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Jun 25
Pandemic and All-Hazards Preparedness and Advancing Innovation Act 2019: What Does It Mean for Me and My Organization?

At ASPR, we’re excited about the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019 (PAHPAIA), which the president signed last night. The new law strengthens public health and healthcare readiness, bolsters response and recovery programs, and increases transparency. What do the changes mean for our non-federal partners? We see some key provisions that can significantly improve preparedness and response for our partners.

Improving preparedness

PAHPAIA authorized a funding increase for the Hospital Preparedness Program from $374.4 million to $385 million which would continue to pass through state and territory health departments to healthcare coalitions. Congress must appropriate specific funding levels as part of the annual appropriations process, including any increase.

ASPR, the Director of National Intelligence, and the Department of Homeland Security are directed to coordinate regularly on threat assessments, including potential emergency health security threats. By coordinating more closely, ASPR will have the critical information to guide decisions about which medical countermeasures should take priority in development and acquisition for the Strategic National Stockpile and the National Pre-Pandemic Influenza Vaccine Stockpile.

Strengthening response

The law reauthorizes the authority giving states and territories the ability to reassign federally funded personnel temporarily in public health emergencies to support the response. When the HHS Secretary declares a public health emergency, states may request temporarily deployment of state personnel whose salaries are funded by HHS in whole or in part under Public Health Service Act programs. Under PAHPAIA, the National Disaster Medical System (NDMS) received direct hire authority which streamlines the federal hiring process for NDMS, making it easier and faster to hire new personnel. The law also authorizes benefits under the Public Safety Officers Benefit program for NDMS personnel which addresses a concern of NDMS personnel. NDMS personnel have jobs in the private sector and are called into federal service during disasters, and these provisions are expected to improve NDMS recruitment, which in turn increases the number of NDMS personnel available to support state and local healthcare emergency operations.

The Hospital Preparedness Program received enhanced authority under the reauthorized law. Coalitions funded under this program now can use the funding for response activities, and work with state health departments and other healthcare coalition members on greater accountability; with the new authorization, ASPR has two years to work with grantees and sub-grantees on coalition success rates; ASPR now could withhold a percentage of program funds from awardees that fail to meet required benchmarks.

PAHPAIA also authorizes ASPR to establish guidelines for the Regional Disaster Health Response System. Under the provisions, ASPR is authorized to use HPP funds to support demonstration projects related to the development and implementation of these guidelines. The Government Accountability Office is required to assess the program within three years and provide Congress with specific findings on success, limitations, and challenges.

Improving medical countermeasure development for emergency preparedness and response

Project BioShield received an increase in its authorized funding levels with appropriations authorized for 10-years. This longer timeframe means Congress can provide funding for a decade rather than on an annual basis. Given that a single medical product can take 10 years or longer to develop, long-term funding like this gives biotech and pharmaceutical companies an incentive to work with our Biomedical Advanced Research and Development Authority (BARDA) on advanced development, manufacturing and acquisition of medical countermeasures.

Programs to develop medical countermeasures for pandemic influenza and other emerging infectious diseases now are authorized to receive annual funding from Congress. In the past, funding to develop medical countermeasures for pandemic influenza and emerging infectious diseases came largely from supplemental appropriations after public health emergencies occurred, such as the H5N1 pandemic in 2009 and the Ebola responses in 2014. Having a standard budget line allows federal and private partners to undertake research, development and manufacturing before a disease spreads. Not waiting having to wait on supplemental budget funding is important because developing medical products takes years and to save lives in public health emergencies every moment counts.

These are exciting changes, and we look forward to working with our partners under the new and reauthorized authorities to protect the American people from modern health threats.

 

Jun 13
Building a Better Network: Four Ways to Make Critical Connections Your Facility Could Rely on During a Medical Supply Shortage

When Hurricane Maria hit in 2017, one unexpected challenge faced by the Healthcare and Public Health (HPH) Sector was maintaining production of medical gases such as oxygen, nitrogen, and argon on the island of Puerto Rico. The power needs for such an operation exceeded available generators; so, for the duration of electricity outages in the area, novel plans had to be devised for the challenging transport and distribution of products across the island.

Partners from the gas manufacturers, healthcare facilities, and the federal and territorial government closely coordinated to make decisions that would ensure patients in hospitals, oxygen-dependent patients in their homes, and manufacturers of critical medical devices, received the gases they needed. By working together, the government and private sector identified and communicated issues. As a result, disruptions of service were prevented.

