Electronics makes it command center in emergency

By MICHAELANGELO CONTE – JOURNAL STAFF WRITER

Hudson County has unveiled a new $725,000 Emergency Management Communications and Command Vehicle, loaded with high-tech electronic equipment for coordinating municipal and state agencies during disasters and police and fire emergencies.

“By allowing us to quickly establish a unified command system, this new vehicle will allow our first responders to make faster real-time decisions – and that will save lives,” Hudson County Executive Thomas DeGise said.

The 40-foot vehicle is the first of its kind in the state, county officials said.

The mobile command center is equipped with 17 public safety radio transceivers, ham, marine and air-band radios, cellular, landline and Internet telephone capabilities. It has five communications consoles capable of controlling all radio and telephone functions from any of the seven workstations.

It is also equipped with satellite network and broadband capabilities, an onboard computer server networked with eight laptop computers, a video helicopter downlink system, onboard weather station, a 30-foot telescoping mast mounted with a camera, six monitors and numerous audio-video recording devices.

It has three slide-out sections for use expanding its width to 13 feet, allowing the enlargement of the mid-ship communications and rear conference room areas. It is fully self-sustaining with two onboard diesel generators that can power the entire vehicle.

The vehicle was paid for by state and federal grants, county officials said.

Florida has launched an Internet-based system that will help facilitate the flow of information between health care facilities and state officials during disasters, the Palm Beach Post reports.

The Emergency Status System, which was unveiled Tuesday at a meeting at Memorial Regional Hospital in Hollywood, Fla., is designed to help the Florida Agency for Health Care Administration collect information and deliver resources to health care facilities during hurricanes and other emergencies.

As part of the system, providers must report their emergency contact information, as well as details about their emergency generator and power and water supplies. When a hurricane is reported, health care organizations also will provide information about their evacuation status, number of patients and available beds, as well as information about the number of patients who have special needs, including those who require electronic ventilators or dialysis.

Once a storm hits, organizations will report any structural damage. Health care facilities also will provide information about their power supplies and request assistance from local emergency officials.

The online system will replace a telephone-based system that was faulty because lines often went out during emergencies (Galewitz, Palm Beach Post, 5/31).

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HOLLYWOOD — Trying to improve its response to the state’s health industry after a hurricane, Florida has set up an Internet-based system that allows hospitals, nursing homes and other health facilities to stay in contact with state officials to report their condition and seek help if needed.

The new Emergency Status System will help the Florida Agency for Health Care Administration more quickly collect information and assist health facilities when power and phone service are interrupted by hurricanes and other disasters.

“This new system helps us help you,” Agency Secretary Alan Levine told about 75 South Florida health-care officials Tuesday at a meeting at Memorial Regional Hospital.

Levine debuted the new Internet-based emergency system at the meeting, calling it a “model for the nation.”

Palm Beach and Broward counties’ health facilities faced numerous problems following Hurricane Wilma last October. Some hospitals’ generators failed. Nursing homes went without air conditioning for more than a week, and many dialysis centers closed because they didn’t have a generator or water.

Before the threat of a hurricane, health-care facilities would use the new online emergency system to disclose their emergency contact information, details about their emergency generator and information about their power and water supplier.

When a hurricane is threatening, facilities would disclose evacuation status, number of patients in the facility and the number of available beds.

The facility also would disclose how many patients it has with special needs, such as those dependent on a mechanical ventilator or dialysis.

After a storm hits, the system would be used by health facilities to disclose their power status and give an update on any structural damage. Facilities also could use the system to request help that local emergency officials cannot provide.

If health-care providers can’t get Internet access, they can use phone lines or relay information through state officials in county emergency operations centers, Levine said.

The Internet-based system will replace a totally phone-based system that the agency had used in prior years, but was challenged because of inoperable phone lines and difficulty updating the data quickly.

At this point, more people have access to the Internet than phone lines.

Levine stressed the new system is not meant to replace the need for local health facilities to have their own hurricane plan and a system to resolve issues at the city or county level.

“Our state plan fails if you fail locally,” Levine said. “We are relying on you to help each other.”

