October 3, 2017
Eric Toner, MD

The horrific mass shooting in Las Vegas on October 1, 2017 has resulted in nearly 60 deaths and more than 500 injuries at the time of this writing. The injured have been transported to a number of hospitals around Las Vegas and have overwhelmed some of the hospitals closest to the scene. A number of the injured  are in critical condition and hence the death toll is likely to rise. Among other issues, this tragedy illustrates the overlap between trauma systems and hospital disaster preparedness.

Public Health & Healthcare Preparedness

Why the CDC Wants In On Blockchain.
For the past several months, Jim Nasr, chief software architect at the CDC's Center for Surveillance Epidemiology, and Laboratory Services, has led a team working on several proofs of concept based on blockchain technology, with an eye toward building real applications next year. Most are geared toward better public health surveillance, which could include using a blockchain to more efficiently manage data during a crisis or to better track opioid abuse. (MIT Technology Review, 10/2/17)


9 Million Kids Get Health Insurance Under CHIP. Congress Just Let it Expire.
If action is not taken soon to restore the funding, the effects will become obvious in schools across the country, with many of the children in the program unable to see a doctor for routine checkups, immunizations, visits when sick and other services.  (Washington Post, 10/1/17)
Tom Price Resigns Over Private Jet Scandal.
Price in recent days had elicited bipartisan outrage over the cost of his air travel. Politico has reported that Price has cost taxpayers more than $1 million between his use of private planes for domestic travel and military jets for recent trips to Africa, Europe, and Asia.  (Business Insider, 9/29/17)

US Pulls Staff from Cuba Over "Specific Attacks."
The US is withdrawing more than half of its staff at its embassy in Cuba in response to mysterious attacks which left its diplomats unwell.  (BBC, 9/29/17)
Snapshot: Trump Administration's Cuts to Navigator Funding.
 The Trump administration recently announced that it would cut funding by 40% for organizations that provide in-person assistance to Americans looking to sign up for coverage, known as the navigator program. The community-based organizations that sign on to be navigators focus on underserved areas or more vulnerable populations
(Medium, 9/29/17)

See also:
CDC Is Deactivating the Emergency Operations Center for the Zika Response.
A team of experts from across the agency, called the Zika Coordination and Operations Transition Team, will lead the transition from EOC activation to routine, long-term activities and will ensure timely coordination and collaboration on scientific, communication, and policy activities.  (CDC, 9/29/17)
US Invests $170 Million in Late-Stage Ebola Vaccines, Drugs.
The Biomedical Advanced Research and Development Authority said on Friday it would buy the drugs and vaccines and keep them in a national stockpile, which would be used to protect Americans in the event of an outbreak of the deadly disease.  (Reuters, 9/29/17)
Congress to Question USAID Over $9.5 Billion Health Project "Fiasco."
Rep. Chris Smith, a Republican from New Jersey, told Devex he is concerned that Chemonics is "mismanaging" the project -- describing it as an "apparent fiasco" -- and he said he wants to learn more about USAID's selection of the contractor as its implementing partner for a project that supports the US government's largest global health initiatives.  (Devex, 9/29/17)
Influenza Vaccination Coverage Among Health Care Personnel -- United States, 2016-17 Influenza Season.
The Advisory Committee on Immunization Practices (ACIP) recommends that all health care personnel (HCP) receive an annual influenza vaccination to reduce influenza-related morbidity and mortality among HCP and their patients and to reduce absenteeism among HCP.  (CDC, 9/29/17)

HHS Boosts Post-Hurricane Maria Medical Surge into US Territories.
More than 500 US Department of Health and Human Services personnel are engaged in today in Puerto Rico and the US Virgin Islands to address residents' medical and public health needs as part of the Trump Administration's government-wide response to the devastation caused by Hurricanes Irma and Maria.  (Department of Health & Human Services, 9/28/17)

See also:
Bavarian Nordic Wins Up-to-$539M BARDA Contract for Smallpox Vaccine.
Bavarian Nordic has won an up-to-$539 million contract from the Biomedical Advanced Research and Development Authority (BARDA) to supply its freeze-dried ImvamuneĀ® smallpox vaccine for the U.S. Strategic National Stockpile.  (Genetic Engineering & Biotechnology News, 9/28/17)
New Study Shows Tdap Vaccination During Pregnancy Can Prevent Whooping Cough in Babies.
CDC recommends women get Tdap during each pregnancy to provide critical short-term protection to babies when they are most at risk for this life-threatening illness.  (CDC, 9/28/17)