If you or your facility are made aware of a drug or medical product shortage through manufacturers, distributors, the FDA, the American Society of Health-System Pharmacists, or CIP’s supply chain newsletter, who do you call for help? Where can you find additional guidance on how to manage the situation?

Drug and medical supply shortages can happen at any time, and they can occur with very little warning due to disasters. Take some time during steady state to identify federal and private sector points of contact and build relationships you can rely on in an emergency. Make sure that these four entities are part of your network:

  • Your Local Health Care Coalition (HCC): If critical supplies are not available, working with other hospitals or healthcare providers in your area can help. HCCs can assist with providing situational awareness, a venue for discussing challenging issues related to medical supply shortages, and a mechanism for establishing clear, consistent communications. There are more than 31,000 HCC members across the country. HCCs are groups made up of healthcare and response entities – such as hospitals, EMS providers, emergency management organizations, public health agencies, and more – working in a defined geographic location to prepare for and respond to disasters and public health emergencies. To find out more about your local HCC, reach out to your local HCC point of contact.

  • The Healthcare and Public Health (HPH) Partnership: The HPH Partnership, managed by ASPR’s Division of Critical Infrastructure Protection, provides a venue for public and private sector collaboration to share threat information, disseminate and discuss best practices, and assess and manage risks to the sector. The HPH Partnership includes subject matter experts in the private sector and at federal, state, and local agencies. During the response to a large-scale emergency, ASPR CIP helps partners gain a better understanding of the evolving situation, and cross sector representatives often provide updates. To get involved or learn more, contact us at CIP@hhs.gov. To stay up-to-date, join the CIP healthcare supply chain mailing list.

  • ASPR TRACIE: Before you are faced with a supply chain shortage – whether it is caused by widespread market conditions or a disaster that has struck your hospital - make sure that you have a plan to protect patient health. As you develop your plan, you can reach out to the experts at ASPR TRACIE for technical advice or to collaborate with your colleagues through their information exchange. In Fall 2019, additional supply chain resources for healthcare coalitions and entities will be made available.

  • FEMA National Business Emergency Operations Center (NBEOC): During disaster response operations, the NBEOC shares information related to public and private stakeholder concerns. The NBEOC sets up an online dashboard and holds daily conference calls during response to a disaster. Drug and supply shortages are covered along with more detailed information on potential impacts to all 16 critical infrastructure sectors than the coverage provided on HPH Sector Partnership calls. The NBEOC provides detailed updates on interdependent lifeline sectors such as transportation, communication, water, and power outages and restoration.

Tap into these existing resources for building partnerships before a major shortage critically impacts your facility. Having the right partner in place can be the difference between scrambling to respond and managing shortages successfully.

The ‘Anticipating and Managing the Challenges Associated with Supply Shortages’ blog series is designed to highlight actions that healthcare organizations can take to protect patient health in the event of a supply shortage. To learn more, check out the first two posts in this series: ‘Four Ways to Plan to Protect Patient Health in a Medical Supply Shortage’ and ‘Exhaustion in the ED and Beyond: Managing Supply Shortages and Staff Fatigue in Healthcare Facilities’. The next post in this series will look at recommendations and resources for building partnerships. Stay up to date as new blog posts are published by following us on Twitter, Facebook or LinkedIn.

Jun 06
BARDA-supported Zika Virus Test Receives FDA Clearance; Ready for Clinical Laboratory Use

The first commercially available Zika virus diagnostic, a product BARDA supported through its advanced research and development program, received authorization for marketing from the U.S. Food and Drug Administration (FDA) on May 23. The test provides results from a blood sample in about four hours. Called the ZIKV Detect 2.0 IgM Capture ELISA, the test exemplifies the progress that is possible with public-private partnerships.

Zika virus emerged as public health threat in 2015, and by 2016 cases of Zika virus were reported in every U.S. state except Alaska. However, the U.S. did not have an approved high-capacity, rapid Zika diagnostic test to inform patient care, a need that was particularly critical for pregnant women.

Early in the outbreak, BARDA prioritized support for the development of Zika-specific serological (IgM) assays, which test blood for antibodies produced by the body’s immune system. BARDA also worked with partners in industry to spur the development of these tests. InBios International, Inc. was one of the companies that answered the call to help diagnose Zika virus infection more effectively.

BARDA funded work by InBios with a $5.1 million contract. The funding supported refinement of the ZIKV IgM Capture ELISA design and performance, manufacturing preparations, and the clinical studies necessary for the FDA de novo premarket pathway, a pathway used when there is no existing classification or predicate device on the market.

