U.S. Response To Health Threats To Be Reviewed

Health and Human Services Secretary Kathleen Sebelius has announced a major review of the government's efforts to develop new protections against pandemics, bioterrorism and other health threats. The review will not just examine the flu, but all public health threats faced today. Sebelius stated, "We'll look for the fastest ways to move to new technologies that will let us quickly produce countermeasures that are more dependable and more robust." The review will be led by Nicole Lurie, assistant secretary for preparedness and response, and will be complete by "early next year," Sebelius said. Read more!

Clarification on H1N1 Priority Vaccination Groups

Henry Claypool from HHS said that we expect clarification on the issue of DSPs being considered health care personnel as related to distribution of the H1N1 vaccine in the next couple of days. This should also clarify which individuals with disabilities fall into the priority groups. Read more!

FDA Fights False Claims About H1N1 Treatments

There are over 140 drugs, devices and pieces of equipment marketed over the Internet that have landed on a list of fraudulent swine-flu-fighting products compiled by the Food and Drug Administration. It is violation of federal law to market products that claim to prevent or treat H1N1 and that have not been approved by the F.D.A. While most claims about products are so outlandish that they are dismissed, it posses the problem that individuals may have a false sense of protection. Read more!

FDA Authorizes Emergency Use of Intravenous Antiviral Peramivir for 2009 H1N1 Influenza for Certain Patients, Settings

In response to a request from the CDC, the FDA announced it has issued an emergency use authorization (EUA) for the investigational antiviral drug peramivir intravenous (IV) in certain adult and pediatric patients with confirmed or suspected 2009 H1N1 influenza infection who are admitted to a hospital. Specifically, IV peramivir is authorized only for hospitalized adult and pediatric patients for whom therapy with an IV drug is clinically appropriate, based on one or more of the following reasons:
1. the patient is not responding to either oral or inhaled antiviral therapy, or
2. when drug delivery by a route other than an intravenous route -- e.g., enteral (absorbed by the intestines) or inhaled -- is not expected to be dependable or feasible;
3. for adults only, when the clinician judges IV therapy is appropriate due to other circumstances. Read more!

Obama Declares Swine Flu a National Emergency

October 24th, President Obama declared the swine flu a national emergency, allowing hospitals and local governments to speedily set up alternate sites and procedures if needed to handle any surge of patients. White House spokesman Reid Cherlin emphasized that this declaration was not in response to any new information but was rather a preventative measure. The declaration allows hospitals to apply to the Department of Health and Human Services for waivers from laws that in normal times are intended to protect patients’ privacy and to ensure that they are not discriminated against based on their source of payment for care, including Medicare, Medicaid and the states’ Children’s Health Insurance Program.
Read more!

New York suspends mandatory H1N1 shots for health workers

New York public health workers will no longer be required to be vaccinated against both the seasonal and H1N1 flu virus.The dispute between the public health employees and the New York State Health Department was settled by a vaccine shortage that made the requirement impossible to implement. Read more!

H1N1 Definitition of "Health-Care Personnel"

During phone calls with CDC, ANCOR requested clarification as to whether direct support professionals are included under “health-care personnel”. CDC stated that they could not clarify that as they are only writing guidelines. CDC emphasized that state health departments execute these recommendations and make the final decisions as to who receives the vaccines first.

ANCOR strongly recommends that everyone contact their state health department and urge them to include direct support professionals in the “health-care personnel” category. Read more!

States Move to Require Some Health Care Workers to Receive H1N1 Vaccination

With the H1N1 pandemic spreading rapidly, many doctors, nurses, and other U.S. health-care workers for the first time are being required by their states to get flu shots, drawing praise from many public-health authorities but condemnation from some employees, unions and other critics who object to mandatory vaccination. Check with your state and local government to find out if they require direct support professionals to receive the H1N1 vaccine.

What's at Issue?
An increasing number of doctors, nurses and other health-care workers for the first time are being required to get flu shots, in part because of concerns that the swine flu pandemic may overwhelm the U.S. health-care system.

Who's Objecting and Why?
Some health-care workers are objecting for a variety of reasons, including concerns about the safety of the vaccine, the sentiment that being vaccinated should remain voluntary and, in some cases, the mistaken fear that the vaccine itself can cause the flu.

For Example...
States: New York this year became the first state to require flu shots, a policy that affects about 522,000 employees.

Hospitals: The Hospital Corp. of America, known as HCA, in Nashville, the nation’s largest private hospital chain, is also requiring the shots this year, a policy that affects an estimated 120,000 employees in 20 states.

