Tag Archives: pandemic

Lawyers Do the Pandemic Pandemonium Tango

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Can the ‘imminent’ pandemic be far off when lawyers begin their pandemic pandemonium preparation?

 

96 pages-Legal Pandemic Checklist

 

On May 2, 2008, Health Lawyers, with the U.S. Centers for Disease Control and Prevention and the Office of Inspector General of the U.S. Department of Health and Human Services (HHS) convened a public interest dialogue session to discuss the role of the health-care sector in community pan-flu preparedness.

The healthcare attorneys are preparing for the next pandemic and believe that the coming pandemic will not be adequately and easily handled despite our modern healthcare system.

Emergency planning is being accepted by attorneys as a prerequisite for effective disaster preparation and unless these elements are considered, evaluated, and addressed in advance, response to public emergencies such as pandemic influenza will be severely handicapped.

 

Just what facets of the pandemic are healthcare attorneys addressing?

  • Train parents in the community regarding issues related to consent to treatment for their children in the event of an influenza pandemic or other mass-casualty situations.
  • § 264(b), adding “influenza caused by novel or reemergent influenza viruses that are causing, or have the potential to cause, a pandemic” to the list of communicable diseases for which the CDC is authorized to detain individuals).
  • Establishing a “crisis standard of care” for emergencies such as pandemics where health-care demands exceed available resources.

This is your euthanasia or culling triage.

  • Health-care organizations need to know what possible sources of immunity are available, understand the scope of provider liability statutes within their states.
  • An influenza pandemic may require the health-care organization to rapidly expand its facility or take over other nearby buildings, called “surge facilities,” in order to meet a high volume of infected patients.
  • Security concerns including the ability to secure medications, controlled substances and limited resources?
  • The systems are in place to determine chronic co-morbid conditions and concomitant medication use when patients are seen by medical practitioners and establishments.

Your preexisting conditions and medications are subjected to a complex algorithm to determine if you will have access to medical treatment and resources during a pandemic- INSTITUTE FOR ALGORITHMIC MEDICINE Comorbidity Index and Score of Charlson.

  • State or local laws authorize governmental or emergency response officials to require non-health-care providers to assist during an influenza pandemic, including authority to commandeer equipment and other assets.

Such as the USPS dispensing medications and other services during a pandemic under CDC Cities of Readiness

  • Applicable state or local public health authority authorized to order compulsory examination, treatment, or vaccination during a disaster, a state of emergency, or a public health emergency.
  • Ordering of these examinations, treatments, or vaccinations to take place at the organization’s facility, will the government agency ordering these activities pay the costs of the procedures or provide the materials and supplies necessary to conduct these activities?
  • In an effort to target key actors in pandemic response and planning, the checklist is divided by specific actors: healthcare facilities, healthcare providers, patients, and state and federal government agents.


For an in-depth discussion of the federal and state laws and regulations affecting workforce management issues, see American Health Lawyers Association, Teleconference Series, Planning for Pandemonium: Pandemic Flu and Other Disasters, at Part III (Jan. 23, 2006).

  • Healthcare provider outsourcing to a third party or “partnering” with other similar employers outside of its region in the event that the effect of the pandemic is geographically limited and staffing support is required.

Outsourcing…might this be an international ‘partner’?

  • Issues related to the licensing, credentialing, and insuring of staff.
  • The potential liability to the organization created by accepting unlicensed out-of-state healthcare professionals in response to an influenza pandemic?
  • Consideration that the Secretary of DHHS may need to waive federal healthcare program physician licensure requirements
  • Problematic consideration: long term care facilities, which generally do not have the resources or training to care for acutely ill individuals.
  • Will the facility be able to obtain sufficient quantities of respiratory support equipment to care for residents with acute respiratory distress secondary to pandemic influenza (e.g., ventilators)?

 

DIA Establishes National Center for Medical Intelligence

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By Matthew Watson, July 11, 2008

On June 2, 2008, the United States Defense Intelligence Agency (DIA) issued a press release announcing the dedication of its National Center for Medical Intelligence (NCMI) at Fort Detrick, Maryland.1 The NCMI, formerly the Armed Forces Medical Intelligence Center (AFMIC), is charged with monitoring and analyzing health events that could negatively impact the health of U.S. military and civilian populations. Such events would include the emergence of pandemic influenza, novel zoonotic diseases or incidents of bioterrorism.1 Continue reading →

The Politically Correct Quarantine

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Biosecurity Emerges

Fair Use Access

The term quarantine elicits a negative connotation that most of us shy away from. The fact of the matter the notion of quarantine is unpalatable so how do decision-makers make the concept socially acceptable?

