Ebola detection and testing rapidly expands in Uganda and US

A presentation slide showing the location of the 2022 Sudan ebolavirus outbreak. The speaker is shown to the right.

Ebola detection and testing rapidly expands in Uganda and US

By Melanie Padgett Powers, writer

A partnership between Uganda and US public health professionals was instrumental in responding to the 2022 Ebola outbreak in Africa. Furthermore, lessons learned from that response helped update guidance on how the US would respond to suspected Ebola cases arriving on US shores.

Ebola is a highly transmissible disease with a mortality rate of 50 to 90 percent without treatment. When people hear “Ebola,” it’s usually referring to the Zaire ebolavirus, explained Trevor Shoemaker, PhD, MPH, at the 2023 APHL Annual Conference May 23 session, “Preparedness and Response Domestically and Abroad—the 2022 Ebola Outbreak” in Sacramento, CA. Shoemaker is team lead, epidemiology, surveillance, clinical and health education, Viral Special Pathogens Branch, US Centers for Disease Control and Prevention (CDC).

The Zaire virus has been responsible for the majority of Ebola outbreaks in recent years and is one of four ebolaviruses known to cause human infection. However, when Ebola broke out in Uganda in September 2022, it was the Sudan ebolavirus.

For the past 12 years, the CDC has been supporting Uganda’s Viral Hemorrhagic Fever (VHF) Surveillance System. “But we’ve been engaged in Uganda ever since the first Sudan virus outbreak detected in the year 2000,” Shoemaker said. For the VHF program, the CDC assisted Uganda’s Ministry of Health, through the Uganda Virus Research Institute, to establish a laboratory to perform in-country diagnostics and enhance the epidemiological and clinical surveillance in the country.

“Most of the things we helped implement were to improve reporting capability, improve the laboratory capacity, detect incident cases very rapidly and report those to the national level so they could take action,” Shoemaker said. “We improved the capability to respond, so this would be quick outbreak investigation and containment.”

They also trained Ugandan health workers on how to properly don personal protective equipment, take a blood specimen for testing, fill out the case report form and safely ship samples to the national laboratory.

The program, which has tested over 20,000 clinical samples, has greatly increased the detection of VHF outbreaks in Uganda and the region, Shoemaker said. Since the program began, it has detected more outbreaks than in the previous 10 years. “It has also reduced the time between initial report of suspected outbreaks and laboratory confirmation by quite a number of days,” he said. The laboratory can provide results within six to 12 hours of receiving the sample and can do confirmatory testing within 24 hours.

In the 2022 Ebola outbreak, there were 164 total cases in nine Ugandan districts, with 77 deaths, which is a 47 percent case fatality rate.

Ebola preparation in the US

Although the risk of Ebola being imported to the US last year was considered low, Shoemaker said, the CDC activated its emergency response structure. CDC Ebola Response Teams were ready to travel to states if needed. CDC updated its guidance for health care workers in the US for suspected Ebola cases. The APHL Biosafety and Biosecurity Committee also updated its Ebola guidance, which was from 2015.

In the US, the CDC oversees the Laboratory Response Network (LRN), a system of approximately 120 US laboratories—including all 50 state public health laboratories—that detect and respond to biological threats.

Before the 2022 Uganda Ebola outbreak, only eight LRN laboratories had the capability to test for the Sudan ebolavirus. Within a month, that was expanded to 27 LRN laboratories, as well as 10 regional emerging special pathogen treatment centers, Shoemaker said. Now, there are 34 laboratories able to test for Sudan virus (as well as the Marburg virus, another severe viral hemorrhagic fever).

To test for the Sudan ebolavirus, the LRN laboratories use the commercial product BioFire FilmArray and the Warrior Panel, which was approved by the US Food and Drug Administration in 2017. CDC uses a real-time reverse transcription–polymerase chain reaction (RT-PCR) assay, similar to what many LRN laboratories already have to test for the Zaire virus. The CDC’s Sudan test is currently undergoing approval to send out to LRN laboratories.

In 2022 in the US, the CDC had clinical consultations for 35 ill returning travelers from the outbreak region and performed tests on three people. All were negative. Compare that to January 2017 to December 2021, Shoemaker said, when there were seven Ebola virus outbreaks and the US performed testing on only nine ill travelers.

Melanie Padgett Powers is a freelance writer and editor specializing in health care and public health.

The post Ebola detection and testing rapidly expands in Uganda and US appeared first on APHL Blog.

Successful COVID-19 exposure notification system shuts down in most states

Photo of an iPhone showing a notification that says, "Exposure Notifications Off."

By Melanie Padgett Powers

As the COVID-19 Public Health Emergency expired on May 11, 2023, the COVID-19 Exposure Notifications System (ENS) in the majority of states also shut down. For the past three years, APHL has played a critical role in the US ENS.

The COVID-19 ENS made it possible for users to receive smartphone alerts when they — or more accurately, their phone — had been in the vicinity of someone who soon after reported a positive COVID-19 test through the ENS.

APHL, in collaboration with Google, Apple and Microsoft, and with program funding and guidance from partners at the Centers for Disease Control and Prevention, has provided support for the ENS by hosting national servers since August 2020.

“The availability of these servers eliminated a significant burden for state public health authorities and enabled exposure notifications to occur across state lines, despite each state having a unique solution,” explained Emma Sudduth, APHL consultant and program manager for the national server operations.