Providers: MedStar Health, the largest health-care employer in the Washington region, is requiring flu shots this year for the first time for all 25,000 of its employees and 5,000 affiliated physicians. Read more!

H1N1 Vaccine Update

HHS officials have recently announced 3.4 million doses will now be available the first week of October however they will all be in the nasal spray form. The nasal spray, FluMist, contains a weakened live virus, while injections contain a killed and fragmented virus. The spray gives a stronger immune reaction but carries a small risk that the virus will multiply too quickly in people with compromised immunity. The normal side effects of FluMist include fever, headache, muscle aches, runny nose, vomiting and wheezing. These side effects mimic the flu, leading to the rumor that flu vaccines cause the illness. Nevertheless, health agencies say the side effects cannot expand into a life-threatening infection. The nasal spray is not recommended for pregnant women, people over 50, and individuals with asthma or heart conditions. This still allows other target groups to receive immunity faster than expected.

Contrary to what experts expected, clinical trials now show the H1N1 vaccine is effective for adults and children ages 10 to 17 with one dose, not two. Children 9 and under will need two doses. Clinical trials have not yet finished for pregnant women. Studies have concluded that once vaccinated, a person develops immunity to the virus within 8 to 10 days. This recent change means that the vaccine supply will go twice as far, which will allow all people within the CDC’s high risk groups to receive vaccination before the flu’s midwinter peak. Read more!

U.S. Chamber Releases H1N1 Flu Guide to Keep Businesses in Business

The U.S. Chamber of Commerce’s National Security and Emergency Preparedness Department announced the release of It’s Not Flu as Usual: An H1N1 Business Preparedness Guide to provide businesses with suggestions on how to keep employees healthy and maintain business operations during the upcoming flu season. The document is designed for businesses of all sizes and includes a 10-point preparedness checklist in addition to information on topics such as federal guidance for workplace planning, vaccines, antiviral drugs, face masks, and respirators.

More information from the U.S. Chamber of Commerce is available at their pandemic planning website. Read more!

ANCOR Releases H1N1 Issue Brief

ANCOR has recently released an H1N1 Issue Brief.The issue brief will be updated as new information comes in. To ensure you have the most updated copy check our Pandemic Flu Website. For questions contact Mary Pauline Jones. Read more!

HHS Conference Call on H1N1

HHS will be hosting an information sharing conference call on H1N1 on September 14, 2009.

Call: 1-800-837-1935; Conference ID: 2H1N1
Date: September 14, 2009
Time: 1:30 -3:00 pm, Eastern DS Time

Opening Remarks --- Chair- Dr. Nicole Lurie, Assistant Secretary for Preparedness and Response
Co-Chairs – CAPT Clare Helminiak, Dr. Sally Phillips, and RADM Ann Knebel
Moderator – Susie Butler, CMS Office of External Affairs

Agenda
The purpose of this information session is to update and inform the provider community about issues around H1N1 preparedness and response, vaccine availability, infection control, and other questions that have come in. We will cover the following topic areas:

1. General Update

2. Vaccines and Antivirals

3. Special Populations

4. Healthcare System Surge Capacity

5. Infection Control and Personal Protective Equipment

Submit questions in advance: We invite you to submit questions now at: H1N1.listening@hhs.gov

Please note – we know that we cannot respond to each individual email question. Submitting questions prior to the call will allow us to address as many questions as possible.

Helpful websites, should you have questions:

· www.flu.gov

· www.cdc.gov/H1N1flu

· http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/ucm100228.htm -- information on antivirals

· http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6539.pdf -- CMS billing information

· http://www.cms.hhs.gov/Emergency/Downloads/Medicare_FFS_Emergency_Qs_As_082609.pdf --Information for Medicare Fee-for-Service Providers

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All callers, please dial: 1-800-837-1935 and use Conference ID 2H1N1.


Read more!

President’s Council of Advisors on Science and Technology (PCAST) releases report assessing H1N1 preparations

A Presidential advisory group released a report assessing the Obama Administration’s preparations for the expected fall resurgence of H1N1 virus and outlining key steps officials can take to minimize the virus’s impact on the nation.

The report concludes that the 2009 H1N1 virus will most likely not resemble the pandemic of 1918-1919 however, it “poses a serious health threat” to the nation when compared to the benign swine flu from 1976. The H1N1 virus is not deadlier than previous viruses, rather it affects more people because it is a new virus that few people have immunity to.