TOLEDO, Ohio – Dr. Paul Rega, ProMedica Air flight physician, Bay Park Community Hospital emergency medicine physician and national and international disaster preparedness speaker talks about “Chemical Terrorism: Nerve Agents and Cyanide – Manifestations and Management.” Spring Trauma Update, ProMedica Health System, Trauma Services, Toledo, Ohio. May 12, 2006

This is a fairly lengthy video post – about an hour.

About Dr. Paul Rega

Dr. Paul Rega, MD, FACEP, is board-certified in both emergency medicine and pediatric emergency medicine. Dr. Rega has been with ProMedica Health System in Toledo, Ohio, for more than 20 years. He’s currently working as a flight physician with ProMedica Air (air ambulance) and as an emergency medicine physician. Dr. Rega is an international speaker on the topics of disasters and terrorism preparation, speaking in Taiwan, Scotland, Chicago and Florida. Dr. Rega is the president of MASCAP, a company that Rega founded to create, develop and sell disaster management products. Dr. Rega is a member of the Regional Medical Response System for northwest Ohio. He also founded OH-1 DMAT (Disaster Medical Assistance Team). He has since retired. OH-1 DMAT has been deployed to Florida after Hurricane Andrew, New York City after 9/11 and Guam after the recent typhoon (just to name a few). As part of his preparation as a DMAT leader, Dr. Rega became interested in biological terrorism. He created Bio-Terry: A Stat Manual to Identify and Treat Diseases of Biological Terrorism. The manual has been translated into German and is currently being sold in Germany and Austria. Rega now works with Medical University of Ohio on disaster and terrorism preparedness.

Podcast: Play in new window | Download

On May 31, 1889, more than 2,000 people

perished when a dam break sent

water rushing through Johnstown, Pa.

June 1 is the start of another hurricane season.  It promises to be a busy one according to certain scientists, pundits, and aficionados.  As if Katrina wasn’t enough of a message to be prepared, some states and preparedness agencies are still trying to encourage civilians to get ready.  Let’s see what they’re doing:

1) Cities are circulating home preparedness checklists.

2) Holding hurricane exhibitions in malls.

3) Offering free home inspections.

4) Tax-free storm supplies.

5)  The Florida Division of Emergency Management is broadcasting public service announcements with recordings of 911 calls placed during Hurricane Ivan in 2004.  One recording is of a woman in distress: “The roof has completely caved in on us,” a woman cries as chilling music swells, only to be told that rescuers cannot come out during the storm.

6)  Mississippi unrolled a “Stay Alert. Stay Alive.” hurricane awareness campaign in April.  It also gave citizens instructions on the development of a “go-kit” for evacuating (flashlight, radio, nonelectric can opener) and, like many others, commanded them to stockpile at least three days’ worth of water and food.

7)  In Florida, the second annual tax holiday on hurricane supplies, from May 21 through June 1, took place.

8)  Hattiesburg, Miss., is buying $4 million worth of generators for its public buildings and water system.

9)  Broward County, Fla., bought a $500,000 command post vehicle to shuttle emergency managers among crisis spots.

10)  Escambia County, Fla., is publishing weekly shopping lists to try to get residents to stock up little by little.

You’d think that Katrina would’ve been enough to shake the complaceny of shore-line Americans down south, but a poll by Mason-Dixon Polling and Research Inc. found that of 1,100 adults along the Atlantic and Gulf Coasts, 83 percent had taken no steps to fortify their homes this year, 68 percent had no hurricane survival kits and 60 percent had no family disaster plan.  For example, in Houston, a spokesman for the city’s emergency center, said only 1,000 people with special needs had registered for public transportation to pick them up in an evacuation. hOwever, during Hurricane Rita, 25,000 such residents needed evacuation.  Go figure!!

Source:  NY Times, May 31, 2006

HHS last week asked for public input on a recommendation from the White House report on Hurricane Katrina that calls for the acceleration of a project to create an electronic health record network, the Lakeland Ledger reports.

The report, which was released in February, includes recommendations for the government to spur ongoing efforts to promote EHRs. In addition, the report calls for an online “vault” where people can voluntarily store their private medical records, the Ledger reports.

Government officials say electronically storing data could help victims of a natural disaster or terrorist attack while also saving billions of dollars in health care costs and improving care delivery. However, privacy advocates argue that too much attention is on the rewards of EHRs rather than the risks, the Ledger reports.