At one point, 28 states were using the ENS and relying on the servers hosted by APHL. Over time, as pandemic restrictions loosened and vaccine uptake increased, some states’ public health authorities discontinued their exposure notification solutions. Most of the remaining states shut down ENS on May 11 as Apple, Google and APHL discontinued their support for key components of the system.

The ENS saved countless lives across the country, as people were alerted to exposures, allowing them to get tested quickly and take precautions to reduce the ongoing spread of COVID-19. Research in Washington state in June 2021 showed that the state’s exposure notifications tool, known as WA Notify, had saved an estimated 30–120 lives and likely prevented about 6,000 COVID-19 cases during the first four months of its use.

By 2023, WA Notify had approximately 235,000 participants share a positive test result, which generated more than 2.5 million anonymous exposure notifications.

“We’re tremendously proud of what WA Notify was able to accomplish in a relatively short amount of time, and eager to find ways to utilize this life-saving technology again in the future,” said Bryant Thomas Karras, MD, chief medical informatics officer at Washington State Department of Health. “Much of WA Notify’s success can be attributed to innovative collaboration among public, private and academic partners,” which included APHL, Apple, Google, Microsoft and the University of Washington.

Unprecedented private-public health partnership

It became clear early on in the pandemic that most states did not have the time, funding or capacity to create their own ENS. Even if they did, it would have resulted in several different types of exposure notifications tools across the country.

To solve this problem, Google and Apple partnered to create a turnkey solution called Exposure Notifications Express (ENX). ENX made it easier for public health agencies to launch a state ENS by eliminating the need to build their own tool. These private technology companies looked to APHL, as a trusted public health partner, to host the servers.

“APHL has a long history of supporting states in data exchange and the hosting of solutions,” said Scott Becker, APHL CEO. “Our participation in the ENS gave the US public health community a capable and accountable partner for hosting key components of this groundbreaking technology.”

APHL stepped up to provide the necessary national key server, which holds the ENS data for the entire country. With APHL taking responsibility for storing and securing the data, states did not have to host and maintain their own servers. The Bluetooth-enabled notifications and the digital language known as “exposure notification keys” protected privacy.

Furthermore, a national centralized server allowed exposure notifications to work between users who had tools published by different states, ensuring notification regardless of state boundaries.

“The national infrastructure supported by APHL was essential to the deployment and maintenance of exposure notification systems,” Karras said. “By securely hosting the [national servers] APHL removed the burden on individual public health authorities to build and host their own servers, and importantly, enabled communication, i.e., interoperability, between exposure notification tools deployed in the U.S. Interoperability ensured that individuals using the systems could seamlessly notify others when traveling across states.”

Lessons for the future

Throughout the nearly three years of ENS, lessons were learned and applied to improve the system over time. This resulted in more states providing an exposure notification solution and more users in those states adopting it, which led to higher levels of notifications.

The knowledge and experience gained with the use of the ENS means that, in the future, public health won’t have to start at baseline to build a system from scratch. In addition, the ability to learn from different states about their experiences with ENS could be leveraged for future public health solutions.

The private-public health partnership — with Google and Apple working together with APHL, along with the public health community and state health departments — was the first of its kind and shows the value of such measures. The ENS saved lives, prevented cases and slowed disease spread. The public health community will continue to explore how such innovations can be used in the future to improve public health.

“Washington State Department of Health recognizes the great value of public-private-academic partnerships and collaboration with other states to develop interoperable systems,” Karras said. “This collaboration allowed us to accomplish something that would not have been possible without working together. We are committed to strengthening these partnerships that have made exposure notification systems so successful.”

At APHL, Sudduth said, “The collaboration between private technology companies and public health in this endeavor made a far stronger solution. Learning from this experience and growing these established relationships will strengthen public health.”

The post Successful COVID-19 exposure notification system shuts down in most states appeared first on APHL Blog.

#PrepYourHealth to Drive During Winter

A person holding up a flashlight. Their car is broken down on the side of a snowy road.

Winter is here, and it’s not alone. It comes bearing weather that can make it dangerous to travel. Driving in wintery conditions such as snow, freezing rain, and ice puts drivers at increased risk of car accidents.(1)

About 21% (or 1,235,000) of the over 5,891,000 vehicle crashes each year are weather-related. Most weather-related crashes happen on wet pavement (70%) and during rainfall (46%). A smaller but no less significant number of them occur during snow or sleet (18%), on icy pavement (13%), and on snowy or slushy pavement (16%).(2)

Over 70% of the nation’s roads are in regions that average more than five inches of annual snowfall. Almost 70% of the U.S. population lives in these regions.(3)

If—like most of the U.S. population—you live somewhere that experiences winter weather, be prepared to drive (or not drive) in it.

Driving in the Snow

Driving in winter weather has its challenges. Snow, freezing rain, ice, and below-freezing temperatures can affect driving conditions. Here are some things to consider before and remember after you get behind the wheel.

  • Know before you go. Call 511 or check your state’s department of transportation webpage to check road conditions. The best way to stay safe when driving in snow is not to. Only go out in winter weather if necessary. Avoid non-essential travel when the National Weather Service issues an advisory.
  • Clean off your car before driving. Flying snow from cars can limit your visibility and the visibility of other drivers. Limited visibility can cause accidents.
  • Follow the everyday rules of the road. Do not text or drive distracted; obey posted speed limits; wear your seat belt; and always drive sober.
  • Slow down to improve your traction when driving on snow or ice. Remember “Ice and snow, take it slow.” Avoid traveling on ice-covered roads, overpasses, and bridges if possible.
  • Put extra space between you and other drivers. Increase your following distance from 3-4 seconds to 5-6 seconds. It takes longer to slow down and stop on icy roads.

