ideas and thoughts on how to make us all more disaster-resilient.
The exhibit highlights current work by planners, engineers, designers, emergency managers, scientists, environmentalists, business leaders and community leaders, some viewable in a short video on the exhibit. For example, constructed just for the exhibit is a Federal Emergency Management Agency (FEMA) “safe room” that would be highly protective if a tornado struck. But the exhibit asks the necessary questions, as well. For example: What if requiring safer construction makes housing unaffordable for many?
While many of the exhibit designs are experimental, the museum’s website also offers resources to learn about steps individuals can take in their own homes and communities to prepare for disasters, remain safe and prevent damage. FloodSmart, for example, is a FEMA resource which lets users see how much damage flooding can cause, assess flood risk and learn about flood insurance.
>>Bonus Link: On June 24, the National Building Museum will hold a competition, Rebuild by Design, that challenges contestants to envision rebuilding designs for communities devastated by Hurricane Sandy.
Recovery after a disaster can take years or even decades—but what most people don’t realize is that recovery starts even before the disaster occurs. Resilience is about how quickly a community bounces back to where they were before a public health emergency—and only a healthy community can do that effectively.
NewPublicHealth recently spoke with Alonzo Plough, PhD, MPH, Vice President, Research-Evaluation-Learning and Chief Science Officer at the Robert Wood Johnson Foundation, about taking steps toward recovery even before a disaster occurs.
NewPublicHealth: What are some important aspects of preparedness that help prepare responders and the community for recovery from a disaster?
Alonzo Plough: Connectivity between organizations, between neighbors, between communities and formal responder organizations is absolutely critical to building community disaster resilience. This allows recovery to go more smoothly because the partners who have to work together in recovery have been working together and connecting to communities prior to a disaster event. Managing the long tail of recovery is easier if there has been recovery thinking in the preparedness phase.
NPH: One of the issues for the panel at the recent Preparedness Summit is the impact of the news spotlight when a disaster occurs, and then the impact of that spotlight turning off. How does that focus impact recovery?
Plough: Often the initial media frames are to wonder why there weren’t preventive mechanisms. In the case of the mudslides in Washington State, for example, why weren’t there zoning restrictions or regulatory restrictions? That initial media frame often will point a finger to ask why houses were allowed to be built in an at-risk location. Why were building permits given at all?
But none of that really addresses the long-term issues of communities working toward recovery, regardless of the specific event. There is a disruption of life as people know it in a disaster that goes on for a long, long period of time. The media doesn’t really capture the complexity of that while they’re focused on the short-term outcomes. When the media focus goes away, the appropriate agencies and organizations who need to be engaged continue their engagement.
A recent survey by the Federal Emergency Management Agency (FEMA), found that only 34 percent of Americans said they would have access to financial, insurance and other records if they had to evacuate in a disaster. Now that hurricane season has begun, that slim response is pushing FEMA regional directors to promote financial preparedness along with other safety reminders.
“Don’t hinder your recovery if disaster strikes. Take the time now to ensure critical documents are safely stored, valuables are adequately insured, and potential spending needs are planned for,” said Andrew Velasquez III, regional administrator for the FEMA Midwest region.
Among FEMA’s tools and advice:
- FEMA has created an Emergency Financial First Aid Kit which provides reams of information, including documents to store online or on a flash drive, such as household bills, credit card statements and loan information. That information can help stabilize your financial status after a disaster and can be critical for avoiding fines if you are late on bills and for certain loans and grants.
- FEMA also recommends enrolling in online banking, direct deposit for paychecks and Go Direct for online deposits of federal benefits such as social security. This will help people avoid disruptions in income due to a disaster.
- FEMA recommends people keep some cash or traveler’s checks in a plastic bag in their Go Kit. After many disasters power outages keep ATMs offline, just when many businesses—also without power to process credit card transactions—were often requiring payment in cash only.
- Take the time now to print out a copy of Recovery after Disaster: The Family Financial Toolkit, developed by the University of Minnesota Extension and North Dakota State University Extension Service after disasters in those states. The toolkit is full of critical information such as what information you’ll need to show to secure a small business loan if your business is destroyed. The kit also has fill-in logs that help keep track of assistance you’ve requested and responses.
>>Bonus Link: The 2014 Consumer Action Handbook has information on avoiding financial scams including many that people can fall prey to after a disaster.
