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A PDF version of our 2013 Winter Newsletter is now available.
-- National Center resources can help prepare for severe spring weather --
Spring has arrived, bringing with it new severe weather risks traditionally associated with the season. Earlier this week, storms flooded the Mississippi in Alabama and Georgia which led to flash floods, power outages in over 11,000 homes and businesses, and closed roads. This weekend will bring more challenges with severe thunderstorms and weather projected to occur from the mid-Mississippi Valley to the southern Plains.
The lull before the storm is the perfect opportunity to stock your emergency kit and review the safety procedures for before and after a storm. Those already affected by floods need to exercise caution when reentering a flooded home in order to reduce health related risks associated with flooding.
The National Center has resources for the disaster health workforce that is preparing their response to these weather events. "Resilience through Learning: Tornadoes" and "Resilience through Learning: Hurricanes and Typhoons" are resource guides that provide disaster health educators and learners with tools to prepare and respond to severe weather events. Learners that visit these pages will find resources that specifically address unique issues inherent in severe weather events.
Within these resource guides, learners will find the Center's online lesson "Tracking and Reunification of Children in Disasters." With this lesson, responders and volunteers can assist in responding to the needs of an unaccompanied child. By filling out the Tracking and Reunification reference card before the storms arrive, responders can easily access key information needed to reunite unaccompanied children with their parent or guardian.
NCDMPH extends its thoughts to those still recovering in Alabama and Georgia. In addition, the Center thanks the disaster workforce and volunteers assisting in the response effort.
April 2nd, 2014
-- NCDMPH Publishes Paper on Disaster Health Competencies in DMPHP --
The National Center for Disaster Medicine and Public Health's Senior Research Associate Lauren Walsh, MPH, Education Coordinator Brian A. Altman, PhD, and Operations Director Kandra Strauss-Riggs, MPH published in the February 2014 edition of Disaster Medicine and Public Health Preparedness the article, "Enhancing the Translation of Disaster Health Competencies into Practice" (2014; 8: 70-78). Richard V. King, PhD is also an author on the paper. Dr. King, Associate Professor at UT Southwestern Medical Center, presented at Learning in Disaster Health: A Continuing Education Workshop as well as in the Center’s disaster learning webinar series.
The article explores discrepancies in the 2012 pyramid learning framework from the article "Core Competencies for Disaster Medicine and Public Health" (2012; 6: 44-52) by categorizing 35 different disaster health competency sets within the four levels of the original competency framework. The framework is designed to accommodate all disaster health competencies, however only 10 of the 35 chosen competency sets were classified with consistency in the four levels.
The authors used the inconsistencies to develop a modified pyramid that better accommodates a wide variety of disaster health competency sets. The revised pyramid is divided into the following areas:
The full-text of the article is now available from the NCDMPH website: "Enhancing the Translation of Disaster Health Competencies into Practice ".
March 26th, 2014
-- Mudslide Causes Tragedy in Washington State Community --
On Monday President Barack Obama signed a federal emergency declaration for a community near Osa, Snohomish County in Washington State that was buried by a mudslide last Saturday. Authorities currently believe the mudslide was caused by a recent downpour. At the time of this posting, 16 people have been found dead and 176 are reported missing.
The 20 feet of mud is mixed with gasoline and bacteria due to the mains and septic tanks that were destroyed with the force of the mudslide. The toxic mud has created dangerous working conditions for the responders searching for the missing.
According to the Centers for Disease Control and Prevention, landslides cause approximately 25-50 deaths per year. Health threats include rapidly moving water, disrupted roadways, and broken electrical, water, gas and sewage lines. The CDC recommends the following for community members in the region surrounding the mudslide:
U.S. Geological Services has more information on landslides as well as instructions on reporting landslides.
The National Center extends our thoughts to families affected by this tragedy and thanks to the responders working in dangerous conditions.
March 20th, 2014
-- SAMHSA Launches Disaster Behavioral Health Disaster Response app --
The Substance Abuse and Mental Health Services Administration recently went mobile with the launch of its SAMHSA Behavioral Health Disaster Response App. This resource is available on a multiple of devices including Android, iOS, and BlackBerry. With the app, responders can readily provide just-in-time resources to survivors as well as prepare for deployment.
Before deployment, users can go through the app's "Readiness Refresher" section which divides content into two roles: Behavioral Health Responder and Supervisor of Behavioral Health Responder. In addition, users can locate SAMHSA treatment locations at their future place of deployment in preparation for their arrival.
After arriving at the site, responders can explore the app's "On-the-Ground Assistance" portion to access critical contacts and publications, online resources, intervention techniques, and information for survivors. The app also takes into consideration the mental health needs of the responder with a stress management and assessment tool.
Returning from assignment can bring additional stress for all in the response process. Users can access the app's "Postdeployment Guide" to utilize relevant publications as well as find resources that can meet their future training needs.
NCDMPH shares SAMHSA's dedication to disaster behavioral health with the following resources:
March 12th, 2014
-- Report Reveals Lack of Focus on Gender Populations in Disaster Policy --
A recent study out of Florida International University explores issues of women's vulnerability and resilience to disasters by interviewing leaders and local officials that assisted with the 2013 Colorado floods. The study titled "Women in the Face of Disaster: Incorporating Gender Perspectives into Disaster Policy" ultimately revealed that local disaster policies and plans did not consider vulnerabilities related to gender.