The diagnostic test is designed to detect a Zika virus-specific Immunoglobulin M, or IgM, antibodies produced by the body’s immune response to the virus. The new test can detect an early immune response at about one week from exposure.

The initial InBios test was made available under FDA Emergency Use Authorization in August 2016 and provided increased capacity for Zika testing nationwide. The FDA-cleared ZIKV Detect 2.0 IgM Capture ELISA differentiates Zika IgM antibodies from those produced by other flaviviruses, such as dengue or West Nile virus. This improvement in specificity reduces the challenges of diagnosing recent Zika infection in people who previously have been infected with another flavivirus.

In just over three years, BARDA has worked with its public-private partners to make great strides in building a portfolio of medical countermeasures to address the threat caused by Zika. This portfolio includes four other Zika diagnostic tests to determine individual infections, including one that potentially can be administered in a doctor’s office and yield results in minutes. BARDA also is working with private sector partners to support the development of Zika vaccines, and pathogen reduction technologies. Two high-throughput tests were supported by BARDA and now are approved and in use to screen the U.S. blood supply.

FDA’s authorization of this latest diagnostic marks another important milestone in the fight against Zika and demonstrates the success of public-private partnerships in the fight against emerging infectious diseases.

May 24
A Critical Crash Course in Chemical Decontamination

​What EMS Professionals Need to Know about Mass Chemical Decontamination

In communities across the country, people rely on Emergency Medical Services (EMS) professionals to make quick, life-saving decisions.  Becoming an EMS professional takes years of training that you can directly apply during most disasters and emergencies, such as hurricanes, floods and earthquakes.

However, do you know how to effectively decontaminate yourself or patients following a chemical event? 

Straightforward Guidance to Help Save Lives

Decontaminating people after a chemical event is simpler than you might think.  According to the Primary Response Incident Scene Management (PRISM), the first evidence-based guidance on patient decontamination, first responders can help people remove up to 99.9 percent of chemical contamination using a method called the triple protocol consisting of:

Disrobing and Dry Decontamination - self care with guidance; Ladder Pipe System - First Responders Using Fire Trucks; Technical Decontamination - Specialists Using Decontamination Units.

The triple protocol approach to decontamination is faster and more effective than traditional methods for treating chemically contaminated patients. 

In fact, dry decontamination alone can remove up to 99 percent of contamination, if the people who have been contaminated follow these six steps:

1) Disrobe: Remove as much clothing as possible; 2) Using the 10:10, Blot then Rub method 3) decontaminate the Hair/Top of Head first; 4) then the face 5) then the hands; 6) Then any other potentially exposed skin areas

Planning and Practicing with Partners

Though these steps are simple to understand, decontamination operations are challenging. The good news is that disrobing and dry decontamination are steps that people can take themselves with guidance from you, the first responder.. However, you need to understand the protocols, incorporate them into your emergency operations plans, and practice them. By providing you with training in advance, you will be better prepared to provide clear instructions, equipment, and support when seconds count.  

Responding to a chemical emergency has unique challenges.  You, as a responder, need to be ready to convince the people in their communities – who will likely be scared, confused, or stressed – that disrobing, listening, and following instructions could help save their lives. You and your EMS colleagues  may need to help with that process by cutting off clothing or providing foil blankets to help alleviate privacy concerns. You may have to be ready to help evacuate patients or, if that is not possible, shelter in place effectively. After disrobing, dry, ladder pipe system, and technical decontamination, you will need to move patients who are unresponsive or have life-threatening injuries to a hospital. 

Before a chemical emergency, work with partners in your community to incorporate chemical decontamination into your emergency operations plans, so you are ready to work together effectively in an emergency.

Tool to Help Tailor Response Operations

When you are responding to a chemical event, wet decontamination may or may not be necessary after dry decontamination, depending on the chemical agent and the amount of time that has elapsed between exposure and decontamination.  The ASPIRE tool is a decision-making aid that can help responders like you make better decisions based on the details of the emergency they are facing.  ASPIRE and the PRISM guidance have been incorporated into CHEMM, the Chemical Hazards Emergency Medical Management web-based resource that includes a suite of preparedness and emergency response tools.  You can also find ASPIRE in WISER (Wireless Information System for Emergency Responders).

EMS professionals are often the first on the scene, and are called on every day to make complex decisions to help save lives in the communities they serve.  During EMS week, take some time to learn how you and your team can help protect the people in your community in the event of a chemical emergency and be ready to use evidence-based guidance and your organization’s plans to make life-saving decisions.  To learn more about mass decontamination and the triple protocol, check out the newly updated PRISM guidance.