The testing ground to see what works and what does not began with the Wild-land Project in the environmental movement. Social engineers applied the science know as ‘fuzzy math’ to contentious issues. Fuzzy math takes an ideology and applies an algorithm to the issue. Through this mathematical mechanism an incremental plan is formulated to get your ideology changed. For instance you goal is to make the mountains off limits to human activity. You have a comment period and record peoples objections. You then apply the algorithm which will give you the plan to incrementally change people’s perception of wilderness areas. One might first put up a small gate, then a larger gate, then add cameras, the add patrols, add warning signs, lastly incrementally make the distance between the wilderness area and humans larger and larger. Tests reveal after time people will look at the wilderness areas, but in a Pavlovian response, not even think of going near the off limit areas.

Link: Wild-lands Fuzzy Math

This type of model is now being applied to the concept of quarantine. This week a series of social distancing articles were posted online. The whole premise of biosecurity is to distance the disease including the farm, ill person or whatever needs to be quarantined from the others. The tool of fear of disease is utilized to ensure compliance. Unfortunately some interesting dynamics occur when social distancing or quarantine occurs. Studies in the mid-twentieth century showed that humans and animals alike suffered various types of trauma due to the isolation (quarantine) factor.

The Pit of Despair: http://en.wikipedia.org/wiki/Pit_of_despair

Implementation of Social Distancing (Quarantine)

Distancing Teenagers

BMC Public Health 2008, 8:61doi:10.1186/1471-2458-8-61

Published: 14 February 2008

Influenza is a viral infection that primarily spreads via fluid droplets from an infected persons coughs and sneezes to others nearby. Social contact networks and the way people interact within them are thus important to its spread. We developed a method to characterize the social contact network for the potential transmission of influenza and then applied the method to school aged children and teenagers.

[...]

Conclusions

High-school students may form the local transmission backbone of the next pandemic. Closing schools and keeping students at home during a pandemic would remove the transmission potential within these ages and could be effective at thwarting its spread within a community. Social contact networks characterized as groups and public activities with the time, level of contact and primary links within each, yields a comprehensive view, which if extended to all ages, would allow design of effective community containment for pandemic influenza.

Utilizing fear and social stigma in a pandemic response

The Journal of Infectious Diseases2008;197:SS7

 2008 by the Infectious Diseases Society of America. All rights reserved.
0022-1899/2008/19704S1-0008 ( pay for view $15.00)
DOI: 10.1086/524986
SUPPLEMENT ARTICLE

Ron Barrett1 and Peter J. Brown2

1School of Nursing and 2Department of Anthropology, Emory University, Atlanta, Georgia

  • Potential conflicts of interest: none reported.

    Financial support: supplement sponsorship is detailed in the Acknowledgments.

Reprints or correspondence: Ron Barrett, School of Nursing, Emory University, 1520 Clifton Rd., Atlanta, GA 30322 ().

This article examines the role of stigma in social and institutional responses to infectious disease emergencies, to better understand and minimize these dynamics in the event of a pandemic of virulent influenza. In addition to their impact on human suffering, fear and stigma can seriously delay detection and treatment efforts, cooperation with contact tracing and isolation measures, and the effective distribution of resources for the prevention and control of infectious diseases. These dynamics are illustrated by the Indian plague epidemic of 1994, which occurred in a region where H5N1 influenza has been detected recently. Public fear and stigma also played a significant role in the social and institutional responses to the 1918 influenza pandemic. These historical models provide important lessons for pandemic preparedness and global health policy.

Introduction of biosocial approach to the prevention for and control of pandemic

 The Journal of Infectious Diseases2008;197:S1S3

2008 by the Infectious Diseases Society of America. All rights reserved.
0022-1899/2008/19704S1-0001 (pay for view 15.00)
DOI: 10.1086/524992
SUPPLEMENT ARTICLE INTRODUCTION

Arthur M. Kleinman,1,4; Barry R. Bloom,5; Anthony Saich,2,3; Katherine A. Mason,1 and Felicity Aulino1

1Department of Anthropology, 2John F. Kennedy School of Government, and 3Harvard Asia Center, Harvard University, Cambridge, and 4Department of Social Medicine, Harvard Medical School, and 5Harvard School of Public Health, Boston, Massachusetts

  • Potential conflicts of interest: none reported.

    Presented in part: Harvard University Asian Flus and Avian Influenza Workshop, Cambridge, Massachusetts, 8–10 December 2006.

    Financial support: supplement sponsorship is detailed in the Acknowledgments.

Reprints or correspondence: Dr. Arthur M. Kleinman, Dept. of Anthropology, Harvard University, William James Hall, 33 Kirkland St., Cambridge, MA 02138 ().