Bridgette Cram, the lead author on the study, outlined five different ways women are vulnerable in a disaster according to the relevant literature. The following is a list of aforementioned vulnerabilities and their relation to Colorado’s flood recovery:
While leaders and local officials did not include gender vulnerabilities in emergency planning, they did note a high participation of women in disaster preparedness and response. Women were frequently seen in disaster education classes and volunteer efforts. Study participants also recommended a range of gender focused preparedness steps for the future including the establishment of peer-to-peer networks and the creation of trainings targeted at vulnerable populations.
NCDMPH will soon take part in conversations regarding gender in disaster. Dr. Elaine Enarson, a disaster sociologist who researches gender relations in disaster, will present a webinar on August 29th at 1:00 p.m. ET. Continue to visit the webinar page for more updates on this presentation.
February 26th, 2014
-- Current Flu Seasons Consist of Resurgence in H1N1 --
A recent Morbidity and Mortality Weekly Report (MMWR) from the Centers for Disease Control and Prevention reported elevated influenza activity in certain parts of the United States. This activity is projected to last several more weeks. A unique aspect of the CDC report is the predominant role of H1N1, commonly known as the swine flu, in this year’s influenza season. Although the flu season is close to over, the CDC urges anyone who has not received the flu shot and is approved by their doctor to get one to visit their local pharmacy to receive the shot. If you received a flu shot at the start of the flu season, you do not need a repeat vaccination.
Persons aged 18-64 are particularly susceptible to this year’s flu, which is a population group with a low vaccination rate. The severity of this year’s flu season is evident when comparing statistics from last year.
Despite the current prevalence of the illness, H1N1 is not at the same epidemic levels it was back in 2009 which included 527 deaths. Locally, the District of Columbia has seen a recent flu surge with 90 percent of the cases identified as H1N1. Virginia and Maryland also are experiencing wide-spread flu in the region.
H1N1 symptoms are similar to the regular seasonal flu. Consult with a medical professional if you have flu symptoms. Visit flu.gov for continued updates on this year’s flu season.
February 13, 2014
-- Hurricane Sandy & Disaster Mental Health Risk Surveillance --
A recent NCDMPH webinar featured Learning in Disaster Health: A Continuing Education Workshop poster winners which included the poster "Integration and Performance of Mental Health Triage Core Competencies in Los Angeles County Disaster Exercise" by Dr. Merrit D. Schrieber and Sandra Shields. Dr. Schrieber et al recently were published in the Annals of Emergency Medicine for their paper, "Snapshot from Superstorm Sandy: American Red Cross Mental Health Risk Surveillance in Lower New York State."
The study assessed mental health impact of Hurricane Sandy in New York State. American Red Cross volunteers used PsySTART, a mental health triage tool, to record survivors' mental health risk factors immediately after Hurricane Sandy. Out of a sample of 18, 823, the study reported 17,979 risk factors. A unique aspect of this study is that it emphasized the psychosocial effects of disasters beyond the adisaster impact site. Survivors surveyed displayed mental health risk factors even if they were located outside the flood or damage zones.
NCDMPH shares the researchers' interest in improving disaster mental health outcomes through the production of psychosocial-focused resources:
The recent report also highlighted the utility of acquiring mental health data from areas beyond the disaster impact site. With this data, responders can justify extending disaster mental health triage in areas surrounding the severest-hit regions.
The National Center applauds the efforts of the American Red Cross and the report authors. By supporting the mental health of disaster-impacted communities, responders contribute to a nation of resiliency.
February 7, 2014
-- CDC Releases 2013-2014 National Snapshot of Public Health Preparedness --
The Centers for Disease Control and Prevention recently released the 2013-2014 National Snapshot of Public Health Preparedness which highlights CDC's preparedness priorities as well as features national and regional preparedness fact sheets. In 2012 alone, 11 storms, including Superstorm Sandy, surpassed $1 billion in damages. Despite these challenges, "state public health staff with incident management lead roles reported for immediate duty an average of nine minutes faster."
To achieve greatest health impact in the current fiscal climate, the CDC focuses on three key priorities that are used as guideposts for future preparedness efforts. The following priorities are guided by the National Strategic Plan for Public Health Preparedness and Response:
The second priority is partially accomplished via "improving the workforce's ability to respond to emergencies by conducting training exercises so staff can practice response skills." NCDMPH supports this priority via providing accredited online training materials on pediatric disaster health as well as resources for educators and trainers.
The report also emphasized the accomplishments of the Preparedness and Emergency Response Learning Centers (PERLCS) which deliver competency-based preparedness training. By 2012, PERLCs reached 210,000 learners and helped communities prepare, respond, and recover from disasters including Superstorm Sandy, the Boston marathon bombing, and tornadoes in Oklahoma and Alabama.
The National Center applauds CDC’s accomplishments and goals featured in the report. NCDMPH will continue to contribute to national public health preparedness by providing training and preparedness resources and conducting research.