May 22
Reinforcing the Front Lines of Disaster Response: ASPR Provides Critical Resources, Stronger Systems, and Lifesaving Training for EMS Professionals

Emergency Medical Service (EMS) personnel respond to emergencies every day and serve on the front lines of the medical response to disasters, terrorist attacks, and mass casualty incidents. The U.S. Department of Health and Human Services (HHS) is dedicated to supporting EMS personnel in enhancing and protecting the health and well-being of all Americans.

As the HHS lead for coordinating the public health and medical response to disasters and other emergencies, the Assistant Secretary for Preparedness and Response (ASPR) is dedicated to supporting EMS personnel and agencies throughout the response continuum. We support agency readiness by ensuring they have the tools and resources needed to effectively and efficiently respond during disasters and to successfully recover and reconstitute after disasters affect their communities.

ASPR provides such support through a number of programs geared toward EMS responders and systems. As an example, EMS is a critical component of the ASPR-led Hospital Preparedness Program and is a required, core component of regional health care coalitions (HCCs). HCCs work regularly with EMS professionals to integrate them fully into the health and medical response to disasters in their communities.

EMS clinicians and system administrators also are encouraged to register for the Technical Resources, Assistance Center, and Information Exchange (TRACIE), ASPR’s healthcare preparedness information gateway, which provides healthcare practitioners access to preparedness and response information and resources. EMS professionals can use the resources from ASPR TRACIE to learn about issues ranging from responding to no-notice events to protecting themselves and their patients during an infectious disease outbreak. To get started, check out the Select EMS Resources.

To assist EMS response operations during disasters, ASPR developed the HHS emPOWER Program and Map, which provides local public health authorities with data and information on at-risk populations within their communities. EMS agencies regularly use this information to anticipate, plan for and respond to the needs of at-risk individuals in their communities and to help ensure all of their community members have the care they need during disasters.

Additionally, ASPR works with interagency partners to improve EMS training, preparedness, and response. ASPR, with our partners in the National Highway Traffic Safety Administration Office of EMS, helped launch the Stop the Bleed initiative and the Until Help Arrives campaign in an effort to encourage everyone to learn how to act as "immediate responders" in the first minutes after an injury.

ASPR is working closely with our partners at the Center for Medicare and Medicaid Innovation (CMMI) on the Emergency Triage, Treat, and Transport (ET3) Model Program. As the program is rolled out in the coming months and years, ASPR will work with CMMI and participating EMS systems to explore viable alternate treatment and transportation modalities during disasters. This will improve EMS system response to disasters by ensuring EMS systems are able to more effectively allocate resources and deliver to patients the right care at the right time.

ASPR is committed to furthering the goals of the EMS Agenda 2050, a people-centered vision for the future of EMS care in the United States. To achieve this vision, the EMS Agenda 2050 focuses on six guiding principles to help EMS systems promote the best possible patient outcomes by looking for solutions that are: adaptable and innovative, safe and effective, integrated and seamless, sustainable and efficient, reliable and prepared, and socially equitable.

While these principles may seem disparate, they are inherently – critically – interconnected. Each complementary principle is vital to the success of EMS system preparedness for emergencies, both great and small. While most 911 responses don’t make the nightly news or cause community-wide impacts, by being prepared for “small” emergencies, EMS systems and responders are demonstrating their continued dedication to being prepared for all emergencies.

The 2019 theme for EMS Week is Beyond the Call, a concept familiar to all paramedics and EMTs. ASPR thanks all of our nation’s EMS clinicians for their continued, dedicated service to the communities they serve and the health and safety of our nation.

May 13
Capacity-Building Toolkit for Including Aging and Disability Networks in Emergency Planning

Today, older adults and people with disabilities are better able to remain in their homes and live independently, thanks in part to the work of Community Based Organizations (CBOs).  But when disasters strike, older adults and people with disabilities are among the hardest hit and they may not be able to effectively respond to, cope with, and recover from a disaster. If you are a part of the aging and disability networks, planning for disasters and emergencies and establishing the partnerships needed to better serve the people who rely on you can be daunting.  However, advance planning can help you protect health and save lives.

The toolkit will help your CBO plan to address the access and functional needs of older adults and people with disabilities and assist consumers with personal preparedness.  With the tools, checklists, and information in this toolkit, your organization has the resources it needs to better prepare for the next disaster.