Millions of people have now seen their phone shake and heard it wail with news of an impending tornado or other disaster. Two years ago the wireless industry rolled out a free service known as wireless emergency alerts, and wireless carriers representing more than 98 percent of subscribers agreed to participate.
People with older phones, however, may not be able to access the alerts. Brian Josef, general counsel for the CTIA—The Wireless Association in Washington, D.C., recommends checking for the capability when buying a new phone and. For your current phone you can check with your carrier’s customer service office to see whether you automatically get the alerts.
People who can’t receive the texts, or who want a double layer of information, can sign up with local emergency management offices and get alerts via phone, text, email and in some cases Twitter—although sessions at the recent Preparedness Summit in Atlanta indicated that while Twitter is growing, it is still not used by many local and state health departments. Check the bottom of your health department home page to find the Twitter handle, if there is one.
Josef also points out that you may find that a neighbor got an alert and you didn’t—but that’s because the alerts are geo-targeted. If you and your neighbor were a few miles away from each other when an alert went out, only the one in harm’s way would get pinged.
But the apps won’t do you much good if your phone loses its charge. Preparedness experts recommend keeping a charged extra battery and portable charger on hand, and some emergency radios also include phone/device chargers.
Other tips to conserve your smartphone battery, according to Mary Clark, Chief Marketing Officer of the mobile technology company Syniverse, include:
- Reduce the brightness of your screen
- Close unnecessary apps
- Use text messages to communicate with friends and family
- Send an initial text to those most important detailing your plans
- Turn off unneeded options such as Wi-fi and Bluetooth
Hurricane season began yesterday and runs through the end of November. New this year for the season are storm surge maps from the National Weather Service (NWS) to underscore the danger that a surge poses during a severe storm. Storm surge is an abnormal rise of water generated by a storm, over and above the predicted tide levels, according to the NWS. “Most people see wind as the key threat in a tropical storm or hurricane, but surge can be far more deadly,” said Dennis Feltgen, a spokesman for the NWS.
The new, color-coded maps will be updated every six hours during storms that pose a surge risk along the Gulf and Atlantic Coasts. The maps highlight:
- Geographical areas where inundation from storm surge could occur
- How high above ground the water could reach in those areas
- Inundation levels that have a 10 percent chance of being exceeded
Maps will be available 45 minutes to an hour after each new advisory, to give cartographers time to plot their points.
The new maps are experimental for two years. The NWS will be collecting and reviewing public comments, and then afterward decide whether the maps will become a permanent product. Even if they don’t, say public health experts, the model maps are important right now in order to educate the public about the threat posed by a surge—even at fairly low heights.
For example, six inches of water can knock over an adult and two feet of water is all that’s needed to carry an SUV, according to the data from the NWS.
The NWS’ Feltgen said Hurricane Sandy is an important example to share when explaining storm surge because of the damage that storm’s surge did to inland communities. For instance, the surge knocked out power to many financial firms on Wall Street, which were then powered by generators as repairs went on for months after the storm. And many residents of high rise apartment buildings in Manhattan and other parts of New York City were stranded or limited to stairs until the electricity was fixed and elevators could run.
Other storm surge facts:
- More than half of the nation's economic productivity is located within coastal zones
- 72 percent of ports, 27 percent of major roads and 9 percent of rail lines within the Gulf Coast region are at or below 4 ft. elevation.
- A storm surge of 23 feet has the ability to inundate 67 percent of interstates, 57 percent of arterials, almost half of rail miles, 29 airports and virtually all ports in the Gulf Coast area.
>>Bonus Link: The National Weather Service has a fact site on storm surge, including photos of the havoc wreaked by surge episodes.
Hurricane season—which officially starts in two weeks—has become a time of year for individuals, communities and organizations to assess their state of readiness for withstanding and surviving a disaster.
A recent Atlantic Cities article profiled a model to follow: the Providence Baptist Church in the Bayview community of San Francisco. Led by local pastor GL Hodge, who has both big box retail and crisis experience, the church has monthly resiliency meetings to establish a local response, and has provided CPR and disaster training to church members through the American Red Cross. The church has also worked to develop community trust by providing after school programs, weekly dinners, a weekly food bank and a shelter on the church grounds that sleeps more than 100 people every night.
