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Nov 27
Giving Your Community Health, Warmth and Resilience

MRC Volunteers Strengthen Communities during the Holiday Season and Beyond

The holiday season is a time for giving. We spend hours (sometimes weeks, months…) searching for and picking out the perfect gifts for friends and family. Many of us donate to non-profits and charitable organizations. We even give to ourselves – often taking important time off to unwind and connect with our loved ones.

Warming shelter in New Orleans, LA MRC volunteers at warming shelter in New Orleans, LA

The holidays also offer an opportunity to give our time and skills to volunteer organizations and think of new ways to connect with our communities. This holiday season, consider donating your time to improve the health of your community by volunteering with the Medical Reserve Corps (MRC).

The MRC is a national network of more than 175,000 volunteers located throughout the United States and its territories. MRC units organize, train, and utilize local volunteers to prepare for and respond to emergencies. MRC volunteers include medical and public health professionals as well as other community members without healthcare backgrounds.

Although volunteering is important all year, winter typically brings a predictable but dangerous series of threats to community health across the country: colder temperatures, winter storms, and power outages.

In January and February 2019, MRC volunteers from across the country – from the Pacific Northwest to New England to the Gulf Coast – devoted more than 700 hours in response to these winter emergencies.

To help their communities weather the storms, MRC volunteers staffed warming centers and overnight shelters; provided call center support at emergency operations centers; assisted with charging stations during extended power outages for residents to charge electricity-dependent equipment and devices; and performed door-to-door wellness checks on residents who may be home bound and without power.

In addition to weather-related events, many MRC units are busy during the winter months keeping their communities healthy by combating the flu virus. MRC volunteers administer vaccines and provide logistical support at hundreds of flu clinics in their local communities, including those held at community events, health departments, and schools. These events provide MRC units with opportunities to test their capabilities to respond to a pandemic or other incident requiring mass dispensing.

All of these activities build communities that are healthier, better prepared, and more resilient. If you are interested in serving your community - whether this holiday season, this winter, or any other time throughout the year - I invite you to find an MRC unit near you, talk to your local coordinator, and ask what their needs are and how you may be able to serve.

MRC tent in Portsmouth, VA MRC volunteers in Portsmouth, VA


Nov 25
There’s No Such Thing as Just-in-time Healthcare and Public Health Preparedness

How to Create and Strengthen Partnerships to Enhance Critical Infrastructure Protection

What does it take to provide patient care? The image of a hospital or doctor’s office just popped into your mind, right? Well, that’s just part of the answer.

Every day, patients rely on complex just-in-time systems for the provision of healthcare. These systems include not only hospitals and other healthcare providers, but also insurance providers, laboratories, medical device suppliers, and more.

Working together, these systems can provide just-in-time supplies of everything from the drugs and therapeutic products to the blood and medical testing needed for patient care. When these systems are working, they can be used to support today’s miracles of modern medicine. Yet when supply chains are disrupted – whether by wildfires, hurricanes, cyber attacks on medical records and payment IT systems, or other issues related to healthcare infrastructure – patient health, even patient lives, are at risk.

Just-in-time re-supply has become the predominant business practice to support modern medicine; however, there is no such thing as just-in-time preparedness. In order to be ready to protect patient health during a disaster or public health emergency, you need to have a plan for managing critical infrastructure failures – and that plan becomes stronger when healthcare and public health partners work together before, during, and after an emergency.

The United States has 16 critical infrastructure sectors whose assets, systems, and networks, whether physical or virtual, are considered so vital to the United States that their incapacitation or destruction would have a debilitating effect on national security. Healthcare and public health form one of those sectors.

To strengthen critical infrastructure, the U.S. Department of Health and Human Services, through ASPR’s Division of Critical Infrastructure Protection, facilitates the coordination of the Healthcare and Public Health (HPH) Sector Partnership.  For efficiency, the HPH Sector Partnership is organized into eight operational categories: direct patient health care, health plans and payers, mass fatality management services, health information and technology, laboratories and blood, medical materials, federal response coordination, and public health.

The HPH Sector Partnership supports effective emergency preparedness and response to nationally significant hazards, such as terrorism and cyber terrorism, infectious disease outbreaks, and natural disasters. HPH partners work together to define and respond to risks, share threat information, develop and disseminate best practices, and address challenges so that each healthcare business, the entire health sector and your community become more resilient. Stakeholders and members of the HPH Sector Partnership engage regularly in confronting challenges in health supply chain coordination, response coordination, cybersecurity coordination, and emerging threat identification.