The new Capacity-Building Toolkit for Including Aging and Disability Networks in Emergency Planning has a wealth of resources to help you prepare for, respond to, recover from and mitigate the health effects of disasters and emergencies.

The toolkit helps the aging and disability networks, which are CBOs funded by the HHS Administration on Community Living (ACL), meet the access and functional needs of older adults and people with disabilities during disasters. Using a whole community approach, the toolkit focuses on building upon the partnerships and expertise that CBOs already have through their day-to-day work with older adults and people with disabilities. It helps CBOs address a range of considerations that may arise before, during, and after an emergency.


The toolkit includes guidance to help CBOs conduct emergency planning within their organizations, more effectively partner with public health and emergency management officials in local emergency planning, and learn about an array of tools for working directly with older adults and people with disabilities to address personal preparedness.  For CBOs that are new to emergency planning, the capacity-building toolkit provides an orientation to emergency planning. Those that already have established emergency preparedness programs can use it as a resource to further enhance their capabilities.

The toolkit offers a large range of guidance, including the following:

  • Readiness assessment
  • Recommendations for identifying community partners
  • Preparedness planning, including creating an emergency operations plan, employee readiness and training, incident command systems, and understanding the emergency support function framework
  • Preparing for public health emergencies
  • Identifying older adults and people with disabilities, including gathering and mapping data
  • Effective communication and messaging for older adults and people with disabilities
  • Evacuation and shelter needs during an emergency
  • Legal advocacy for older adults and people with disabilities
  • Disaster recovery


The toolkit also provides users with multiple resources and recommendations, along with planning worksheets and templates that can be tailored to the CBO’s mission and the specific needs of the communities they serve.

The new toolkit isn’t just for CBOs.  Public health and emergency management professionals can use the toolkit to learn how they can better partner with CBOs that serve older adults and people with disabilities when it comes to emergency planning, response, recovery, and mitigation.  CBOs possess knowledge, experience, and expertise that can be leveraged to help identify individuals with access and functional needs and provide outreach to older adults, people with disabilities, their caregivers, and family members. CBOs can serve a vital role in emergency planning to ensure that consumers have access to community services, supports, and disaster assistance.

ASPR developed the new Capacity-Building Toolkit for Including Aging and Disability Networks in Emergency Planning with assistance from ACL, the National Association of County and City Health Officials (NACCHO), and the Association of State and Territorial Health Officials (ASTHO).  Before the toolkit was published, these partners held two stakeholder engagement sessions with ACL national partner organizations and a virtual focus group with aging and disability network members.

The toolkit will help your CBO plan so that you are ready to meet the access and functional needs of the older adults and people with disabilities and assist consumers with personal preparedness.  With the tools, checklists, and information in this toolkit, your organization has the resources it needs to better prepare for the next disaster.

May 13
Project BioShield: Enhancing Preparedness, Ensuring Treatment Options


Stockpiling Novel Antibiotics Safeguards Nation, Sustains Commitment to Industry

Bacteria evolve and change, becoming more dangerous and deadly, and often developing resistance to existing medical countermeasures. Consider some of the resistance problems we face today. In recent years, we’ve seen increasing incidences of multi-drug resistant salmonella, gonorrhea, and typhoid, just to name a few examples. Now, think about what would happen if evolution or terrorists created antibiotic-resistant strains of biothreat agents, such as anthrax, plague, tularemia, melioidosis, or glanders. A bioterrorism attack or outbreak of drug-resistant forms of any of these agents could lead to a catastrophic loss of life.

Within ASPR, BARDA is working with its partners in private industry to support biothreat-focused antibacterial research and the development of medical countermeasures (MCMs) to overcome antibiotic-resistant infections, enhance U.S. healthcare system preparedness, and strengthen national security.


The Never-Ending Journey

Unfortunately, the enterprise of maintaining an effective antibacterial armamentarium is a never-ending journey; the importance of that point cannot be understated. The emergence of antibiotic-resistant bacteria means that existing antibiotics, long considered reliable medications, may not be effective. Moreover, the rapid progression of biotechnology means that antibiotic-resistant bioterror agents have been, or are increasingly accessible to, our adversaries.

In addition, antibacterials serve as a foundational element of our modern healthcare system, preventing or treating secondary opportunistic infections. Simply put, in order to save lives in a public health emergency, it is not enough to provide medical interventions for the primary injury or exposure – you must provide for the full continuum-of-care through to full patient recovery.

As part of ASPR’s broader mission to save lives and protect Americans from modern, evolving health threats, the Strategic National Stockpile (SNS) secures a variety of antibiotics that may be deployed nationwide as targeted medical countermeasures against these infectious agents.

