Keystone Health Preparedness Digest

December 3, 2024

Volume 13, Issue 23 

Good and Not Forgotten: Emergency Management Lessons from the Pandemic

Keep leaning forward—even when current trends say to relax

Anyone who has been in the hospital through the years of the pandemic has become accustomed to closely monitoring respiratory virus data to adequately manage supplies, space, and staffing. 

As emergency managers, some may think that we are pessimistic about what could be coming down the pike. Perhaps a better way to think about it is our reliance on a forward-leaning posture to be ready to meet the emergency when it occurs.

Read the new HAPevolve blog post by Ryan Weaver, HAP manager, emergency management. 

Read HAPevolve's New Blog Post

Emergency Preparedness Expertise

HAP’s Emergency Management team helps Pennsylvania's hospitals and health systems prepare for public health emergencies and serves as a national model for best practices. Learn more about HAPevolve's Emergency Preparedness Solutions.

HOT TOPICS

USDA confirms more avian flu in US dairy cattle and poultry, CIDRAP: USDA testing confirms more outbreaks in dairy cattle and poultry, and LA County warns that recalled raw milk was sold in at least 10 retail stores.

National Preparedness News and Updates

COVID-19

Antiviral COVID-19 drug molnupiravir tied to large drop in deaths in older patients, CIDRAP: The greatest risk reductions in COVID-related and all-cause deaths were seen among women and hospitalized patients.

Very few US adults getting new flu, COVID, RSV vaccines, even in nursing homes, CIDRAP: By November 9, 35 percent of adults reported having received the flu vaccine and 18 percent the updated COVID-19 vaccine, and 40 percent of those aged 75 years and older had ever received an RSV vaccine.

INFECTIOUS DISEASES

H5N1 Avian Flu

California reports avian flu in retail raw milk sample, CIDRAP: The USDA confirmed more poultry outbreaks in five states, including commercial farms in California and Utah.

Avian flu confirmed at 62 more California dairy farms as virus strikes more poultry, CIDRAP: Brisk activity continues in California at dairy and poultry farms, as poultry outbreaks expand to Midwestern states.

CDC confirms H5N1 in California child as Hawaii details testing results, CIDRAP: Also, today California health officials report another illness in a dairy farm worker, pushing the national total this year to 55.

Tracking the U.S. Bird Flu Outbreak Has Been Hard. It’s About to Get Harder, STAT News: In the months since the outbreak was first detected, the spread of the H5N1 virus in cows has not been contained, with infections reported in 380 herds in 14 states so far. Now, with cold and flu season looming, it is likely to become significantly more difficult for the country’s public health departments to track the virus. In the weeks and months to come, when dairy farm workers or others culling infected poultry flocks develop influenza-like symptoms, what ails them could be a common cold, COVID-19, regular influenza, or a bird flu virus.

Spotting a new flu virus before it starts to transmit more easily among humans and stopping that spread—if it is possible—could make the difference between a close call and something no one wants, another pandemic. Trying to do this surveillance at any point in the year is devilishly tough. Doing it in flu season will be next-level hard, experts warn. “It’s going to be more challenging. You’re going to have more viruses that are in circulation, more cases coming forward. The labs are going to have much more to do,” said Maria Van Kerkhove, the World Health Organization’s acting director of epidemic and pandemic preparedness and prevention.

USDA and HHS Detail New Actions to Halt Spread of Bird Flu, ASPR HPH Infectious Disease Update: USDA and HHS have released updates on the whole-of-government approach being taken to rapidly respond to the ongoing bird flu outbreak. An “epi strike team” and a “case management team” have both been deployed to California to assist their efforts, as a total of 137 dairy herds in the state have tested positive for H5N1 so far. USDA has transferred $824 million to fund programs design to respond to the outbreak in California, meant to cover costs for “vet fees and shipping costs associated with testing herds” among other things. HHS has been working with California “to prepare for a potential outbreak” in humans even before cases began to rise in California dairy herds. CDC has deployed a “multilingual epidemiological field team to assist with the investigation of H5N1 infections in both dairy cows and farm workers who may have been exposed to infected cattle” in the state.

In Washington state, USDA is “providing technical support and resources to help on-the-ground response efforts, following established processes for detections of highly pathogenic avian influenza in poultry.” CDC is also “deploying a team to Washington to support its response efforts at a commercial egg farm in the state. The agency is awaiting specimens from Washington for confirmatory avian flu testing and will then assess further action.” USDA/HHS Fact Sheet

Emerging Disease

US respiratory virus activity remains low ahead of holiday season, CIDRAP: With flu and COVID levels still low but expected to rise, the CDC said vaccination is a good way to cut risk over the holiday season.