Snowplows are a common sight on roads and highways during and after a winter storm. They travel slowly, make wide turns, stop often, overlap lanes, and exit the road frequently. If you find yourself driving behind a plow, keep your distance. Don’t crowd the plow.

Roadside Emergency Kit

Prepare as if a roadside emergency will happen to you. Pack a roadside emergency kit that includes the items you need to handle travel delays like a flat tire and more serious roadside emergencies. A kit should include:

  1. Food and water
  2. Emergency lighting (e.g., flashlight or headlamp) and batteries
  3. Car and portable chargers for your cellphone
  4. First-aid supplies
  5. Warm clothes, blankets, and sleeping bags
  6. Spare tire, jack, and lug wrench
  7. Jumper cables and safety glasses
  8. Emergency hammer and seat belt cutter
  9. Road flares
  10. An ice scraper, folding shovel, and brush

Go beyond the basics by including these items in your roadside emergency kit:

  • A portable carbon monoxide (CO) detector
  • A road map or atlas
  • A whistle to signal for help
  • Sanitation and personal hygiene items
  • Multi-purpose tool

Add other supplies based on your personal needs.

What to do If You’re Stranded

Winter storms can leave you stranded. Last year, a snowstorm trapped motorists in their vehicles on Interstate 95 for more than a day. (4) If you become stalled in or stranded by winter weather, stay focused on yourself and your passengers, your car, and your surroundings.

  • Stay with your vehicle.
  • Make yourself visible to rescuers:
    • Turn on the dome light at night when running the engine.
    • Tie a bright-colored cloth, preferably red, to your antenna or door.
    • Raise the hood of your car if it’s not snowing.
  • Wrap your entire body, including your head (without obstructing your breathing), in layers of clothing, blankets, and sleeping bags to prevent hypothermia. Hypothermia (abnormally low body temperature) is a dangerous condition that can happen when a person is exposed to extremely cold temperatures.
  • Run the engine for about 10 minutes per hour to run the heater and charge your cellphone. Open a window slightly to let fresh air in and avoid carbon monoxide (CO) poisoning.
  • Keep the exhaust pipe clear of snow to prevent CO poisoning.

Learn more about staying safe before and after a winter storm.

Resources

References

  1. https://policyadvice.net/insurance/insights/winter-driving-statistics/
  2. https://ops.fhwa.dot.gov/weather/q1_roadimpact.htm
  3. https://ops.fhwa.dot.gov/weather/weather_events/snow_ice.htm
  4. https://apnews.com/article/snow-storm-weather-195-virginia-660346cff578c655186ac517fb45f17f

Thanks in advance for your questions and comments on this Public Health Matters post. Please note that CDC does not give personal medical advice. If you are concerned you have a disease or condition, talk to your doctor.

Have a question for CDC? CDC-INFO (https://www.cdc.gov/cdc-info/index.html) offers live agents by phone and email to help you find the latest, reliable, and science-based health information on more than 750 health topics.

Resolve to Be Ready, Part II

A calendar with the year 2023 circled in red marker.

January is the time many of us make resolutions for the new year. Sometimes resolutions feel too big and long drawn out. As a result, our motivation to see them through can peter out before the end of the year.

Last year, we suggested 12 micro-resolutions to help you prepare your health for emergencies. Here are a dozen more ways to resolve to be ready this year.

January

Be prepared to prevent data loss. Data loss happens more often than you might think.

This month’s micro-resolution is to back up your important files. These include medical records, financial documents, family photos, and emails. Save at least one extra copy of your files to an external storage device or the cloud. This ensures you can still access the information if the original is lost, damaged, or destroyed.

February

February is National Canned Food Month. Canned goods are an emergency preparedness staple. And for good reason. They are reasonably affordable, require little to no preparation, and have a long shelf life.

As often as people buy and cook with canned goods, some can find food labels confusing. This month’s micro-resolution is to improve your food label literacy. One way to do that is to get the FoodKeeper app to help you maximize the freshness and quality of the items in your emergency food supply.

March

Severe weather, including tornadoes, can happen at any time of year. They are, however, more likely to happen in most places during the spring months(1)

This month’s micro-resolution is to take a SKYWARN® Storm Spotter Program class. You’ll learn:

  • Basics of thunderstorm development
  • Fundamentals of storm structure
  • Identifying potential severe weather features
  • Information to report
  • How to report information
  • Basic severe weather safety

Classes are free and open to the public.

Storm spotters are volunteers. They help keep their local communities safe by providing timely and accurate reports of severe weather to the National Weather Service.

April

April is National Financial Literacy Month.

Developing a habit of putting money aside—even if it is a small amount—is the easiest way to develop an emergency fund and build financial resiliency. Without savings, the financial shock of an emergency could affect you, your family, and your community.

This month’s micro-resolution is to download and fill out the “Your Disaster Checklist” (available in multiple languages). Use it to help you keep track of account numbers, valuables, medical information, and more.

May

May 5 is World Hand Hygiene Day. Effective handwashing is a practical skill that you can easily learn, teach to others, and use every day to help prevent the spread of illness and disease.

This month’s micro-resolution is for parents and caretakers. Teach the children in your care when and how to wash their hands.