November is National Critical Infrastructure Security and Resilience Month and it is a great time to learn more and commit or reaffirm your commitment to keeping our nation’s critical infrastructure secure and resilient every day.

To stay up-to-date on issues at the intersection of public health, healthcare and critical infrastructure protection, join our mailing list and check out our new podcast, Building Resilient Health Infrastructure with ASPR. To get involved in the HPH Sector Partnership, email us at CIP@hhs.gov.


Nov 06
Take a Shot at Decreasing Hospital Acquired Infections and Enhancing National Health Security

A Case for Encouraging Seasonal Influenza Vaccination among Healthcare Workers


Last year marked the 100th anniversary of the 1918 influenza pandemic, which killed approximately 675,000 people in the United States according to the Centers for Disease Control and Prevention (CDC).  Although that number is daunting, it doesn't take a pandemic for influenza to seriously threaten patient health.  The disease burden for seasonal flu is still stunning 100 years later. While flu varies in severity, every year in the U.S., flu sickens millions, hospitalizes hundreds of thousands and kills tens of thousands.

How can hospitals and healthcare facilities help stop the spread of flu and protect their clinicians, staff, and patients? Start by encouraging clinicians and staff to get a seasonal flu vaccine each year, which provides important protection against flu and its potentially serious consequences.

CDC, the Advisory Committee on Immunization Practices (ACIP), and the Healthcare Infection Control Practices Advisory Committee (HICPAC) recommend that all U.S. healthcare workers get vaccinated annually against influenza.  Yet about one in five healthcare workers are not getting vaccinated to protect themselves – and their patients – from the morbidity and mortality associated with seasonal flu.  More concerning, nearly one in three healthcare workers in long-term care settings, such as nursing homes, do not get their seasonal flu vaccinations.

Vaccinating healthcare workers helps prevent the spread of healthcare acquired flu infections, as recently emphasized in the National Action Plan to Prevent Healthcare Associated Infections. Hospital acquired cases of flu threaten everyday health, but they would also severely complicate treatment during a public health emergency.

In the event of a severe flu season, hospitals and healthcare facilities will need to surge to care for patients. Increasing flu vaccination among healthcare workers decreases the incidence of healthcare worker absenteeism due to sickness or doctors' visits, and the likelihood that healthcare workers will infect or be infected by people who have come to their facilities seeking treatment.  It is one simple action that protects both everyday health and strengthens national health security.

The good news is that programs to encourage healthcare workers to get vaccinated make a difference. According to CDC, vaccination rates among healthcare workers are highest when their workplaces require vaccination or offer on-site vaccination at low or no cost.

If you manage a hospital or healthcare facility, there are many reasons to encourage your staff to get vaccinated – from the cost savings associated with lower rates of absenteeism among staff to the national security implications of influenza on surge capacity. It doesn't matter which reason motivates you the most, as long as you encourage your staff to get vaccinated. Ready to take the next steps?  Learn about additional steps your hospital or healthcare facility can take to promote vaccination in the work place.

Nov 01
Opportunities and Cybersecurity Risks for the Healthcare and Public Health Sector

Next-Generation Medical Technologies and Emerging Health Security Threats

Cutting-edge innovations in medical technology help medical professionals improve patient health outcomes during disasters and every day. While these new, evolving technologies bring great promise for patient care, they also introduce an element of risk into your hospitals and healthcare systems.

The Internet of Medical Things (IoMT), artificial intelligence (AI), and machine learning (ML) are all transforming the way healthcare is provided, but is your hospital or healthcare facility ready to face the new cyber security and privacy challenges associated with the use of these revolutionary technologies?  

The IoMT is comprised of interconnected medical devices and applications that collect data, which is then provided to healthcare IT systems through online computer networks. For example, smart beds, wearable medical devices, infusion pumps, and embedded devices are all new technologies in IoMT. These devices  present major benefits to providers and patients such as improved drug management, process automation, and enhanced data analytics across multiple domain’s, improved patient outcomes, and remote patient monitoring. IoMT devices connect to a variety of healthcare systems, networks, and other tools within a healthcare delivery organization.

