Public health preparedness
kkrisberg | June 13, 2017Last year’s emergency Zika funding is about to run out and there’s no new money in the pipeline. It’s emblematic of the kind of short-term, reactive policymaking that public health officials have been warning us about for years. Now, as we head into summer, public health again faces a dangerous, highly complex threat along with an enormous funding gap.
“The Zika threat will get worse,” said Claude Jacob, chief public health officer at the Cambridge Public Health Department in Massachusetts and president of the National Association of County & City Health Officials (NACCHO). “And the…
kkrisberg | June 6, 2017When you ask public health advocates about President Trump’s recent budget proposal, you typically get a bewildered pause. Public health people don’t like to exaggerate — they follow the science, they stay calm, they face off against dangerous threats on a regular basis. Exaggerating doesn’t help contain diseases, it only makes it harder. So it’s concerning when you hear words like this about Trump’s budget: “devastating,” “not serious,” “ludicrous,” “unfathomable.”
Released in late May, Trump’s fiscal year 2018 federal budget proposal calls for cutting the budget at the Centers for Disease…
kkrisberg | May 18, 2017A Zika attack rate of just 1 percent across the six states most at risk for the mosquito-borne disease could result in $1.2 billion in medical costs and lost productivity, a new study finds. That’s more than the $1.1 billion in emergency Zika funding that Congress approved last year after months of delay and which is expected to run out this summer.
“One of the troubling things last year was that (Zika funding) was viewed as a cost — every week, there was another delay and more people becoming infected and more chances of birth defects,” study co-author Bruce Y. Lee, an associate professor at…
kkrisberg | April 14, 2017Public health is in trouble.
Last month, President Trump released his proposed budget for fiscal year 2018. It was more of an outline, really, and didn’t provide many details, but it did call for a nearly 18 percent cut to the U.S. Department of Health and Human Services and for block granting the budget at the Centers for Disease Control and Prevention. At the same time, the White House supports repealing the Affordable Care Act. That repeal would also eliminate the Prevention and Public Health Fund, which now accounts for about 12 percent of CDC’s budget and funds critical public health…
kkrisberg | July 8, 2016In 2005, the World Health Assembly adopted a revised version of its International Health Regulations, a legally binding treaty among 196 nations to boost global health security and strengthen the world’s capacity to confront serious disease threats such as Ebola and SARS. A decade later, just one-third of countries have the ability to respond to a public health emergency. That’s why Rebecca Katz thinks it’s time to get creative.
“How can we think creatively about incentives for countries to build the required public health capacity under international treaty obligations,” Katz, an associate…
kkrisberg | May 12, 2016With near constant news on the threat of Zika virus and a quickly growing evidence base detailing the virus’ devastating impact on fetal brain development, you’d think Congress could get its act together to make sure our public health system is fully prepared and equipped to confront the mosquito-borne disease. Sadly, you’d be wrong.
It’s been nearly three months since the White House submitted a request to Congress proposing $1.9 billion in emergency funding to support a full range of activities needed to prepare for, prevent, detect and respond to Zika in the United States. As of today, May…
kkrisberg | November 25, 2014Months before the first case of Ebola was diagnosed in Texas, the state’s public health laboratory had begun preparing for the disease to reach U.S. shores. And while the virus itself is an uncommon threat in this country, the response of the nation’s public health laboratory system wasn’t uncommon at all — in fact, protecting people’s health from such grave threats is exactly what public health laboratorians are trained to do.
“Having that preparedness background, we’re always ready to get that call at 3 in the morning,” said Grace Kubin, director of the Laboratory Services Section at the…
revere | April 26, 2010What are we to make of the swine flu pandemic? The only thing I feel confident about is that it will be some time before we really know. A great deal of data and experience was gained in the year since the pandemic H1N1 took everyone by surprise but it will be a while before we can harvest all of it. Meanwhile I can say things were better than we thought they might be and certainly better than everyone's worst fears, but how much better -- better, how bad -- they were we just don't know. It was a very good year for people in my age category (over 65) as for reasons now becoming a bit clearer…
revere | April 3, 2010Better late than never. When the Bush administration proposed sweeping airport quarantine rules in 2005, even those of us most concerned about avian influenza thought it was a fruitless policy on scientific grounds, not to mention issues of civili liberties and economics. The airlines hated it, too:
The regulations, proposed in 2005 during the Bush administration amid fears of avian flu, would have given the federal government additional powers to detain sick airline passengers and those exposed to certain diseases. They also would have expanded requirements for airlines to report ill…
revere | April 1, 2010The AMA just took over a journal called Disaster Medicine and Public Health Preparedness. In fact they proudly announced they were the exclusive publisher and distributor of the journal, formerly published by Lippincott, Williams and Wilkins. I wouldn't even know about it except it was in connection with a press release of an article likely to be of interest any health care worker: ":Which Health Care Workers Were Most Affected During the Spring 2009 H1N1 Pandemic?" by Santos, Bristow and Vorenkamp of Weill-Cornell Medical School in New York. And the AMA even said it was redesigning the…
revere | March 30, 2010There is a good Canadian Press by Michael Macdonald about the often long time it takes to make a full recovery from flu. A full blown case of classical influenza can really lay you low for days or weeks. People often report never having felt so sick. But once you are "recovered" and back to work or your daily activities you aren't necessarily fully recovered:
Marga Cugnet thought she knew what she was in for when she came down with swine flu last October.
