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November 29, 2014

Posts in "Disease Control"

November 18, 2014

Spotlight: Ebola Preparedness, Nurse Vigils and Private Group Efforts in Africa

A House Energy and Commerce Committee panel this morning examines domestic health system preparedness for treating Ebola patients. The committee quizzes FDA Commissioner Tom Frieden, plus other HHS officials on readiness to handle patients with the Ebola virus. The session also features the chiefs of Texas and Nebraska hospitals that have treated Ebola patients.

At the same time this morning, a nurse advocacy group, which held a vigil at the White House last week to raise awareness about concerns of woeful health facility preparedness policies for health professionals, takes its case to steps of the headquarters of the Department of Labor’s Occupational Safety and Health Administration.

This afternoon, a House Foreign Affairs Committee panel hears the perspective of several private groups who have been providing health services to Ebola patients in West Africa. Witness at the hearing include representatives from International Medical Corps, Global Communities and Africare.







November 17, 2014

Week Ahead: Examining the U.S. Response to Ebola

Congress this week is busy negotiating options and a pathway toward a year-end spending package. However, a wide range of committees also catches up on reviews of U.S. activities and conditions in West Africa regarding the outbreak of the Ebola virus. A Senate committee on Wednesday is poised to advance a bill that adds Ebola drugs to an existing FDA priority drug review program. Additionally, a separate Senate committee mulls overall public health preparedness concerns with FDA Commissioner Thomas Frieden.

Meanwhile, two House Energy and Commerce panels review Ebola response efforts with Frieden and the status drug development activities with National Institute of Health officials. Another House panel this week discusses efforts by private groups battling the virus in West Africa.

November 14, 2014

Weekly Roundup: Emergency Ebola Funding Seeks a Spending Bill Home

Congress this week returned from the longest election recess break since 1960 and immediately began posturing on an upcoming spending bill and other possible available options for the lame duck session. A temporary extension of fiscal 2015 spending expires on Dec. 11. Congressional appropriators spent the week urging passage of a complete full-year spending package, which would include funding for health agencies and programs. Alternatively, some Republicans suggest a further spending bill extension, which would shift spending decisions into January.

The U.S. had no Ebola patients for only a few days this week. Following the release of a NY physician on Tuesday, a new patient from Sierra Leone arrives in Nebraska on Saturday. The administration’s emergency funding request for Ebola response activities, both in West Africa and domestic preparedness was examined on Wednesday in a Senate hearing (view Roll Call video). Separately, a House committee hearing on Thursday largely supported emergency funding to help the State Department respond to the Ebola outbreak in West Africa.

The biggest threat to the Ebola funding request appears to be if Congress resorts to a further extension of stopgap spending instead of a complete omnibus measure due to political pressures. In that case, a portion of the extra Ebola funding would likely be tacked onto a stopgap continuing resolution. However, the entire spending bill package is also threatened by possible Republican reaction to any White House action on immigration policies.

Meanwhile, a Senate committee this week set up a pathway for action on a measure (S 2917) adding Ebola drug research to an existing FDA drug development program. Action over the next few weeks is also possible on a bill (HR 5059) seeking to reduce veterans’ suicide rates. Also, the House on Thursday completed voting — and sent to the President — a bill renewing traumatic brain injury research programs (S 2539) and a measure urging the FDA to expedite the approval of sunscreen ingredients (S 2141).


November 10, 2014

Week Ahead: Committees Examine New Ebola Response Funding; Allows Exchange Plan Viewing Today

House and Senate committees this week return to examination of the U.S response to the Ebola virus outbreak in West Africa and a review of domestic public health preparedness plans. Senate appropriators on Wednesday afternoon seek details from Health and Human Services Secretary Sylvia Mathews Burwell and the HHS Ebola response duo of FDA Director Thomas Frieden and Anthony Fauci the director of National Institute of Allergy and Infectious Diseases, plus State and Homeland Security department officials. On Thursday the House Foreign Affairs Committee also examines international Ebola response efforts in West Africa.

The White House last week requested $6.18 billion in additional funding. The formal request includes $2.4 billion for Department of Health and Human Services agencies, with the bulk of funding directing toward Centers for Disease Control and Prevention efforts to respond to the outbreak and other infectious disease threats. The White House also seeks $2.1 billion for the U.S. Agency for International Development for humanitarian assistance; $157 million for the Biomedical Advanced Research and Development Agency to manufacture vaccines for clinical trials; and $112 million for the Defense Advanced Research Projects Agency research on the virus. Other funding will be held in a contingency fund pending further developments of the epidemic (view White House fact sheet). The funding is in addition to $88 million in CDC and drug development funds approved by Congress earlier this year and $750 million in reprogrammed Pentagon spending for a West African relief mission.