However, the increased connectivity provided by IoMT also creates cybersecurity risks such as potential for unauthorized access to patient health information, changes to prescribed drug doses, and interference with the device’s function. Cyber security and privacy professionals must address the IoMT risks not only for the “device” but also holistically, across the entire network of systems and applications, which include physical security, mobile interfaces, authentication, and authorization.

An additional challenge for the IoMT is patching and updating the embedded operating systems and applications of the devices as some provide critical patient care and require specially handling. If your hospital or healthcare facility use IoMT devices, check out the Health Industry Cybersecurity Practices document on Managing Threats and Protecting Patients or the National Institute of Standards and Technology (NIST) project on Securing Telehealth Remote Patient Monitoring Ecosystem for references to help you better protect patient health while leveraging these new technologies. Check back periodically for progress because this project will result in a Cybersecurity Practice Guide with practical steps to address IoMT challenges.

Recent developments in AI and ML have led to smarter autonomous systems which can learn for themselves and keep up with the velocity and volume of data that networked systems produce. The introduction of AI and ML in health care have led to the development of new applications and tools that are starting to have a significant positive impact on chronic disease management, cancer diagnostics, radiology, and interventional medicine.

There are, however, very distinct and new vulnerabilities associated with AI and ML tools and applications. For example, data poisoning, logic corruption and data manipulation can introduce data that causes a ML-based system to make mistakes or introduce specific data patterns that are designed to be misclassified by learning systems. The most common defensive techniques for these attacks include “data sanitization” and “anomaly detection”, which themselves are in the process of maturing. To learn more about the evolution of recommendations on AI and ML, see Artificial Intelligence at NIST.

While attention to fundamental cyber security and privacy principles such as defense in depth, non-repudiation principles, encryptions, continue to be critical, it is equally important to become familiar with the innovative technologies in the HPH sector and the new cybersecurity threats that come with these technologies.   


Oct 11
The power of partnership: BARDA ushers in 50th FDA-approved product for health security

At BARDA, we are proud to have established unique partnerships with industry that create solutions for the American people. By working together, we have earned – as of last week – our 50th and 51st U.S. Food and Drug Administration (FDA) approvals, licensures and clearances in the past 12 years for products that address some of our nation’s most challenging health security threats. BARDA and our private sector partners achieved eight of these in the past year alone, substantially increasing the nation’s health security preparedness.

 

BARDA FDA Approvals


From our first, a pandemic influenza vaccine licensed in 2007, to last week’s clearance of the first anthrax diagnostic test that could be used in non-government labs in a surge capacity, we have tackled hefty scientific and business challenges.

Many health security threats involve bacteria or chemicals for which clinical trials cannot be performed in humans. To overcome this hurdle, we worked closely with FDA on a path for approval of such products using the Animal Rule. Raxibacumab, a treatment for anthrax, became the nation’s first medical countermeasure to utilize this path, earning FDA approval in 2012. Since Raxibacumab was approved, our partnerships have resulted in five additional approvals using the Animal Rule, including three products that can be used to treat white blood cell depletion that occurs after a radiological or nuclear event. Even as we utilize this pathway, we continue to explore new technologies that could pave a more efficient path to approval.

Another hurdle has been the return on investment for the private sector and taxpayers. To overcome this challenge, we have reduced the business risk and costs not just by providing non-dilutive funding and deep technical assistance but also by focusing on products that could have multiple uses and commercial uses.

In some cases, we’ve sponsored development for new indications of approved products like Seizalam and Silverlon. Midazolam was an approved sedative and became the first approved as an anti-seizure drug to treat prolonged seizures caused by chemical exposure. Silverlon was cleared initially as a silver-impregnated wound dressing and became the first product cleared in the U.S. for use in treating chemical burns from mustard gas.

In other cases, we’ve sponsored development of products that meet needs in the commercial market and health security, such as for XERAVA (eravacycline), a novel, fully synthetic tetracycline antibiotic that was approved in 2018 to treat complicated intra-abdominal infections. The antibiotic also could be used against serious Gram-negative infections, including those caused by multi-drug resistant pathogens, and, with FDA Emergency Use Authorization, could be used to treat anthrax, plague, or tularemia.

Nineteen of our 51 approvals are vaccines, diagnostics, or treatments that increase our preparedness for influenza pandemics. The technologies that BARDA has supported to prevent, diagnose or treat pandemic influenza can also be used to combat the seasonal influenza epidemic.