June

June is Pet Preparedness Month. It’s also the start of the Atlantic hurricane season. What better time of year to practice evacuating with your pet:

  • Train your pets to get in and stay in their carriers by making it a comfortable place.
  • Take your pets for rides in a car like one you would evacuate in.
  • Know where your pet might hide when stressed or scared. Practice catching your pet, if needed.

Have your entire family practice evacuating with your pets so everyone knows what to take, where to find the pets, and where to meet.

July

Most locations in the contiguous United States will experience their hottest day of the year between July 15-31.(2) Hot weather—regardless of when it happens and how long it lasts—can cause heat-related illness.

This month’s micro-resolution is to learn the symptoms of heat-related illness what to do if someone shows signs of heat stroke, exhaustion, or cramps.

August

August 20 is National Radio Day. Radio is one of many ways you can stay informed before, during, and after an emergency. Other ways include local television, social media, and Wireless Emergency Alerts (WEAs).

WEAs look like text messages. They are designed to get your attention with a unique sound and vibration repeated twice. This month’s micro-resolution is to check the settings on your mobile device to make sure you are receiving WEAs.

September

September is not just National Preparedness Month. It is also National Self-Care Awareness Month. Emergencies, including disease outbreaks and natural disasters, can cause increased stress. You and others might feel fear, anxiety, and other strong emotions. It’s important to take care of your family and friends, but it should be balanced with care for yourself.

This month’s micro-resolution is to find one small way each day to care for yourself. Yours might include:

  • connecting with friends and family. Talking with people you trust about your feelings and concerns can relieve stress.
  • showing kindness to others. According to researchers, helping others release hormones that boost your mood and wellbeing
  • practicing relaxation techniques like meditation and deep breathing exercises. Relaxation techniques can help slow your breathing, lower blood pressure, and reduce muscle tension and stress.

October

October is Health Literacy Month. People need information they can find, understand, and use to make the best decisions for their health every day. The same is true during an emergency when there’s usually an increase in the amount of information and speed at which it comes out.

One thing you can do to improve your health literacy is to ask questions of healthcare professionals. For example, your pharmacist is trained to help you manage and improve your health every day. They can give you patient-centered answers to questions on many topics, including emergency preparedness. Ask your pharmacist these questions the next time you visit the pharmacy.

November

Winter is coming. It may arrive in some parts of the country before the month end.

This month’s micro-resolution is to prepare your car for winter. Now is a good time to equip your vehicle with a roadside emergency kit. Winterize your ride with the following items:

  • Food and water
  • Ice scraper and a folding shovel
  • A flashlight and batteries
  • Car and portable chargers for your cellphone
  • First-aid supplies
  • Winter clothes, blankets, and sleeping bags
  • Road flares
  • Jumper cables

December

December is Hi Neighbor Month. Neighbors can be an important source of assistance in the hours, days, and weeks after an emergency. Because they live close—maybe even next door—neighbors might be your first and best option for help after a tornado or during a power outage.

This month’s micro-resolution is to find a way to get involved with your neighbors. Ways to get involved include

  • offering to help your neighbors, especially people who are older, live alone or with a disability, or rely on electricity-dependent equipment, prepare for emergencies.
  • involving trusted neighbors in your emergency action planning.
  • joining an organization active in disaster, such as your local Medical Reserve Corps Unit or Community Emergency Response Team.

Resources

References

  1. https://www.nssl.noaa.gov/education/svrwx101/tornadoes/
  2. https://www.climate.gov/news-features/featured-images/if-things-go-%E2%80%9Cnormal%E2%80%9D-most-us-locations-will-have-their-hottest-day

 

Thanks in advance for your questions and comments on this Public Health Matters post. Please note that CDC does not give personal medical advice. If you are concerned you have a disease or condition, talk to your doctor.

Have a question for CDC? CDC-INFO (http://www.cdc.gov/cdc-info) offers live agents by phone and email to help you find the latest, reliable, and science-based health information on more than 750 health topics.

In Case You Missed It: Favorite Blog Posts of 2022

Decorative image that says "2022"

Late December is a good time to reflect on the happenings of the past 12 months.

The Center for Preparedness and Response (CPR) published 26 posts to the Public Health Matters blog in 2022. The posts explored various topics related to personal and public health preparedness. All were written with the intention of helping readers build individual resilience to emergencies, including disease outbreaks and natural disasters.

Here are some of our favorites.

10 Questions to Ask Your Pharmacist

A pharmacist talking with a customer.

Pharmacists are trained to help you manage and improve your health every day. They can give you patient-centered answers to questions on many topics, including emergency preparedness.

This post suggests 10 questions you might ask your pharmacist. Some questions you might ask your pharmacist include

  • How do I prepare an emergency supply of medicines?
  • How do I keep medicines cold during a power outage?
  • How do I safely dispose of expired, unwanted, unused, or damaged prescription medicines?

The answers to these and other questions can help you prepare for emergencies.

Prep Your Health with Advance Care Planning

Someone completing an organ donor registration form.Preparedness isn’t a prediction of the future. There’s no guarantee that you’ll need advance care planning. You may never need others to make healthcare decisions on your behalf.

Advanced directives, including living wills, are legal documents that go into effect only if you are incapacitated and unable to speak for yourself. They relieve family members from wondering if they “did the right thing” on your behalf.

This post suggests ways you can plan for personal health emergencies that can leave you incapable of making decisions for yourself.

Good Cents: Prep Your Finances for Emergencies

A couple discussing their finances.Emergencies—especially when multiple occur at the same time—can test your ability to financially respond and recover.