But the health administrator from Weyburn, Sask., said she was annoyed and somewhat dejected when the potent H1N1 virus left her with…
revere | March 29, 2010A day or two after CDC's Morbidity and Mortality Weekly Reports (MMWR) released a report about risks to pregnant women from pandemic 2009 flu, CDC held a suddenly announced press briefing about the current H1N1 situation (I listened in but a transcript should be up on the site by the time you read this; check this page). The occasion for the briefing was a worrisome increase in hospitalizations and deaths in CDC's Georgia backyard. Despite housing CDC, Georgia has one of the lower flu vaccination rates in the country and now is experiencing an unexpected recrudescence of H1N1 flu, with…
revere | March 19, 2010As predicted, the pandemic of 2009 is beginning to yield more data, some of it directly applicable to pressing practical questions. The answers are still preliminary, and, as with all science, subject to revision. But it's what we have at the moment, and a letter that just appeared in the CDC sponsored journal Emerging Infectious Diseases, addresses an important question. During a flu outbreak, can hospitalized patients contract influenza from blood transfusions? Since people getting transfusions already have compromised health (else why would they be getting a transfusion?), they are at high…
revere | January 17, 2010There is an old vaudeville joke where a man goes to the doctor complaining about pain in his arm:
Doctor: Have you ever had it before?
Man: Yes, once before.
Doctor: Well, you have it again.
CDC reported on their weekly FluView website on Friday that the Iowa Department of Public Health (IDPH) reported to CDC that in September a boy (age not stated) had a flu like illness from which he fully recovered and for which he hadn't required hospitalization. In November IDPH determined it was swine flu, but not the pandemic H1N1 but a swine-origin H3N2. According to CDC there was "no clear exposure"…
revere | December 25, 2009So far the pandemic of 2009 has been bad enough but not anywhere near as bad as one could imagine. Let's hope it stays that way. While winning new knowledge from actual disease and sickness is not anyone's favorite strategy, it is likely we will learn a great deal about influenza in the years to come as we begin to mine the wealth of data it is producing. Science, even at its most urgent, is still a slow, methodical process, but this pandemic and the resources devoted to tracking it and the tools being developed to analyze it is a watershed event in flu science. Dogmas will fall and probably…
revere | December 18, 2009I'm an epidemiologist and I train epidemiologists so you expect me to think epidemiology is important to public health. Epidemiology describes the pattern of diseases in the community and tries to figure out why some patterns exist and not others. It is used for both applied health research (causes of disease and disease outbreaks), disease control and for administrative purposes (how many hospital beds will we need, for example). When I was in medical school most epidemiology, such as there was, was done by medical doctors or employees of federal, state and local health departments. Starting…
revere | December 12, 2009We complain when there isn't enough swine flu vaccine and we complain when our health departments don't count all the cases. It's probably good so many people are out of work and can't eat in restaurants, because they aren't getting inspected because all available staff are trying to deal with the flu pandemic:
The current swine-flu wave may have peaked, but thousands of public health workers are trying to vaccinate millions of people against the new disease, fearing that another wave could emerge in the new year. Yet recession-driven budget cuts have thinned their ranks so far that they are…
revere | November 16, 2009We were asked repeatedly offline and in the comments for our views on what was or was not going on in the Ukraine, but we steadfastly declined to post on it. We didn't know any more than you can find out from news sources, so we had nothing to add in the way of hard information, We did know there was a WHO team on the ground and we thought it best to wait to find out more. We still don't know much, except that news reports are suggesting that the health care system in the Ukraine is a shambles and its likely the chaos and panic were self-inflicted more than virally inflicted. Mike Coston over…
revere | November 12, 2009I don't know if the rest of the world laughs at the US, but I feel quite sure they at least shake their collective heads when they hear how we lack one of the most important non-pharmaceutical measures against pandemic flu: paid sick leave. Of course only those countries with a policy of paid sick leave would be shaking their heads. It turns out, though, that's just about everybody:
The United States is one of only five countries in the world without a national policy on paid sick leave, Dodd said.
"We're in the company - and I say this respectfully of these countries - of Lesotho, Liberia,…
revere | November 5, 2009For somebody so out to lunch on so many issues there is something undeniably likable about Ron Paul. As congressthings, he and Dennis Kucinich (there's an odd couple) had the clearest and best positions on the Iraq debacle. And as a principled libertarian (there seem to be some big chinks in Paul's libertarian armor -- like reproductive choice -- but his passion is undeniable), there is something admirable about him. It almost makes you forget his principles are self-centered, wrong-headed and inhumane. Little gnome-like figures aren't supposed to be that unfeeling toward others. Anti-science…