We know the nation must be ready to face all health security threats – the ones known today, those emerging, and those not yet imagined. By partnering to create innovative countermeasures tailored to meet unique national security demands for rapid response, we become better prepared to act quickly to save lives.

Our preparedness to save lives requires end-to-end solutions – from rapidly recognizing the problem to treating patients quickly, safely, and effectively. Hence our focus on disruptive innovation to detect disease earlier; better, faster vaccine technologies that protect patients and healthcare providers; and host-directed therapeutics for more effective treatment.

Over the past 12 years, in our pursuit of transformative medical countermeasures that will protect the American people in public health emergencies, we have partnered with more than 300 companies, from micro and small businesses to global pharmaceutical corporations. We continue to build and strengthen these partnerships using every business tool at our disposal. We know that the right science and technology truly can transform how people understand and participate in the preservation of public health and health security, resulting in a world in which invention unlocks the power of the collective good to overcome potential threats.

We continue to welcome new partners who share our passion for disruptive innovation to enhance our nation’s health security. Learn more about what we are pursuing next through the BARDA Broad Agency Announcement and start a conversation with us by requesting a meeting.

Sep 26
Helping Your Community Become Prepared, Not Scared

Eight Trainings Your MRC Unit Can Offer to Enhance Community Preparedness



Is your Medical Reserve Corps unit looking for a way to bolster community preparedness? You can start by providing community members with training that gives them skills they need to respond – and the confidence to use those newfound techniques.  When an emergency or natural disaster happens, many people want to help – but they just don’t know what to do.  

The good news is that many people can learn lifesaving skills in a couple of hours – no medical background needed.

 Calcasieu Parish MRC (LA)-cropped.jpg

Consider this: according to a National Survey of the Public Regarding Bleeding Control, 77 percent of respondents who had been trained in severe bleeding control indicated they were “very likely to aid a car crash victim.” But just 51 percent of respondents with no training indicated that they would be very likely to help.  Being knowledgeable, trained, and prepared for an emergency can help alleviate hesitation and fear when disaster strikes, which can, in turn, lead to a stronger bystander response.

The Medical Reserve Corps (MRC), a national network of volunteers who help make their communities stronger and healthier during disasters and every day, can play a critical role in helping to provide information and training to community members so they feel educated and empowered to act before, during, and after an emergency. From natural disasters to health-related incidents, individuals and communities that are informed and trained to respond are more inclined to act when needed, and often better able to withstand and recover from disasters – and help their neighbors do so, too.

Below are examples of eight programs that MRC units can incorporate into their volunteer training plans and community-based outreach programs to teach community members life-saving skills and enhance overall individual and community preparedness:

  1. You are the Help Until Help Arrives ─ You Are the Help Until Help Arrives empowers the public to take action and provide lifesaving care before professional help arrives. The program encourages the public to take these five steps in situations where someone may have a life-threatening injury:
    • Call 9-1-1
    • Protect the injured from harm
    • Stop bleeding
    • Position the injured so they can breathe
    • Provide comfort

  2. First Aid/Cardio-Pulmonary Resuscitation (CPR)/ Automated External Defibrillator (AED) ─ First Aid/CPR/AED training teaches individuals how to recognize and respond appropriately to cardiac, breathing, and first aid emergencies.


MRC Trainer demonstrating how to check airway
  1. Stop the Bleed ─ Active Shooter training teaches individuals how to prepare for and respond to active shooter incidents, including how to create an emergency plan and safely evacuate or shelter in place during an incident.

  2. Active Shooter ─ Active Shooter training teaches individuals how to prepare for and respond to active shooter incidents, including how to create an emergency plan and safely evacuate or shelter in place during an incident.

  3. Naloxone Administration for Opioid Overdose ─ Naloxone administration training teaches individuals to recognize the signs and symptoms of an opioid overdose and how to respond by administering naloxone, which can reverse the potentially fatal respiratory depression caused by opioid overdose.

  4. Psychological First Aid (PFA) ─ Psychological First Aid training teaches individuals the basic skills to offer emotional comfort to survivors of traumatic events, assist in addressing immediate needs and concerns, and foster long-term adaptive functioning and coping.

