Archive for the ‘Health & Human Services’ Category

Anthrax Bioterrorism Modeling, an Analysis of Prepositioning Antibiotics and PODS, Part 2

Wednesday, February 29th, 2012

Author: An Interview with Dr. Sid Baccam, Senior Scientist – Computational Epidemiologist, IEM

Our continued conversation with Dr. Sid Baccam addresses his basis for determining incubation periods for anthrax and the benefits and challenges of prepositioning antibiotics versus the benefits and challenges of Points of Dispensing (POD) access. If you missed the first part of the interview, click here.

Since there has never been a widespread anthrax attack, what did you use as a basis for determining incubation periods for anthrax? Besides the 2001 attacks, the only other real widespread anthrax event took place in Sverdlovsk, Russia in 1979. At that time, the Russians weren’t forthcoming with information about the event. Later, a team of American researchers went into Russia to investigate. They found out that it was an aerosol release of anthrax spores from a bio-weapons facility. It took a couple of years to get the data on incubation period and mortality rates. But there are many caveats that come with that because it was 12-13 years after the event and it is unclear whether we got all the data. No one is walking into this with blinders on thinking this is perfect data that has been compiled on incubation periods for anthrax. (more…)

Anthrax Bioterrorism Modeling, an Analysis of Prepositioning Antibiotics and PODS (Points of Dispensing)

Thursday, February 23rd, 2012

Author:  An Interview with Dr. Sid Baccam, Senior Scientist – Computational Epidemiologist, IEM

anthrax virusIEM Computational Epidemiologist Dr. Sid Baccam has been working with the Department of Health and Human Services for the past 9 years developing models to analyze response to bioterrorism attacks involving anthrax or other bioterrorism agents. Dr. Baccam has been specifically focused on post-exposure prophylaxis (PEP) dispensing logistics and its impact on medical consequences. The results of his work were recently cited in a National Academy of Sciences (NAS)/Institute of Medicine (IOM) report that analyzed strategies for prepositioning antibiotics to improve response to a terrorist attack involving anthrax.

We sat down with Dr. Baccam to gain a deeper understanding of his work with anthrax and bioterrorism response planning.

What is the nature of the modeling and simulation work that you are doing for HHS?

We’ve been working with HHS since 2003, helping them and answer two basic questions—how many people could possibly become sick or die from different biological attacks and what types of medical intervention strategies can we employ to help mitigate the impacts of biological attacks. We build models and simulations to help senior decision makers better understand how a biological attack may play out depending on different response policies. We combine a lot of information in our models, from infectious doses required to cause infection in people, to how the diseases may progress in the presence or absence of medical interventions, and the speed of the public health response, so we can show decision makers the potential consequences.

It’s very hard for people to conceptualize all the moving parts and to know how different factors affect the outcome – that’s where our models are the most beneficial. (more…)

A Modeler’s Review of ‘Contagion’

Wednesday, September 28th, 2011

Author: Mike Boechler, Director, Research & Development Programs, IEM

Would descent into anarchy and selfishness be our reaction to an event like the one portrayed in the movie Contagion? Or would we pull together and become more altruistic in the face of such a massive catastrophe?

And that, too, is natural enough. In fact, it comes to this: nobody is capable of really thinking about anyone, even in the worst calamity.

Until now I always felt a stranger in this town, and that I’d no concern with you people. But now that I’ve seen what I have seen, I know that I belong here whether I want it or not. This business is everybody’s business.

Albert Camus: The Plague

We’ve been modeling infectious disease outbreaks at IEM for more than a decade now, so when Contagion was released, I was most interested in seeing how this type of disaster scenario would be portrayed on the big screen. Fairly reasonably, as it turns out.

Spontaneous adaptation to the outbreak, such as social distancing and isolation is shown in the film, as is selfishness, murder, and the breakdown of law and order. The film is an ambitious attempt to portray a scenario that could indeed happen one day. But how people would react to an event like this is unknown, since such an outbreak is unprecedented in recent history, and humans are quite unpredictable, to say the least.