The financial shock of an emergency—however minor—can affect you, your family, and your community. Research suggests that people who struggle to recover from a financial shock have less savings to help protect against a future emergency. They may rely on credit cards or loans, which can lead to debt. They may also pull from other savings, like retirement funds, to cover these costs.

This post suggests ways you can financially prepare for emergencies. A no-cost way to do that is to use the Consumer Financial Protection Bureau’s “Your Disaster Checklist” to help you keep track of account numbers, valuables, and more.

Arizona Creates ASL Glossary of Emergency Management Terms

A sign language interpreter at a press conference.People who are Deaf and hard of hearing can struggle to access information in their daily lives, to say nothing of the difficulties they can face during an emergency.

This post highlights the work done by the Arizona Department of Emergency and Military Affairs and the Arizona Department of Health Services to improve access to information during emergencies. They created an American Sign Language (ASL) glossary of emergency management terms. The glossary is used by the Deaf and hard-of-hearing community and certified ASL interpreters to communicate emergency information during a disaster.

3 Ways to Improve Your Food Label Literacy

A person pushing a grocery cart down an aisle.Canned goods are an emergency preparedness staple. And for good reason. They are reasonably affordable, require little to no preparation, and have a long shelf life.

This post suggests ways you can improve your food label literacy. Knowing how to read food labels is a practical skill that can help you avoid food allergens, reduce sodium and sugar in your diet, reduce food waste, and better manage your emergency food supply.

 

Thanks in advance for your questions and comments on this Public Health Matters post. Please note that CDC does not give personal medical advice. If you are concerned you have a disease or condition, talk to your doctor.

Have a question for CDC? CDC-INFO (http://www.cdc.gov/cdc-info/index.html) offers live agents by phone and email to help you find the latest, reliable, and science-based health information on more than 750 health topics.

Alzheimer’s & Public Health Emergencies

A caregiver talking to and consoling an older adult.

November is Alzheimer’s Awareness Month and National Family Caregivers Month

Alzheimer’s disease is the most common type of dementia and is a progressive disease that begins with mild memory loss and possibly the loss of the ability to carry a conversation and respond to the environment. It involves parts of the brain that control thought, memory, reasoning, and language.(1)

People living with Alzheimer’s and other dementias can face unique challenges during emergencies. These challenges can put them at increased risk for injury and wandering. Planning ahead is important.(2)

Gather Supplies

Emergencies can leave caregivers and those they care for without access to important supplies. Caregivers can take steps and precautions to prepare for an emergency by gathering supplies. Consider the needs of the person with Alzheimer’s and store supplies in a watertight container(3). Some items to consider include:

  • Incontinence undergarments, wipes, and lotions
  • Pillow, toy, or something the person can hold on to
  • Favorite snacks and high-nutrient drinks
  • Important contact info for doctors
  • Copies of important paperwork
  • Recent photos of the person you are caring for

Having an emergency kit with essential supplies can help caregivers be ready in an emergency. Make sure that those helping you take care of the person with Alzheimer’s know where to find the emergency supplies and how to respond to an emergency.

Build a Support Network

Currently, many people living with Alzheimer’s disease are cared for at home by family members.(1) Caregiving takes a network of family, friends, and doctors who are willing to help in case of emergencies. To build your support network you can do the following(3,4):

  • Identify specific neighbors or nearby family and friends who would be willing to help in a crisis.
  • Make a plan of action with them should the person with Alzheimer’s be unattended during a crisis.
  • Tell neighbors about the person’s specific disabilities, including the inability to follow complex instructions, memory loss, impaired judgment, disorientation, and confusion.
  • Give examples of simple one-step instructions that the person may be able to follow
  • Choose a contact person who will check on you during a disaster and decide how you will communicate with each other (for instance, by telephone or knocking on doors).
  • Create a list of contact information for family members and friends. Leave a copy by your phone(s) and include one with your emergency supplies.

Support networks can help caregivers have a plan in case they are not able to assist the person in their care. Having these relationships among family, friends, and doctors can ease the burden of worry in case of an emergency.

Prepare for Wandering

Alzheimer’s disease can make it hard for a person to recognize familiar places and faces and can lead to wandering or becoming lost or confused about where they are.(5)

Emergencies can lead to a change in routine when a person must evacuate to a safer place. Trying to keep their routines and reassuring them they are safe can help during an emergency and keep them from wandering.(6)

It is important to stay with a person with Alzheimer’s during an emergency, but separation can still happen. Here are some tips to help you prevent wandering during an emergency or evacuation:(7)

  • Make sure the person with Alzheimer’s wears an ID bracelet or is enrolled in the MedicAlert Wandering Support Program.
  • Do not leave the person alone. Even those who aren’t prone to wandering away may do so in unfamiliar environments or situations.
  • If evacuating, help manage the change in environment by bringing a pillow and blanket or other comforting items they can hold onto.
  • When at a shelter, try to stay away from exits and choose a quiet corner.
  • When appropriate, share the diagnosis with others, such as hotel or shelter staff, family members, and airline attendants, so they can better assist.
  • Try to stay together or with a group; it only takes a moment to get lost. Do not leave the person living with dementia alone.
  • Do your best to remain calm, as this may help reduce anxiety or confusion.

Have your network of friends, family members, and doctors know the plan in case of an emergency and you are unreachable. These tips can help you prepare yourself and the person in your care for disasters and changes in routine.