  5. Personal and Family Preparedness ‒ Personal and Family Preparedness training teaches individuals how to develop, practice, and maintain emergency plans that reflect what must be done before, during, and after a disaster to protect themselves and their property.

  6. Severe Weather and other Threat-Specific Training ‒ Trains individuals on common threats in their community ‒ weather events, possible radiological events due to nearby nuclear plants, etc. ‒ and helps them prepare beforehand and know what to do to protect themselves and their property should an emergency event occur.

MRC traininer demonstrating CPR techniques

To assist MRC units in rolling out the above programming, the MRC Program Office within the Office of the Assistant Secretary for Preparedness and Response recently developed a Training Community Members to Respond Guide. It includes more details about each program and available curricula and resources. Questions or suggested additions to the guide can be directed to MRCcontact@hhs.gov.

Sep 18
A close encounter of the worst kind: Sepsis

Day four of the annual professional meeting began like so many others: I had one more talk to give, and then a dash to the airport for the flight home. At lunchtime, I noticed a slight headache. By the time the session began mid-afternoon, the headache was worse. I bummed a couple of over-the-counter pain pills from a colleague (thank heavens for better prepared friends!), chugged a botTim Buchman recovering in the hospitalle of water, and listened to the three talks that preceded mine.

I felt a bit lightheaded starting my presentation. About ten minutes in, I had a shaking chill. Not a big one, not one that caused me to stumble, but a chill nonetheless. The audience did not notice—it was a talk I had given before, I knew the words that needed to accompany each frame. The session wrapped, I had another bottle of water, and started the journey.

Twelve hours, several more chills, and a few more bottles of water later, I made it home. I was exhausted. I told my wife that I thought I might be getting the flu (despite having received the seasonal immunization) and just needed to catch up on rest. She said “fine, but please let your doctor know”. Yes, we doctors have doctors.

My doctor also happens to be my neighbor down the street. He decided to stop by the house—"just to have a quick look” at me. He said that I didn’t look too bad, rest was a good idea, but maybe it was also a good idea to go over to the hospital and get some lab work done. No, I didn’t have a fever—but then I had continued my diet of over-the-counter pain medications that also happened to be antipyretic. Besides, I wanted nothing more than some sleep.

I took my doctor’s advice, and upon arriving at the hospital my white blood count was reported to be two and half times the upper limit of normal. My kidney function was only about 40% of the expected value. While I was not jaundiced, the lab data showed that my liver was not processing bilirubin well. Oh, and by this time my left leg had swollen to twice normal size and turned bright red. In “doctor-speak”, the diagnosis was erysipelas—likely caused by group A streptococcus—and I easily met the Sepsis-3 vital organ dysfunction criteria.

Did I mention that my blood pressure had started to fall?

I was admitted to the hospital, blood cultures were taken, IV fluids were started. Within minutes, I received broad spectrum antibiotics. I don’t remember much more about that first day in the hospital, except having the presence of mind to decline transfer to the VIP pavilion—better to be around medical and nursing staff who would treat me just as they treated everyone else.

By the next day, I was much better. The initial antibiotics had accomplished their “expected miracle”, the spectrum had been narrowed to address the likely pathogen, and my vital organ functions were improved. Only then did I begin to appreciate just how sick I had been.

That’s how sepsis is. Sepsis shows up uninvited, arrives unannounced, and triggers deep fatigue–all the while scrambling your brain just enough to hide the fact that “a little rest” might presage “the big sleep”. I treat sepsis, I study sepsis, I write articles on sepsis—and I was sure that sepsis was something that happened to other people.

That was six months ago this week. Unfortunately, it’s more than a bad memory. Becoming a “sepsis survivor” is not the same as being completely cured: sepsis confers excess risk of all-cause mortality for at least several years. My particular infection carries some likelihood of recurrence. On the advice of my healthcare team, I now carry specific countermeasures with me whenever I travel along with an instruction to begin taking the drugs should I experience similar symptoms. I have acquired some persistent leg swelling that requires me to wear compression stockings on a daily basis, a constant reminder that I remain vulnerable.

I was invited to join BARDA DRIVe and the Solving Sepsis team for my sepsis subject matter expertise in August 2018. Yet it took a personal encounter with sepsis for me to understand that no matter who we are, where we are, and what we do, we are all vulnerable. The BARDA DRIVe Solving Sepsis program is accelerating the development of transformative technologies to address sepsis as well as working with government partners. As September is Sepsis Awareness Month, this is a reminder to us all to be aware of the signs of Sepsis.