The aspects of the Contagion story that are perhaps the most unsettling are its high mortality rate, its rapid spread, and the mundane origin of the virus. The Contagion pathogen appears to be based on a mix of animal reservoirs of diseases such as influenza and Ebola, and spreads like SARS. The Contagion scenario is a perfect storm.

Deadly contagious pathogens are constantly evolving and moving among species as their host defenses allow, and as humans continue to colonize previously undisturbed ecosystems the opportunity for these novel diseases to invade our populations increases. Exacerbating this problem is the fact that in our globalized economy we now move so rapidly and frequently around the planet that any such invasion could spread quite rapidly among many regions and emerge almost simultaneously- like hundreds of separate fires that erupt across a city, more or less at once, overwhelming the fire departments.

I continued this conversation with the Durham Herald-Sun, and their reporter asked similar questions about how prepared are we to deal with a Contagion scenario. (Read interview).

Part II – Bioterrorism planning study focuses on traffic and public access to points of dispensing (PODs)

Wednesday, July 6th, 2011

Attached is Part II of a video interview with IEM’s Dr. Sid Baccam, primary author of “Mass Prophylaxis Dispensing Concerns: Traffic and Public Access to PODs” which was published in the June issue of Biosecurity and Bioterrorism. To see the first part of the interview, see Bioterrorism planning study, part 1

To read the full paper, Mass Prophylaxis Dispensing Concerns: Traffic and Public Access to PODs. See more information on IEM’s capabilities and expertise in healthcare emergency preparedness.

Bioterrorism planning study focuses on traffic and public access to points of dispensing (PODs)

Tuesday, June 28th, 2011

Author: Dr. Sid Baccam, Senior Scientist – Computational Epidemiologist, IEM

IEM scientists, led by Computational Epidemiologist Dr. Sid Baccam, published a paper in the June issue of the journal Biosecurity and Bioterrorism entitled “Mass Prophylaxis Dispensing Concerns: Traffic and Public Access to PODs.” Points of Dispensing, or PODs, are used by emergency responders to quickly dispense post-exposure prophylaxis (PEP) to the public following a bioterrorism event. Any failure in PEP dispensing could have serious public health consequences, which is why IEM has focused study efforts on issues related to POD access. The project described in the paper was partially funded by the US Department of Health and Human Services (HHS) as part of a larger study on PEP dispensing logistics and medical consequences.

Below is a video interview with the lead author of the paper, Dr. Sid Baccam.

 
(more…)

Japan’s radioactive worry: Is a pill for our prevention equal to a pound of cure?

Friday, March 18th, 2011

Author: Debbie Kim APRN, MSN, Sr. Health Care System Analyst, IEM

Once again, the evening news has me scratching my head and wondering if it is time to call my healthcare provider to secure a prescription for Potassium Iodide or even Prussian Blue?  As a nurse and healthsystem analyst, I want to protect my family.  But wait!  I have a shellfish allergy, and one television medical expert said that I might not be able to take Potassium Iodide at all.  Are the drugs safe for all my family members? What about my dog, Oscar?  Time to revisit some facts.

There are several pharmacological agents that are being mentioned as being important to limit the effects of internal contamination from radioactive materials. Standard planning and response activity around a nuclear reactor includes a variety of activities, including issuing Potassium Iodide (KI) to those individuals who may have been exposed  to Iodine 131 (I-131). Another drug, Prussian blue, is a “chelating” agent that can remove radioactive materials from the body by binding with them.  Prussian blue is effective for treating exposure to Cesium and Thallium. Cesium-137 (Cs-137) has been detected from the smoke coming out of the Fukushima nuclear power plant in Japan.  (Prussian blue is also a paint color well known to artists, but medical Prussian blue is formulated differently – so please don’t eat the paint!)  A third drug, Diethylenetriamene pentaacetate (DTPA), is also a chelating agent. DTPA is approved by the Food and Drug Administration (FDA) for chelation of Plutonium, Americium and Curium. None of these radioisotopes (Plutonium, Americium or Curium) have been associated with the nuclear reactor fires in Japan. (more…)