Steps to help try to prevent large scale death and injury if an earthquake or other disaster hits include distribution of plastic bags to seniors to store their medicines and ID if they need to evacuate; placards that fit on door knobs indicating if they’re OK or need help in the event of a disaster; and a proposal that would use community development funds to train young men how to strengthen the foundations of senior’s homes, which would improve the chance that the structures would survive a disaster.
“We’re preparing a culture of preparedness,” says Hodge.
Read the full story here.
>>Bonus Link: Read a previous NewPublicHealth interview with Irwin Redlener, MD, director of the National Center for Disaster Preparedness at Columbia University’s Mailman School of Public Health.
In the wake of disasters communities often share stories of resiliency, not just to show how far they have come, but to model for others the critical need for an infrastructure of planning and preparedness when disaster hits. When the bombs went off at the Boston Marathon last year, Achilles International, a non-profit group that pairs able-bodied runners with disabled people, already had a chapter in place in the Boston area.
The group reached out using social media, as well as bright yellow banners and shirts during twice-weekly training sessions along the Charles River, to help attract attention and encourage Bostonian volunteers and potential athletes to join up. One survivor did. Thirty-one-year old Mery Daniel, a single mother of a five-year-old, who is close to completing her medical boards to become a general practitioner physician, lost one leg and suffered damage to the other during the blast. She joined up with Achilles and ran its 5K Hope and Possibility race—her first race ever—using a hand cycle last June.
The community rallying around the Boston Marathon over the last year has resulted in several new competitors joining up to compete in the Boston Marathon. A team of thirty differently abled Achilles runners, each with at least one guide for the race, will be wearing yellow Achilles shirts in today’s marathon. Their disabilities—ranging from Dwarfism and scoliosis to visual impairment—have not held them back.
“The stories about the survivors’ recoveries brought attention to the fact that people with disabilities have opportunities to do things they enjoy and learn new skills,” said Eleanor Cox, director of chapter development for Achilles. “So when the chapter put extra effort this past year into outreach through social media, word of mouth and the bright yellow banners on the Charles—matched up with people wanting to volunteer and people with disabilities wondering what was possible—it turned a previously quieter Achilles chapter into a strong one. Boston Strong.”
>>Bonus Link: Read more from Boston Marathon Survivor Adrianne Haslet-Davis on Recovery, Care, and Collaboration on the RWJF Culture of Health blog.
The Center for Public Health Readiness and Communication (CPHRC) at the Drexel University School of Public Health in Philadelphia recently re-launched DiversityPreparedness.org, a clearinghouse of resources and an information exchange portal to facilitate communication, networking and collaboration to improve preparedness, build resilience and eliminate disparities for culturally diverse communities across all phases of an emergency. The site had originally been developed by Dennis Andrulis, now at the Texas Health Institute, and Jonathan Purtle, who co-writes a blog on public health for the Philadelphia Inquirer.
- Read a previous NewPublicHealth interview with Dennis Andrulis
- Read a previous NewPublicHealth interview with Jonathan Purtle
NewPublicHealth recently spoke with Esther Chernak, MD, MPH, the head of CPHRC, about the re-launched site and her work in preparedness.
NewPublicHealth: Tell us a little bit about your background and how you came to lead the Center for Public Health Readiness and Communication.
Esther Chernak: I’m an infectious disease physician by training and pretty much have been working in public health since I finished my infectious disease fellowship in 1991 at the University of Pennsylvania. I started working in the Philadelphia Department of Public Health in its city clinic system doing HIV/AIDS care, and then became the Clinical Director of HIV Clinical Programs for the health centers back in the early ’90s when the epidemic was obviously very different. I then moved to working in infectious disease epidemiology as a staff doctor in the acute communicable disease control program and was involved in infectious disease surveillance and outbreak investigations for a number of years.
Then in 1999, I took a job with the City Health Department in what was then called bioterrorism preparedness. That was the time when major cities in the country were just beginning to be funded to do bioterrorism response plans. Groups that were involved in bioterrorism preparedness recognized relatively quickly that despite the fact that we were dealing with planning for novel strains of influenza and pandemic preparedness and SARS and smallpox, we were also dealing with many, many really significant infectious disease outbreaks, and then ultimately non-infectious disease related issues that had huge impacts on public health, such as earthquakes and hurricanes. Those links helped prepare me for my role at the Center.