If you, a family member, a friend or a colleague, think, “Could this be sepsis?”

Ask the question.

Seek prompt medical attention.

You might save a life.

The life you save might be your own.

Sep 13
Continuous Demands, Multiple Disasters, Mounting Stress

How Emergency Responders can Protect against Burnout, Compassion Fatigue, and PTSD

As any emergency responder knows, EMS providers, healthcare professionals and other emergency responders work in fast-paced, demanding, challenging environments. Although this work can be incredibly rewarding, the accumulation of daily stressors coupled with the intense pressures associated with a disaster – such as taking on unfamiliar duties, witnessing horrific events, comforting traumatized people, working back-to-back shifts, eating poorly, and sleeping rarely – can have serious repercussions for responder behavioral health.

According to research by the Substance and Mental Health Services Administration, about one in three emergency responders suffers from post-traumatic stress disorder or depression. In addition, responders and staff in emergency response agencies are at an increased risk over the long term for experiencing compassion fatigue and burnout.

At an individual level, behavioral health problems can be hard to recognize and address. At an organizational level, they can seriously hinder your emergency management organization or healthcare facility’s ability to respond effectively.

So how can you recognize when someone needs help and what can you do to help them? Start by learning some core concepts, warning signs, and ways to help.


What are burnout and compassion fatigue, and PTSD?

Burnout, compassion fatigue, and PTSD are sometimes used almost interchangeably but they actually describe different conditions, each with its own specific symptoms, although these can overlap. Being able to understand the causes of each condition can help you recognize a problem and identify some strategies that could help you or members of your team.

BurnoutCompassion Fatigue
(Secondary Traumatization)
Posttraumatic Stress
Disorder
cell phone icon stressed person icon hazard icon
What Causes It?

Day-to-day work-related stress, which are often intensified during a disaster or emergency

What Causes It?

Over-identifying with or taking on the trauma and emotional distress of others

What Causes It?

A frightening or highly distressing event that results in symptoms of re-experiencing,avoidance, arousal, and changes in mood or thinking


Burnout

Serving as an emergency responder is stressful at any time, but disasters can quickly compound stress. For many responders, disasters lead to longer hours or shift work; require people to work with insufficient resources; increase the chance of interpersonal conflict with colleagues, patients, and others; and disagreement about the most effective way to execute the mission.

Burnout can have serious consequences. Individuals who are experiencing burnout may feel helpless or like they can’t control their environments. These feelings can lead to poor job performance, a bad attitude, or strained relationships at home and at work.

If you see these signs, take steps to keep the problem from getting worse. Sometimes, simple things can help someone who is suffering from burnout bounce back.

Steps to keep burnout from getting worse infographic


Compassion Fatigue

The emotional demands on emergency responders during a disaster can be constant. Although empathizing with the people that you are helping is important, over-identifying with patients and family members can lead to compassion fatigue, also known as secondary traumatization.

People who suffer from compassion fatigue tend towards emotional extremes: they may be numbed to the suffering of others or they may be over-engaged and find it hard to “unplug” from their work. To complicate matters, people who experience compassion fatigue often don’t realize that they are struggling.

Like burnout, compassion fatigue can be serious if it is left unaddressed. Responders who suffer from compassion fatigue are more likely to become depressed and are more prone to substance abuse and social isolation.

But there are things that you can do if you recognize compassion fatigue.

Recognizing compassion fatigue infographic


Posttraumatic Stress Disorder

During a disaster, emergency responders frequently have to work through frightening events that may be traumatizing. Emergency responders have been called on to pull people out of the World Trade Center, treated children with gunshot wounds after school shootings, or witness the severe injury or even death of a colleague. After a traumatic event, people with PTSD may find themselves reliving the event and they may become agitated, hostile, hyper-vigilant, or self-destructive. People suffering from PTSD may isolate themselves from others, making it harder to identify the problem. Further compounding the issue, first responders often work in organizations or environments that downplay the importance of seeking help with managing stress and distress.

PTSD is both serious and treatable. It often requires professional intervention and guidance along with organizational support that recognizes the value of seeking help. If you think you are suffering from PTSD, get help. Start by getting an physical and mental health assessment, as effective treatment often relies on a combination of approaches. If you think that someone you work with may be suffering from PTSD, encourage them to seek help.