Optimistic in the Face of Ongoing Tragedy: Progress toward a World Free of Human Rabies.
Rabies is a fatal disease that kills an estimated 59,000 people each year, almost half of whom are children. The majority of deaths occur in Africa and Asia. All of these deaths are vaccine-preventable with timely administration of post-exposure prophylaxis (PEP), the shots needed to prevent rabies from developing in bite victims.  (CDC, 9/28/17)
New Software Tracks Health of Emergency Responders.
The freely available software can be used by anyone involved in the preparedness and protection of emergency responders, including: incident command staff, response organization leadership, health, safety and medical personnel, and emergency responders.  (CDC, 9/28/17)
NIH Wants to Develop a Zika Vaccine, Hopes Never to Use It.
The National Institutes of Health continues to test an experimental vaccine that could prevent the mosquito-borne virus linked to serious birth defects, Anthony S. Fauci said during a policy forum on examining modern medicine.  (Bloomberg BNA, 9/28/17)
Maryland Lawmakers Move to Block Frederick Biolab Shutdown.
Rep. John Delaney, D-Potomac, along with Maryland Democratic Sens. Ben Cardin and Chris Van Hollen successfully added amendments to a defense authorization bill to prevent the center from being immediately shut down.  (Southern Maryland Online, 9/27/17)
HHS Leverages Potential Respiratory Drug as Chemical Weapon Antidote.
A potential antidote to treat the life-threatening effects of inhaled chlorine gas, a national security threat, will receive drug development support under a contract between the Biomedical Advanced Research and Development Authority (BARDA), a component of the HHS Office of the Assistant Secretary for Preparedness and Response (ASPR), and GSK, one of the world's leading research-based pharmaceutical and healthcare companies.  (ASPR, 9/27/17)
HHS Advances Point-of-Care Diagnostic Test for Anthrax.
A point-of-care diagnostic test that may be able to determine within 15 minutes whether a patient has been infected with the bacterium that causes anthrax is moving forward in research and development with the support of the US Department of Health and Human Services' Office of the Assistant Secretary for Preparedness and Response.  (Department of Health & Human Services, 9/26/17)
Chemical and Biological Attacks: Underground Transport Restoration Project.
A critical aspect of cleaning up chemical and biological warfare agents is figuring out what the contaminant is and how far it has spread. Sandia National Laboratories' engineer Bob Knowlton has worked on this challenge for a dozen years. His team has developed scientific sampling methods to determine the extent and nature of the contamination.  (Global Biodefense, 9/25/17)
Rapid Assessment Tools for Responders to Address Needs of Individuals Experiencing Homelessness during Disasters.
Natural disasters and emergencies - such as hurricanes, flooding and other extreme weather conditions - create challenges and significantly impact communities. The recent destruction and devastation caused by this year's hurricanes highlight concerns for the addressing the disaster needs of impacted populations.  (ASPR, 9/19/17)
CRADA Opportunity for Evaluating Influenza Vaccines and Therapeutics in an Influenza A Healthy Volunteer Challenge Model.
The NIAID seeks to enter into a Cooperative Research and Development Agreement (CRADA) with one or more biotechnology or biomedical companies to use the Influenza A Healthy Volunteer Challenge Model developed by NIAID for the purposes of developing new influenza drug treatments or vaccines.  (FedBizOpps.gov, 9/17)
BARDA Industry Day.
BARDA invites you to participate in our annual conference at which you can learn about US Government medical countermeasure requirements, interact with BARDA and AMCG staff, and network with private sector colleagues working in this space.  (MedicalCountermeasures.gov, 9/17)

Homeland Security & Disaster Preparedness
Homeland Security: No Credible Threat Against Other Public Venues.
The Department of Homeland Security said Monday that Acting Secretary Elaine Duke has been briefed on the Las Vegas shooting and the department knows of no "credible threat" to "other public venues" in the United States at this time.  (The Hill, 10/2/17)