Also this week, the House Veterans Affairs Committee honors Veterans’ Day sentiments in a hearing on recently enacted legislation expanding veterans’ health care treatment options.

Separately, a new enrollment period for health insurance exchanges begins on Nov. 15 but you can see plan data online starting today. The Centers for Medicare and Medicaid Services says that early look at plan details will assist consumers prior to beginning the formal enrollment process.


November 7, 2014

Weekly Review: Election Shock and New Health Law Battles; Additional Ebola Response Funding Requested

The 2014 congressional mid-term elections this week vaulted Republicans into control of the Senate and bolstered GOP majorities in the House. The new Congress, which convenes in January, will press the White House on changes – including a possible an outright repeal — of the Affordable Care Act.

CQ Roll Call followed the election as results came in on Tuesday evening (view Roll Call election maps) and wrapped up the election in an election impact conference on Thursday (view C-SPAN video of election commentary and reporter roundtable discussion).

The newly reconfigured Congress will likely also pressure the administration on federal agency and health program spending priorities and policies. Additionally, a new Congress requires a restructuring of committees that can address health care issues. Separately, election results for state governorships signaled a likely delay in any further action on expanding the Medicaid program.

However, the old Congress returns starting next week to wrap-up remaining topics, primarily an extension of federal spending beyond the scheduled Dec. 11 expiration of funding for federal agencies. The White House requested that the spending bill, which likely will extend fiscal 2015 funding into the new year, include new emergency funding to bolster the U.S. response to the Ebola outbreak in West Africa and precautionary efforts to support domestic preparedness programs.

Meanwhile, the Supreme Court this week passed up on an opportunity to accept a legal challenge to health insurance subsidies offered to policies purchased on the federally operated insurance exchanges. Justices meet again today in a private conference and have another opportunity to consider accepting pending cases. Official notice of the decision – or no decision – will be officially posted on Monday morning. [Update: CQ Roll Call's Todd Ruger reports (subscription) that the court on Friday agreed to hear the health law subsidy challenge case. The White House said it is confident the court will agree that the intent of the law was to include subsidies in all states].


November 3, 2014

Google Tracks the Flu

Since 2008, Google has examined individual user web searches as a tool to gauge when and where influenza is striking in real time. The tool, Google Flu Trends, is designed to assist public officials to learn about outbreaks as soon as possible. A Google blog last week noted that the annual flu-tracking tool has undergone some refinements and now covers 29 countries.

Using Internet searches to track the influenza outbreaks poses fewer privacy concerns than a separate effort to track the Ebola virus in West Africa by using cell phone data. Healthopolis noted earlier this month that cell phone data tracking on Ebola is hindered by data privacy rules.


Week Ahead: Election Impact Conference; Medicaid Conference, Ebola Response & the Health Impact of Climate Change

The mid-term elections on Tuesday are the primary focus ahead of lawmakers’ return next week for a lame duck session. On Thursday, CQ Roll Call is holding a post-election impact conference. Scheduled speakers include notable political insiders and CQ Roll Call reporters and editors.

For those interested in a respite from post-election analysis, the National Association of Medicaid Directors this week hosts a conference on the Medicaid program. The conference begins on Tuesday with an address from Health and Human Services Secretary Sylvia Mathews Burwell. However, the election also impacts the Medicaid program. CQ HealthBeat’s (@CQHealthTweet) Rebecca Adams reported (subscription) last week that the election results for state governors’ races could stall or expedite plans for a further Medicaid expansion into states that have not taken advantage of federal funding enticements to expand eligibility for Medicaid program.

The American Association for the Advancement of Science on Tuesday holds a discussion on the work of individuals and governments in West Africa in containing the Ebola virus outbreak. Also on Tuesday, the Center for Global Development hosts a panel discussion on challenges relating to efforts to fight drug-resistant Tuberculosis. Separately, a Society for International Development panel will discuss efforts to engage women as a means to foster stronger health care systems and improved health outcomes.

Meanwhile, a two-day conference begins today at the National Academy of Sciences examines scientific models on the health risks of climate change.  The sessions will be webcast and follows the release this weekend of a new UN report on the dire-consequences of climate change.


October 31, 2014

Economist: Economic Woes of Ebola in West Africa; Drug Manufacturers Expedite Work on Vaccines

The Ebola crisis is ravaging the economies of the Ebola stricken West African countries of Liberia, Sierra Leone and Guinea. The Economist magazine this week reports that the World Bank estimates the cost to the region at $33 billion over the next 18 months. Prices of food and some basic products have doubled but some commodity-based businesses have been able to continue to export products.