Resources

References

  1. https://www.cdc.gov/aging/aginginfo/alzheimers.htm
  2. https://www.nia.nih.gov/health/infographics/6-tips-how-older-adults-can-prepare-disaster
  3. https://www.nia.nih.gov/health/disaster-preparedness-alzheimers-caregivers
  4. https://www.cdc.gov/aging/emergency-preparedness/creating-plan/index.html
  5. https://www.alz.org/help-support/caregiving/stages-behaviors/wandering
  6. https://www.helpforalzheimersfamilies.com/learn/prevent-wandering/five-triggers/
  7. https://www.alz.org/help-support/caregiving/safety/in-a-disaster

Thanks in advance for your questions and comments on this Public Health Matters post. Please note that CDC does not give personal medical advice. If you are concerned you have a disease or condition, talk to your doctor.

Have a question for CDC? CDC-INFO (http://www.cdc.gov/cdc-info/index.html) offers live agents by phone and email to help you find the latest, reliable, and science-based health information on more than 750 health topics.

#PrepYourHealth for Power Outages

A young woman and boy make hand shadow puppets using a flashlight against a white wall.

October is Energy Awareness Month

Power outages (i.e., when the electrical power goes out unexpectedly) and precautionary power shutoffs are happening more often because of and to prevent emergencies. These emergencies include disasters, such as hurricanes and wildfires.

The U.S. Energy Information Administration (EIA) says, on average, U.S. electricity customers experienced just over 8 hours of electric power interruptions in 2020. That was the most since EIA began collecting electricity reliability data in 2013.(1)

The EIA further reported that customers in Alabama, Iowa, Connecticut, Oklahoma, and Louisiana experienced the most time with interrupted power in 2020. Severe weather was a factor in all these states.

  • Alabama experienced several hurricanes, including a direct hit from Hurricane Sally.
  • Tropical Storm Isaias left about 750,000 electricity customers in Connecticut without power. Some didn’t have power for over a week.
  • A derecho affected Iowa and other parts of the Midwest. It caused widespread power outages, damaged grid infrastructure, and forced the early retirement of Iowa’s only nuclear power plant.
  • An ice storm in October was to blame for widespread power outages across Oklahoma.
  • Louisiana experienced three hurricanes and two tropical storms.(1)

The impacts of power outages and power shutoffs are felt by everyone. Here are some ways you can prepare your health for a power outage.

Be Power Prepared

Be prepared to be without electricity during an emergency and, possibly, for several days after.

A power outage can affect people’s ability to use devices and the availability of refrigeration. This makes it especially important that people who rely on durable medical equipment and refrigerated medicines like insulin take steps to prepare. For example:

  • Identify emergency lighting, safe heating alternatives, and backup power sources for your mobile devices, appliances, and medical equipment.
  • Create an emergency power plan that includes model and serial numbers for your medical devices.
  • Read the user manual or contact the manufacturer to find out if your medical device is compatible with batteries or a generator.
  • Fully charge your cellphone, battery-powered medical devices, and backup power sources if you know a disaster, such as a hurricane, is coming.
  • If possible, buy manual alternatives for your electric devices that are portable, dependable, and durable. For example, a manual wheelchair, walker, or cane as a backup for an electric scooter.

Power outages can also put people at increased risk for post-disaster hazards, such as food and carbon monoxide poisoning.

The effects of emergencies, such as power outages, are experienced differently by different populations.

The places of our lives, including our neighborhoods and built environment, can influence our experience with emergencies.(2)

People who live in rural areas and places with an aging infrastructure may experience more frequent and longer-lasting power outages and face greater adversity because of it. They may also have limited access to the supplies they need to prepare for power outages.

Planning for Power Outages

People who use electricity- and battery-dependent assistive technology and medical devices must have an emergency power plan in case of a power outage.

Checklists are a way to break large jobs down into smaller chores. They can help you pack for a trip, grocery shop, and even prepare for emergencies.

The Americans with Disabilities Act (ADA) National Network’s emergency power planning checklist is for people who use electricity and battery-dependent assistive technology and medical devices. These include:

  • Breathing machines (e.g., respirators and ventilators).
  • Power wheelchairs and scooters.
  • Oxygen, suction, or home dialysis equipment.

The Food and Drug Administration’s “How to Prepare for and Handle Power Outages” guide for home medical device users is another useful planning resource. Use it to organize your medical device information, identify the supplies for the operation of your device, and know where to go or what to do during a power outage.

Health Care Preparedness

A power outage or shutoff can limit the operations of hospitals, outpatient clinics, pharmacies, and other patient-care facilities.

Healthcare facilities need electricity to care for patients, provide services, and “keep the lights on.” Since many facilities have resident populations, hygiene and feeding are also part of the electrical demand.

Resilience to power outages begins with the leadership at the facility. Here are some resources to help healthcare facilities plan for and respond to public health emergencies.

Additional resources to help healthcare systems and hospitals plan for public health emergencies are available on the CDC website.

Resources

References

  1. https://www.eia.gov/todayinenergy/detail.php?id=50316
  2. https://www.atsdr.cdc.gov/placeandhealth/howdoesPlaceaffectHealth.html

Thanks in advance for your questions and comments on this Public Health Matters post. Please note that CDC does not give personal medical advice. If you are concerned you have a disease or condition, talk to your doctor.

Have a question for CDC? CDC-INFO (http://www.cdc.gov/cdc-info/index.html) offers live agents by phone and email to help you find the latest, reliable, and science-based health information on more than 750 health topics.

Improve Health Literacy Before an Emergency

A worried looking older woman stares at a laptop computer.

