The XV Collection: Perverse Outcomes of Novel Therapies

  The XV Collection: Perverse Outcomes of Novel Therapies Posted August 10, 2018 by post-info by Andrew Read Yale professor Steve Stearns once warned that the transition from Young Turk to Old Turkey happens quickly.

Deep brain stimulation in Parkinson’s disease, modelling chromatin dynamics, ant obstacle courses

  Deep brain stimulation in Parkinson’s disease, modelling chromatin dynamics, ant obstacle courses   post-info Check out our Editors-in-Chief’s selection of papers from the May issue of PLOS Computational Biology. Quantitative theory of deep brain stimulation of

PLOS Biology in the media – March

0000-0002-8715-2896 PLOS Biology in the media – March   post-info March has been a bumper month at PLOS Biology with lots of research hitting the press. A selection of our top picks this month include

Progress and Challenges for Neglected Tropical Diseases: An Anniversary Assessment

0000-0002-8715-28960000-0001-7318-5892 This year PLOS celebrates the 10th anniversary of PLOS Neglected Tropical Diseases (PLOS NTDs). The festivities are off to an impressive start with a strong presence at the 2017 NTD Summit in Geneva, Switzerland, a

10 Ways CDC Gets Ready For Emergencies

Dr. Stephen Redd, Director, Office of Public Health Preparedness and Response
Dr. Stephen Redd, Director, Office of Public Health Preparedness and Response

One of the best parts of my job is the opportunity to learn from a wide range of experiences. We have an obligation to not only respond to emergencies today, but to prepare for tomorrow by learning from the past. Our work extends to households affected by disease, communities ravaged by disasters, and U.S. territories battling new and changing threats. In fact, all over the world – we try to get ahead of, and manage, complex responses that touch many lives through ever changing circumstances. In an ideal world the health in every community would be at a level that would make recovery and reliance easier. The reality is that emergencies happen in all kinds of environments and populations.

The Public Health Preparedness and Response National Snapshot is our annual report that gives us an opportunity to showcase the work that we and our state partners do. The report reminds us that no matter how big the emergency, we need to work together to respond to the best of our ability—with the cards we are dealt.

Here are 10 ways CDC’s Office of Public Health Preparedness and Emergency Response worked to keep people safer in 2016 that can inform our work going forward.

1) Four Responses at Once: An Unprecedented Challenge

CDC experts continue to provide 24/7 monitoring, staffing, resources, and coordination in response to natural disasters, terrorist attacks, and infectious disease threats. In early 2016, CDC managed four public health emergencies at the same time through our Emergency Operations Center :

  • Ebola
  • Flint, Michigan, Water Quality
  • Zika Virus
  • Polio Eradication

See us in action:

2) A Complex Threat: Zika Hits the U.S.

CDC scientists and responders were activated in CDC’s Emergency Operations Center, where they combed through research, developed and distributed diagnostic tests, and provided on-the-ground mosquito control and education to protect people at higher risk for the virus, including pregnant women and infants.

3) Right Resources, Right Place, Right Time

CDC’s Strategic National Stockpile is ready to send critical medical supplies quickly to where they are needed most to save lives. The stockpile is the nation’s largest supply of life-saving pharmaceuticals and medical supplies that can be used in a public health emergency if local supplies run out.

Last year, we helped conduct 18 full-scale exercises and provided training for 2,232 federal and state, local, tribal, and territorial emergency responders to ensure that systems for delivering medicines are functioning well before they are needed in an actual emergency. We continue to work with our federal, state, local, and commercial partners to make sure every step of the medical supply chain – from manufacture to delivery – is coordinated.

4) State and Local Readiness

CDC connects with state and local partners to provide support and guidance, helping every community get ready to handle emergencies like floods, hurricanes, wildfires, or disease outbreaks.

This year, we created a new process to evaluate how well state and local jurisdictions can plan and execute a large-scale response requiring the rapid distribution of critical medicines and supplies. Through this program, we conducted assessments of 487 state and local public health departments. The information from these assessments will be used to help improve the ability to get emergency supplies quickly to those who need them most.

5) Cutting-Edge Science to Find and Stop Disease

To protect lifesaving research, CDC experts in biosafety and biosecurity conducted approximately 200 laboratory inspections and thousands of assessments of those who handle dangerous select agents and toxins like anthrax, plague, and ricin to keep these materials safe, secure, and out of the hands of those who might misuse them.

CDC’s Laboratory Response Network (LRN)l also develops and deploys tests to combat our country’s most pressing infectious and non-infectious health issues, from Ebola to Zika virus to opioid overdose. The network connects over 150 labs to respond quickly to high priority public health emergencies.

6) Protecting Our Most Vulnerable

CDC supports efforts all across the country to help those who may not be able to help themselves when a crisis strikes. Some populations, like children, older adults, and others with functional and access needs may need extra help during and after an emergency.