The Harvard University Asian Flus and Avian Influenza Workshop, held in December 2006, introduced a biosocial approach to the preparation for and control of pandemics. A biosocial approach brings together the biological and social sciences to develop an integrative, collaborative response to the threat of pandemic influenza. The articles in this supplement provide a representative sampling of some of the ways in which the workshop worked toward this biosocial vision. These articles address the historical “siting” of epidemics, political and structural pandemic preparedness in China, lessons to be taken from the 1976 “swine flu affair,” possibilities for genetic engineering as an alternative to poultry vaccination, issues to be considered in the control of infectious disease in swine and avian species, the ecology of influenza in migratory birds, and issues of stigma and trust during the control of epidemics. The need to build public trust and public health infrastructure is one of the primary messages of this collection.

As we see this idea of social distancing and quarantine unfold take a serious look at the consequences of such actions though they may appear to be a good idea.
From the trenches,
Celeste

 

SPP-Implementation of Pandemic Plan

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One Step Closer to the ‘ONE Big Happy Family’

In August the SPP/NAU met to unveil it’s “plan” for the Pandemic Influenza and on November 1-2 the ‘leaders’ signed an Memorandum of Understanding (MOU) to implement their ‘plans’. I have searched the SPP site, the GHSI site, and HHS sites and the actual document has not been released. I will post it when and if it becomes available.

North American countries agree to coordinate infectious disease efforts

Nov 2, 2007 (CIDRAP News) – The United States, Canada, and Mexico yesterday vowed to help each other during public health emergencies and outlined the types of aid they could provide and accept from each other in the event of a pandemic or other infectious disease outbreak.

A memorandum of understanding was signed by health leaders from the three countries: Mike Leavitt, secretary of the United States Department of Health and Human Services (HHS), Jose Angel Cordova Villalobos, Mexico’s secretary of health, and Tony Clement, Canada’s minister of health, according to an HHS press release from yesterday.

http://spp.gov/

http://www.hhs.gov/

The health ministers were meeting in Washington, D.C, with health representatives from the G7 countries, Mexico, and the European Union at the Global Health Security Initiative’s eighth ministerial forum, according to a press release today from Health Canada. Discussion topics included pandemic influenza and biological, chemical, and radionuclear terrorism threats.

http://www.ghsi.ca/english/index.asp

Members GHSI http://www.ghsi.ca/english/members.asp

“As North American neighbors, we owe it to our citizens to work together whenever possible to minimize the spread and impact of an infectious disease outbreak or other public health emergency that may affect our nations,” Leavitt said in the HHS press release.

The memorandum stipulates that all three countries agree to improve their public health emergency preparedness and response as they relate to border health, laboratory testing, diagnosis and treatment, epidemiological investigation, and infectious disease control, the press release said. The countries also agree to share laboratory information before and during an emergency, collaborate on the review and sharing of assay methods, reagents, and laboratory results, and participate in trilateral or bilateral exercises to test emergency response.

In August, leaders from the three nations who met at a security summit in Quebec unveiled a North American pandemic influenza plan designed to share expertise, coordinate public health messages, and overcome anticipated obstacles at national borders.

The memorandum of understanding the health leaders signed yesterday directs the three countries to implement protocols to share:

  • Health-care and public health personnel
  • Regulated medical products from national stockpiles
  • Unregulated medical supplies from national stockpiles
  • Specimens and reagents from each country’s national reference laboratories

From the trenches,

Celeste

Pandemic Plans

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Health & Human Services has released their annual report on our pandemic and all hazards.

Pandemic November Progress Report2007

The Pandemic and All Hazard ACT 2006

Title I: National Preparedness and Response, Leadership, Organization, and Planning

Title II: Public Health Security Preparedness

Title III: All-Hazards Medical Surge Capacity

Title IV: Pandemic and Biodefense Vaccine and Drug Development

From the trenches,

Celeste

Biosecurity/Pandemic/Avian Resource Guide

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Do ya think they just might be serious about this? If they are, what does that mean for you? Are you prepared?

I just received a government report that the influenza level is currently slightly higher than epidemic, ummm…..

The National Animal Identification System is not just about tagging animals, it is under the biosecurity umbrella of surveillance, Phase III of NAIS. The plans involve zoontic (animal-human) transmission. Therefore, might you be next in the tagging scheme? The UN definition of animal does include humans. As there is scientific-evidence of aggressive cancer developing from tags (chips) which would you prefer….cancer…or the flu?

Please do your homework on the dangers of vaccinations and anti-virals before we get begin hearing big news on the epidemic and pandemic. Weigh your choices carefully. Healthy living, good food, and natural healing remedies should be evaluated as you decide how you will deal with future flu seasons.

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