October is Health Literacy Month

Getting the right person to deliver the right message at the right time saves lives, but only if the audience can make sense of the message.

People need information they can find, understand, and use to make the best decisions for their health every day. The same is true before and during an emergency when there’s an increase in the amount of information and speed at which it comes out.

Health literacy is all about finding, understanding, and using information and making information findable, understandable, and usable. Health literacy is important to effectively prepare for and safely respond to an emergency like a natural disaster.

Two Parts to Health Literacy

The definition of health literacy was updated in August 2020 to acknowledge health literacy as the shared responsibility of individuals and organizations.

Organizational health literacy is the degree to which organizations equitably help people find, understand, and use information and services to inform health-related decisions and actions for themselves and others.

Personal health literacy is the degree to which people have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.

Health Literacy in an Emergency

Taking care of our health is part of everyday life, not just when we visit a doctor, emergency department, or hospital.

Health literacy can help you prepare your health for an emergency and stay healthy during an emergency. For example, health literacy can affect your ability to

Many different factors can affect a person’s health literacy. Often people face multiple challenges that can make it difficult or even impossible for them to find, understand, and use information to make decisions. These challenges can include cultural differences, physical or mental disabilities, and unfamiliarity with emergency response terms.(1)

The term “social distancing” is one that confused people, who—up until the COVID-19 pandemic—had little or no experience with disease outbreaks. CDC responded by taking a plain language approach. Instead of asking people to “social distance” themselves from others, CDC said to “stay 6 feet away from others.”

Plain language is not “dumbing down” information or changing the meaning of a message. It’s about creating communication people can understand the first time they read it or hear it.

Bring Down Barriers to Health Literacy

Health literacy is the shared responsibility of the whole community. Businesses, schools, community leaders, government agencies, health insurers, healthcare providers, the media, and many other organizations and individuals all have a part to play in improving health literacy. Some of the ways we can do that include the following:

  • Work with health educators and other preparedness partners to familiarize people with health information and services and build their health literacy skills over time.
  • Consult with trusted messengers, including community, cultural, and faith leaders, to better understand your audience (e.g., cultural and linguistic norms, environment, and history) and to recruit members of your intended audience who can help you develop your messages or test them.
  • Work with trusted messengers to share your messages.
  • Use certified translators and interpreters who can adapt to your intended audience’s language preferences, communication expectations, and health literacy skills.
  • Practice clear communication strategies and techniques (e.g., follow plain language guidelines and define new and unfamiliar terms and acronyms).
  • Translate messages into multiple languages, including American Sign Language. Publish messages in alternate formats like braille, large print, and simplified text.(2, 3)

Improving health literacy requires many sectors and organizations to work together to make health information, resources, and services accessible to everyone.

Be About It

Everyone is responsible for improving health literacy. Here are some ways health, including crisis and emergency risk communicators, can “be about” improving health literacy.

Visit the Non-CDC Training webpage for more training materials on health literacy, plain language, cultural competency, consumer-patient skill building, and shared decision-making.

References

  1. https://medlineplus.gov/healthliteracy.html
  2. https://www.cdc.gov/healthliteracy/shareinteract/TellOthers.html
  3. https://www.cdc.gov/healthliteracy/learn/Understanding.html

Resources

Thanks in advance for your questions and comments on this Public Health Matters post. Please note that CDC does not give personal medical advice. If you are concerned you have a disease or condition, talk to your doctor.

Have a question for CDC? CDC-INFO (http://www.cdc.gov/cdc-info/index.html) offers live agents by phone and email to help you find the latest, reliable, and science-based health information on more than 750 health topics.

Public Health Emergency Preparedness (PHEP) funding program marks 20 years

Photo of three individuals wearing yellow personal protective equipment (PPE).

By Jill Sutton, specialist, Emergency Preparedness and Response, APHL

This year marks the 20th anniversary of the CDC Public Health Emergency Preparedness (PHEP) Cooperative Agreement, a program that was developed in 2002 to strengthen preparedness capabilities in public health departments across the US.

Public health preparedness today can be attributed to developments in policy and funding since the September 11, 2001 terrorist attacks and the anthrax attacks that followed shortly after. Over the last 20 years, public health preparedness has evolved from a bioterrorism focus to an all-hazards approach, a framework that focuses on how we prepare and respond to a wide range of public health threats like infectious diseases and natural disasters as well as biological, chemical, nuclear and radiological events.

What is PHEP?

Since 2002, the PHEP program has been a critical source of funding, guidance and technical assistance for state, local and territorial public health departments. Thanks to PHEP, health departments are able to support preparedness and response activities and strengthen their preparedness capabilities so they are ready when public health emergencies strike.

At the local level, public health departments invest their PHEP funds to:

  • Enhance preparedness infrastructure,
  • Conduct trainings and exercises,
  • Hire dedicated preparedness staff,
  • Establish and maintain systems that enable the early detection of public health threats like monkeypox or COVID-19,
  • Quickly acquire emergency supplies and equipment, and
  • Rapidly share public health data to inform response needs.

As a result of these investments, communities are more prepared for public health emergencies than they were 20 years ago, but there’s still more that needs to be done. Federal preparedness funding has declined over the last 20 years, forcing PHEP recipients to cut positions, preparedness trainings and exercises, and equipment needs from their budgets. This has caused public health departments to be unable to expand or maintain their preparedness capabilities. A lack of sustainable funding directly impacts the capacity of state, local and territorial health departments to prepare for and respond to public health threats that arise in the communities they serve.