See also: 
DoD Boosts Personnel Aiding Hurricane Relief Efforts in Puerto Rico.
The number of DoD personnel deployed to help their fellow citizens in Puerto Rico jumped from around 4,600 to around 6,400 members, Gov. Ricardo Rossello said during a San Juan news conference today.  (Department of Defense, 10/1/17)
FEMA Rethinking Policy that Bans Churches from Disaster Aid.
Federal disaster-relief officials say they're "considering making changes" to a policy banning churches, synagogues and mosques from receiving rebuilding aid that's routinely given to other non-profits, such as zoos and museums.  (Bloomberg, 9/29/17)
An Absent EPA Climate Report, and a Tale of Two Flooded Superfund Sites.
Hurricane Harvey flooded more than a dozen Superfund toxic waste sites when it devastated the Texas coast in late August. An EPA report predicted the possibility of climate-related problems at toxic waste sites like those in Texas, but the page detailing the report on the agency's website was made inactive months before the storm.  (NPR, 9/29/17)
Trump Tweets About "Amazing" FEMA Response in Puerto Rico but Locals Say "Still Waiting" for Aid.
Residents of Puerto Rico and outside observers have taken the government to task for what they see as delayed or insufficient action after Maria, the strongest hurricane to hit the island in nearly 90 years.  (ABC News, 9/28/17)

See also: 
Trump Waives Jones Act for Puerto Rico, Easing Hurricane Aid Shipments.
The waiver of the law, known as the Jones Act, comes as federal and local officials report more supplies trickling onto the increasingly desperate island. But the Trump administration remains under pressure to step up the recovery effort.  (New York Times, 9/28/17)

Defense Bill Requires Declassification of Toxic Releases.
In an unusual assertion of congressional authority over national security classification policy, the Senate adopted a provision that would require the Secretary of Defense to declassify certain classified documents regarding military exposures to toxic releases.  (Federation of American Scientists, 9/28/17)
National Flood Insurance Program Borrowing Authority.
This Insight evaluates the National Flood Insurance Program (NFIP) borrowing authority to receive loans from the US Department of the Treasury (Treasury), particularly in the context of major floods, and discusses the current financial situation of the NFIP as it begins to pay claims from Hurricanes Harvey and Irma.  (Congressional Research Service, 9/22/17)
This Obscure DC-Area Office Helps US Special Operators Hunt Down and Secure Loose WMDs.
Coordinating the Pentagon's strategy to combat the spread of weapons of mass destruction, which is essentially equal arms control and direct action, is a complicated and multi-faceted mission.  (The Drive, 9/21/17)
Hurricanes and Electricity Infrastructure Hardening.
This Insight discusses the measures undertaken by electric utilities to prevent or mitigate power outages resulting from severe weather events. Power lines and transformers used to provide electricity to customers are particularly susceptible to damage due to their exposure to the elements.  (Congressional Research Service, 9/20/17)

Radiological & Nuclear Disaster Preparedness
NRC Seeks Comments on Draft FY 2018-2022 Strategic Plan.
The draft establishes a framework for the next four years for the NRC to achieve its mission to license and regulate the nation's civilian use of radioactive materials to provide reasonable assurance of adequate protection of public health and safety, and to promote the common defense and security.  (NRC, 9/27/17)

Science & Technology Policy
Social Media is "First Tool" of 21st-Century Warfare, US Lawmaker Says.
 Senator Mark D. Warner (D-VA) 
believes Russia's use of social media to influence last year's election demonstrated how warfare has moved away from the battlefield and toward the internet.  (DefenseOne, 9/29/17)
National Science Foundation: Actions Needed to Improve Oversight of Indirect Costs for Research.
 GAO f
ound that NSF does not consistently take steps to ensure it pays no more than its fair share of indirect costs, which could unnecessarily limit the amount of funds available for research.  (GAO, 9/28/17)
Advancement of Emerging Technology Applications for Pharmaceutical Innovation and Modernization: Guidance for Industry.
This guidance provides recommendations to pharmaceutical companies interested in participating in a program involving the submission of chemistry, manufacturing, and controls information containing emerging technology to FDA.  (FDA, 9/17)
This Week's Hearings

Examining Patient Access to Investigational Drugs. US House Committee on Energy & Commerce, Subcommittee on Health. 10/3/17, 10:15 AM. Rayburn 2322. More


The Federal Response to the Opioid Crisis. US Senate Committee on Health, Education, Labor & Pensions. 10/5/17, 10 AM. Dirksen 430. More


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