WHO warns of global measles surge, with 10 million cases last year, CIDRAP: Since 2020, no country has been able to reach its 2019 first-dose coverage level.

CDC announces deadly Listeria outbreak linked to ready-to-eat meat, poultry, CIDRAP: In California, one pregnant woman and her twins were sick, and both infants died.

CDC lifts level 3 travel advisory for Marburg in Rwanda, CIDRAP: Rwanda has now gone more than three weeks with no new cases.

First clade 1 mpox case detected in US, in California, CIDRAP: The California case makes the United States the sixth country outside of Africa to report an imported clade 1 case.

Three countries report new polio cases, CIDRAP: Nigeria reported a single case of cVDPV2 in September and now has 81 cases for the year.

WHO: 3 countries report new cholera outbreaks, CIDRAP: Countries reporting the latest outbreaks are Iraq, Lebanon, and South Sudan.

CYBERSECURITY

The latest CISA Vulnerability Bulletin provides a summary of new vulnerabilities that have been recorded by the NIST National Vulnerability Database (NVD) in the past week. In some cases, the vulnerabilities in the bulletin may not yet have been assigned CVSS scores. Please visit NVD for updated vulnerability entries, which include CVSS scores once they are available.

Free Cybersecurity Services and Tools: As part of Department of Homeland Security's Cybersecurity and Infrastructure Security Agency's (CISA) continuing mission to reduce cybersecurity risk across U.S. critical infrastructure partners and state, local, tribal, and territorial governments, CISA has compiled a list of free cybersecurity tools and services to help organizations further advance their security capabilities. This living repository includes cybersecurity services provided by CISA, widely used open-source tools, and free tools and services offered by private and public sector organizations across the cybersecurity community. Any reference to specific commercial products, processes, or services by service mark, trademark, manufacturer, or otherwise, does not constitute or imply their endorsement, recommendation, or favoring by CISA.

AI IN HEALTH CARE

Six things high-achieving organizations do to wring real value from AI, AI in Healthcare: What makes an organization an AI leader? Demonstrating success in one of two pursuits. Either the org has a) developed cutting-edge AI capabilities and is already using them to consistently generate substantial value. Or it has b) put an AI strategy in place and is starting to generate value from the effort. Combined, those two groups comprise 26 percent of the field in a recent survey of 1,000 organizations around the world. The “a” group was just 4 percent, the “b” group the other 22 percent. The remaining 74 percent “have yet to show tangible value from their use of AI,” write the authors of the survey report. “These categorical distinctions are important because leaders far outperform the others.” The report was authored by 12 subject matter experts at Boston Consulting Group, aka BCG, which also commissioned the survey. Full report

The authors name six things that AI leaders “do differently.” These are:

1. They focus on core business processes as well as support functions. “A common misconception is that AI’s value lies mainly in streamlining operations and reducing costs in support functions,” the authors learned via the survey. “In fact, its greatest value lies in core business processes, where leaders are generating 62 percent of the value.”
2. They are more ambitious. Three-quarters of the most forward-looking companies “focus on company-level innovation core to the business,” BCG reports. By contrast, only 10% of other companies do so—“and if they leverage AI at all, it is mainly for productivity.”
3. They invest strategically in a few high-priority opportunities to scale and maximize AI’s value. Data on AI adoption shows that leaders pursue, on average, only about half as many opportunities as their less advanced peers, the authors write. “Leaders focus on the most promising initiatives,” they add, “and they expect more than twice the ROI in 2024 that other companies do.”
4. They integrate AI in efforts both to lower costs and to generate revenue. “Almost 45 percent of leaders integrate AI in their cost transformation efforts across functions, compared with only 10 percent of non-leaders,” BCG found.
5. They direct their efforts more toward people and processes than toward technology and algorithms. Leaders follow the rule of putting 10 percent of their resources into algorithms, 20 percent into technology and data and 70 percent into people and processes, the authors write.
6. They have moved quickly to focus on GenAI. Leaders use both predictive AI and GenAI, and they are faster in adopting GenAI, the authors share. This is key.

HEALTH SYSTEM PREPAREDNESS

HHS ASPR announces new funding to fill gaps in biothreat diagnostics, CIDRAP: Though the funding covers melioidosis and Marburg tests, ASPR said the new capability can be repurposed to develop and produce tests for other biological threats when needed.