We must continue to recognize that antimicrobial resistance is, in-and-of-itself, a threat to our national security, whether of deliberate or natural origin. To this end, the 2018 National Biodefense Strategy specifies a need to “reduce the emergence and spread of antimicrobial-resistant pathogens domestically and internationally,” with a specific call to “accelerate basic and applied research and development of new antimicrobials, novel preventatives and therapeutics, vaccines, and diagnostic tests.”

In response to the growing concern over biothreat agents, the strategy also makes a specific call to “prioritize the development and procurement of MCMs with the highest potential to reduce severe morbidity and mortality,” as part of a broader goal to “enhance MCM development, sustainment, and availability.”


BARDA partnerships drive results

BARDA is charged with preparing the nation for public health emergencies by directly supporting the development of new antibacterial products. Since 2010, BARDA has provided over $1.2 billion in non-dilutive funding, including grants, contracts, and other transactional agreements, to companies with antibiotic candidates that have the potential to address bioterrorism pathogens and the unmet medical needs created by antimicrobial resistance. Through these partnerships, BARDA has helped make possible the FDA approval of three new antibiotics (Rempex’s VABOMERE, Achaogen’s ZEMDRI, and Tetraphase’s XERAVA), all of which are available now on the commercial market to clinicians.

Taking advantage of the potential within the current antibacterials landscape, BARDA now is seeking to support late stage development and procurement of promising antibiotics to counter biothreat agents of concern. Such newly developed antibiotics hold the potential ability to overcome known mechanisms of resistance, and therefore augment drugs currently held in the Strategic National Stockpile (SNS). Through Project BioShield, BARDA partners with industry to support the necessary studies that may achieve a threat-specific indication and to procure initial supply of these antibiotics for the SNS.

By supporting biothreat-focused research of antibacterials, including those specifically designed to overcome antibiotic-resistant infections, BARDA can better prepare the U.S. healthcare system to respond to future public health emergencies.


The next step: advanced development under Project BioShield

BARDA is seeking antibiotics that can be used under Emergency Use Authorization (EUA) pre-approval or receive FDA marketing authorization to treat a biothreat pathogen (Y. pestis, B. anthracis, F. tularensis, B. mallei and/or B. pseudomallei) for delivery to the SNS. The Request-for-Proposal (RFP) announced today describes the specific criteria involved in Project BioShield contract awards for advanced development of new antibiotics.

Any contract (or contracts) awarded will be designed specifically to support necessary late-stage development activities including non-clinical studies and Phase IV post-marketing commitments that will support approval of the agent(s) for a biothreat indication.

As substantial investments in biothreat-focused medical countermeasures, Project BioShield contracts also signal a commitment to private industry, which plays a vital role in biodefense by taking risks to bring new products to market. By acting as a potential buyer of critically-needed medical products, the government ensures that the SNS will remain relevant, robust and effective by way of sustained innovation.

Ultimately, BARDA’s acquisition of vital antibacterials using Project BioShield will enhance the biomedical preparedness of the nation by supporting and incentivizing the development of products for biothreat pathogens.

May 07
Help guide the future of disaster health readiness, response, and recovery

HHS seeks outside experts for national advisory committee

Disaster readiness, response, and recovery are complex and the threats involved continue to evolve. The nation faces a myriad of potentially challenging health effects following a disaster. The HHS Secretary depends on the advice, expertise, and counsel of outside experts from the National Biodefense Science Board for recommendations to help make complex decisions and guide the future of disaster health preparedness, response, and recovery. Participating on the board provides a unique way to get involved in public service.

Advising on complex issues

Drawing on diverse expertise, the NBSB advises on current and future trends, challenges, and opportunities presented by advances in biological and life sciences, biotechnology, and genetic engineering with respect to threats posed by naturally occurring infectious diseases and chemical, biological, radiological, and nuclear agents.

Over the past few years, the board has provided recommendations on:

  • aligning the implementation of the National Biodefense Strategy with the challenges faced by state, territorial, local, and Tribal Nation stakeholders;
  • enhancing systems and operational plans to deploy and utilize medical countermeasures during a public health emergencies; and
  • strategic communications with stakeholders to incentivize local preparedness and align utilization of resources, especially related to protecting and supporting vulnerable populations.

Drawing on diverse expertise

The NBSB’s 13 voting members and 20 non-voting ex officio members represent practicing health care professionals, including pediatric health, as well as experts from pharmaceutical, biotechnology, and device industries; health care consumer organizations; and a public health official from state, territorial, local government or Tribal Nation.