January 28th, 2014
-- Paper reports on disaster preparedness among older adults in the US --
The American Journal of Public Health recently published a paper from the University of Iowa, School of Public Health, regarding the natural disaster preparedness levels among older US adults. "Preparedness for Natural Disasters among US Adults: A Nationwide Survey" measured these preparedness levels by interviewing subjects on a set of factors that may adversely affect their safety in a disaster.
An overall preparedness score was calculated by analyzing data on demographic characteristics, disability or functional limitations, personal preparedness, and/or familiarity with preparedness concepts. Led by MPH student Dr. Tala M. Al-Rousan, the study found that preparedness in the older population is negatively affected by factors including age, physical disability, income, and lower educational attainment. The research revealed an lack of preparedness in the senior population with only 1/3 of the population engaged in any preparedness materials.
Dr. Al-Rousan recommends the following preparedness materials for both older adults and response workers:
More resources for disaster preparedness can be found in the National Center's Resources for Core Competencies in Disaster Health page.
January 16th, 2014
-- West Virginia Chemical Spill: A Public Health Crisis --
The Centers for Disease Control and Prevention recently created a webpage compiling information on MCHM, the chemical that recently spilled in the Elk River in West Virginia. In addition, MCHM has now been assigned a Chemical Abstracts Service Registry Number (CASRN) of 34885-03-5.
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On the evening of January 9th, over 30,000 residents of West Virginia were devastated by a catastrophic chemical leak of of 4-Methylcyclohexanemethanol (CASRN: 34885-03-5; "MCHM"; "crude MCHM" or "4-Methylcyclohexane methanonal") into the Elk River. MCHM, a chemical known to cause skin and eye irritations as well as breathing problems and vomiting, is used to clean coal.
The event posed a challenge to disaster responders who had to learn about the properties of MCHM during their response. Due to a lack of information on MCHM, the Centers for Disease Control and Prevention deferred to their guideline of one part MCHM per million parts water. For over five days, residents and facilities in nine counties could not use tap water beyond flushing the toilet. While the immediate crisis is close to over, there are still significant health effects of water loss and chemical exposure. Secretary of the West Virginia Department of Health and Human Resources reported that 14 people have been admitted to area hospitals due to exposure and 231 people were treated and released.
Extended water loss can cause a variety of severe health effects. A Morbidity and Mortality Report from 2011 reported on the effects of water loss in Alabama after pipes burst in January 2010. Much like how West Virginia was not prepared for the chemical leak, Alabama did not have a significant plan in place to cope with burst pipes. Follow-up research in Alabama revealed health issues that included acute gastrointestinal illness, acute respiratory illness, and reports of skin and eye irritation.
The National Center for Disaster Medicine and Public Health extends its gratitude to the disaster health workforce working tirelessly to serve the communities affected by the spill. For more information about chemical exposure, visit the National Library of Medicine’s Toxicology Data Network.
January 8th, 2014
-- Two Centers of USUHS Collaborate to Produce Curriculum Recommendations --
The National Center for Disaster Medicine and Public Health and the Center for the Study of Traumatic Stress, two research institutes with the Uniformed Services University of the Health Sciences, recently collaborated on a set of curriculum recommendations for disaster health professionals. "Curriculum Recommendations for Disaster Health Professionals: Disaster Behavioral Health" is the second in a series of disaster health curriculum recommendations from NCDMPH. The first set of curriculum recommendations from NCDMPH were based on the pediatric population.
These recommendations provide resources on planning education and training activities on behavioral health factors in disasters to those working with health professionals. As with many NCDMPH products, these recommendations align with the disaster health core competencies outlined in the Disaster Medicine and Public Health Preparedness article "Core Competencies for Disaster Medicine and Public Health."
This resource can help address the Nation's need of a health workforce that is sensitive to disaster behavioral health. These recommendations feature the following topics:
The curriculum recommendations are not prescriptive but rather adaptable to the needs and circumstances of the educator. Additionally, the recommendations can be tailored to each educator's needs when they create trainings.
The National Center looks forward to future partnerships and collaborations with CSTS. Congratulations to authors Dr. Brian Flynn and Dr. Joshua Morganstein for creating this comprehensive and useful resource.
January 2nd, 2014
-- Centers for Medicare & Medicaid Services Proposes Emergency Preparedness Requirement --
The Centers for Medicare & Medicaid Services recently released a proposed rule suggesting national emergency preparedness requirements for Medicare and Medicaid participating providers. CMS research suggests that providers' current disaster preparedness efforts are not comprehensive and lack coordination.
The proposed rules address current gaps in providers' plans and also ensure that these providers coordinate with federal, state, tribal, and local emergency preparedness systems. CMS compiled the requirements by reviewing guidance from CDC, FDA, HRSA, ASPR, and other federal, state, and private agencies.
In order to create a comprehensive preparedness program, CMS created a list of four benchmark standards for Medicare and Medicaid providers:
The National Center will continue to track the status of these proposed rules and looks forward to their possible contribution to the resiliency of the nation. The Centers for Medicare & Medicaid Services' proposal is open for commentary until February 25th, 2014.