The Economist also reports on drug manufacturers redoubling efforts to produce an Ebola vaccine. The World Health Organization has partnered with GlaxoSmithKline and a U.S. firm, NewLink Genetics, to expedite work on a vaccine. The drugs will be ready for testing in Africa by the end of the year. Also, Johnson & Johnson announced announced last week that it will begin human trials in January on a separate vaccine.


Weekly Review: State Quarantine Battles Wait Out 21-Day Incubation Periods

The debate over travel restrictions on persons arriving from the Ebola ravaged region in West Africa shifted this week to posturing over the effectiveness and legality of varying state-level quarantine requirements. Last weekend’s imbroglio over initial strict quarantine rules in New York and New Jersey shifted to less stringent home-based quarantines and monitoring protocols in other states. The Centers for Disease Control and Prevention offered new monitoring guidelines, which helped states to minimize quarantine rules

A nurse, returning from assisting with West Africa relief efforts and originally interred in a New Jersey hospital, was released to travel to Maine. However, the dispute over the legality of Maine’s home-based quarantine has escalated into a current battle between the nurse and the state’s governor and health officials.

Anxiety over Ebola cases in the United States now festers as the current influx of returning volunteers wait out a 21-day waiting period for the possible incubation of the Ebola virus. Also, planning for possible new domestic Ebola cases is haunted by an Associated Press report that the U.S. health care system, especially smaller hospitals, are poorly prepared to handle even localized Ebola cases.

Meanwhile, Secretary of Defense Chuck Hagel this week finalized orders for a 21-day post-mission quarantine of returning military personnel currently serving in West Africa. The White House this week parried questions about the difference between an enforced quarantine for U.S. troops but not for returning civilian health care workers.

Congress is busy preparing for next week’s general election and the next congressional hearing on Ebola, originally scheduled for next week, was delayed until Nov. 12. Witnesses scheduled to testify are Health and Human Services Secretary Sylvia Mathews Burwell and Centers for Disease Control and Prevention Director Tom Frieden. However, the newly appointed Ebola response czar, Ron Klain, is not currently slated to appear before the panel. Separately, various bipartisan pairs of lawmakers are plotting a legislative strategy to press for increased Ebola and other medical research funding.



October 29, 2014

Bipartisan Duos Identify Ways to Expedite Ebola Research Funding

When Congress returns next month, it really has one primary task – to extend the federal government’s ability to spend money. And lawmakers are already starting to talk about how Ebola might fit into that discussion.

The current short-term federal appropriations measure expires Dec. 11, and an extension will likely address the mechanics of funding for research on Ebola drugs. Bipartisan congressional leaders on Tuesday were calling for funding adjustments to speed Ebola drug development.

In the House, Michigan Republican Mike Rogers and California Democrat Anna G. Eshoo urged appropriators to include additional funding instructions in an HHS bio-defense program to expedite Ebola drug and vaccine research efforts.

In the Senate, the leaders of the Health, Education, Labor and Pensions Committee, Democrat Tom Harkin of Iowa and Republican Lamar Alexander of Tennessee, announced plans to introduce a bill that would allow funding for Ebola drug research through an existing FDA program designed to expedite the development of drugs to combat neglected tropical diseases. The senators note that Ebola is not currently listed as a qualifying drug for the program.

But discretionary spending limits and annual funding priority battles limit the expansion of medical research funding. CQ HealthBeat’s (CQHealthTweet) Kerry Young reports (subscription) that Utah Republican Sen. Orrin G. Hatch and Massachusetts Democratic Sen. Elizabeth Warren are circulating a separate draft bill intended to change that by marking off a permanent allocation of federal funding for biomedical research, separate from the contested pool of discretionary funds.

October 28, 2014

States Begin to Follow New CDC Guidance on Quarantines

The Centers for Disease Control and Prevention on Monday issued new guidelines on monitoring for the Ebola virus in travelers arriving from the Ebola infected region in West Africa. The new policy calls for home quarantines at the most restrictive level and ongoing monitoring for a 21-day period. The policy seeks to stem early attempts to enforce stricter state quarantines.

New York and New Jersey this weekend began implementing a hospital-based quarantine policy, which led to the CDC’s new less restrictive guidance on monitoring incoming persons potentially exposed to the virus. On Monday, New Jersey released its first quarantined patient and New York earlier updated its screening plan at JFK airport to include home monitoring. A range of states followed suit on Monday with updated guidelines that focus on home-based quarantines and activity restrictions. A sampling of states issuing updated guidelines include: Illinois, Maryland, Virginia, Georgia (assumes individual compliance), Minnesota and Maine.