Rep. Cliff Stearns (R-Fla.), chair of the consumer protection subcommittee, is sponsoring a data security bill and said he hopes security issues become more urgent following reports that a laptop with veterans’ records was stolen from a Veterans Affairs employee who took it home.

Daniel Dodgen, who is responsible for HHS’ response to the White House report, said the department’s request for public input was “to see what’s happening in the private sector,” and he added that “depending on what kind of response we get, that would make it clear what our next steps might be” (Reiss, Lakeland Ledger, 5/30).

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Katrina Prompts Next Debate: Digital Records vs. Privacy

By Cory Reiss – Ledger Washington Bureau

WASHINGTON — Hurricane Katrina looms in the minds of disaster officials facing a hurricane season that starts Thursday, partly because of the havoc it wreaked on the vital records of thousands on the Gulf coast.

Now the Bush administration sees the Internet as a virtual refuge from the storms.

Katrina destroyed vast quantities of personal documents, including hospital records, adding to the woes of many victims. In response, the Department of Health and Human Services last week asked for public input on the practical, financial, regulatory and privacy issues surrounding the business of digitizing American lives.

The government has begun to wrestle with deep issues about a burgeoning industry that puts a person’s entire history — birth certificate, family photos, wills, medical records — in computers accessible over the Internet. The White House wants to encourage that.

Americans have become accustomed to shopping, trading and banking online. But critics of data security laws worry the trend is moving too far and too fast.

The disclosure last week that a government computer had been stolen containing private data on 26 million veterans, which prompted an uproar on Capitol Hill, spotlighted those concerns.

“None of us,” said Beth Givens, director of the Privacy Rights Clearinghouse, “whether we’re veterans or not, can be assured that our sensitive personal data are secure.”

Awareness of electronic privacy and identity theft is at a pitch. Two committees in the House were in open warfare last week about digital security legislation, and the government is wrestling with recent disclosures about federal investigators collecting domestic telephone records.

But practicalities, like hurricanes, are pressing. Government officials say electronic storage could bail out people if their lives are wrecked by a natural disaster or terrorist attack.

Some consumer advocates say the trends are inevitable, but they argue security guarantees are woefully behind.

Rep. Cliff Stearns, a Florida Republican who chairs the consumer protection subcommittee and is pushing a data security bill in the House, said he hopes the issue is more urgent in the wake of disclosures that veterans’ records were stolen from an employee of the Department of Veterans Affairs who took them home on a laptop. Congressional panels held two emergency hearings on the matter last week.

“This whole thing becomes a tipping point,” Stearns said of the escalating reliance of government and society on digital personal records, “where unless there’s privacy this thing will just become out of control.”

The Energy and Commerce Committee, which has passed Stearns’ security bill, is in a battle with the Financial Services Committee, which has passed rival legislation. Consumer groups prefer the Stearns bill while industries such as data brokers and banks prefer the alternative. Both panels are jockeying for the Republican leadership to move their version to the floor.

A key issue is the circumstances that would require a private company to tell consumers their personal data has been breached.

How these debates will wind up affecting businesses such as Arkiva, an Internet venture based in Florida, is not clear. Bruce Roberson and a partner created Arkiva in October in response to the devastation Hurricane Katrina wrought on property and personal records.

For a fee, the company will send a photographer to a person’s home to take pictures of every room, for insurance purposes, as well as of every vital record that defines a person.

Arkiva, of Coral Springs, is among a growing number of companies offering personal data “vaults” accessible over the Internet.

The query by Health and Human Services could spark debate about oversight as well.

In February, a White House panel made a slew of recommendations for better preparedness and response to disasters like Katrina. Among them were recommendations that the government speed an ongoing effort to create digital medical records that could be shared among doctors and hospitals, and work with the private sector to promote online vaults where people can voluntarily store their private records.

Daniel Dodgen, who is responsible for the department’s response to the White House report, said the department’s request for public input does not necessarily mean the agency will do anything to help the businesses or the consumers who use them.

“Our plan is to see what’s happening in the private sector,” he said, “and depending on what kind of response we get, that would make it clear what our next steps might be.”

Arkiva and other such companies say their data is fully encrypted and password protected. But consumer groups say there are no guarantees that hackers will always be thwarted.