From planning for the 69 million children who may be in school when disaster strikes to the millions of Americans who need to make sure prescriptions are filled, medical equipment is working, and help arrives even if power is out and roads are blocked, it’s up to us to protect our most vulnerable in emergencies.

7) Emergency Leaders: The Future of Incident Response

When every minute counts, we need people who have the knowledge to step in and take immediate action. Learning and using a common framework like the CDC Incident Management System helps responders “speak the same language” during an event and work more seamlessly together.

CDC experts train leaders from around the world—25 countries in 2016—through an innovative, four-month fellowship based at our Atlanta headquarters. Lessons learned from this course were put to work immediately to head off an outbreak of H5N1 influenza in Cameroon.

8) The Power of Preparedness: National Preparedness Month

Throughout September, CDC and more than 3,000 organizations—national, regional, and local governments, as well as private and public organizations— supported emergency preparedness efforts and encouraged Americans to take action.

The theme for National Preparedness Month 2016 was “The Power of Preparedness.” During our 2016 campaign , we recognized the successes of countries and cities who have seen the direct benefits of being prepared, looked at innovative programs to help children and people with disabilities get ready for emergencies, and provided tips for home and family on making emergency kits.

9) Health Security: How is the U.S. Doing?

As part of the Global Health Security Agenda, teams of international experts travel to countries to report on how well public health systems are working to prevent, detect, and respond to outbreaks. In May, a team made a five-day visit to the U.S. to look at how well we’re doing.

In the final report, the assessment team concluded that, “the U.S. has extensive and effective systems to reduce the risks and impacts of major public health emergencies, and actively participates in the global health security system.” They recognized the high level of scientific expertise within CDC and other federal agencies, and the excellent reporting mechanisms managed by the federal government.

10) Helping YOU Make a Difference

Get a flu shot. Wash your hands. Make a kit. Be careful in winter weather. Prepare for your holidays. Be aware of natural disasters or circulating illnesses that may affect you or those you care about. There are many ways to prepare, and in 2016 we provided the latest science and information to empower every one of us to take action.

Every person needs knowledge to prepare their home, family, and community against disease or disaster before an emergency strikes. Whether it’s how to clean mold from a flooded home, how to wash your hands the right way, or how to use your brain in emergencies, our timely tips and advice put the power of preparedness in your hands. From the hidden dangers of hurricanes to the heartbreaking dangers of flu, there are steps we can all take to stay safe every day as we work toward a healthy and protected future.

For more ways we are helping protect America’s health, check out the new National Preparedness Snapshot.

To find out more about the issues and why this work matters, visit our website.

 

The Power of Preparedness

The Power of Preparedness. National Preparedness Month 2016.

Dr. Stephen Redd, Director, Office of Public Health Preparedness and Response
Dr. Stephen Redd, Director, Office of Public Health Preparedness and Response

If there were one thing I’d wish for, it would be the ability to predict when and where the next infectious disease outbreak would occur and stop it before it starts. I can’t do that. And neither can anyone else.

At this moment, in addition to combating Zika in the United States and polio in Nigeria and Pakistan, we’re putting out the last embers of Ebola in West Africa, stomping out cholera in Tanzania and Kenya, and fighting yellow fever in Angola. We’re keeping vigilant for the re-emergence of H5N1 influenza and Middle East respiratory syndrome, and monitoring chikungunya, dengue, monkeypox, Lassa fever, measles…the list goes on.

It’s a lot to do. And these are just the diseases we know about. The brutal fact is that there are diseases we haven’t discovered yet. They’re out there, waiting to expose the cracks in our systems – to find the places where we aren’t watching, the areas where we aren’t prepared. And we can’t know the potential danger.

Finding – and filling – the gaps

The fact is, if you leave an opening – any opening – disease will find it. This is why it’s critical to have strong public health systems in place before emergencies happen. We can do more to recognize what causes outbreaks, respond to them faster, and bring them under control more effectively.

Around the world and at home, we need to know the level and types of disease that are normally present, so we can detect when there’s a change that requires our attention. We need safe laboratories that can rapidly diagnose the cause of illness close to the source. We need emergency operations centers that can bring experts together quickly to make decisions. Until we have these things, there will be gaps.

And where there are gaps, there is the potential for disaster. The unexpected eruption of Ebola in West Africa showed us this clearly. Before that there were others: HIV raged undetected for a decade; SARS spread to 37 countries across three continents in four months; Anthrax drew the world’s attention to the threat of intentional releases of lethal pathogens.

The human and economic costs are dear. SARS killed nearly 800 people and cost an estimated $40 billion. Ebola has killed over 11,000 people and cost billions. The potential costs of Zika to the lives of our children are unfathomable.

The value of being prepared

Each day, we continue to learn by doing. Every disaster teaches us how to do better the next time. We are seeing results, both here at home and in countries around the world.