Getting professional help is critical. Here are some other steps you can take in addition to seeing professional help.

Additional steps to treating PTSD infographic

The road to recovery form PTSD can be long, but people do recover. If you are diagnosed with PTSD, stick with your treatment and commit time and energy to recovery. If someone you know is recovering from PTSD, support them throughout the recovery process.


Promoting Disaster Behavioral Health Self-Care

During September, people and organizations take some time out to think about preparing for disaster. Preparing for the behavioral health impacts of a disaster is an important part of individual and organizational preparedness. Before a disaster strikes, learn about steps you and your organization can take to prevent burnout and compassion fatigue, decrease stress, promote wellness, and encourage self-care.

The Disaster Behavioral Health Self Care for Healthcare Workers Modules, a new series of in-depth video modules from ASPR TRACIE, provide information for front line healthcare and social service workers to use before a disaster strikes so they are better able to recognize signs of burnout and compassion fatigue and take steps to mitigate them. To learn more about PTSD, visit the National Center for Posttraumatic Stress Disorder. For a more in-depth list of resources, see the ASPR TRACIE Responder Safety and Health Topic Collection.

Aug 30
HHS’ efforts better prepared Puerto Rico, U.S. Virgin Islands for Dorian

Hurricane Dorian didn’t deliver the damage, destruction, and mass patient caseload to Puerto Rico and the U.S. Virgin Islands that many people anticipated the storm would — and that’s a good thing. Nevertheless, Puerto Rico was ready for a hurricane in a way it has never been before thanks to the efforts by HHS’ Division of Recovery team.

Over the past two years, federal and territory government agencies and non-government organizations have worked together to prepare Puerto Rico and the U.S. Virgin Islands healthcare systems for hurricanes and other natural disasters. These U.S. territories are still recovering from Hurricanes Irma and Maria, which devastated the islands in 2017, and a direct hit from Dorian could have undone much of the hard work done over the last two years.

For example, the ASPR Division of Recovery worked diligently with the Puerto Rico Department of Health to facilitate regionalized networks of hospitals, primary care facilities, dialysis centers, emergency medical services, and emergency management. These networks have greatly advanced the situational awareness, logistics, plans, supplies, and other response mechanisms across the island.

Dr. Elaine Kolodziej, from Centro de Medico, thanks HHS staff for preparedness efforts in Puerto Rico.
Dr. Elaine Kolodziej, from Centro de Medico, thanks HHS staff for preparedness efforts in Puerto Rico.


Through these networks — a healthcare coalition — hospitals, federally qualified health centers, clinics, and other key healthcare facilities can support each other better during disasters. Local healthcare facilities can transfer or refer patients easily to regional hospitals to keep local facilities from getting overwhelmed; hospitals also can transfer or refer patients to the trauma center. Regional hospitals also have systems in place to allocate resources like generator fuel or medical supplies to help local hospitals.

The Puerto Rican Department of Health now has a system in place to monitor the real-time status of hospitals on the island so it knows when hospitals are open, closed, on generator power, or likely to need generator fuel when the power is out for an extended period of time. Sharing resources, situational awareness, and a common operating picture for meeting the medical needs at the regional level helps ensure there are no shortfalls.

Territory organizations now have the tools and resources they didn’t have before to help people with access and functional needs for the most vulnerable populations — children, the elderly, and people who are at-risk because of their health conditions.

The U.S. Virgin Islands’ hospital has greater dialysis capability than in the past to support more dialysis patients if regular dialysis centers are not available after storms.

Thankfully, Dorian’s impact to Puerto Rico and the U.S. Virgin Islands was not significant, but the storm presented an opportunity to test and evaluate the progress the territories have made with help of the ASPR Division of Recovery since Hurricanes Irma and Maria. Health officials and emergency managers know that the question is not “if,” but “when” the territories will face another impactful storm — but it was Hurricane Dorian that proved Puerto Rico and the U.S. Virgin Islands are more resilient, stronger, and better prepared to face the challenges brought by future disasters.

Visit https://www.phe.gov/about/oem/recovery/Pages/default.aspx to learn more about disaster recovery for health and social services, including tools that can help health and emergency managers plan for and recover from disasters more effectively. The guides, sample plans, measures and other tools can help you learn more about your community and leverage resources to help your community recover.