As we also celebrate National Preparedness Month, we honor the 20th anniversary of PHEP and all that it has helped our nation accomplish. Whether we are facing a pandemic or not, we need to remain prepared for the next public health emergency. It is our sincere hope that funding for PHEP will rise to ensure our nation’s public health system is prepared for the next emerging threat.

The post Public Health Emergency Preparedness (PHEP) funding program marks 20 years appeared first on APHL Blog.

10 Questions to Ask Your Pharmacist

Female pharmacist helping a senior customer.

September 25 is World Pharmacists Day

Pharmacists are a bridge between you and your doctor. Your pharmacist might also be the health professional you see and talk to most often about your health.(1)

Pharmacists are trained to help you manage and improve your health every day. Your pharmacist—along with your doctor or nurse—can give you patient-centered answers to questions on many topics, including medicines and immunizations. They can also teach you practical skills, including how to use blood glucose monitors and asthma inhalers, and advise ways you can prepare your health for emergencies.What is patient-centered communication? Patient-centered communication acknowledges the whole person, their personality, life history, and social structure to develop a shared understanding of the problem, the goals of treatment, and the barriers to that treatment and wellness.

Here are some example questions you might ask your pharmacist the next time you visit the pharmacy.

  1. How do I prepare an emergency supply of medicines? Talk to your doctor or pharmacist about how you can create an emergency supply of medicines. Some states have emergency prescription refill laws that authorize pharmacists to refill a prescription before it’s due when under an emergency declaration. These laws vary by state. Learn more about the law where you live.
  2. What type of over-the-counter drugs should I include in my emergency supplies? Maintain an emergency supply of over-the-counter medicines, including pain and fever relievers, cough and cold suppressants, antihistamines, and antidiarrheal medicines in age-appropriate strengths.
  3. What kind of records should I keep with my important paperwork? Keep copies of all your prescriptions. You may need them in case you lose, run out, or damage your medicine. Having written records of your prescriptions makes it easier for another doctor to write a refill if you can’t reach your doctor or pharmacy during an evacuation or emergency.(2)
  4. How do I travel (e.g., evacuate) with medicine? Do not keep medicines in the glove compartment of your car. Keep them in their original containers. Keep the containers away from and out of sight of children and pets.(3, 4)
  5. How do I take care of my medicine during an emergency? Keep your medicines in a cool, dry place away from heat, air, light, and moisture.
  6. How do I store medicines safely at home and when traveling (e.g., evacuating) with children and pets? Any medicine, including those you buy without a prescription, can cause harm if taken in the wrong way or by the wrong person or a pet. Put your medicines up and away and out of reach and sight to prevent adverse drug effects.
  7. How do I keep medicines cold during a power outage? Use a cooler, ice, and chemical ice packs. If you use insulin to manage diabetes, try to keep your insulin as cool as possible without freezing it. Insulin that has been frozen can break down and is less effective. You can use insulin in opened or unopened vials that have been stored at room temperature (between 59°F and 86°F) for up to 4 weeks.(5)
  8. How do I judge the safety of medicine after an emergency? Do not take medicine that has changed color, texture, or smell, regardless of its expiration date. Also, do not take pills that stick together, are harder or softer than normal, or are cracked or chipped. Contact your pharmacist or healthcare provider if you are unsure about a drug’s safety. When in doubt, throw it out.(6)
  9. How do I safely dispose of expired, unwanted, unused, or damaged prescription medicines? The best way to dispose of most types of medicines is to drop them off at a drug take-back location.(7) This may be your local pharmacy or police station.
  10. What can I do if I am unable to take my medicine as prescribed because it was damaged? Can I share medicines with a friend or family member if they take the same kind? Medicines are only safe to use by the person whose name is on the prescription. You could experience an allergic reaction, an interaction with other medications, or other serious side effects from using someone else’s prescription medicine. People who share their drugs may experience side effects if they ration their supply to share with others.(8)

Make your pharmacist an important member of your healthcare team. Contact your local pharmacist or the FDA if you have questions about medicine.

FDA’s Division of Drug Information has pharmacists available to answer questions about drug use and safety. You contact them at 1-855-543-3784, druginfo@fda.hhs.gov, and on Twitter at @FDA_Drug_Info.

Learn more ways to prepare your medicine cabinet for emergencies.

References

  1. https://www.cdc.gov/heartdisease/pharmacist.htm
  2. https://blogs.cdc.gov/publichealthmatters/2017/10/preparing-your-medicine-cabinet-for-an-emergency/
  3. https://medlineplus.gov/ency/patientinstructions/000534.htm
  4. https://www.cdc.gov/medicationsafety/protect/campaign.html
  5. https://www.cdc.gov/diabetes/library/spotlights/managing-insulin-emergency.html
  6. https://www.fda.gov/drugs/emergency-preparedness-drugs/safe-drug-use-after-natural-disaster
  7. https://www.fda.gov/drugs/safe-disposal-medicines/disposal-unused-medicines-what-you-should-know
  8. https://health.gov/myhealthfinder/healthy-living/safety/use-medicines-safely

Thanks in advance for your questions and comments on this Public Health Matters post. Please note that CDC does not give personal medical advice. If you are concerned you have a disease or condition, talk to your doctor.

Have a question for CDC? CDC-INFO (https://www.cdc.gov/cdc-info/index.html) offers live agents by phone and email to help you find the latest, reliable, and science-based health information on more than 750 health topics.