Although only the board’s voting members can approve sending recommendation forward to HHS, the board’s voting and non-voting members work together to develop recommendations for the Secretary and/or Assistant Secretary to use in making decisions about current and future issues in disaster health preparedness, response, and recovery.

As a federal advisory committee, the NBSB complies with the Federal Advisory Committee Act, including scheduling meetings that are open to the public and making recommendations public. The board’s membership is also public information.

Each member serves for a 3-year term, and the terms of five members expire December 31, 2019. HHS will accept nominations for new board members through June 15. New members will begin their terms in January 2020.

Professionals interested in helping to guide the future of biodefense and biosecurity: apply today to join to the National Biodefense Science Board.


May 06
The Intersection of Hurricane Response and Opioid Use Disorder

What Disaster Responders, Healthcare Professionals, and Disaster Relief Service Providers Need to Know

Hurricane season is just around the corner.  If you are thinking about ways to prepare for the next hurricane, take a moment to consider this:  approximately 2.1 million people have an opioid use disorder according to the National Survey on Drug Use and Health and over 47,000 of them died by overdose in 2017 according to a study by the Centers for Disease Control and Prevention.  After a hurricane, flood or other disaster, responders, emergency healthcare professionals, and disaster relief service providers face the challenge of considering the specific vulnerabilities of people struggling to manage treatment and recovery while meeting the increased needs of the community at large. 

People in substance use recovery rely on healthcare systems and substance use and mental health treatment and recovery services that are frequently disrupted in a hurricane.  When access to medication-assisted treatment, including methadone, buprenorphine and naltrexone, is compromised, patients suffering from an opioid use disorder face potential health complications, such as the onset of rapid withdrawal symptoms and relapse.

If access to medication assisted treatment is restricted, individuals may seek out illicit opioids, such as heroin, to avoid experiencing withdrawal. The stress of managing the aftermath of a hurricane, flood or other disaster may result in more people with opioid use disorder reverting to illicit drug use to soothe their anxiety and distress, causing more instances of overdose and the necessity for rapid emergency medical treatment in shelters or in the community. 

Here are five things you can do before a disaster strikes to prepare to help people who are suffering from opioid use disorder:

  • Learn to Recognize and Respond to Opioid Withdrawal: When people abruptly stop using medication-assisted treatment, their bodies may enter withdrawal. The symptoms of opioid withdrawal can include anxiety, restlessness, perspiration, chills, fever, muscle pain, watery eyes, a runny nose, restless sleep, yawning, tremors, irritability, “goose bumps” (piloerection), severe nausea, vomiting, cramps, and diarrhea. These symptoms can last for several days and can be severe. To cope with the effects of withdrawal, individuals may seek medical attention from emergency providers. Be ready to help people who are suffering from withdrawal or connect them with medical professionals who can provide them with the care they need.
  • Identify Drug Treatment Services and Health Centers in Your Area:  Before a disaster strikes, familiarize yourself with the location and services of local drug treatment facilities and health centers, including those that provide medication assisted treatment. Most have plans in place to provide take home medications and supplies in advance of a hurricane or severe storm or agreements with one another to provide services if necessary. Find out what those plans are in advance of a storm so you understand how people in recovery can maintain their treatment. To get started, use SAMHSA’s Behavioral Health Treatment Locator.  You can also work with agencies that address substance abuse in your state as you develop your plan.  HRSA-funded community health centers may provide additional resources.  To find out about low- or no-cost HRSA-funded community health centers services in your area, use the HRSA health center locator.
  • Provide Space and Privacy: Disaster relief service providers can facilitate ongoing access to support strategies by ensuring shelters and disaster recovery centers have space set aside to enable 12-step meetings or private consultations with substance abuse and mental health volunteers and workers. 
  • Tell People about SAMHSA’s National Helpline:  Have materials on hand to refer people to treatment and support, such as SAMHSA’s National Helpline. The helpline is a free, confidential, and available 24/7 (in English and Spanish) for individuals and families facing mental and/or substance use disorders. You can reach SAMHSA’s National Helpline at 1-800-662-HELP (4357) or use TTY at 1-800-487-4889.
  • Have a Plan to Help People following an Overdose:  If you work or volunteer in disaster evacuation shelters, learn to recognize the signs of an opioid overdose and have a plan in place to help them. People who have overdosed on opioids may be unconscious or unable to wake up; have very small pupils; have slow, shallow, or difficulty breathing; have difficulty breathing; and/or have fingernails or lips that are turning blue or purple. If someone in your shelter is experiencing an opioid overdose, be ready to help. Naloxone, a non-addictive, life-saving drug, can be used to reverse an overdose and treat patients or staff members who have been exposed to opioids, but you need to have staff who are trained to administer it and you need to be ready to administer it quickly. The drug works by binding to opioid receptors in your body and reversing or blocking the effects of opioids.  To learn more, check out SAMHSA’s Opioid Overdose Prevention Toolkit.