Aug 21
The Evolution of the Strategic National Stockpile

Twenty Years of Stockpiling Critical Medical Products and Training Professionals to Respond to 21st Century Health Threats


Twenty years ago, Congress established the Strategic National Stockpile (SNS), originally named the National Pharmaceutical Stockpile, with a $51 million appropriation and a handful of staff quietly housed in CDC’s National Center for Environmental Health. Today, the SNS is part of the HHS Assistant Secretary for Preparedness and Response and holds a $7 billion inventory as well as vast experience in preparing for and responding to a variety of public health threats. Over time, the SNS has strengthened the federal government’s response capabilities so that the country is more prepared than ever to help protect the health and safety of the American people.

For the last two decades, experts at the SNS have worked to stockpile lifesaving products and build partnerships so we are ready to respond when disaster strikes. As a result, today’s SNS has the capacity to get the right medicines, supplies and devices to the right people at the right time.

SNS 20 Year History

One of our first collaborative efforts was working with the New York City Department of Emergency Operations responsible for medical countermeasure planning and the Federal Aviation Administration. On Sept. 11, 2001, one month after the three organizations staged their first full-scale exercise, an early morning attack on the World Trade Center and the Pentagon shocked the nation and the world. The stockpile was called into action as part of the government’s immediate response to the deadliest terrorist attack on U.S. soil and delivered medicines and supplies within 12 hours of the request.

On the heels of that incident came the 2001 anthrax attacks, which served as a wake-up call for the United States and the western world on the realities of bioterrorism. Scientists in laboratories and doctors in hospitals became acutely aware of the dangers of bioterrorism and voiced concern about their ability to identify such illnesses and treat patients to save lives.

Identification of bioterrorism-related diseases is not as straightforward as one might think. Illnesses caused by bioterrorism often mimic the symptoms of other, more common maladies. In the wake of the anthrax attacks, treatment options were extremely limited. In addition, even after a healthcare provider identifies a cause, treatment is not always readily available. For twenty years, we have worked with our public and private partners to expand the treatment options that are stockpiled in the SNS and to build the partnerships and protocols to respond on a moment’s notice.

The crises of 2001 led to a cultural shift in how public health, emergency management, and medical experts think about national security. These potential threats resulted in public health becoming an important component in the national security framework and changed the way state and local health departments worked and interacted with other agencies and sectors. Health departments became accepted as important partners by traditional emergency management and first responders, including law enforcement, fire departments and emergency medical services. The nation’s ability to respond to disasters strengthened with each area of government working together.

Since 1999, the stockpile responded to more than 60 public health emergencies, including natural disasters and disease outbreaks with the potential to threaten public health. The SNS deployed medicines, supplies, equipment and expertise for multiple major natural disasters, including Hurricanes Katrina, Sandy, Harvey and Maria, as well as flooding in North Dakota. When the SNS responds to an emergency, it fills major gaps, providing medicines, medical supplies, equipment, personnel and more.

The SNS also has deployed medical countermeasures rapidly and efficiently in the wake of disease outbreaks. During the 2009 H1N1 influenza pandemic, the SNS demonstrated its ability to deploy antiviral drugs and personal protective equipment nationwide for an influenza emergency. The SNS shipped 25 percent of its total supply of influenza antiviral medications to 62 areas in just 7 days.

In emergencies, the SNS works with public and private sector partners to find and close gaps. For example, during the 2014 Ebola response, the SNS coordinated with supply chain partners to identify gaps in the commercial supply of personal protective equipment (PPE) to healthcare facilities. Requests for PPE in hospitals were prioritized, and the SNS established a small supply of Ebola-specific PPE to better prepare for future outbreaks.

Emergencies can overwhelm state and local medical resources even with the best preparation. To help in those situations, the SNS has evolved to become the nation’s largest supply of life-saving pharmaceuticals and medical supplies for use in a public health emergency. Staff at the SNS are honored to serve our country in this unique capacity.

Whether you work for a hospital, a healthcare facility, or public health department, learning about the SNS can help you enhance your organization’s preparedness and national health security. Discover our in-person and online training opportunities to increase your understanding of the assets available from the SNS and teach you how to receive, stage, and use the products during emergencies, and more. For more information, see the Strategic National Stockpile Course Listing.

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