We know that preparedness can stop unexpected health threats, even when the disease is fast moving and deadly. Take Nigeria as an example: with a highly trained team of disease detectives and an emergency operations center at the ready, Nigeria was able to thwart Ebola’s spread in Lagos and elsewhere in Nigeria, stopping the outbreak at 20 cases and averting a potential public health catastrophe.

Cameroon’s emergency operations center was recently able to head off an outbreak of H5N1 influenza by activating within 24 hours of notification. Through investments in training and preparedness, they have dramatically improved their response times – just one year ago, it took that same center eight weeks to respond to an outbreak of cholera.

At home, our flu program serves as a gold standard for how to be flexible and responsive in an emergency. When H1N1 influenza hit, we were able to act faster and more effectively through systems we already had in place for vaccine shipping, coverage, and monitoring. The outbreak response also demonstrated how we can work effectively across sectors – across CDC, between levels of government, and with global partners like the World Health Organization and ministries of health.

Despite these successes, nearly 70 percent of countries remain unprepared to handle a public health emergency. That’s a scary number – and a lot of vulnerable people.

Building well for the future

We cannot accept the status quo; we must put our investments into work that will make the world a safer place for us all. In doing this, we must first believe – as I do – that it is possible to create positive change and get results.

In a time when what pops up in one corner of the world can find its way across the globe in a matter of hours, we all have a responsibility to each other to be prepared.

We cannot take this responsibility seriously enough.

More resources to learn about global preparedness:

Read our other National Preparedness Month blogs:

Science for the People: Mandatory Vaccination

sftpThis week, we’re talking about disease prevention, public health, and whether or not some types of vaccinations should be mandatory. We’ll spend the hour in a panel discussion with Barry Bloom, Harvard University’s Distinguished Service Professor of the Department of Immunology and Infectious Diseases, University of Toronto public health ethicist Alison Thompson, pediatrician and University of Pennsylvania vaccinology professor Paul Offit, and Nicholas Little, Vice President and General Counsel at the Center for Inquiry.


Filed under: This Mortal Coil Tagged: Alison Thompson, Barry Bloom, Disease, ethics, Harvard University, law, medicine, Nicholas Little, Paul Offit, Podcast, public health, science for the people, University of Pennsylvania, University of Toronto, Vaccination

Deep Reads: Andreas Vilhelmsson’s journey into the world of global public health

The fifth entry for our Deep Reads blog series is written by Andreas Vilhelmsson, a post-doctoral researcher at the Department of Global Political Studies at Malmö University, Sweden. His research focuses mostly on patient reporting of adverse drug reactions and … Continue reading »

The post Deep Reads: Andreas Vilhelmsson’s journey into the world of global public health appeared first on PLOS Blogs Network.

Science for the People: Bodies Everywhere

sftp

This week, Science for the People is looking at the morbid and fascinating history of our attempts to grapple with disease and death. We’re joined by medical historian Richard Barnett to talk about his book The Sick Rose: Disease and the Art of Medical Illustration.

And we’ll speak to mortician and blogger Caitlin Doughty about her new book Smoke Gets In Your Eyes: And Other Lessons from the Crematory, and her ongoing YouTube series “Ask a Mortician“, about the history, science and cultural attitudes attached to dealing with the deceased.

*Josh provides research help to Science for the People and is, therefore, completely biased.


Filed under: The Art of Science, This Mortal Coil Tagged: Art, Ask a Mortician, Caitlin Doughty, death, Disease, illustration, Order of the Good Death, Podcast, Richard Barnett, sciart, science for the people, Smoke Gets in Your Eyes, The Sick Rose

Doctors Without Borders: Don’t wait for Ebola magic bullets

Earlier this week I argued that hand-wringing over the lack of Ebola vaccines and drugs is misguided. We have effective tools to fight Ebola right now.

This week in the New England Journal of Medicine, physicians from WHO and Médecins sans Frontières make a similar argument much more eloquently:

There has recently been immense media, public, and medical attention to specific treatments for Ebola virus infection. Although these experimental interventions represent important potential treatments, they also reflect our seemingly innate focus on developing magic bullets. It seems that focusing on reducing mortality in the existing “control group” by applying the current standard of care is less interesting, even if much more likely to be effective. Though we recognize the potential incremental value of new antiviral options, we believe that EVD requires a greater focus on available basic care…

Public health interventions including characterizing the outbreak epidemiology, contact tracing, social mobilization, and public education are essential steps in stopping Ebola and will ultimately save many more lives than can be saved by individual patient care…

Excellent clinical care and improved outcomes will result in improved community compliance, will help to break transmission chains, and will lead to a greater willingness of health care workers to engage in care delivery. To quote William Osler, “The best preparation for tomorrow is to do today’s work superbly well.”


Filed under: This Mortal Coil Tagged: Disease, doctors without borders, Ebola, Infectious disease, Linkonomicon, medecins sans frontieres, MSF, outbreak, vaccine, who, world health organization