The group lists several prime recommendations including: accelerating the preparation of flu vaccines for distribution to high-risk individuals; clarifying guidelines for the use of antiviral medicines; upgrading the current system for tracking the pandemic’s progress and making resource allocation decisions; accelerating the development of communication strategies—including Web-based social networking tools—to broadcast public health messages that can help mitigate the pandemic’s impact; and identifying a White House point person with primary authority to coordinate key decisions across the government as the pandemic evolves.
For more about PCAST, visit: http://www.ostp.gov/cs/pcast.

The Obama administration is already taking action based on the recommendations of PCAST. The CDC is expected to release revised flu treatment guidelines by the end of the month.

At the same time, problems with vaccine production are arising. The government expected to have 120 million vaccines available October 15th, however it now estimates it will only have 45 million vaccines ready and 20 million more would be ready each week through the end of December. Read more!

State Updates on H1N1 Virus

New York and Arizona both have had changes to the handling of the H1N1 virus.

The New York State Health Department is requiring health care workers across the state to be vaccinated for the seasonal flu and the H1N1 virus. The regulation affects workers and volunteers who come into contacts with patients at hospitals, in home health care agencies, and in hospice care, but through a technicality in state law, not in nursing homes.

Banner Hospitals across the state of Arizona have discontinued using the one-hour H1N1 virus test. The decision to halt use of the test, which was primarily used in emergency rooms, came because of the high number of false negatives the test produced. According to Banner microbiologist, roughly 50% of patients with negative results actually had the virus. Banner hospitals will now rely on the standard H1N1 test that takes 24 to 72 hours to complete.
Read more!

CDC Releases Business Plan for Upcoming Flu Season

The Department of Commerce Secretary Gary Locke, Department of Health and Human Services Secretary Kathleen Sebelius, and Department of Homeland Security Secretary Janet Napolitano announced new guidance for businesses to plan for and respond to the upcoming flu season. The CDC designed the guidance to help employers prepare for the impact the seasonal and 2009 H1N1 virus could have this fall and winter on their employees and operations.

The guidance may be found at http://www.flu.gov/plan/workplaceplanning/guidance.html. CDC has also produced a communication toolkit for businesses and employers, which is attached and may also be found at http://www.flu.gov/plan/workplaceplanning/toolkit.html.
Read more!

Effective Emergency Management: Making Improvements for Communities and People with Disabilities

EAD & Associates along with The National Council on Disability (NCD) released a report titled Effective Emergency Management: Making Improvements for Communities and People with Disabilities. The report recommends changes in emergency management and goes over practices that would better address the needs of people with disabilities. The report dives into examples of existing successful practices and evaluates emergency preparedness, disaster relief, and homeland security program efforts taken by both public and private sectors. Read more!

H1N1 Virus Webcast and Update

Join HHS Secretary Sebelius, DHS Secretary Napolitano and Education Secretary Duncan for an important webcast on emergency preparedness related to the flu epidemic.

Participants will be able to learn about: the latest information on vaccine development; vaccine planning and preparedness efforts; federal funding support for sate efforts and ; progress on planning and preparedness for schools, child care centers, businesses and communities.

Registration is not required. To view the Webcast, visit www.flu.gov at 3:00 pm EDT on Tuesday, August 4. Please note, you will need Flash (http://www.adobe.com) installed on your computer in order to view the live video stream.

Other Questions? Please email HHSIGA@hhs.gov

Flu Panel Creates Priority List for Vaccine
A 15-member panel of experts met Wednesday at the Centers for Disease Control and Prevention in Atlanta to create a list of who should get the pandemic flue vaccine first. When the vaccine is available in September, the first to receive it will be pregnant women, the caretakers of infants, children and young adults ages 6 months to 24, people with chronic illness ages 25 to 64, and health-care workers.

Unlike most flu strains, people over the age of 65 are rarely contracting this strain. Speculation is that it is due from exposure to similar flu strains that circulated years ago. Children under 6 month are not able to receive the vaccine due to their immune system not being developed.

The vaccine will come in two forms: the traditional flu shot and a “live” vaccine squirted into the nose. The question of whether one or two shots is needed has still not been answered and the vaccination program is expected to start before an answer is found.

For More information please visit www.flu.gov.
Read more!

Administration Releases Grants to States and Calls on Nation to Prepare for Fall Flu and H1N1 Virus

HHS July 7th sent out a press release asking the public to prepare for the fall flu season and ongoing H1N1 flu outbreak. Secretary Sebelius asks the “American people to become actively engaged with their own preparation and prevention. It’s a responsibility we all share.” HHS launched a new website www.flu.gov to help centralize communications about the H1N1 flu as well as a Public Service Announcement campaign to encourage the public to become more involved.