“It’s problematic to put all this information on the Internet when we don’t have guarantees of privacy whatsoever,” said Ed Mierzwinski, director of the consumer program for the U.S. Public Interest Research Group.

The White House report on Katrina recommended accelerating a project to create a network of electronic health records that could save billions in health care costs and ease delivery.

Privacy advocates say too much attention is on the rewards and not enough on the risks.

The World Privacy Forum issued a report May 3 that said identity theft using medical records, for insurance fraud and other purposes, “is deeply entrenched in the health care system.”

What is chikungunya fever?
Chikungunya fever is a viral disease transmitted to humans by the bite of infected mosquitoes. Chikungunya virus (CHIKV) is a member of the genus Alphavirus, in the family Togaviridae. CHIKV was first isolated from the blood of a febrile patient in Tanzania in 1953, and has since been identified repeatedly in west, central and southern Africa and many areas of Asia, and has been cited as the cause of numerous human epidemics in those areas since that time. The virus circulates throughout much of Africa, with transmission thought to occur mainly between mosquitoes and monkeys.  

Background:  A while back, I posted several dispatches regarding a weird disease called Chikungunya (CHIK).  You can search it out.  Anyway, victims were concentrated in exotic lands, but there was always the potential that this disease could reach our country.  Well, it’s happened.  Not in the good old USA, but to our neighbor to the north.

Four imported cases of Chikungunya (CHIK) virus infection have been identified among Canadians travelling to offshore islands in the Indian Ocean of East Africa.  The 4 Canadian cases were from Quebec (1), Ontario (2), and Alberta (1) and their travel history included visits to the island of Reunion, Mauritius, and the Seychelles Islands during the month of February. 

Patients presented with a history of fever, rash, and ongoing arthralgias which are symptoms typical of CHIK infection.

Serological testing (hemagglutination inhibition) confirmed the presence of CHIK antibody in the patients’ sera. Imported cases of CHIK have been documented, outside the endemic Indian Ocean basin, in Europe (France, Switzerland, Germany and Belgium), Far-eastern Asia (China), and now North America (Canada).

WHO seeks data on avian flu treatment – By Andrew Jack in London

Three years after the human H5N1 flu virus outbreak began, the World Health Organisation lacks a comprehensive database of treatment and patient care.

Of the 218 confirmed cases of human H5N1 infections since 2003, 124 have died. But the WHO’s treatment information comprises only a handful of academic studies based on fewer than a third of all patients.

“There is a paucity of this information at the WHO which we are working to correct,” said Maria Cheng, a spokeswoman for the WHO. “The information that we have is probably best described as fragmentary.”

Greater details – on which drugs have been used, how long after the onset of symptoms and to what effect – would provide valuable extra information for doctors assessing how best to treat cases in future.

The WHO is drafting a questionnaire to gather more information from frontline health workers, but still needs approval from the officials and countries concerned.

Ms Cheng said a study funded by the US National Institutes of Health would begin this autumn in just three of the 10 countries affected by bird flu, and could take two years to complete.

The WHO, which has received extra finance in recent months amid rising concern about a human pandemic, says that, even though its network of staff incorporates most of the affected countries, its efforts to gather information have been hampered by factors such as a lack of funds.

In revised treatment guidelines issued this month, which drew principally on three academic studies covering about 70 H5N1 patients and earlier research focused on milder seasonal flu, the WHO made a “strong recommendation” for the use of Tamiflu and a “weak recommendation” for Relenza.

But little is known about the effectiveness of either drug in severe cases of human flu or of the H5N1 virus, about which experts are most concerned.

“It would certainly be worthwhile to try to get hold of all the data. But it is not easy to approach hospitals for access to clinical notes, gain permission and hope they contain sufficient information,” said Menno de Jong from the hospital for tropical diseases in Ho Chi Minh City in Vietnam.

Roche, the Swiss pharmaceutical company that manufactures Tamiflu, refers to just two academic papers, covering fewer than 20 treatment successes in Thailand and Vietnam, and to a conference presentation on 10 further cases in Turkey.

David Reddy, the executive responsible for the drug, said more data collection should be the next priority for the WHO, but “the clear focus, and the right one, is saving lives and preventing further infections”.

He stressed that Roche was working with the WHO and the NIH on future research but had difficulty in collecting data independently because of concerns about confidentiality.