Nuclear Terminology: Getting It Right, Part II

Tuesday, March 15th, 2011

Author: Debbie Kim APRN, MSN, Sr. Health Care System Analyst, IEM

This morning on National Public Radio, I heard reports of the third reactor fire in Japan, and a fire now in a storage area. They are reporting an hourly release of radiation into the environment. To follow up on Gary Scronce’s previous blog post (Nuclear Terminology: Getting it Right), I wanted to discuss radiation measurement. The CDC Radiation Emergencies website explains it all very clearly. As Gary wrote, there is a difference between emitted radiation and absorbed radiation dose. To measure both, a sensor needs to be in place to provide that measurement. As a nurse, part of what I have always done is to teach patients and their families about treatments and their effects.

Just to make things more confusing there are different naming conventions for describing radiation that is emitted into the environment—radiation dose and radiation risk. There are “conventional units” (or terminology) that some of us old-timers remember such as the Curie (Ci), rad and rem. Then there is the newer System Internationale (SI) that uses the terms becquerel (Bq), gray (Gy) and sievert (Sv). Reporters have been using both versions of the terminology to describe the events surrounding the fires around the reactor site in Japan. (more…)

Nurses as Emergency Managers Prepping for Any Disaster

Wednesday, June 23rd, 2010

Note: This article is the third in a periodic series of online articles focusing on emergency management and how its principles can be incorporated into nursing practice. Full articles appear on http://nursing.advanceweb.com

There are a lot of views on how to begin the preparedness process. There are even more on how to do a “proper” risk assessment. People go through multiple years of post graduate training and can receive a PhD in risk management and assessment. So, how can a nurse in the field possibly use risk assessment without an advance degree on the topic? That’s what this article is designed to tell them. So, if you want a down and dirty review on risk assessment and how it applies to the medical field, this is the article for you!

See Full Prepping for Any Disaster article

Defining and Developing Leadership in Healthcare Emergency Management

Thursday, June 10th, 2010

Author: Erin Downey MPH, ScD, Senior Health Systems Analyst, IEM 

The word ‘leadership’ is used liberally. We see it used in reference to managers, directors, and decision-makers, and its meaning is frequently “person in charge” or “person responsible.” In healthcare emergency management – and particularly when a disaster occurs that has tested a community’s response system – scrutiny of the response begins with evaluating the leadership of the affected community. Any perceived leadership strengths or weaknesses will be immediately and severely criticized in the media. Action documentation will use ‘leadership’ in the sense of the word described above; rarely, however, do we see language consistently associated with this kind of leadership in healthcare emergency management and more often than not we see contradictions in how the term is defined[i]. 

But we know it when we experience it. 

Fortunately leadership theory provides definitions of leadership and allows us to identify behavioral characteristics—associated with task effectiveness—to aid our use of the term[ii]. Many of these characteristics transcend fields, cultures, gender, organizational structure, and national boundaries. This allows emergency healthcare management professionals to examine leadership, via observation of individual leadership style, as we would in other industries, e.g., banking, oil exploration, mining.  (more…)

An Unorthodox Nursing Career

Wednesday, May 12th, 2010

Author: Chris Hiles, MS, BSN, RN, Emergency Manager, IEM

After graduating last year with my Master’s degree, I figured it was time for me to continue my quest to bring emergency management to the nursing masses. Advance for Nurses is a regional magazine that takes unsolicited article submissions. I figured the worse they could say is “no” and was surprised when they embraced the idea of a series of articles on emergency management from a nurse’s perspective. This article about emergency management preparedness in nursing was designed to set the tone for the series, explain my credentials, and show that I really am a nurse who engages in emergency management rather than an emergency manager who used to be a nurse. See full emergency management in nursing article.