UPDATE July 10, 2009: States Now Eligible to Receive $350 Million for H1N1, Seasonal Flu Preparedness Efforts--Grants Will Support Work to Protect Public Health, Prepare for H1N1 and Seasonal Flu

Secretary Sebelius today announced the availability of $350 million in grants to help states and territories prepare for the H1N1 flu virus and the fall flu season. The grants were funded by the recent supplemental appropriations bill that was passed by Congress and signed into law by the President on June 24, 2009.


Read more!

Public Emergency Declared Due to Spread of H1N1 Influenza Virus (Swine Flu)

HHS declared a public health emergency April 26th because a strain of the H1N1 Influenza Virus (swine flu) (H1N1) has been diagnosed in people in the United States, Mexico, Canada and elsewhere. In the U.S., the CDC has confirmed 3 deaths as a result of the H1N1 flu virus. View an interactive map of swine flu cases worldwide or a flu tracker. On April 29, the World Health Organization (WHO) raised the influenza pandemic alert from phase 4 to phase 5, meaning that a pandemic may be imminent.

HHS Secretary Sebelius announced April 30th that the federal government will purchase 13 million additional treatment courses to fight pandemic flu and is sending 400,000 treatment courses to Mexico to help slow the spread of the H1N1 flu virus. The Agency has approximately 50 million treatment courses in a Strategic National Stockpile and has released 11 million courses to the states to augment the 23 million treatment courses already in state stockpiles. Read an FDA Patient Fact Sheets on Relenza and Tamiflu. Sebelius and Homeland Security Secretary Napolitano also held a webcast on Thursday, April 29th to answer the public’s questions about the H1N1 flu virus.

CDC recommends taking the following steps to prevent the spread of swine flu:
• Avoid close contact with people who are sick or when you are sick.
• Stay home when you are sick.
• Cover your mouth and nose when coughing or sneezing.
• Clean your hands often.
• Avoid touching your eyes, nose or mouth.
• Practice other good health habits.

The CDC has released H1N1 Q&A, information on occupational health issues associated with H1N1 influenza virus and interim guidance. You can also follow the CDC on its Twitter site.

Visit ANCOR's Emergency Preparedness web page for more information about pandemic flu, emergency preparedness and disaster relief.

Additional resources for preparing for pandemic influenza include:
Ready.gov
American Red Cross
Long-Term Care and Residential Services Checklist
Individual and Family Planning and Checklist
Business Pandemic Flu Planning Checklist
State and Local Planning and Response Activities
State Pandemic Plans
U.S. Department of Health and Human Services
Centers for Disease Control and Prevention
Interagency Coordinating Council on Emergency Preparedness and Individuals with Disabilities
CDC Guidance on Protecting At-Risk Populations During a Pandemic

Related Articles:
State and Federal Governments Prepare for Possible Pandemic
Many States Do Not Meet Readiness Standards for Pandemic Flu

Read more!

ANCOR Urges CMS to Review Medicaid Requirements during a Pandemic Emergency

ANCOR sent a letter to CMS on April 30 highlighting challenges that could face providers in the event of a pandemic emergency and urging action to address these challenges.

In the letter, ANCOR outlined specific concerns and questions including:

• Reimbursement rates during hospital stays
• The prohibition against reimbursement for provider direct support staff/personal assistance for hospitalized individuals
• The financial burden to providers when multiple people supported by the same agency are hospitalized
• The possibility that individuals from ICFs/MR that are considered to be 24-hour health care facilities may be prohibited from being admitted to the hospital during a pandemic
• The lack of clear communication to providers from public health officials
• The need for greater in-home supports of community activities are suspended
• Vulnerable Population’s Access to and Coordination with Public Health Resources
  

ANCOR suggested that:

• CMS sponsor a nationwide webinar or conference call(s) that include providers regarding protection of Medicaid beneficiaries, guidance to providers, and CMS clarification, waiving, or suspension of any Medicaid programmatic and payment requirements.
  
• CMS’ State Medicaid and State Operations establish a public and website devoted to the H1N1 flu virus.
• CMS/CMSO include ANCOR in notice of and dissemination of any information forwarded to state Medicaid agencies, national and state MR/DD agencies, and national and state units on aging.
  

ANCOR will continue its dialog with CMS as this situation unfolds. If you have questions about pandemic flu or emergency preparedness, please forward them to Anne Fiala (afiala@ancor.org). Read more!