EDUCATION

Drones for Emergency Management

Federal Emergency Management Agency (FEMA)

December 4 from 1–2:30 pm ET

Register

Please join the FEMA Region 2 National Preparedness Division in partnership with the Ocean County, NJ, Sheriff’s Office for a discussion on starting a drone program. Emergencies happen fast and without warning.

----------

EPA Tools & Resources Training Webinar: ECOTOX Knowledgebase and PFAS Updates

U.S. Environmental Protection Agency (EPA)

December 5 from 3–4 pm ET

Register

This webinar will demonstrate EPA’s Ecotoxicology Knowledgebase (ECOTOX) tool, which gives quick access to reliable and up-to-date information about how chemicals potentially affect ecologically relevant species. ECOTOX is a comprehensive, publicly available knowledgebase providing single chemical environmental toxicity data for over 12,000 chemicals and species, including aquatic life, terrestrial plants, and wildlife. ECOTOX provides robust curated toxicity data for aquatic and terrestrial organisms to support ecological risk assessments, site assessments, criteria/benchmark development, and other research. The knowledgebase is additionally used to aid the prioritization and assessment of chemicals. This presentation will include information on updates to ECOTOX data for PFAS to support hazard evaluation and development of ecological risk assessment screening values. ECOTOX Knowledgebase Resource Hub

----------

Enhancing the Resilience of Healthcare and Public Health Critical Infrastructure

National Academies

December 9 from 9 am–5:30 pm ET and December 10: 9 am – 3 pm ET

Register

When disaster strikes, critical infrastructure failures, from loss of power and water to failures of IT infrastructure and systems, can follow. Strengthening the resilience of healthcare and public health (HPH) infrastructure requires ongoing investment, innovation, and collaboration across all levels of government, the private sector, and civil society during steady state, and response, and recovery phases.

HPH infrastructure, technology, and operations are rapidly changing and are increasingly interdependent and interconnected. Threats to the nation’s critical social and physical infrastructure systems are also rapidly evolving and highly complex, posing potentially new or growing risks of disruption and challenging the assumptions used to design and protect these system.

The National Academies Forum on Medical and Public Health Preparedness for Disasters and Emergencies is organizing this workshop to examine strategies, policies, and innovative actions to improve the resilience of HPH critical infrastructure to impacts from disasters and other emergencies.

----------

National Advisory Committee on Individuals with Disabilities and Disasters Public Meeting

December 10 from 1:30–3:30 pm ET

Register

During this meeting, the NACIDD will discuss recommendations related to: Expansion of the existing HHS emPOWER Program and Development of an analysis of the Emergency Response Framework and the Community Lifelines framework to find gaps in equitable and compliant incident management and disaster response activities.

----------

Understanding the Health Impacts of Military Service

American Society on Aging

December 11, 1–2 pm ET

Register

Veterans do not come home from war; they come home with war. Join this 1-hour webinar to explore the unique health needs of veterans. The session will cover the physical, psychological and psychosocial health consequences of military service, combat and toxic exposure. It will reveal common injuries from complex, war-specific conditions. The discussion also will focus on a team-based approach to care management that includes clinical pearls you can adapt to your care setting.

Want to receive the KHPD in your inbox as soon as it comes out?

Subscribe online!

ITEMS OF INTEREST

ASPR RISC Toolkit 2.0

Risk Identification and Site Criticality (RISC) Toolkit is an objective, data-driven all-hazards risk assessment that can be used by public and private organizations within the Healthcare and Public Health Sector to inform emergency preparedness planning, risk management activities, and resource investments. The RISC Toolkit provides owners/operators in the HPH Sector with nationally recognized standards-based evaluation criteria in an easy-to-follow, guided format. It can be utilized by a wide variety of HPH stakeholders including but not limited to hospitals, long-term care facilities, community health centers, health care coalitions, and public health agencies. The RISC Toolkit contains three self-assessment modules. These allow users to identify external threats and internal hazards specific to their site by using objective national-level data; assess the vulnerability of their site based on industry standards and guidance; and evaluate the criticality of and consequences to their site in the event of an incident. The RISC Toolkit compares multiple facilities across systems, coalitions, and regions to identify dependencies and interdependencies in a consistent and repeatable method to help create a more resilient healthcare system.

 Visit us online at www.hapevolve.com!