Responding to a hurricane while ensuring that you meet the needs of all members of your community, including those with opioid use disorder, is complex and challenging. By using these five strategies to enhance your disaster response plan, you and the members of your community will be better prepared to help individuals with opioid use disorders withstand the challenges of a natural disaster while helping their recovery efforts thrive.


Apr 30
Promoting Calm and Coping in Your Community following Acts of Mass Violence

Over half of all recorded mass shootings have happened in the last decade.  From major cities like Las Vegas, NV and Tampa, FL to smaller places like Newtown, CT and Aurora, CO, communities have been struck by violence that inspires fear, stresses local healthcare systems, and leaves lasting scars.  Unfortunately, today mass shooting can happen anywhere, from schools and college campuses to movie theaters, concerts and night clubs.

But just as emergency managers, healthcare facilities, and communities can prepare for deadly hurricanes, wildfires or tornadoes, they can also prepare to help the people who rely on them after an act of mass violence.

Responding in the First Hours:  How You Can Get Ready

Acts of mass violence are typically perpetrated to inspire fear and panic in survivors – and they often do.  One of the best ways for public health professionals to help their communities prepare is to develop a basic understanding of the psychological impact of mass violence.

Before a disaster strikes, build partnerships with community organizations in the areas you serve. Developing a Disaster Behavioral Health Coalition to bring partners together before a disaster strikes could help you coordinate health services more effectively. You can also learn more about your community’s strengths and areas for improvement by using the Disaster Behavioral Health Capacity Assessment Tool.  Before a disaster strikes, learn about programs and resources that already exist to help you respond to a disaster. You can also tap into volunteer resources by working with the Voluntary Organizations Active in Disaster (VOADs) to respond more effectively.

In the moments and days after a disaster, people typically feel a wide range of emotions, from shock and numbness to anger and despair.  Make sure that members of your community – from emergency responders to members of community groups and other partners – understand and are ready to administer psychological first aid.

Although most disaster behavioral health activities are carried out by state, local, tribal and territorial entities (SLTT), federal partners, particularly those from the U.S. Department of Health and Human Services, can help its SLTT public health professionals prepare for, respond to, and recover from the behavioral health impacts of disasters. To learn more about the tools, guidance and partnership opportunities, see Disaster Behavioral Health:  What the Feds Do.

Preparing Your Community to Respond

Arming your community members with basic information on disaster response can enable them to help protect health and save lives during disasters. Teaching people about the basics of emergency response can also help them feel less helpless in a disaster by empowering them to help.

Did you know that a person can die from blood loss in just five minutes?  Typically, bystanders are first on the scene after a mass-casualty incident and they are the people who are best positioned to provide lifesaving care in an emergency.  Learning to apply a tourniquet takes only a few minutes and it can save someone’s life.  Use the Stop the Bleed materials to help teach people in your community the three easy steps they need to know to help save lives in an emergency.

To give your community a more in-depth understanding of simple things that they can do to help in a disaster, use the Until Help Arrives program.  The course is available as an online training and many Medical Reserve Corps (MRC) units teach a more in-depth version of the course.  If you are interested in getting MRC units to help, reach out to a unit in your area.  You may also want to consider hosting courses for the community in psychological first aid.

Facing Mid- and Long-Term Issues

Over time, as individuals and communities recover, many of the people who were directly affected by the incident will return to their normal daily routine and activities, feeling better in a matter of weeks. Others, however, may continue to have difficulty readjusting to their day-to-day lives. 

Some members of the community may isolate themselves, report feeling on edge, have difficulty sleeping, or have other long-term mental health issues related to the disaster.  These members of the community may have post-traumatic stress disorder (PTSD), which can be treated.  Learn about treatment options and work with your partners, especially those in your Disaster Behavioral Health Coalition, to help people with PTSD get the treatment they need.

Acts of mass violence stress communities and can cause serious psychological stress. By planning for a no-notice mass casualty event, public health professionals and their partners will be better equipped to support their communities through the recovery and healing process. 

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