October 27, 2014

Equating Ebola and the Flu on Capitol Hill

ebolasignphoto e1414346947759 240x321 Equating Ebola and the Flu on Capitol Hill

Sign at a deli on Capitol Hill, Sunday, October 26, 2014

CQ Roll Call staff today will be offered an annual flu shot. This year’s inoculation is especially pressing due to concerns about the Ebola virus, which have initial symptoms that are identical with the flu. The similarity of symptoms poses some possible confusion and increased anxiety as flu season begins. Reuters reported last week that hospitals fear a deluge of patients with the flu fearing they have Ebola.

This sign on Sunday greeted people walking by a popular Capitol Hill deli/grocery store. It seems the confusion has already begun.





By Paul Jenks Posted at 1:29 p.m.
Disease Control

This Week: Quarantine Wrangling

The focus this week, outside of preparations for next week’s congressional elections, will be on new state quarantine orders on health care workers returning from service in West Africa. On Friday, the governors of New York, New Jersey and Illinois initiated a mandatory quarantine targeting returning medical workers. This weekend Florida instituted a 21-day active monitoring regime for new arrivals. New York on Sunday adjusted the terms of the quarantine order, allowing persons under observation to be quarantined at home.

Separately today, the Centers for Disease Control and Prevention begins a previously announced revised post-arrival monitoring process for persons arriving from West Africa. A White House meeting on Sunday assembled a large group of federal officials ahead of possible new revisions to policies on monitoring incoming travelers.

Meanwhile this week, the Society for Women’s Health Research hosts a panel discussion on Wednesday at Washington, DC’s Union Station on expectations and experiences on breast cancer screening. Also on Wednesday, the Association of American Medical Colleges holds a teleconference on research on medical school application and enrollment data. On Thursday, the Cato Institute examines recent federal court rulings on the IRS’ interpretation of the 2010 health care overhaul law. The group is keen on garnering the court’s consideration of a challenge to the legality of federal insurance subsidies in states that utilize the federally operated insurance exchange.

The next congressional hearing on Ebola concerns and health care spending takes place on Wednesday, Nov. 6, after next week’s election.



October 24, 2014

Week in Review — Ebola: House Hearing Today; New Case Identified in New York; Airport Screening & Monitoring Revamped

A House committee today examines the coordination of federal agencies in responding to the Ebola crisis. The hearing session includes testimony from federal agency officials but excludes Centers for Disease Control and Prevention Director Thomas Frieden and the newly appointed federal Ebola response czar Ron Klain. The hearing is colored by a newly identified case in New York City. A doctor, who recently returned from an international aid mission in Africa, is now undergoing treatment at a New York hospital.

Testimony at this morning’s hearing will include an update on the U.S. military mission in Liberia and Senegal, where more than 630 U.S. military personnel have been deployed to build medical facilities and help with logistics. Also, the session will likely address Department of Homeland Security enhancements to the airport screening process. The process was adjusted this week to funnel travelers from West Africa to enter the U.S. through the five selected airports offering Ebola screening. An airline trade group noted that the change in itineraries would impact about nine people each day.

Additionally, the CDC is requiring all passengers arriving from Ebola infected countries to submit to post-arrival monitoring for 21 days, the standard period for incubation of the virus. The CDC this week also updated its guidance to hospitals on proper protective procedures for treating an Ebola patient.

Earlier this week, the remaining U.S. Ebola cases and persons under observation as a result of the initial Texas patient were gradually closing. In Africa, the World Health Organization announced the end of Ebola outbreaks in Senegal and Nigeria but a new case emerged this week in Mali. The pandemic continues in Liberia, Sierra Leone and Guinea.



October 21, 2014

Ebola: CDC Updates Guidance on Protective Gear and Drinking Chlorine

There have been no new confirmed Ebola cases in the U.S since October 15. But the last two cases were health care professionals treating the first – and only U.S. identified patient. The Centers for Disease Control and Prevention on Monday updated its guidance protocols for health care worker protective gear when treating an Ebola patient. The guidance and summary stresses a more thorough coverage of the body with protective equipment and urges rigorous training on donning and doffing protective suits. The new guidance follows some critiques offered last week on agency’s original guidance for protective gear.

The updated instructions are also accompanied by a separate warning to health professionals not to drink chlorine or disinfectant solutions. It is (hopefully) safe to assume that health care professionals know not to drink disinfectants but the CDC hopes to dispel a rumor that drinking chlorine can prevent the Ebola virus. Separately on Wednesday, the Department of Health and Human Services hosts a webinar on health worker protection and a previously released emergency room preparedness checklist.






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